On Breast Cancer Screening in Older Women
Authors: Otis W. Brawley
Journal: Annals of Internal Medicine (2021)

EditorialsJanuary 2022On Breast Cancer Screening in Older WomenOtis W. Brawley, MDOtis W. Brawley, MDJohns Hopkins University, Baltimore, MarylandAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-4235 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Breast cancer control efforts have led to a 40% reduction in U.S. age-adjusted mortality since 1988 (1). Even with substantial progress, there are substantial controversies in breast cancer control. Is tomosynthesis mammography (3-dimensional) superior to standard digital mammography (2-dimensional)? At what age should screening begin? How often should women undergo screening? At what age should screening stop?The gold standard for addressing these questions is the prospective randomized trial. Indeed, 10 prospective randomized trials have assessed the question, "Does mammographic screening save lives?" Collectively, these studies suggest that routine mammography reduces relative risk for cancer death in women aged 50 ...References1. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin. 2021;71:7-33. [PMID: 33433946] doi:10.3322/caac.21654 CrossrefMedlineGoogle Scholar2. Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164:279-96. [PMID: 26757170] doi:10.7326/M15-2886 LinkGoogle Scholar3. Jayasekera J, Mandelblatt JS. Systematic review of the cost effectiveness of breast cancer prevention, screening, and treatment interventions. J Clin Oncol. 2020;38:332-350. [PMID: 31804858] doi:10.1200/JCO.19.01525 CrossrefMedlineGoogle Scholar4. Schousboe JT, Sprague BL, Abraham L, et al. Cost-effectiveness of screening mammography beyond age 75 years. A cost-effectiveness analysis. Ann Intern Med. 2022;175:11-9. doi:10.7326/M21-8076 Google Scholar5. Neumann PJ, Sanders GD. Cost-effectiveness analysis 2.0. N Engl J Med. 2017;376:203-205. [PMID: 28099837] doi:10.1056/NEJMp1612619 CrossrefMedlineGoogle Scholar6. Zhang L, King J, Wu XC, et al. Racial/ethnic differences in the utilization of chemotherapy among stage I-III breast cancer patients, stratified by subtype: findings from ten National Program of Cancer Registries states. Cancer Epidemiol. 2019;58:1-7. [PMID: 30415099] doi:10.1016/j.canep.2018.10.015 CrossrefMedlineGoogle Scholar7. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA. 2012;307:1513-6. [PMID: 22419800] doi:10.1001/jama.2012.362 CrossrefMedlineGoogle Scholar8. Bandi P, Minihan AK, Siegel RL, et al. Updated review of major cancer risk factors and screening test use in the United States in 2018 and 2019, with a focus on smoking cessation. Cancer Epidemiol Biomarkers Prev. 2021;30:1287-1299. [PMID: 34011554] doi:10.1158/1055-9965.EPI-20-1754 CrossrefMedlineGoogle Scholar9. Mandelblatt J, van Ravesteyn, Schechter C, et al. Which strategies reduce breast cancer mortality most? Collaborative modeling of optimal screening, treatment, and obesity prevention. Cancer. 2013;119:2541-8. [PMID: 23625540] doi:10.1002/cncr.28087 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Johns Hopkins University, Baltimore, MarylandGrant Support: By grant P30 CA006973 from the National Cancer Institute and Bloomberg Philanthropies.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4235.Corresponding Author: Otis W. Brawley, MD, Johns Hopkins University, 1550 Orleans Street, Suite 1M16, Baltimore, MD 21231; e-mail, Otis.[email protected]edu.This article was published at Annals.org on 23 November 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Screening Mammography Beyond Age 75 Years John T. Schousboe , Brian L. Sprague , Linn Abraham , Ellen S. O'Meara , Tracy Onega , Shailesh Advani , Louise M. Henderson , Karen J. Wernli , Dongyu Zhang , Diana L. Miglioretti , Dejana Braithwaite , and Karla Kerlikowske Metrics Cited byHow Would You Screen This Patient for Colorectal Cancer? Grand Rounds Discussion From Beth Israel Deaconess Medical CenterRisa B. Burns, MD, MPH, Carol M. Mangione, MD, MSPH, David S. Weinberg, MD, MSc, and Zahir Kanjee, MD, MPH January 2022Volume 175, Issue 1Page: 127-128KeywordsBreast cancerBreast cancer screeningCancer screeningHealth care ePublished: 23 November 2021 Issue Published: January 2022 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...