Newspaper article Charleston Gazette Mail

When to Stop Mammograms Tricky Issue as US Ages More

Newspaper article Charleston Gazette Mail

When to Stop Mammograms Tricky Issue as US Ages More

Article excerpt

WASHINGTON - Lost in the arguing over whether women should begin mammograms at age 40 or 50 or somewhere in between is the issue they'll all eventually face: when to stop. "There's a point at which everybody begins to scratch their head and say how much longer do you have to keep doing this? said American Cancer Society specialist Robert Smith.

It's an increasingly complex balancing act as older women are living even longer. The risk of breast cancer rises with age. But so do the odds of other serious illnesses that may be more likely to kill in a senior's remaining life span - or to make them less able to withstand the rigors of cancer treatment.

"If we pick up a cancer in someone who's 75 and they die at 76 of something else, did it really matter? That's really the question here, said Dr. Susan Boolbol, breast surgery chief at Mount Sinai Beth Israel Medical Center in New York.

Medical guidelines don't agree.

The cancer society's advice: Women should continue mammograms as long as their overall health is good and they have a life expectancy of at least 10 more years. Last week, guidelines issued by the U.S. Preventive Services Task Force said there's not enough evidence to recommend for or against mammograms at age 75 and older, because that age group just hasn't been studied enough to tell.

Getting such evidence is "critical, given the graying of America, said Dr. Jeanne Mandelblatt, an expert on cancer and aging at Georgetown University.

Indeed, some in the 80-and-beyond crowd are as spry as 60- somethings.

"People are taking better care of themselves, said Yale University pathologist Dr. Fattaneh Tavassoli. "If we don't start discussing it, it's going to be more difficult to come up with management approaches for these patients.

She recently reported that Yale's medical center is diagnosing more breast cancer at 90 and older, averaging about eight diagnoses a year since 2000, compared with one a year during the 1990s. Many were diagnosed after the woman or doctor detected an abnormality, not from routine mammograms, Tavassoli said. But she's asked if other hospitals see a similar trend and also wants to study what treatment they underwent. …

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