The biggest myths about breast cancer after age 60

From: optum.com

You may have heard that older women don’t need mammograms or can’t do anything about their risk factors. Here’s the truth behind five breast cancer myths.

You’ve probably been getting regular mammograms for decades. Mammograms are low-dose X-rays of your breast. It’s a great habit, since you’re doing something good for your health.

This screening test is one of the best ways to spot breast cancer in its earliest and most treatable stage. But if your mammograms have been normal all this time, you may wonder if it’s still worth it to continue getting them in your 60s and 70s.

The short answer is yes. The average age of a woman with a breast cancer diagnosis is 62, according to the American Cancer Society (ACS). And women have a 1 in 8 chance of getting breast cancer during their lifetime.¹ So, screenings are still an important part of your health as you get older. And so are the things you can do to help lower your risk of breast cancer, no matter how old you are.

There are still a lot of misunderstandings about breast cancer in older women. We separate fact from fiction so you can make the best choices for your health.

Myth #1: You don’t need to get as many mammograms in your 60s and 70s

FACT: Regular screenings are still a good idea.

That’s because your risk of cancer goes up as you age, explains Jennifer Menell, MD. She’s a radiologist at Optum in Mount Kisco, New York.

It’s not surprising that there’s some confusion about how often older women need to get screened. Different organizations have slightly different timelines, so talk to your doctor or specialist about what’s right for you. Here are the current guidelines:^{2, 3}

For women between the ages of 40 and 74: As of May 2023, the U.S. Preventive Services Task Force’s new draft guidelines recommend that women get screening mammograms every 2 years from age 40 until 74. (This recommendation is expected to become official in the near future.) The American College of Radiology recommends that women of average risk get yearly screenings starting at age 40.
For women ages 75 and older: Talk with your doctor about whether to continue screenings. Your doctor will recommend what’s best for you depending on your risk factors and health.

Mammograms are still one of the best ways to detect breast cancer, no matter your age. Not only do regular mammograms spot tumors when they’re small, but also, according to the ACS, women who get regular mammograms have:⁴

A lower chance of needing treatments such as surgery or chemotherapy
A better chance of being cured

If you have the choice, ask for a 3-D mammogram, recommends Dr. Menell. It can show the inside of each breast layer by layer.⁴ So it’s more likely to spot a tumor more clearly. That means you’re less likely to be called back for follow-up imaging, she adds.

Just note that 3-D mammograms cost more, and the extra cost may not be covered by your insurance.⁴

Myth #2: Mammograms are the only screening test older women need.

FACT: Not necessarily, especially if you have dense breasts.

If you have dense breasts, that means you have more fibrous tissue than fatty tissue.⁵ On a mammogram, dense tissue looks white, and the more white areas there are, the harder it is to spot small tumors. Breasts get less dense over time, but nearly one-third of women over 65 still have dense breast tissue.⁶

How will you know if you have dense breasts? When you get a mammogram, the radiologist is required by law to tell you.⁷ If you do have dense breasts, talk to your doctor about it. Together, you can decide whether to get another test called a breast ultrasound.

This test uses sound waves and their echoes to make pictures of the inside of your breasts.⁵ An ultrasound can spot small masses that might not show up on a mammogram.

Myth #3: If you feel a lump in your breast, you have breast cancer.

FACT: Not all lumps are signs of breast cancer.

Feeling a mass or lump in your breast can be scary. And it’s true that it’s one of the most common signs of breast cancer.⁸ But sometimes these lumps are cysts, tissue that’s clumped together or dense breast tissue that feels like a lump.⁹

Cancerous lumps tend to feel like hard knots with uneven edges, and they aren’t usually painful. But not always. Some cancerous tumors are soft, round and tender.

No matter what the lump feels like, though, let your doctor know. It needs to be addressed, Dr. Menell says. That often means getting a mammogram to check it out.

There are other signs that may be breast cancer too. Make an appointment with your doctor if you notice:⁸

Your breast, or a part of it, is swollen.
The skin around your breast looks dimpled or like an orange peel.
Your breast or nipple hurts for no reason.
The skin on your breast or nipple is red, dry, thick or flaky.
Your nipple seems to be turning inward.
Your nipple is leaking fluid or blood.
The lymph nodes under your arm are swollen, which could be a sign of cancer that has spread.

Myth #4: It’s too late to lower your risk of breast cancer after age 60.

FACT: There are steps you can take to help prevent breast cancer no matter how old you are.

You can’t change certain risk factors for developing breast cancer.¹⁰ One is getting older. Another is having a family history of breast cancer or ovarian cancer. But there are still plenty of ways you can lower the odds. And a lot of them include continuing, or even starting, healthier habits.¹⁰

Get more active. Women who aren’t getting enough exercise have a higher chance of breast cancer. So, do something active that gets your heart pumping on most days a week, whether it’s walking, playing pickleball or doing yard work.
Stop smoking, if you smoke. Talk to your doctor about ways to quit.
Cut down on alcohol. Any amount of wine, beer or hard liquor ups your risk of getting breast cancer. But if you do drink, stick to one drink a day at most.^¹

Myth #5: Breast cancer is hard to treat in older women.

FACT: Treatment has come a long way, no matter what your age.

If by chance you do get a diagnosis, don’t panic. When breast cancer is detected via screening and there are no symptoms yet, the vast majority of women are cured, Dr. Menell says. In fact, women who are diagnosed with cancer that has not spread outside the breast have a 99% survival rate after 5 years.¹²

Treatment can include surgery, radiation, chemotherapy, hormone therapy, targeted therapy or a combination of those. Together, you and your doctor will decide which is the right treatment for you.¹³

So talk to your doctor about continuing breast cancer screenings. Your Optum doctor or specialist is there to advise you on the right mammogram schedule based on your personal breast cancer risk. They also stand ready to answer any questions you may have. Don’t hesitate to speak up.

Sources