Senior Health: The Mammogram Issue

Oct 26th, 2010 | By | Category: Lifestyle, Health & Fitness

A lot has been said the past couple of years about the advisability (or not) of having a mammogram before the age of 50 and after 75.  The recommendations have changed, based on the United States Preventive Services Task Force statements issued November, 2009, and updated a month later.

Until late 2009, annual mammograms were recommended for all women 40 and over, no matter the level of risk or personal issues an individual might be facing.  The new recommendations by the USPSTF are based on breast cancer research and more individualized testing protocols. 

“Prior to the new recommendations, women age 40 and older were all recommended to be screened in the same manner,” said UCSF breast cancer researcher Karla Kerlikowske, MD. “I think we owe it to women to do better than that and to move toward more risk-based screening.”

   University of California, San Francisco.

But the furor over the changed recommendation hasn’t lessened in the past two years.  Many women, advocacy and medical groups believe mammos should be done every year, as a preventive measure to detect breast cancer.  These groups clearly believe the recommendations should not have been changed; they want annual mammograms for all women over the age of 40, as has been the case for several decades now.  And what about those of us over 75?

A study in Europe published in 2008 revealed a reduction in breast cancer mortality among women ages 70-75 who had undergone screenings (mammograms). 

“In 1986-1997 the average was 166 deaths per 100,000 women aged 75-79 and in 2006 it was 117 per 100,000.”

This study suggests that the survival rate increases when women ages 70-75 have breast cancer that is detected by screenings; i.e., screenings increase the survival rate.

The USPSTF recommendations are an attempt to develop a more risk-based and individualized protocol for breast cancer screenings, rather than a one-size fits all approach.  The new health care reform legislation uses the pre-2009 standards, that is mammograms for women over the age of 40 are covered as preventive health care in the health care reform bill.

However, the new USPSTF standards are leading us into a new world where medical care for women may be based on individual need, individual history, individual concerns and symptoms and individualized care regarding an issue that hits at the heart of every woman alive.

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