Should there be an upper age limit for breast cancer screening?

Abstract

Aim: Breast cancer screening age is between 40-69 years in women of our country. The purpose of this study is to examine the effect of breast cancer screening on tumor diameter and surgical technique for women at or above the screening age interval. Material and Method: The data of 133 female patients aged 40 and above who underwent surgery due to the breast cancer between years 2010 and 2018 in Ordu, Turkey, were collected retrospectively. Patients were divided into two groups as Group 1 (n = 102, between ages 40-69) and Group 2 (n = 31, aged 70 and above). Results: In Group 1, the average tumor diameter of 48 patients (47.1%) diagnosed with physical examination (PE) was 2.96 +/- 1.2 cm and average tumor diameter of 54 patients (52.9%) diagnosed with mammography (MG) was 1.48 +/- 0.58 cm (p < 0,001). In Group 1, 36 (66.7%) of 54 patients diagnosed with MG underwent breast conserving surgery (BCS), and 18 (33.3%) underwent modified radical mastectomy (MRM). Meanwhile, 25 (52.1%) of 48 patients diagnosed with PE underwent BCS and 23 (47.9%) underwent MRM (p = 0.13). In Group 2, the average tumor diameter of 24 (77.4%) patients diagnosed with PE was 3.18 +/- 1.48 cm and the average tumor diameter of 7 (22.6%) patients diagnosed with MG was 2.74 +/- 0.79 cm (p = 0,55). In Group 2, 3 (42.9%) of 7 patients diagnosed with MG underwent BCS, and 4 (57.1%) underwent MRM. Meanwhile, 9 (37.5%) of 24 patients diagnosed with PE underwent BCS, and 15 (62.5%) underwent MRM (p = 0.79). Discussion: Tumor diameter was determined to be smaller in breast cancer screening group among women at or above the age interval of the breast cancer screening program. Although, the effect of screening on surgery type was not statistically significant, it has increased breast-conserving surgery. The breast cancer screening program should not be planned according to the chronological age, and instead, life expectancy should be regarded.