Breast cancer screening in the over 70s

Introduction

Routine invitation for breast screening currently ceases in Wales over the age of 70 despite the incidence of breast cancer remaining high in this group. Attendance for screening aged over 70 is low compared with the invited population, often attributed to lack of awareness of eligibility and how to access screening. If screening is to be extended, the motivation to attend and outcomes need to be understood.

Methods

This audit of prospectively collected data from Breast Test Wales Screening (South East Wales) identified all women over 70 years who attended. In those where cancers were detected, age, pathological data, previous screening history, family history, clinically palpability and breast symptoms were recorded.

Results

A total of 5,736 women attended aged 71 to 92 years in a 3-year screening round (1 April 2006 to 31 March 2009) with numbers attending decreasing with higher age. In total, 295 (5.1%) were recalled to assessment and 81 (1.4%) were diagnosed with cancer. A total of 61.5% of the cancers were grade 2, 77% <20 mm and 84% node-negative. The majority had an excellent or good Nottingham Prognostic Index, mirroring national data for the younger invited population. Of those diagnosed with cancer, 61.6% had four or more previous screens; 28.9% of women reported a family history; 55.4% were clinically palpable and of these 49% had themselves noticed a change in the breast.

Conclusions

This study indicates that women continue to attend regularly after invitation ceases. Clinical concerns and family history awareness may be motivators but as cancers detected have good prognostic indices, screening this group may be beneficial.