AFP, posted on Saturday, September 24, 2022 at 10:32
With less than 40 or more than 75, women are less on the radar to detect breast cancer despite the existence of risks for older women, warn specialists, who advocate better surveillance.
Breast cancer is the most common and deadly cancer among women worldwide, with some 54,000 new cases each year and more than 12,000 deaths in France.
But “mortality has decreased thanks to treatment and screening,” stressed Pr. Emmanuel Barranger, general director of the Antoine Lacassagne center in Nice, during a press conference of the French Society of Senology and Breast Pathology on Thursday.
The earlier a cancer is detected, the better the chances of survival and the less intense and aggressive the treatments will be.
Many rich countries therefore carry out an organized screening policy, also promoted each year in France by Pink October, a variation of the Anglo-Saxon National Breast Cancer Awareness Month campaign.
In France, women aged 50 to 74 have been invited, since 2004, to screening examinations including mammograms every two years, 100% covered, to detect a possible tumor.
After a strong increase in the early years, this screening has stagnated and concerns about half of the target women, worrying certain specialists in a context where the frequency of breast cancer is increasing in almost all age groups except in the 55-65 year old.
But, above all, the question arises of the strategy to adopt when one is too young or too old to benefit from such an organized projection. There is also the risk of a possible “overdiagnosis”: tumors can be identified, when they would never have evolved into cancer, with the danger of starting a heavy and useless treatment.
For the French Society of Senology and Breast Pathology, “the question of screening does not arise for women under 40 years of age, apart from women with a high risk of cancer (genetic predisposition, family history of breast cancer)”, but it is “more complex for women 40 to 50 years old, since 15% of cancers occur in this age group.”
To “detect more and better” cancers, the European Commission also recommended this Tuesday, among other things, lowering the age from which women are eligible for organized breast cancer screening in the EU to 45 years.
– 3 cm cancers –
Under 40, what supervision?
“You must already identify, with a health professional, a risk factor or not”, and “there is no reason to have a mammogram before the age of 40 otherwise”, judged Thursday Luc Ceugnart, president of the SFSPM and head of the medical unit. imaging center at the Oscar-Lambret center in Lille.
Surveillance of women is also important. For example, “if there is a lump in the breast, a changed-looking breast, and it persists after a change in the menstrual cycle, it should be checked out” and “not bury your head in the sand,” she insisted.
The alarm is greater for women over 75, even as life expectancy increases and aging increases cancer risk.
“A large number of women over 74 years of age think that follow-up is no longer necessary, which leads to the management of late-stage cancer,” the SFSPM worries in a press release. “Sometimes we see 80-year-old women arrive with 3-centimeter cancers, they didn’t get a mammogram because they no longer received the invitation to screening,” according to Professor Barranguet.
With a large tumor, affected lymph nodes, or even metastatic cancer, the danger increases. And, the older you get, the harder it can be to recover from chemotherapy, for example.
Should systematic screening be extended to these older patients? Not for specialists, but they want to encourage patients and doctors to continue monitoring individually.
For those over 75 years of age, the SFSPM defends “a great communication effort” and a mammogram, with a prescription, every two years.
An annual clinical examination (palpation) is also desirable, according to her, but “is rarely done, in particular due to the medical demographic crisis, but also due to the lack of information from health professionals.”