Breast Cancer Screening Through The Years

Breast Cancer Screening

Through the Years

Objective of this presentation is to provide an overview of current breast cancer screening guidelines for women aged 70 and olderUnderstanding these guidelines is important for informed decision making in the management of breast health in older women

For Women Over 70

Breast Cancer Screening Guidelines

OBJECTIVES

Breast Cancer Treatment

Survival Rates High survival rates due to advances in treatment and early detection

Impact Screening can reduce breast cancer mortality and lead to earlier diagnosis

Prevalence Breast cancer is one of the most common cancers among women

STATISTICS

ACOG Breast Cancer Risk Factors

• Family history of breast cancer, ovarian cancer, or other hereditary breast and ovarian syndrome- associated cancer
• Known deleterious gene mutation
• Prior breast biopsy with specific pathology
• Atypical hyperplasia (lobular or ductal)
• Lobular carcinoma in situ
• Early menarche
• Late menopause
• Nulliparity
• Prolonged interval between menarche and first pregnancy
• Menopausal hormone therapy
• Not breastfeeding
• Increasing age
• Certain ethnicities (eg, increased risk of BRCA mutation in Ashkenazi Jewish women)
• Higher body mass index
• Alcohol consumption
• Smoking Dense breasts on mammography
• Prior exposure to high-dose therapeutic chest irradiation in young women (10-30 years old)

Other Guidelines Different recommendations may exist based on regional practices and professional organizations

American Cancer Society Annual or biennial mammography for women aged 70 and older based on overall health and life expectancy

USPSTF Biennial mammography for women aged 40-74 For women 75 and older, decision should be individualized

Overview of Screening Guidelines

Women’s preferences and values play a crucial role in decision-making

Personal Preferences

Health and functional status impact benefit-risk ratio of screening

Overall Health

Factors Influencing Screening Decisions

Screening may be less beneficial for those with limited life expectancy

Life Expectancy

Screening mammography should not be performed in asymptomatic patients with normal exams who have a less than 5-year life expectancy

Choosing Wisely Campaign

Recommendations for Practice

Individualized ApproachTailor screening recommendations based on health status, life expectancy, and personal preferences Regular Review Continuously evaluate benefits of screening in light of the woman’s current health and life expectancy Informed Decision-Making Provide comprehensive information to help women make informed choices about their screening options

Reduced Mortality Evidence suggests a decrease in breast cancer mortality with regular screening

Improved Outcomes Early detection often leads to less aggressive treatments and better survival rates

Early Detection Increases likelihood of detecting cancer at a more treatable stage

BENEFITS OF SCREENING

Over-Diagnosis Detection of cancers that may not have impacted the woman's health during her lifetime

Screening Challenges Increased likelihood of other health conditions and reduced ability to tolerate aggressive treatments

False Positives Can lead to unnecessary anxiety and additional testing

Risks and Limitations

Recommendations for Practice

Individualized ApproachTailor screening recommendations based on health status, life expectancy, and personal preferences Regular Review Continuously evaluate benefits of screening in light of current health and life expectancy Informed Decision-Making Provide comprehensive information to help women make informed choices about their screening options

Research More studies are needed to refine guidelines and improve screening strategies for older women Personalized Screening Development needed of more personalized screening protocols considering various health and demographic factors

Looking to the Future

Screening guidelines for women over 70 emphasize individualized decision-making, balancing benefits and risks

Discussions should be encouraged between women and healthcare providers to make informed choices based on individual health status and preferences

Conclusion

Thank You!