Breast Screenings for Older Women

Screenings for breast cancer in older women has risen but that doesn’t necessarily mean that the result is earlier breast cancer detection.  There has been a large increase in the use of digital mammography technology, which is more expensive than standard film technology, but it has not shown that it’s more effective in detecting breast cancer in women aged 65 and older, according to a study done at the Yale School of Medicine. Overall, Medicare spending for breast cancer screenings and related procedures rose from $666 million in 2001-2002 to $962 million in 2008-2009, according to the study.
An assistant professor engaged in the study expressed concern about the cost of sustainability because the increase has been so noticeable.  The professor also said that guidelines for breast cancer screenings for older women need to be established to minimize unnecessary biopsies/or over-diagnosis as well as cost control.
New technologies, which are theoretically superior but financially unsustainable can’t be sustained by the health care system; and the patients deserve to know which treatments are effective and which aren’t.
The United States Preventive Services Task Force does not recommend breast cancer screening for women age 75 years and older, but the study found that Medicare still spent an increasing amount per woman 75 years and older in the study.
Typically, breast cancers treated with a lumpectomy require radiation therapy following surgery to ensure the lowest risk of recurrence.  Standard radiation treatment requires patients to return after healing from surgery to begin daily radiation treatment to the entire breast five days per week, for a total of three to six weeks.
It’s believed that the new, more expensive treatment option will help women who live in rural areas because they are often less likely to travel a great distances for their breast cancer treatments.  Distance can create an obstacle for women to repeatedly return for radiation treatment.  Unfortunately, these women often choose to have a mastectomy in order to avoid the need for radiation and more travel.
The new technology is still not widely available in the United States, but has been used in Europe since the 1990s.  And it started being used more extensively in the United States about a decade ago and has been studied in clinical trials.
According to the American Cancer Society, approximately 40,000 women die annually from breast cancer and 232,670 new cases will be diagnosed in women each year.
This study was supported by the National Cancer Institute and the Cancer Center Support Grant at the Yale Cancer Center.