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Keywords:
Breast, Mammography, Ultrasound, Screening, Diagnostic procedure, Cancer
Authors:
M. Lorenzon, A. Nitti, E. Cimino, A. Linda, R. Girometti, C. Zuiani; Udine/IT
DOI:
10.1594/ecr2017/C-2881
Aims and objectives
The risk of breast cancer increases with age Fig. 1 ,
thus more than 30% of breast cancers are diagnosed in women 70 years old or older [1].
Even though the American Cancer Society recommends that screening mammography should continue as long as a woman is in good health and is expected to live 10 more years or longer,
the U.S.
Preventive Service Task Force recently stated that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older [2].
The goals of treatment in old patients are typically different than in young patients.
In most cases breast cancer in old,
healthy women should be considered more as an inconvenience than a threat to their lives (in particular in the frequent cases of favorable molecular profile) [3].
Nonetheless,
even in elderly patients,
a significant percentage of tumors possess an aggressive biological phenotype,
affecting relapse-free and overall survival [4].
The diagnosis of such a tumor in an old woman can be particularly critical,
since many of these patients have comorbidities that result in loss of function potentially compromising their breast cancer care.
Chemotherapy treatment of old patients with advanced disease is problematic,
while surgery,
radiation therapy and hormonal therapy have improved breast cancer care for the elderly,
but require a diagnosis at an early stage to be useful [5].
Thus,
for reasons different than in young women,
and specifically to have the chance to use effective and less-aggressive therapies,
achieving an early diagnosis is relevant even in old women.
In this clinical scenario,
it is well known that screening mammography has sensitivity and specificity higher in old women than in young women [6].
The purpose of our work was to evaluate the usefulness of screening with mammography and ultrasound in elderly women,
retrospectively assessing all the women aged 70 years or older who received a diagnosis of breast cancer in a six months’ period in our Institute,
comparing clinical features,
histologic presentation,
dimensions at mammography and ultrasound between patients with and without symptoms.