When is too old for mammograms?

jacgrehanjul

Read this interesting article.  It's from a nurse in a nursing newsletter, but it's still understandable for anyone:

http://onsopcontent.ons.org/Publications/SIGNewsletters/bc/bc7.1.html#story9

Then tell me what you think.

Valgirl

Interesting article.  My Aunt's on my Dad's side all lived into their 90's.  I don't ever remember them having mammograms as they got older.   They did go to the Dr. on a regular basis to monitor their blood pressure etc.   None of my Dad's relatives had any type of cancer though.

mawhinney

The above mentioned article is a thought provoking. Definitely worth reading.  Next time I see my doctors I am going to be asking at what age do they recommend stopping screening procedures and active treatment.  Much might depend on activity level, general health, and wishes of the patient. I think it is good to think about & sort out personal feelings about these things before the need arises.

Valgirl ~ Your aunts may have lived in an age went mammograms were  not readily available or routinely done.

barbe1958

Breast cancer is normally faster growing in younger women. Would I want to live with a slow growing cancer in my breast? Well, I did, until I knew about it! So I see their point. But if someone wants to continue mammograms, let them. I'd probably have stopped around the 75 year old mark though both sets of grand parents lived to mid 90's...I know I won't make it that far.The treatments of chemo are pretty harsh once you watch someone go through it. My Dad before he died of lung cancer said he wouldn't have done all the treatments if he knew he was just going to die anyway! I've taken those words to heart. It was guilty pressure on our parts to have him fight, but looking back it just took him longer to die!

What's that phrase....."The operation was a success, but the patient died."

I read the column above that one about the women in the mid-East who aren't told that they have breast cancer. Their families are, and it's the family who decides if the woman should be told. Pretty barbaric in some ways, but maybe kind in another......

MarieKelly

I think the appropriate time to say goodbye to annual mammograms is when the patient, or the patients family if the patient is incapable of making such decisions, comes to the conclusion that it's unlikely they would choose to do much of anything about it if a cancer were found.  What point is there is knowing a cancer exists if there's no intent to treat it? Knowing it's there under those circumstances would only cause needless anxiety.

But I don't think placing an age date to the end of annual screening is appropriate.  Not everyone is on the downhill slide when they reach their 70's. That article mentioned the recommendation to cease all breast screening at age 74. Well. my mother is now 91 and still very active socially, very involved in volunteer work, drives herself within a radius of about 15 miles from home (except at night) and does most of the grocery shopping, cleaning and cooking in our home. Until this last year when back problems began limiting her, she also did a lot of yardwork and gardening. She never had a mammogram in her life.  

When she was 74, she had more energy and stamina then I do now at 56 and than many do at half that age. Even now at 91, you'd never guess she was much older than 70.  Had she been someone routinely getting annual mammograms, I think it would be unethical to suddenly stop them and deprive her of the benefit of early detection just because she was 74 since she had so very many productive years still ahead of her at that age. 

barbe1958

MarieKelly, the point of stopping them is not to "kill" them, but there is no point in aggressive treatment on a slow growing cancer, which is the type most older women would get. Also, as you read, the risk of anaesthetic and surgery is much higher the older you get. If I was 85 and told I have a very slow growing cancer that wouldn't be an issue for 10-15 years, then I would forgo any treatment and have quality of life over quantity at that point.

Chevyboy

I read the article, & man, that's a tough one!  I am 73, & never thought twice about having the lumpectomy....I DID ask about "how old do I have to be to not have a mammogram?"  And I've been told "Never too old."  I know about women in their 80's getting breast cancer, but they didn't have mammograms, & by the time they found their own lump, it had progressed to their bones.

And yet other women in their 80's who ARE otherwise healthy have their surgery, radiation, & do just great....It's like the closer I get to 80, the more afraid I become...not of getting cancer, or any other disease, but how my family will look at this....It's like "Aren't I worth a shot at this?"   I "feel" so much younger, & I want to feel valuable & then just drop off somewhere in the dead of night, without nary a whimper!

My one gal-friend said if she ever found out she had cancer she would not treat it...I asked her "Are you NUTS?"....But she said she is ready to give it up, & go into Hospice if needed, because "you really get good care there, with no pain."   What a dink!

So everyone has a different opinion...I think you just take it a day at a time....

Like I'm getting hearing aids Thursday, because I lost almost all my hearing from 14 months on Tamoxifen....THAT makes me sad, & mad, & like WHY couldn't someone TELL me this was a possibility.  Oh well, at least I can hear with hearing aids! 

voraciousreader

This has been a very sore subject for me.  I was familiar with the guidelines and recently brought up the subject with my vigorous 86 year old, retired nurse, mother's internist.  My mother has ALWAYS gone for her annual screenings.  I remember as a child, she would load up all of her friends in our station wagon and, bless her, take all of them for mammograms!  Through the years, she's had so many biopsies on her cystic breasts, that I've lost count.  During the summer months when she visits me, she can't wait to return home because she will have an "important" appointment scheduled for either a sonogram or a mammogram.  She is so frightened of getting breast cancer, that my brother, sister and I have chosen NOT to tell her about MY diagnosis, which, btw, the doctors do not think is herititary.

So, what did her internist say about her getting annual mammograms?  He said, she would probably die from something else and that he recommended that she continue getting annual mammograms...BUT she doesn't have to have one EXACTLY at a year following her previous one.  She could have one at 15 months.

My sister, who is also a nurse, and I believe that with all of the radiation she's had from all of her mammograms, she's probably increased her risk of breast cancer, rather than reduced it.  We also agreed that if psychologically it makes our mother feel better to have them, then she will continue to do so.

We had a very long talk with our mother and she's given the topic lots of consideration since our visit to the internist.  Since then, she has told me that she's not going to make herself "crazy" anymore about going "regularly."  She also said, that since she had a procedure for a kidney stone that gave her sepsis and made her critically ill, she's going to think twice, in the future, about having any more procedures.  She has promised us that she will think more carefully about the risks and benefits before she has anymore screening, not only of her breasts, but the rest of her body.

I want to add, about a decade ago, she looked at her report from her heart echogram and it said she had "mild calcification of her aeorta" and she's worried ever since that she would get an aeortic aneurysm."  Meanwhile, ten years have passed and she still has "mild calcification."

I don't think there is any answer to whether or not women reach an age and should decline mammograms.  Instead I think, at a certain age, we should have a healthy discussion with our physicians about how much screening we need.  And, I think we need to have that discussion on a regular basis or even more often if our health declines.