Table 2.

Summary of Reasons to Screen and not to Screen Older Women for Breast Cancer

Reasons to Screen Older Women	Reasons Not to Screen Older Women
Breast cancer incidence increases with age	Anxiety related to false positive tests (approximately 20% of older women screened over 10 years experience a false positive)
Mammography is a more sensitive test among older women	Complications and anxiety from a benign breast biopsy (approximately 2% of older women screened over 10 years experience a benign breast biopsy)
Reassurance from a truly negative test	False reassurance from an erroneously negative test
Detect breast cancer at an early stage when less aggressive treatment may be recommended	Overdiagnosis-diagnosis of breast cancers that otherwise would not have caused problems or symptoms in an older woman’s lifetime (approximately 30% of screen detected tumors among older women). Older women have increased risk of complications from treatment (surgery, radiation, endocrine therapy, chemotherapy)
May reduce breast cancer mortality  1–2 older women out of 1000 may avoid breast cancer death after 10 years	Women with <10 year life expectancy very unlikely to benefit and may only experience harm