Doctors should be based on life expectancy, if the decision whether mammography for their oldest female patients since do to order or screening likely outweigh the benefits, if women are expected to live at least another decade, after a review of the scientific literature of the experts at UCSF and Harvard Medical School.
National guidelines recommend doctors individualized screening decisions for women 75 and older make. But the analysis, published online in JAMA (March 31, 2014), found that because this age group was not included in mammography studies, there is no evidence that screening helps them to lead longer and healthier lives.
The authors, said that many women in this age group anyway, use regular mammograms without discussion on uncertainty or potential damage or further tests, which contained cancer or precancerous lesions that live not real for women unnecessary treatment of the slowly growing threat.
She came to the conclusion that women who to be achieved a decade life or more should speak with their doctors and weigh potential benefits of diagnosis of cancer dangerous but treatable by mammography against the possibility of misdiagnosed or aggressively treated for an ulcer, that no real harm.
"People should be informed about what we can do in medicine good and bad effects, and that is true for mammography,", said Louise Walter, MD, UCSF Professor of medicine and head of the Department of Geriatrics.
The authors came to their conclusions after reviewing all trials of 1990 to 2014 lasting, identifies risk factors for late life breast cancer in women 65 years and more, as well as the studies that assessed the value of mammography for women 75 and older.
There were no randomized trials the benefits of screening of women over 74, she couldn't tell whether mammography for women of advantage was. Longitudinal studies found that healthy older women who were shown with mammography were less breast cancer die, but screening was not beneficial for women with serious medical problems.
Modelling studies show two mammograms for every 1,000 women would prevent the number of cancer deaths in the 1970s, presented every two years for 10 years. These studies employees but also, that about 200 of these women test results, indicating that she had cancer, if they do not, and about 13 would be treated for cancers that have nothing would.
Doctors use to assess complex algorithms of breast cancer risk, but these calculations lose their ability to predict the disease in the oldest women, change as risk factors as women age.
For example, how a woman was old, when she arrived, her period and if she bore children and at what age are important factors in determining breast cancer risk for women under 75. But these factors are no longer relevant, if women over the age of 75 years. Instead, it is the most important risk factor for breast cancer age itself.
"Things, possibly when older women probably looking ahead with before recently hormone exposure, such as lifelong obesity have to do high bone density or taking hormones that are associated with higher levels of estrogen,", said Mara Schonberg, MD, MPH, Assistant Professor of medicine at Harvard Medical School. "Distant hormone claims, such as the age, who got her period that a woman for the first time, to no great difference in the who do breast cancer in this older population." Age is the biggest risk factor for breast cancer."
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The above story is based on materials , from the University of California-San Francisco. The original article was written by Laura Kurtzman. Note: materials for content and length can be processed.
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