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January 14, 2019

New Breast Cancer Screening Technologies in Older Women—Is It Time to Pump the Brakes?

Author Affiliations
  • 1Section of General Internal Medicine, Yale University School of Medicine, New Haven Connecticut
  • 2Cancer Outcomes, Public Policy and Effectiveness Research Center (COPPER), Yale School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2019;179(3):289-290. doi:10.1001/jamainternmed.2018.7767

Although mammography was introduced in the United States in the late 1970s, Medicare did not cover screening mammography until 1991.1 The delay reflected a broader historical reluctance to cover preventive services. The Social Security Act of 1965, which established Medicare, initially excluded coverage of preventive services in part because these services were ill defined and of uncertain benefit at the time. This was also true of mammography. By 1991, to our knowledge, no clinical trials of mammography had included women older than 74 years, and there was skepticism about its effectiveness in this age group.1

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    1 Comment for this article
    Glad someone is bringing this topic up again.
    Armin Weinberg, PhD | Baylor College of Medicine
    Not sure why some topics have difficulty gaining traction but this one has. I'm glad to see a thoughtful piece has surfaced even though it has been some time since we tried to address it and might at that time have had a different take on it. Nonetheless, here are a couple of citations from way back when if anyone is interested!

    France, AC, Nanney, M, Riddler, EW, Weinberg, AD, "Controlling Breast Cancer in Older Women: The Physician's Role" Texas Medicine, 1992, May, 88(5):68-70.

    Friedman, LC, Woodruff, A, Weinberg, AD., et.al, “Breast Cancer Screening
    Behaviors and Intentions Among Asymptomatic Women 50 Years and Older”. American Journal of Preventive Medicine, July/August, 1995, 11(4) pp.218-223.