Contact: Lisa Rhodes 203/938-2597
MASONIC GERIATRIC HEALTHCARE CENTER STUDIES VALUE OF
MAMMOGRAPHY SCREENING FOR WOMEN AGED 75 PLUS
(Wallingford, CT) - Masonic Geriatric Healthcare Center recently released the results of its study examining the value of mammography screening for women aged 75 and older and who had no history of breast cancer at the American Geriatric Society's annual conference in Atlanta. Data gathered suggested that, when effects of treatment preferences and comorbidities were considered, the overall value of screening mammography was limited in this population.
While the risk of developing breast cancer increases with age and accounts for 2% of all deaths among women over 80, studies assessing the risks and benefits of screening older women have been limited. The Masonic Geriatric Healthcare Center research, done in conjunction with other healthcare professionals from University of Connecticut Health Center, sought to begin to address the recommended guidelines for breast cancer screening for this population.
In the study, 384 mammograms were administered to 182 women over the age of 75 who did not have a history of breast cancer. Initial mammographic examination produced abnormal findings for over 48% of the study population. Of the 13 who were diagnosed with breast cancer, just seven of the women chose treatment, while five refused due to co-existing diseases (one decision pending).
One of the patients receiving treatment died of congestive hearth failure, and two of those refusing treatment died, one secondary to heart disease and the other metastatic carcinoma (the only patient to die as a result of breast cancer). Nearly all patients in the sample study, 96%, had some form of written advanced directive in their charts.
The study suggests that physicians should first discuss the implications of an abnormal mammogram with older women before proceeding with the diagnostic test. In addition to patient's personal preferences regarding treatment, physicians should also consider all of patients' co-existing health challenges and quality of life issues.
According to Masonic Geriatric Healthcare Center's Vice President of Medical Affairs Erlinda Rauch, MD, who administered the study with her colleagues Ronald Schwartz, MD, and Gerard Kerins, MD, MPA, "One of the greatest drawbacks of screening women of this age is the anxiety an abnormal mammogram can cause. Considering that 3.85% of the study group was treated, the overall value of mammography screening was limited in this study."
Although American Cancer Society guidelines call for annual mammography screening for women beginning at age 40, there is no upper age limit specified. Considering that the number of women in the 75-plus age category continues to grow rapidly, along with pressure to provide cost-effective care, it stands to reason that further research is necessary in order to establish appropriate care guidelines, say the researchers. Particular areas of future study should include patients' general attitudes toward mammograms, treatment decisions based upon cancer diagnosis and reasons for such preferences, and the impact of exam on morbidity, mortality and cost measures.
Masonic Geriatric Healthcare Center is a 548-bed, multi-level care facility that specializes in the care of older adults. The Center serves as a teaching facility in geriatrics for the University of Connecticut Health Center Medical School.
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