Opting into breast screening over the age of 70 years: seeking evidence to support informed choice

Aim: To provide evidence specific to the Scottish population regarding the risk–benefit balance of women >70 years opting into continued breast screening, which may be used as a basis for patient information documentation.

Materials and methods: The present study consisted of a parallel, retrospective data analysis of breast cancer mortality data for breast cancer cases diagnosed between 2009 and 2013 (n=22,013) followed up to 31/12/18, and breast screening programme data from 2010 and 2015 (n=47,235). Screening outcome measures included recall for assessment, oncome of assessment, and tumour features. Tumours were classified as high, intermediate, or low risk according to grade and presence of invasion. Mortality data were linked to age at diagnosis and cause of death was recorded.

Results: The proportion of all deaths due breast cancer is inversely related to age at diagnosis. From 77 years, women are more likely to die with breast cancer, than directly due to breast cancer. Mammographic screening accurately identifies breast cancer in older women; however, many of the cancers detected were considered intermediate or low risk.

Conclusions: Harms may outweigh the benefits of continued breast screening in older women. This information should be available to all older women.