A study in JAMA Oncology senior authored by professor of health care policy Nancy L. Keating, MD, MPH, has established the first surveillance mammography guidelines for breast cancer survivors aged 75 years or older.

After engaging a multidisciplinary panel, the study first evaluated the harms and benefits associated with mammography and reviewed the risk of ipsilateral and contralateral breast cancer events among breast cancer survivors. It then developed mammography guidelines that were reviewed by clinician focus groups and the International Society for Geriatric Oncology before finalization.

The final guidelines recommend discontinuation of routine mammography for all breast cancer survivors when their life expectancy is less than five years. Survivors with a life expectancy of five to ten years may consider discontinuing mammography, while those with a life expectancy greater than ten years should continue mammography.

The risk for both ipsilateral and contralateral breast cancer events was found to be low in most older breast cancer survivors. The study team encourages shared decision-making between patient and doctor to ensure that recommendations are being best tailored to each patient. They also recommend ongoing clinical breast examinations and diagnostic mammography to evaluate clinical symptoms and findings.

“We have long supported shared decision making about mammography screening for women without cancer, particularly for women for whom benefits are small,” says Keating. “Benefits of surveillance mammography are also small for many breast cancer survivors. These guidelines provide clinicians and patients with information to quantify the benefits and harms and make informed decisions about continuing and stopping mammography.”

This study has been featured by Medscape and Radiology Business.