Secondary Prevention of Breast Cancer in the Older Woman: Issues Related to Screening

With advancing age, the prevalence of breast cancer and consequently the positive predictive value of screening tests increase. However, limited life expectancy may reduce the benefit of cancer screening. The integration of serial mammography, yearly or every two years, with yearly physical examination of the breast, reduces the breast cancer related mortality among women aged 50 to 70 years and may be beneficial for older women. Of all age-related barriers to screening, the lack of physician support has been the most significant. A reversal in this trend was witnessed by a recent increase in mammography use by women aged 69 to 75 years. On the basis of existing data, it is reasonable to recommend screening for women up to age 75 years and for older women whose life-expectancy is estimated at three years or longer.