Over-Diagnosing Breast Cancer in Older Women

Over-Diagnosing Breast Cancer in Older Women

It has been reported that more than 240,000 women in the United States will receive a breast cancer diagnosis this year, and many of them will begin treatment right away. However, recent studies suggest that this may not be the best approach.

Women aged 70 to 85 are often overdiagnosed with breast cancer, which can lead to unnecessary worry and invasive treatments such as surgery and chemotherapy that do not improve their quality of life.

Overdiagnosis occurs when breast cancers are detected through screening that would not have caused symptoms or harm. Dr. Ilana Richman, the lead author of the study and an assistant professor of medicine at Yale School of Medicine, explains that overdiagnosis is likely to occur when cancer grows slowly or when a person’s life expectancy is short.

Screening practices for older patients are addressed

A recent study published in the Annals of Internal Medicine highlights the importance of reevaluating breast cancer screening practices and having informed discussions with patients.

While mammography is a widely used screening method, there is a lack of research for older women. Many randomized screening trials exclude individuals over the age of 74, which leaves uncertainty about the full benefits and potential drawbacks of screening.

The study analyzed breast cancer diagnoses and related fatalities over a 15-year follow-up period, involving 54,635 women aged 70 and above. The results showed a significant likelihood of overdiagnosis among older women. Specifically, an estimated 31 percent of women aged 70 to 74, 47 percent of those aged 75 to 84, and 54 percent of those aged 85 and older were affected.

Dr. Richman, one of the researchers involved in the study, emphasized the need for better tools to identify which women may benefit from screening and which breast cancers are unlikely to be progressive. This can help avoid overtreatment and ensure that patients receive the best possible care.

Overdiagnosis: Risks and Benefits

Dr. Richman identifies two major obstacles in implementing the study’s findings in clinical practice. Firstly, finding a balance between the potential benefits of screening and the risks of overdiagnosis presents a challenge on an individual level due to the uncertainties in the current data.

Secondly, discussing overdiagnosis with patients can be difficult due to its abstract nature and its inability to be directly observed, making it hard to fit into a busy clinic visit.

To overcome these issues, Dr. Richman suggests the need for tools that can facilitate patient-provider conversations and provide personalized information to women. This will ensure that screening decisions align with the values of patients.

According to the American Cancer Society, breast cancer rates peak among women aged 70 to 74, and the risk decreases as women age into their 80s due to other causes like heart disease or other cancers.

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