ArticleJournal of general internal medicine2024
Benefits and Harms of Mammography Screening in 75 + Women to Inform Shared Decision-making: a Simulation Modeling Study.
Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Healthcare provider perspectives on a clinical decision tool to support individualized exercise prescriptions and discussions for breast cancer survivors.Journal of cancer survivorship : research and practice · 2026Article
- User Perspectives on a Clinical Decision Tool to Support Individualized Exercise Prescriptions for Breast Cancer Survivors Not Meeting Exercise Guidelines: Cross-Sectional Survey.JMIR formative research · 2026Article
- Breast cancer survivors' perspectives on a clinical decision tool to support individualized exercise prescriptions and discussions.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Breast cancer screening in women aged 75 and older: Insights from an aging region in Japan.Preventive medicine reports · 2025Article
- A scoping review of web-based, interactive, personalized decision-making tools available to support breast cancer treatment and survivorship care.Journal of cancer survivorship : research and practice · 2025Article
- Development and Validation of a Simulation Model-Based Tool to Support Individualized Physical Activity Discussions and Prescriptions for Breast Cancer Survivors.JCO clinical cancer informatics · 2025Article
- Breast Cancer Incidence Trends in Older US Women by Race, Ethnicity, Geography, and Stage.JAMA network open · 2025Observational
- Creating a Mammography Conversation Aid for Shared Decision-Making Between Clinicians and Women Aged 75 and Older.Journal of the American Geriatrics Society · 2025Article
- Impact of endocrine therapy regimens for early-stage ER+/HER2-breast cancer on contralateral breast cancer risk.NPJ breast cancer · 2025Article
- A Nationally Representative US Health and Retirement Study on Mammography Screening Use and Its Predictors Among Older Adult Women Ages 60 to 85.Breast cancer : basic and clinical research · 2025Article
- Clinical and sociodemographic characteristics associated with health-related quality of life among older breast cancer survivors.Women's health (London, England)Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundGuidelines recommend shared decision-making (SDM) around mammography screening for women ≥ 75 years old.
objectiveTo use microsimulation modeling to estimate the lifetime benefits and harms of screening women aged 75, 80, and 85 years based on their individual risk factors (family history, breast density, prior biopsy) and comorbidity level to support SDM in clinical practice. DESIGN, SETTING, AND
participantsWe adapted two established Cancer Intervention and Surveillance Modeling Network (CISNET) models to evaluate the remaining lifetime benefits and harms of screening U.S. women born in 1940, at decision ages 75, 80, and 85 years considering their individual risk factors and comorbidity levels. Results were summarized for average- and higher-risk women (defined as having breast cancer family history, heterogeneously dense breasts, and no prior biopsy, 5% of the population). MAIN OUTCOMES AND MEASURES: Remaining lifetime breast cancers detected, deaths (breast cancer/other causes), false positives, and overdiagnoses for average- and higher-risk women by age and comorbidity level for screening (one or five screens) vs. no screening per 1000 women.
resultsCompared to stopping, one additional screen at 75 years old resulted in six and eight more breast cancers detected (10% overdiagnoses), one and two fewer breast cancer deaths, and 52 and 59 false positives per 1000 average- and higher-risk women without comorbidities, respectively. Five additional screens over 10 years led to 23 and 31 additional breast cancer cases (29-31% overdiagnoses), four and 15 breast cancer deaths avoided, and 238 and 268 false positives per 1000 average- and higher-risk screened women without comorbidities, respectively. Screening women at older ages (80 and 85 years old) and high comorbidity levels led to fewer breast cancer deaths and a higher percentage of overdiagnoses.
conclusionsSimulation models show that continuing screening in women ≥ 75 years old results in fewer breast cancer deaths but more false positive tests and overdiagnoses. Together, clinicians and 75 + women may use model output to weigh the benefits and harms of continued screening.
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