Breast Cancer Screening after 75: A Tale of Four Women

Hello bOObs Bloggettes:

Today I’m going to share a few elderly friends’ stories about breast cancer (BC) screening as fodder for any of you with mothers in the age group of 75+.

— I previously mentioned my friend who had an irregular mammogram around age 75, but here is a synopsis of her story again. Following a biopsy, the surgeon insisted that the pathologist’s finding that her lump was benign was wrong. So my friend agreed to have a lumpectomy — only to find out from a post-surgery second biopsy that she didn’t have cancer at all. I watched her go through all this anxiety for weeks over nothing. In fact, we were packing our bags for Mexico because she didn’t want conventional cancer treatments and asked me to help her find a clinic South of the Border (but that’s another story for later).

— My second friend was the sweet mother of a girlfriend. Cancer ran in their family like wildfire: My friend’s father died of it, her brother died of it, and my girlfriend has since died of BC. (Was it something in their house that was the toxic cause? That’s another blog.) Her mother found a lump in her breast at age 80 — but the doctor said even if it was cancer, she was going to die of something else first before the cancer spread due to her age. So they didn’t treat it at all. Remember that the majority of BCs in women after menopause are slow-growing tumors as they are no longer estrogen-driven BC, which are faster growing. So her doctor made the right call, it appears, because the woman is still alive at 100 and happily not dying of cancer.

— PERSONAL FAMILY STORY: Right around my mother turning 80 (she’s 96 now!), her brilliant doctor said she no longer had to get screened every year — and she had been diligently getting her mammograms every year for 40 years.  I told her she should feel very lucky and kiss her doctor because another friend of mine received that many mammograms and finally developed DCIS BC in her 70s. Then she got diagnosed a second time with another DCIS in the other breast; she received two mastectomies — which she now regrets. Were all those mammograms with their radiation and compression trauma to the breast the cause of her DCIS in the first place?  That’s the question I have to pose (see my blogs on DCIS).

— This takes me to the fourth story: A neighbor/friend who is well over 80 had a discussion about mammography with me last year. I told her what my mother’s doctor and what my friend’s mother’s doctor had both said — stop screening after 75 or 80!  I could tell that day that my neighbor was unconvinced, and sure enough she went and got a mammogram regardless — and they found breast cancer. So she just had surgery (either a mastectomy or lumpectomy, not sure which) and she’s now on a chemotherapy pill, which very well may give her harmful side-effects. Why would you put a woman at that age through all of that trauma and anxiety and give her a toxic medication? Is it just to avoid liability for the doctor’?  The other doctors weren’t worried about that, so there must be something else in the Standard of Care they they felt protected them (or they just have the common sense not to do that to their elderly patient and/or a lot more courage to row against the Standard of Care tide).

Let’s now look at what assorted U.S. entities are saying about screening over 75:

When I interviewed the American Cancer Society in 2016 for my film “bOObs”, then Chief Medical Officer/VP Dr. Otis Brawley said the ACS recommended this as a compromise between the differing factions and their opinions: “…women age 40 to 44 who want [mammography] should get it, but we recommend that all women start getting it at age 45. And then we recommend it annually from 45 to 54, and women should get it every 1 to 2 years 55 onward.”

However, the U.S. Preventative Services Task Force (USPSTF) says this about screening over age 75: “The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older.”

Of course, the radiology associations want us to get screened every year starting at 35 or 40 and keep screening until we’re in the grave. One can only surmise that this is to keep their radiologist members gainfully employed without giving a hoot about the patient (yes, I’m cynical).

But across The Pond in the EU, they do not recommend any screening after age 75 (see my last blog).  So why is the U.S. so keen on screening until death? At least the USPSTF bravely stated its uncertain view, citing insufficient evidence. And God bless the EU for its apparent courage to think outside the box on behalf of the patient!

BOOBS BOTTOM LINE: If you or your loved one is over 75, talk to your doctor about whether to continue on with screening or not — because a decision to keep screening may send you or them on a potentially unnecessary tumultuous journey.

Blog at you soon, thanks for reading and helping to spread the word!  (Please see the “share” links below.)  And we’d love to hear comments from you! (see below as well)

Stay healthy,

Megan

Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts

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