Several important tests are now available to help women maintain the best possible health as they age. The most common ones used are mammography and bone density-screening.

Mammography

Mammography has been available for many years, and, although many new imaging tests have been looked at, it remains the gold standard of evaluation for breast lumps and breast cancer. The precise age at which the benefits from screening mammography justify the potential harms is a subjective judgment and should take into account patient preferences and physician recommendations. Patients must be informed of the potential benefits (reduced chance of dying from breast cancer), potential harms (such as false positive results or unnecessary biopsies), and the limitations of the test that apply to women of certain ages. Studies have shown that the balance of benefits and potential harms of mammography improves with increasing age between 40 and 70.

So, when should you start receiving routine screening for breast cancer? Most North American medical organizations agree that routine mammography should be performed annually in women over the age of 50. There is some controversy regarding screening women ages 40 to 49. Routine annual mammography is definitely recommended for women ages 40 to 49 who are at high risk of breast cancer; that is, women with a family history of breast cancer in a mother or sister or a family history of pre-menopausal breast cancer, along with women with a previous breast biopsy having atypical cells and women with first childbirth after age 30. In other low-risk women, most authorities recommend mammography every one to two years in women ages 40 to 49.

Many women are frightened of mammograms–they fear the procedure and fear the results. With modern equipment, the discomfort of mammograms is quite minimal, especially if done with an experienced, well-trained technician. Most studies reveal that about 6.5% of screening mammograms will have some abnormality that requires additional testing, such as additional mammogram views or ultrasound. However, the vast majority of these turn out to be benign lesions.

Breast cancer is the most common non-skin malignancy in the United States and second only to lung cancer as a cause of cancer-related death. Most studies have shown that breast cancer screening with mammography reduces mortality from breast cancer. With early detection and the therapies available now, breast cancer is often curable. So, everyone, get up to date on your mammograms!

Bone-Density Screening

Bone-density screening is relatively new in the range of preventative screening tests. There are several test options for bone-density screening, but the DEXA scan is considered the gold standard. This test allows your physician to test the density of your bones, hopefully detecting bone loss and treating it before hip or vertebral fractures occur. Osteoporosis occurs primarily after menopause, with as many as 20 to 30 percent of Caucasian women having true osteoporosis and as many as 54 percent having low bone density, or osteopenia.

Osteoporosis presents an enormous burden on elderly women. Osteoporotic fractures often lead to significant decrease in quality of life, including loss of independence, but they also incur substantial costs to the individual and our overburdened health care system.

Screening for bone density is usually started in the post-menopausal age group. The test involves a simple painless scan of the spine and hip to determine bone density as compared with normals of the same age. Osteopenia (low bone density) and frank osteoporosis both increase fracture risk. There are now many interventions for treatment of this very serious disabling disease. You should discuss with your physician obtaining this evaluation if you are in this age group, especially if you have risk factors such as family history of osteoporosis, smoking, use of medications such as steroids or anticonvulsants, excessive alcohol consumption, white or Asian race, and low body weight. It is also recommended that all women take 1,200 to 1,500 mg of calcium per day and participate in regular weight-bearing exercise for 30-45 minutes 4-5 days a week to help prevent osteoporosis.

With these excellent screening tests, women can live happier, healthier, more independent lives. It is recommended that all women discuss these important tests with their physician on a regular basis.