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Breast Cancer Screenings do more Harm than Good for Women over 70

Update Date: Mar 21, 2014 10:38 AM EDT
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Preventive care can effectively reduce mortality rates and health care costs. By diagnosing cases earlier, patients can receive treatments faster and improve their survival rates. In a new study, however, researchers found that preventive breast cancer screening programs created by the government might not be beneficial for women over 70. The researchers from the Netherlands found that extending these screening programs to older women did not help reduce the number of diagnosed cancer cases that had reached the advanced stages.

"For a screening program to be effective, one would expect that the incidence of early stage breast cancer would increase while the incidence of advanced stage cancer would decrease because any cancer would have been detected at an earlier stage," Dr. Gerrit-Jan Liefers, MD, Ph.D., a surgical oncologist and head of the geriatric oncology research group at Leiden University Medical Centre said "However, when we investigated the effect of extending the screening program in The Netherlands from age 69 to 75, we found that it had not led to a decrease in the rate of advanced breast cancers detected, while the numbers of early stage tumors strongly increased. This implies that the effect of screening in elderly women is limited and leads to a large proportion of over-diagnosis."

Dr. Liefers and his team examined data on 25,414 women taken from The Netherlands Cancer Registry. The women were between the ages of 70 and 75, and were diagnosed with breast cancer from 1995 to 2011. The researchers reported that after the nation extended the breast cancer screening programs to include women up to the age of 75, the number of early stage breast cancer cases that were diagnosed increased from 260 woman per every 100,000 cases in 1995 to 382 cases per 100,000 women in 2011. Early breast cancer included stages 0, I and II.

When the researchers examined the incidence rate of advanced breast cancer, which included stages III and IV, they found that the rate barely changed at all. In 1995, the rate was 59 cases per 100,000 women and in 2011, the number of cases per 100,000 women fell to 53. The researchers concluded that screening women aged 70 and older could actually be more harmful.

"A prediction tool should be developed in order to estimate which women are at increased risk of breast cancer and should receive breast cancer screening, instead of screening the whole population. For example, an older woman with a long life expectancy who has certain risk factors for developing breast cancer could benefit from breast cancer screening. In contrast, an older woman with multiple other diseases or life-limiting conditions, and without any risk factors for breast cancer, will only be at risk of over-diagnosis and overtreatment and may not benefit from screening," Dr. Liefers said according to the press release.

The study, "Breast cancer screening in older women," was presented at the European Breast Cancer Conference.

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