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Management of Breast Cancer in Older Women pp 127–142Cite as

Mammographic Breast Screening in Elderly Women

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Abstract

The National Health Service Breast Screening Programme (NHS BSP) was established in 1987 following publication of the Forrest Report (Forrest et al. 1986). This advocated mammographic breast screening for all UK women between ages 50 and 64, based on evidence from a number of large screening trials from the USA, UK, Sweden, and Canada (Table 9.1). There were three reasons cited for the upper age cut off at 65: other cause mortality, lower attendance rates with increasing age, and breast cancer running a less aggressive course in older women.

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References

  • AGS (2004) American geriatrics Society position statement: Breast cancer screening in older women. http://www.americangeritrics.org/staging/products/positionpapers/brstcncrPF.shtml

  • Alexander FE, Anderson TJ, Brown HK et al (1999) Lancet 353:1903-1908

    Article  PubMed  CAS  Google Scholar 

  • Barratt AL, Irwig LM, Glasziou PP, Salkeld GP, Houssami N (2002) Benefits, harms and costs of screening mammography in women 70 years and over: a systematic review. Med J Aust 176:266-272

    PubMed  Google Scholar 

  • BASO (2006) NHS Breast Screening Programme and Association of Breast Surgery at the British Association of Surgical Oncology. An audit of screen detected breast cancers for the year of screening April 2005 to March 2006. At: http://www.cancerscreening.nhs.uk/breastscreen/publications/ba05-06.html. Accessed 21 Apr 2009

  • BCCOM (2006) Breast Cancer Clinical Outcome Measures (BCCOM) project. Analysis of the management of symptomatic breast cancers diagnosed in 2002. At: http://www.wmpho.org.uk/wmciu/documents/BCCOM_annual_report.pdf. Accessed 21 Apr 2009

  • Boer R, de Koning HJ, van Oortmarssen GJ, van der Maas PJ (1995) In search of the best upper age limit for breast cancer screening. Eur J Cancer 31A(12):2040-2043

    Article  PubMed  CAS  Google Scholar 

  • Boer R, de Koning HJ, Threlfall A, Warmerdam P, Street A, Friedman E, Woodman C (1998) Cost effectiveness of shortening screening interval or extending the age range of NHS breast screening programme: computer simulation study. Br Med J 317:376-379

    Article  CAS  Google Scholar 

  • Broeders MJ, Verbeek ALM, Straatman H, Peer PGM, Pasker de Jong PCM, Beex LVAM, Hendriks JHCL, Holland R (2002) Repeated mammographic screening reduces breast cancer mortality along the continuum of age. J Med Screen 9:163-167

    Article  PubMed  CAS  Google Scholar 

  • Brown J, Garvican L, Moss S (2002) An investigation into the effect of extending routine mammographic screening to older women in the United Kingdom on the time it takes to screen. J Med Screen 9:15-19

    Article  PubMed  CAS  Google Scholar 

  • Bryant H, Mah Z (1992) Breast cancer screening attitudes and behaviours of rural and urban women. Prev Med 21:405-418

    Article  PubMed  CAS  Google Scholar 

  • Bynum JPW, Braunstein JB, Sharkey P, Haddad K, Wu AW (2005) The influence of health status, age, and race on screening mammography in elderly women. Arch Intern Med 165:2083-2088

    Article  PubMed  Google Scholar 

  • Carney PA, Miglioretti DL, Yankaskas BC, Kerlikowske K, Rosenberg R, Rutter CM, Geller BM, Abraham LA, Taplin SH, Dignan M, Cutter G, Ballard-Barbash R (2003) Individual and combined effects of age, breast density and hormone replacement therapy use on the accuracy of screening mammography. Ann Intern Med 138:168-175

    Article  PubMed  Google Scholar 

  • Charlson ME, Pompei P, Ales KL, McKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373-383

    Article  PubMed  CAS  Google Scholar 

  • Daidone MG, Coradini D, Martelli G, Veneroni S (2003) Primary breast cancer in elderly women: biological profile and relation to clinical outcome. Crit Rev Oncol Haematol 45:313-325

    Article  Google Scholar 

  • Dean L, Geshchicter CF (1938) Comedocarcinoma of the breast. Arch Surg 36:225-235

    Article  Google Scholar 

  • Diab SG, Elledge RM, Clarke GM (2000) Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 92:550-556

    Article  PubMed  CAS  Google Scholar 

  • Dolan NC, Lee AM, McDermott MM (1997) Age related differences in breast carcinoma knowledge, beliefs and perceived risk among women visiting and academic general medicine practice. Cancer 80(3):413-420

    Article  PubMed  CAS  Google Scholar 

  • Eaker S, Dickman PW, Bergkvist L, Holmberg L (2006) Differences in management of older women influence breast cancer survival: Results from a population-based database in Sweden. PloS Med 3(3):e25

    Article  Google Scholar 

  • Eddy DM (1989) Screening for breast cancer. Ann Inter Med 111(5):389-399

    Article  CAS  Google Scholar 

  • Erbas B, Amos A, Fletcher A, Kavanagh AM, Gertig DM (2004) Incidence of invasive breast cancer and ductal carcinoma in situ in a screening program by age: should older women continue screening. Cancer Epidemiol Biomarkers Prev 13(10):1569-1573

    PubMed  Google Scholar 

  • Faulk RM et al (1995) Clinical efficacy of mammographic screening in the elderly. Radiology 194(1):193-197

    PubMed  CAS  Google Scholar 

  • Forrest P et al (1986) Breast cancer screening. Report to health ministers of England, Wales, Scotland and Northern Ireland. HMSO, London

    Google Scholar 

  • Gajdos C, Tartter PI, Bleiweiss IJ, Lopchinski RA, Bernstein JL (2001) The consequences of undertreating breast cancer in the elderly. J Am Coll Surg 192:698-707

    Article  PubMed  CAS  Google Scholar 

  • Golledge J, Wiggins JE, Callam MJ (2000) Age-related variation in the treatment and outcomes of patients with breast carcinoma. Cancer 88:369-374

    Article  PubMed  CAS  Google Scholar 

  • Gosney MA (2005) Clinical assessment of elderly people with cancer. Lancet Oncol 6(10):790-797

    Article  PubMed  Google Scholar 

  • Gunnfeld EA, Ramirez AJ, Hunter MS, Richards MA (2002) Women’s knowledge and beliefs regarding breast cancer. Br J Cancer 86:1373-1378

    Article  Google Scholar 

  • Hakama M, Pukkala E, Heikkila M, Kallio M (1997) Effectiveness of the public health policy for breast cancer screening in Finland: population based cohort study. Br Med J 314:864-867

    Article  CAS  Google Scholar 

  • Heflin MT, Oddone EZ, Pieper CF, Burchett BM, Cohen HJ (2002) The effect of co-morbid illness on receipt of cancer screening by older people. J Am Geriatr Soc 50:1651-1658

    Article  PubMed  Google Scholar 

  • IARC (International Agency for Research on Cancer) handbook: breast cancer screening (2002) Vaino H and Bianchini F (eds) IARC Press, Lyon, pp 87-117

    Google Scholar 

  • Jansen JThM, Zoetelief J (1997) Assessment of lifetime gained as a result of mammographic breast cancer screening using a computer model. Br J Radiol 70:619-628

    PubMed  CAS  Google Scholar 

  • Jonsson H, Johansson R, Lenner P (2005) Increased incidence of invasive breast cancer after the introduction of service screening with mammography in Sweden. Int J Cancer 117(5):842-847

    Article  PubMed  CAS  Google Scholar 

  • Kaplan RM, Saltzstein SL (2005) Reduced mammographic screening may explain declines in breast carcinoma in older women. J Am Geriatr Soc 53:862-866

    Article  PubMed  Google Scholar 

  • Kerlikowske K, Salzmann P, Phillips KA, Cauley JA, Cummings SR (1999) Continuing screening mammography in women aged 70 years: Impact on life expectancy and cost effectiveness. JAMA 282(22):2156-2163

    Article  PubMed  CAS  Google Scholar 

  • Kumar ID, Reed MWR, Wyld L (2004) Breast screening in the older woman. Efficacy and awareness of availability. Eur J Surg Oncol 30(9):1012

    Google Scholar 

  • Mah Z, Bryant H (1992) Age as a factor in breast screening knowledge, attitudes and screening behaviours. Can Med Assoc J 146(12):2167-2174

    CAS  Google Scholar 

  • Mandelblatt JS, Wheat ME, Monane M, Moshief RD, Hollenberg JP, Tang J (1992) Breast cancer screening for elderly women with and without co-morbid conditions: A decision analysis model. Ann Intern Med 116:722-730

    Article  PubMed  CAS  Google Scholar 

  • Mandelblatt J, Saha S, Teutsch S, Hoerger T, Siu AL, Atkins D, Klein J, Helfand M and the Cost Work Group of the US Preventative Task Force (2003) The cost effectiveness of screening mammography beyond age 65 years. A systematic review for the US preventative services task force. Ann Intern Med 139:835-842

    Google Scholar 

  • Mandelblatt JS, Schechter CB, Yabroff R, Laurence W, Dignan J, Extermann M, Fox S, Orosz G, Silliman R, Cullen J, Balducci L as the Breast Cancer in Older Women Consortium (2005) Towards optimal screening strategies for older women. J Gen Inter Med 20:487-496

    Google Scholar 

  • Marwill SL, Freund K, Barry PP (1996) Patient factors associated with breast cancer screening amongst older women. J Am Geriatr Soc 44(10):1210-1214

    PubMed  CAS  Google Scholar 

  • McCarthy EP, Burns RB, Freund KM, Ash AS, Shwartz M, Marwill SL, Moskowitz MA (2000) Mammography use, breast cancer stage at diagnosis and survival among older women. J Am Geriatr Soc 48:1226-1233

    PubMed  CAS  Google Scholar 

  • McCarty KS, Silva JS, Cox EB, Leight GS, Wells SA, McCarty Sr KS (1983) Relationship of age and menopausal status to oestrogen receptor content in primary carcinoma of the breast. Ann Surg 197:123-127

    Article  PubMed  Google Scholar 

  • McPherson CP, Swenson KK, Lee MW (2002) The effect of mammographic detection and comorbidity on the survival of older women with breast cancer. J Am Geriatr Soc 50:1061-1068

    Article  PubMed  Google Scholar 

  • Miller AB, To T, Baines CJ, Wall C (2000) Canadian National breast screening study-2: 13-year results of a randomized trial in women aged 50-59 years. J Natl Cancer Inst 92:1490-1499

    Article  PubMed  CAS  Google Scholar 

  • NHS Breast Screening Programme (2006) Audit of breast cancer in women aged 50 to 74. April 2006. NHS Breast Screening Programme Pub No 62

    Google Scholar 

  • Nystrom L, Andersson I, Bjurstam N, Frisell J, Nordenskjold B, Rutqvist LE (2002) Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 359:909-919

    Article  PubMed  Google Scholar 

  • Otten JD, Broeders MJ, Fracheboud J, Otto SJ, de Koning HJ, Verbeek AL (2008) Impressive time related influence of the dutch screenig programme on breast cancer incidence and mortality 1975-2006. Int J cancer 123(8):1929-1934

    Google Scholar 

  • Page DL, Dupont WD, Rogers LW et al (1995) Cancer 76:1197-1200

    Article  PubMed  CAS  Google Scholar 

  • Raik BL, Miller FG, Fins JJ (2004) Screening and cognitive impairment: Ethics of foregoing mammography in older women. J Am Geriatr Soc 52:440-444

    Article  PubMed  Google Scholar 

  • Rich JS, Black WC (2000) When should we stop screening. Eff Clin Pract 3:78-84

    PubMed  CAS  Google Scholar 

  • Rosenberg RD, Hunt WC, Williamson MR, Gilliland FD, Wiest PW, Kelsey CA, Key CR, Linver MN (1998) Effects of age, breast density, ethnicity and oestrogen replacement therapy on screening mammographic sensitivity and cancer stage at diagnosis: review of 183, 134 screening mammograms in Albuquerque, New Mexico. Radiology 209:511-518

    PubMed  CAS  Google Scholar 

  • Sabel M, Aichinger U, Schultz-Wendtland R (2001) Radiation exposure in X-ray mammography. Fortschr Rontgenstr 173:79-91

    Article  CAS  Google Scholar 

  • Sader C, Ingram D, Hastrich D (1999) Management of breast cancer in the elderly by complete local excision and tamoxifen alone. Austr N Z J Surg 69:790-793

    Article  CAS  Google Scholar 

  • Satariano WA, Ragland DR (1994) The effect of co-morbidity on 3-year survival of women with primary breast cancer. Ann Inter Med 120:104-110

    Article  CAS  Google Scholar 

  • Schaefer G, Rosen PP, Lesser ML, Kinne DW, Beatie EJ (1984) Breast carcinoma in elderly women: pathology, prognosis and survival. Pathol Annu 19:195-218

    PubMed  Google Scholar 

  • Shapiro S, Venet W, Strax P, Venet L (1988) Current results of the breast cancer screening randomised trial. The Health Insurance Plan (HIP) of greater New York study. In: Day NE, Miller AB, Bern A (eds) Screening for breast cancer. Hans Huber, Toronto, pp 3-15

    Google Scholar 

  • Siapush M, Singh G (2002) Sociodemographic variations in breast cancer screening behaviour among Australian women: Results from the 1995 national health survey. Prev Med 35:174-180

    Article  Google Scholar 

  • Siegelmann-Danielli N, Khandelwal V, Wood GC (2004) Breast cancer in elderly women: combined effect of tumor feature, age, comorbidities and treatment approach. Poster at the San Antonio breast cancer conference, p 20

    Google Scholar 

  • Smith RA, Cokkinides V, Eyre HJ (2007) Cancer screening in the United States 2007: a review of current guidelines, practices and prospects. CA Cancer J Clin 57:90-104

    Article  PubMed  CAS  Google Scholar 

  • Smith-Bindman R, Kerlikowske K, Gebretsadik T, Newman J (2000) Is screening mammography effective in elderly women. Am J Med 108:112-119

    Article  PubMed  CAS  Google Scholar 

  • Spiers NA, Matthews RJ, Jagger C, Brayne C, Matthews FE, Boult C, Robinson TG and MRC-CFAS (2005) Diseases and impairments as risk factors for disability onset in the older population in England and Wales: findings from the MRC cognitive function and ageing study (MRC CFAS). J Gerontol (Med Sci) 60A:248-254

    Google Scholar 

  • Stout NK, Rosenberg MA, Trentham-Dietz A, Smith MA, Robinson SM, Fryback DG (2006) Retrospective cost effectiveness analysis of screening mammography. J Natl Cancer Inst 98:774-782

    Article  PubMed  Google Scholar 

  • Tabar L, Vitak B, Chen HH (2000) The Swedish two counties trial twenty years later. Updated mortality results and new insights from long-term follow-up. Radiol Clin North Am 38:625-651

    Article  PubMed  CAS  Google Scholar 

  • Tabar L, Yen M-F, Vitak B, Chen H-HT, Smith RA, Duffy SW (2003) Mammography service screening and mortality in breast cancer patients: 20 year follow-up before and after introduction of screening. Lancet 361:1405-1410

    Article  PubMed  Google Scholar 

  • Van Dijck J, Verbeek ALM, Beex LVAM, Hendriks JHCL, Holland R, Mravnac M, Straatman H, Were JM (1997) Breast cancer mortality in a non randomised trial on mammographic screening in women over age 65. Int J Cancer 70:164-168

    Article  PubMed  Google Scholar 

  • Walter L, Covinski KE (2001) Cancer screening in the elderly: a framework for individualized decision making. JAMA 285(21):2750-2756

    Article  PubMed  CAS  Google Scholar 

  • Walter LC, Eng C, Covinski KE (2001) Screening mammography in frail older women. J Gen Intern Med 16:779-784

    Article  PubMed  CAS  Google Scholar 

  • Walter LC, Lindquist K, Covinski KE (2004) Relationship between health status and use of screening mammography and papanicolaou smears amongst women older than 70 years of age. Ann Intern Med 140:681-688

    Article  PubMed  Google Scholar 

  • Wenger CR, Beardslee S, Owens MA, Pounds G, Oldaker T, Vendely P, Pandian MR, Harrington D, Clark GM, McGuire WL (1993) DNA ploidy, S-phase and steroid receptors in more than 127, 000 breast cancer patients. Breast Cancer Res Treat 28:9-20

    Article  PubMed  CAS  Google Scholar 

  • Wildiers H, Kunkler I, Biganzoli L, Fracheboud J, Vlastos G, Bernard-Marty C, Hurria A, Extermann M, Girre V, Brain E, Audisio RA, Bartelink H, Barton M, Giordano SH, Muss H, Aapro M (2007) Management of breast cancer in elderly individuals: recommendations of the international society of geriatric oncology. Lancet Oncol 8:1101-1115

    Article  PubMed  Google Scholar 

  • Wyld L, Garg DK, Brown H, Reed MWR (2004) Stage and treatment variation with age in postmenopausal women with breast cancer: compliance with guidelines. Br J Cancer 90(8):1486-1491

    Article  PubMed  CAS  Google Scholar 

  • Wyld L, Reed MW (2007) Surgery for the older women with breast cancer. Eur J Cancer 43:2253-2263

    Article  PubMed  Google Scholar 

  • Yancik R, Ries LG, Yates JW (1989) Breast cancer in ageing women. A population based study of contrasts in stage, surgery and survival. Cancer 63:976-981

    Article  PubMed  CAS  Google Scholar 

  • Zackrisson S, Andersson I, Janzon L, Manjer J, Garne JP (2006) Rate of over diagnosis of breast cancer 15 years after end of Malmo mammographic screening trial: follow up study. Br Med J 332:689-690

    Article  Google Scholar 

  • Zahl P-H, Strand BH, Maehlen J (2004) Incidence of breast cancer in Norway and Sweden during introduction of Nationwide screening: prospective cohort study. BMJ 328:921-924

    Article  PubMed  Google Scholar 

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  1. Academic Unit of Surgical Oncology, University of Sheffield, Sheffield, UK

    Lynda Wyld

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  1. Lynda Wyld
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  1. University of Sheffield, Sheffield, S10 2JF, United Kingdom

    Malcolm W. Reed

  2. Marshalls Cross Road, St Helens, WA9 3DA, United Kingdom

    Riccardo A. Audisio

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Wyld, L. (2010). Mammographic Breast Screening in Elderly Women. In: Reed, M., Audisio, R. (eds) Management of Breast Cancer in Older Women. Springer, London. https://doi.org/10.1007/978-1-84800-265-4_9

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