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Mammography Guidelines Developed for Older Breast Cancer Survivors

TUESDAY, Feb. 16, 2021 -- In a special communication published online Jan. 28 in JAMA Oncology, expert consensus guidelines are presented to enhance clinical practice regarding mammography for breast cancer survivors aged 75 years and older.

Rachel A. Freedman, M.D., M.P.H., from the Dana-Farber Cancer Institute in Boston, and colleagues conducted a literature review and developed expert consensus guidelines to facilitate tailored decision-making for routine surveillance mammography for breast cancer survivors aged 75 years and older.

The researchers found that based on the literature review, in most older breast cancer survivors, the risk for ipsilateral and contralateral breast cancer events was low. In the final consensus guidelines, discontinuation of routine mammography is recommended for all breast cancer survivors when life expectancy is less than five years, including those with a history of high-risk cancers; mammography discontinuation should be considered when life expectancy is five to 10 years; and mammography should be continued when life expectancy exceeds 10 years. To optimally tailor recommendations, individualized shared decision-making is encouraged after weighing the benefits and harms associated with surveillance mammography and patient preferences. Ongoing clinical breast examinations and diagnostic mammography are recommended to assess clinical findings and symptoms; patients should be reassured that these practices will continue.

"We anticipate that these recommendations will provide a framework for clinicians to use in discussions with older breast cancer survivors and will facilitate an individualized approach to surveillance mammography use and discontinuation," the authors write.

Several authors disclosed financial ties to the biopharmaceutical and health technology industries.

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