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Comment & Response
February 2018

False Information About Breast Cancer Screening

Author Affiliations
  • 1University of Arkansas for Medical Sciences, Little Rock
JAMA Intern Med. 2018;178(2):299-300. doi:10.1001/jamainternmed.2017.7087

To the Editor We appreciate the opportunity to respond to the Editorial by Grady and Redberg1 published in a recent issue of JAMA Internal Medicine on physician adherence to screening guidelines for breast cancer. Grady and Redberg1 bring attention to anchoring to age cutoffs set by the US Preventive Services Task Force (USPSTF) as a primary consideration for breast cancer screening. Breast cancer remains in the top 3 causes of death for women ages 35 to 64 years in the United States. Women in this age range are typically wage earners, mothers, caregivers, and spouses. But breast cancer is also a cancer of advancing age, accounting for approximately 60% of cancer deaths in women older than 64 years.2 Solutions for breast cancer morbidity and mortality are often blurred in the haze of mammography screening debates. Addressing benefit and risk of screening in what constitutes varied populations of women is perhaps the more difficult question at hand. This task remains particularly taxing for women at advanced age, requiring office evaluation that includes stratifying risk according to estimates of remaining life expectancy, burden of chronic disease, and functional status, all aligned with patient wishes.

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