Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 269

There is no recommendation for or against the clinician recommending self‐examination or breast‐self‐awareness or the clinician doing the clinical breast examination.^35‐37 The National Comprehensive Cancer Network (NCCN) recommends both.² The American Cancer Society (ACS) recommends breast self‐awareness if the woman is interested, and the United States Preventive Services Task Force (USPSTF) recommends against both self‐awareness and clinical examinations.^35,37 Breast self‐awareness may allow women to detect lesions or breast cancers not seen on mammography or those that develop between mammograms.^35,36

Mammography is the mainstay of breast cancer screening. Research has shown mammography to be effective up to age 84.³⁶ There is a lack of agreement among organizations regarding screening intervals for mammography or when to stop mammography. The ACS recommends annual mammography for women 55 and older, or they may transition to biennial mammography. Women should continue mammography if their overall health is good and life expectancy is 10 or more years. The NCCN recommends annual mammography without guidelines for stopping.³⁶ Few studies describe women’s decision‐making to stop mammography.³⁶ It appears that some women and their health providers, recognizing that the expected benefit of early detection declines with remaining life expectancy, consciously decide to discontinue screening following a serious health event.^36,37 The USPSTF recommends biennial screening mammography for women up to age 74.³⁷