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June 28, 2000

Screening Mammography in Elderly Women—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(24):3202-3204. doi:10.1001/jama.283.24.3198

In Reply: To make evidenced-based recommendations related to breast cancer screening of elderly women, the efficacy (or lack thereof) of screening mammography needs to be better defined. Additional time preference and utility data are also needed, and guidelines for a threshold for average life expectancy gained and cost per year of life saved are required. In the meantime, elderly women and their physicians must decide whether to continue or discontinue screening mammography at age 70 years. In an effort to build a clinically relevant and useful model to facilitate this decision, we focused on the 2 most important factors that would influence decisions about screening in the elderly: (1) level of breast cancer risk determined by age and BMD measurement, and (2) time preference or discount rate.