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Review ArticleClinical Review

Breast Cancer Screening in Older Women: The Importance of Shared Decision Making

Sarina Schrager, Viktoriya Ovsepyan and Elizabeth Burnside
The Journal of the American Board of Family Medicine May 2020, 33 (3) 473-480; DOI: https://doi.org/10.3122/jabfm.2020.03.190380
Sarina Schrager
From the University of Wisconsin Department of Family Medicine and Community Health, Madison (SS); the University of Wisconsin School of Medicine and Public Health, Madison (VO); and the University of Wisconsin Department of Radiology, Madison (EB).
MD, MS
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Viktoriya Ovsepyan
From the University of Wisconsin Department of Family Medicine and Community Health, Madison (SS); the University of Wisconsin School of Medicine and Public Health, Madison (VO); and the University of Wisconsin Department of Radiology, Madison (EB).
BA
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Elizabeth Burnside
From the University of Wisconsin Department of Family Medicine and Community Health, Madison (SS); the University of Wisconsin School of Medicine and Public Health, Madison (VO); and the University of Wisconsin Department of Radiology, Madison (EB).
MD, MS, MPH
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References

  1. 1.↵
    1. Siegel RL,
    2. Miller KD,
    3. Jemal A
    . Cancer statistics. CA: A Cancer Journal for Clinicians 2018;68:7–30.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Howlader N,
    2. Noone AM,
    3. Krapcho M,
    4. et al.
    [Internet]. SEER cancer statistics review, 1975-2009, National Cancer Institute, based on November 2011 SEER data submission, posted to the SEER web site 2012. Bethesda, MD, National Cancer Institute. Available from: https://seer.cancer.gov/csr/1975_2009_pops09/.
  3. 3.↵
    1. Hillner BE,
    2. Penberthy L,
    3. Desch CE,
    4. McDonald MK,
    5. Smith TJ,
    6. Retchin SM
    . Variation in staging and treatment of local and regional breast cancer in the elderly. Breast Cancer Res Tr 1996;40:75–86.
    OpenUrl
  4. 4.↵
    1. McCarthy EP,
    2. Burns RB,
    3. Freund KM,
    4. Ash AS,
    5. et al
    . Mammography use, breast cancer stage at diagnosis, and survival among older women. J Am Geriatr Soc 2000;48:1226–33.
    OpenUrlPubMedWeb of Science
  5. 5.↵
    1. Randolph WM,
    2. Goodwin JS,
    3. Mahnken JD,
    4. Freeman JL
    . Regular mammography use is associated with elimination of age-related disparities in size and stage of breast cancer at diagnosis. Ann Intern Med 2002;137:783–90.
    OpenUrlCrossRefPubMedWeb of Science
  6. 6.↵
    1. Howlader N,
    2. Noone AM,
    3. Krapcho M,
    4. et al.
    [Internet]. SEER cancer statistics review, 1975-2012, based on November 2014 SEER data submission, posted to the SEER web site 2015. Bethesda, MD, National Cancer Institute. Available from: http://seer.cancer.gov/csr/1975_2012/.
  7. 7.↵
    1. Oeffinger KC,
    2. Fontham ETH,
    3. Etzioni R,
    4. et al
    . Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 2015;314:1599–614.
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Qaseem A,
    2. Lin JS,
    3. Mustafa RA,
    4. Horwitch CA,
    5. Wilt TJ
    . Screening for breast cancer in average-risk women: a guidance statement from the American College of Physicians. Ann Intern Med 2019;170:547–60.
    OpenUrlCrossRef
  9. 9.↵
    1. Siu AL
    , US Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2016;164:279–96.
    OpenUrlCrossRefPubMed
  10. 10.↵
    1. Walter LC,
    2. Schonberg MA
    . Screening mammography in older women: a review. JAMA 2014;311:1336–47.
    OpenUrlCrossRefPubMedWeb of Science
  11. 11.↵
    1. Mandelblatt JS,
    2. Cronin KA,
    3. Bailey S,
    4. et al
    . Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med 2009;151:738–47.
    OpenUrlCrossRefPubMedWeb of Science
  12. 12.↵
    1. Barratt A,
    2. Howard K,
    3. Irwig I,
    4. Salkeld G,
    5. Houssami N
    . Model of outcomes of screening mammography: information to support informed choices. BMJ 2005;330:936.
    OpenUrlAbstract/FREE Full Text
  13. 13.↵
    1. Carney PA,
    2. Miglioretti DL,
    3. Yankaskas BC,
    4. et al
    . Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Ann Intern Med 2003;138:168–75.
    OpenUrlCrossRefPubMedWeb of Science
  14. 14.↵
    1. O'Meara ES,
    2. Braithwaite D,
    3. Onega T
    1. Henderson LM
    , for the Breast Cancer Surveillance Consortium, O'Meara ES, Braithwaite D, Onega T. Performance of digital screening mammography among older women in the United States. Cancer 2015;121:1379–86.
    OpenUrlCrossRefPubMed
  15. 15.↵
    1. Vyas A,
    2. Madhavan S,
    3. Sambamoorthi U
    . Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer. Breast Cancer Res Treat 2014;148:645–54.
    OpenUrlCrossRefPubMed
  16. 16.↵
    1. Badgwell BD,
    2. Giordano SH,
    3. Duan ZZ,
    4. et al
    . Mammography before diagnosis among women age 80 years and older with breast cancer. JCO 2008;26:2482–8.
    OpenUrlAbstract/FREE Full Text
  17. 17.
    American Academy of Family Physicians [Internet]. Breast cancer—clinical preventive service recommendation. American Academy of Family Physicians; 2016 [cited 2019 May 21]. Available from: https://www.aafp.org/patient-care/clinical-recommendations/all/breast-cancer.html
  18. 18.↵
    1. Vacek PM,
    2. Skelly JM
    . A prospective study of the use and effects of screening mammography in women aged 70 and older. J Am Geriatr Soc 2015;63:1–7.
    OpenUrlPubMed
  19. 19.↵
    1. Dijck JV,
    2. Verbeek AL,
    3. Beex LV,
    4. et al
    . Breast-cancer mortality in a non-randomized trial on mammographic screening in women over age 65. Int J Cancer 1997;70:164–8.
    OpenUrlCrossRefPubMedWeb of Science
  20. 20.↵
    1. McPherson CP,
    2. Swenson KK,
    3. Lee MW
    . The effect of mammographic detection and comorbidity on the survival of older women with breast cancer. J Am Geriatr Soc 2002;50:1061–8.
    OpenUrlCrossRefPubMedWeb of Science
  21. 21.↵
    1. Bond M,
    2. Pavey T,
    3. Welch K,
    4. et al
    . Systematic review of the psychological consequences of false- positive screening mammograms. Health Technol Assess 2013;17:1–170.
    OpenUrlCrossRefPubMedWeb of Science
  22. 22.↵
    1. Walter LC,
    2. Eng C,
    3. Covinsky KE
    . Screening mammography for frail older women: what are the burdens? J Gen Intern Med 2001;16:779–84.
    OpenUrlCrossRefPubMedWeb of Science
  23. 23.↵
    1. Welch HG,
    2. Black WC
    . Overdiagnosis in cancer. J Natl Cancer Inst 2010;102:605–13.
    OpenUrlCrossRefPubMedWeb of Science
  24. 24.↵
    1. Puliti D,
    2. Duffy SW,
    3. Miccinesi G,
    4. et al
    . Overdiagnosis in mammographic screening for breast cancer in Europe: a literature review. J Med Screen 2012;19:42–56.
    OpenUrlCrossRefPubMed
  25. 25.↵
    1. Sox HC
    . Screening for disease in older people. J Gen Intern Med 1998;13:424–5.
    OpenUrlCrossRefPubMedWeb of Science
  26. 26.↵
    1. Raik BL,
    2. Miller FG,
    3. Fins JJ
    . Screening and cognitive impairment: ethics of forgoing mammography in older women. J Am Geriatr Soc 2004;52:440–4.
    OpenUrlCrossRefPubMedWeb of Science
  27. 27.↵
    1. Schwartz LM,
    2. Woloshin S,
    3. Fowler FJ Jr.,
    4. Welch HG
    . Enthusiasm for cancer screening in the United States. JAMA 2004;291:71–8.
    OpenUrlCrossRefPubMedWeb of Science
  28. 28.↵
    1. Hoffman RM,
    2. Lewis CL,
    3. Pignone MP,
    4. et al
    . Decision-making processes for breast, colorectal, and prostate cancer screening: the DECISIONS survey. Med Decis Making 2010;30:53–64S.
    OpenUrlCrossRef
  29. 29.↵
    1. Arias E
    . United States life tables 2008. National Vital Statistics Reports 2012;61:3.
    OpenUrl
  30. 30.↵
    National Comprehensive Cancer Network [Internet]. Breast cancer screening and diagnosis. Version 1. 2016. Available from: https://www.nccn.org/.
  31. 31.↵
    1. Sima CS,
    2. Panageas KS,
    3. Schrag D
    . Cancer screening among patients with advanced cancer. JAMA 2010;304:1584–91.
    OpenUrlCrossRefPubMedWeb of Science
  32. 32.↵
    1. Tan A,
    2. Kuo YF,
    3. Goodwin JS
    . Potential overuse of screening mammography and its association with access to primary care. Med Care 2014;52:490–5.
    OpenUrl
  33. 33.↵
    1. Yourman LC,
    2. Lee SJ,
    3. Schonberg MA,
    4. Wildera EW,
    5. Smith AK
    . Prognostic indices for older adults: a systematic review. JAMA 2012;307:182–92. Prognostic indices available from: http://www.eprognosis.org.
    OpenUrlCrossRefPubMedWeb of Science
  34. 34.↵
    1. Schrager SB,
    2. Phillips G,
    3. Burnside E
    . A simple approach to shared decision making in cancer screening. Fam Pract Manag 2017;24:5–10.
    OpenUrl
  35. 35.↵
    1. Schrager S
    . Five ways to communicate risks so that patients understand. Fam Pract Manag 2018;25:28–31.
    OpenUrl
  36. 36.↵
    1. Schonberg MA,
    2. Hamel MB,
    3. Davis RB,
    4. et al
    . Development and evaluation of a decision aid on mammography screening for women aged 75 and older. JAMA Intern Med 2014;174:417–24.
    OpenUrl
  37. 37.↵
    1. Schonberg M
    [Internet]. Should I continue having mammograms? For women age 75 to 84 Years. Beth Israel Deaconess Medical Center; 2013. Available from: https://www.bidmc.org/-/media/files/beth-israel-org/research/research-by-department/medicine/general-medicine-research/research-faculty/decision-aid-758432019.pdf.
  38. 38.↵
    1. Schonberg M
    [Internet]. Should I continue having mammograms? For women age 85 or older. Beth Israel Deaconess Medical Center; 2013. Available from: https://www.bidmc.org/-/media/files/beth-israel-org/research/research-by-department/medicine/general-medicine-research/research-faculty/decision-aid-8532019.pdf.
  39. 39.↵
    University of Sydney [Internet]. Should I continue having mammograms to screen for breast cancer? A decision aid for women aged 70 and older at their next screening mammogram. 2003. Available from: http://www.psych.usyd.edu.au/cemped/docs/Mammogram_DecisionAid.pdf.
  40. 40.↵
    The Ottawa Hospital Research Institute [Internet]. Patient decision aids. 2019. Available from: https://decisionaid.ohri.ca/AZsearch.php?criteria=breast+cancer+&search=Go.
  41. 41.↵
    1. Elwyn G,
    2. Frosch D,
    3. Thomson R,
    4. et al
    . Shared decision making: a model for clinical practice. J Gen Intern Med 2012;27:1361–7.
    OpenUrlCrossRefPubMed
  42. 42.↵
    Schrager SL [Internet]. Breast cancer screening shared decision making toolkit. Madison: University of Wisconsin-Madison School of Medicine & Public Health; 2018. Available from: https://www.hipxchange.org/ScreeningMammo.
  43. 43.↵
    1. Schonberg MA,
    2. Ramanan RA,
    3. McCarthy EP,
    4. Marcantonia ER
    . Decision making and counseling around mammography screening for women aged 80 or older. J Gen Intern Med 2006;21:979–85.
    OpenUrlCrossRefPubMedWeb of Science
  44. 44.↵
    1. Torke AM,
    2. Schwartz P,
    3. Holtz LR
    . Older adults and forgoing cancer screening: “I think it would be strange.” JAMA Intern Med 2013;173:526–31.
    OpenUrl
  45. 45.↵
    1. Schoenborn NL,
    2. Lee K,
    3. Pollack CE,
    4. et al
    . Older adults' views and communication preferences about cancer screening cessation. JAMA Intern Med 2017;177:1121–8.
    OpenUrl
  46. 46.↵
    1. Schoenborn NL,
    2. Boyd CM,
    3. Lee SJ,
    4. Cayea D,
    5. Pollack CE
    . Communicating about stopping cancer screening: comparing clinicians' and older adults perspectives. Gerontologist 2019;99:S67–76.
    OpenUrl
  47. 47.↵
    1. Lee S,
    2. Smith A,
    3. Widera E,
    4. Yourman L,
    5. Schonberg M,
    6. Ahalt C
    [Internet]. Prognosis communication. ePrognosis. 2020. Available from: https://eprognosis.ucsf.edu/communication/index.php.
  48. 48.
    Practice bulletin number 179: breast cancer risk assessment and screening in average-risk women. Obstet Gynecol 2017;130: 241–3.
    OpenUrl
  49. 49.
    1. Monticciolo DL,
    2. Newell MS,
    3. Hendrick ER,
    4. et al
    . Breast cancer screening for average-risk women: recommendations from the ACR Commission on Breast Imaging. J Am Coll Radiol 2017;14:1137–43.
    OpenUrlCrossRefPubMed
  50. 50.
    Canadian Task Force on Preventive Health Care [Internet]. Breast cancer update. 2018 [cited 2019 May 21]. Available from: https://canadiantaskforce.ca/guidelines/published-guidelines/breast-cancer-update/.
  51. 51.
    National Health Service [Internet]. National Health Service breast screening programme overview. 2015 [cited 2019 May 27]. Available from: https://www.gov.uk/guidance/breast-screening-programme-overview.
  52. 52.
    Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice. 9th ed. East Melbourne: Royal Australian College of General Practitioners; 2018.
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The Journal of the American Board of Family     Medicine: 33 (3)
The Journal of the American Board of Family Medicine
Vol. 33, Issue 3
May/June 2020
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Breast Cancer Screening in Older Women: The Importance of Shared Decision Making
Sarina Schrager, Viktoriya Ovsepyan, Elizabeth Burnside
The Journal of the American Board of Family Medicine May 2020, 33 (3) 473-480; DOI: 10.3122/jabfm.2020.03.190380

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Breast Cancer Screening in Older Women: The Importance of Shared Decision Making
Sarina Schrager, Viktoriya Ovsepyan, Elizabeth Burnside
The Journal of the American Board of Family Medicine May 2020, 33 (3) 473-480; DOI: 10.3122/jabfm.2020.03.190380
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  • Article
    • Abstract
    • Case
    • Background
    • Screening Guidelines for Women over 74
    • Benefits and Harms
    • Taking into Account General Health, Comorbidity, and Life Expectancy
    • Strategies for an Effective Discussion
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Keywords

  • Breast Cancer
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  • Early Detection of Cancer
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  • Risk Assessment
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