One of the Swedish trials screened women at 33-month intervals. Until recently, the US government effectively imposed a screening interval of 24 months through its biennial mammography benefit coverage for Medicare patients. This eliminates the dilemma once faced by physicians who recommended annual mammography to their Medicare patients. There is some consensus that little is to be gained by screening mammography if life expectancy is less than five years. 11 Life expectancy in the US for a woman from birth today is 79 years.
Sensory deficits can make any discussion of screening recommendations difficult.
Considering coexisting health conditions when recommending screening mammography has both practical and ethical implications. The ethics of healthcare in the elderly extends far beyond screening mammography and deserves ongoing deliberation. It should be noted that screening mammography is reserved for asymptomatic women with the primary goal of detecting breast cancer in a preclinical stage. An elderly woman with a breast complaint, such as a palpable mass, should be offered a diagnostic mammogram and surgical consultation despite advanced age. The biology of breast cancer is probably no different between younger and older women.