When can you stop having mammograms?

I mentioned in a previous post that the American Cancer Society identified age 70 as the end of the line for low risk women to get Paps. Ducking the date with the speculum (the first of which, incidentally, was fashioned out of a pewter spoon) is one of those age DOES have its privileges things.

What about ending the annual encounter with the mammogram machine? European investigators presented the results of two large studies at last week's 6th European Breast Cancer Conference that address the ideal interval and cut-off age for older women and breast cancer screening.

In 1998, The Netherlands extended the national breast cancer-screening program to women up to age 75 from the previous age limit of 70. Investigators tracked the incidence of death from breast cancer in women ages 75-79 during the time period 2003-2006, five years after the expanded screening offering began. Compared with a ten year period beginning in the mid '80s, the breast cancer mortality for this age group dropped nearly 30%. Clearly, mammograms done on women in their late 70s were picking up breast cancers that would have otherwise proved lethal if not detected.

Researchers on the UK Breast Screening Frequency Trial randomized 100,000 women ages 50-62 to receive mammograms either annually or every 3 years. The two groups were followed over 13 years, and the risk of breast cancer death was virtually the same whether the women were annually squashed in the mammo machine or submitted to the test once per 3 years.

One of the reasons, investigators theorized, that women over 70 benefitted from screening is that their breast tissue was less dense, and thus mammograms were easier to read and more accurate at detecting early cancers. Senior researcher Jacques Fracheboud noted, however, that "it is not necessarily an argument for continuing screening beyond 75 because many tumors found at this stage are slow growing and may never reach the stage of causing a problem."

Breast density is a consideration for the somewhat younger group as well. Those women ages 50-62 with dense breasts--i.e. hard to image with mammograms--may well be doing themselves a disservice to embrace the every 3 year embrace of the mammogram plates. Before you decide that this interval is for you, or before you chuck the test at 75, check with your doctor to see if these decisions are appropriate in your case.