Question of the Week

For March 24, 2015

A 75-year-old woman comes for a routine office visit and asks if her next mammogram is necessary. She has been compliant with her annual mammograms since age 50 and is due for her next one in a month.

Her medical history consists of hypertension, type 2 diabetes, hypothyroidism, osteoarthritis, and congestive heart failure, which developed after a recent acute myocardial infarction. She notes that the heart failure is affecting her activities of daily living and that she cannot walk up a flight of stairs without feeling short of breath. She states that her mother died suddenly at age 72 after a heart attack.

On physical examination, her breasts are small, with no lumps or nodules on palpation. Her nipple–areola complexes are normal to inspection and to palpation. The rest of her physical examination is normal.

Routine laboratory testing shows a mildly elevated glucose level, but other values are within normal limits.

What is the best evidence-based recommendation to give this patient regarding breast-cancer screening?

Continue annual screening mammograms indefinitely
Switch from annual screening mammography to annual MRI of the breast
Switch from annual screening mammograms to monthly breast self-examinations
Discontinue screening mammography
Increase the interval between screening mammograms to 3 years

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