Science

Breast cancer: before 40 years of age and especially after 75 years of age, there is also a risk – Sciences et Avenir

Women under 40 or over 75 years of age are at lower risk of being diagnosed with breast cancer, despite the risks for older adults, experts warn, who are calling for better surveillance.

Breast cancer is the most common and deadly disease among women worldwide, with about 54,000 new cases and more than 12,000 deaths each year in France.

But “mortality has decreased thanks to treatment and screening,” said Emmanuel Barranger, director general of the Antoine Lacassagne Center in Nice, on Thursday during a press conference of the French Society of Senology and Pathology of the Breast.

The earlier cancer is detected, the greater the chance of survival and the less severe and aggressive treatments.

So many wealthy countries have organized screening policies promoted annually in France by Pink October, a variant of the Anglo-Saxon Breast Cancer Awareness Month campaign.

In France, women aged 50 to 74 have been invited for screening, including mammography, every two years (100% coverage) since 2004 to detect a possible tumor.

After strong growth in the early years, this screening has stalled and covers about half of the targeted women, which is of concern to some experts in a context where the incidence of breast cancer is increasing in almost all age groups except 55-65 years.

But above all, there is the question of the strategy to be adopted when a person is too young or too old to benefit from such organized screening. There is also the risk of possible “overdiagnosis”: tumors can be detected, while they would never have degenerated into cancer, with the danger of starting a difficult and useless treatment.

For the French Society of Senology and Pathology of the Breast, “the question of screening does not arise for women younger than 40, except for women at high risk of developing cancer (genetic predisposition, family history of breast cancer)”, but it is “more difficult for women under 40”. “. women between the ages of 40 and 50, as 15% of cancer cases occur in this age group.”

To “detect more and better” cancers, the European Commission also recommended on Tuesday, among other things, lowering to 45 the age at which women are eligible for organized breast cancer screening in the EU.

– 3 cm crayfish –

Up to 40 years, what kind of supervision?

“You should have already determined with a healthcare professional whether or not you are a risk factor,” and “otherwise there is no reason to get a mammogram before the age of 40,” Luc Seunard, SFSPM president and head of the medical institution, said Thursday. image processing center at the Oscar-Lambre Center in Lille.

Breast cancer is the most common and deadly disease among women worldwide (AFP/Archive – DIDIER PALLAGES)

The woman’s vigilance is also important. For example, “if there is a tumor in the breast, an altered appearance of the breast, and it persists after a change in the menstrual cycle, you should get checked out” and “don’t bury your head in the sand,” he insisted.

Women over 75 years of age are of the greatest concern, even though life expectancy is increasing and aging increases the risk of cancer.

“A large number of women over 74 believe that there is no longer a need for follow-up care that induces treatment for advanced cancer,” the SFSPM worries in a press release. “Sometimes we see 80-year-old women arrive with 3 cm cancer, they didn’t get a mammogram because they didn’t receive screening invitations anymore,” says Prof Barrange.

With a large tumor, affected lymph nodes, or even cancer with metastases, the risk increases. And the older you get, the harder it can be to recover from, say, chemotherapy.

Should systematic screening be extended to these older patients? Not for specialists, but they want patients and physicians to continue to follow up individually.

Thus, for those over 75 years of age, the SFSPM advocates “serious communication efforts” and a doctor’s order mammogram every two years.

An annual clinical examination (palpation) is also desirable, she says, but “is rarely done, in particular because of the demographic and medical crisis, and also because of the lack of information from medical workers.”

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