Skip to content

Breast Cancer Health Center

Font Size

Breast Cancer Screening (PDQ®): Screening - Health Professional Information [NCI] - Special Populations

Individuals With Little to Gain from Screening

Women with limited life expectancy

Recommended Related to Breast Cancer

Breast Cancer's Relationship Toll

For many women, the diagnosis of breast cancer represents not only a major physical battle, but also the ultimate emotional challenge -- one that affects every relationship in our life.  Indeed, from friendships to romance, from being a parent to being a daughter, the way you relate to everyone -- and the way they relate to you -- can be affected.    "I do think cancer has more impact on emotions and emotional relationships than other catastrophic diseases, because with cancer, death is often...

Read the Breast Cancer's Relationship Toll article > >

Achieving balance between the benefits and harms of screening is especially important for women with a life expectancy of 5 years or less. Such women might have end-stage renal disease, severe dementia, terminal cancer, or severe comorbid disease with functional dependencies in activities of daily living. Early cancer detection and prompt treatment are unlikely to reduce morbidity or mortality within a woman's 5 years of expected survival, but the negative consequences of screening will occur immediately. Abnormal screening may trigger additional testing, with the attendant anxiety. In particular, the detection of a low-risk malignancy would probably result in a recommendation for treatment, which could impair rather than improve quality of life, without improving survival. Despite these considerations, many women with poor life expectancy due to age or health status often undergo screening mammography.[1] A sizable proportion of patients with advanced cancer continue to undergo cancer screening tests that do not have a meaningful likelihood of providing benefit. For example, among women with advanced cancer compared with controls, at least 1 screening mammogram was received by 8.9% (95% confidence interval [CI], 8.6%–9.1%) versus 22.0% (95% CI, 21.7%–22.5%).[2]

Elderly women

Screening mammography in women older than 65 years often results in additional diagnostic testing in 85 per 1,000 women, with cancer diagnosed in 9 women. The testing is often accomplished over many months, which may cause anxiety.[3] While screening mammography may yield cancer diagnoses in approximately 1% of elderly women, many of these cancers are low risk. A study of California Medicare beneficiaries aged 65 to 79 years demonstrated this clearly. The relative risk (RR) of detecting localized breast cancer was 3.3 (95% CI, 3.1–3.5) among screened women. Diagnosis of metastatic cancer was reduced among screened women (RR = 0.57), suggesting a benefit of mammography screening in elderly women, though it comes with an increased risk of overdiagnosis.[4]

Screening women in their 80s and 90s should be performed on a case-by-case basis, with comorbid diseases and life expectancy taken into consideration when making this decision.

    1|2|3
    Next Article:

    Today on WebMD

    Breast Cancer Overview
    From self-exams and biopsies to reconstruction, we’ve got you covered.
    Dealing with breast cancer
    Get answers to your questions.
     
    woman having mammogram
    Experts don’t agree on all fronts, but you can be your own advocate.
    woman undergoing breast cancer test
    Many women worry. But the truth? Most abnormalities aren’t breast cancer.
     
    Breast Cancer Treatments Improving
    VIDEO
    Resolved To Quit Smoking
    SLIDESHOW
     
    Woman getting mammogram
    Article
    Screening Tests for Women
    SLIDESHOW
     
    ovarian cancer overview slideshow
    SLIDESHOW
    serious woman
    Article
     
    what is your cancer risk
    HEALTH CHECK
    10 Ways to Revitalize Slideshow
    SLIDESHOW