Regular mammograms significantly reduce the risk of a late-stage breast cancer diagnosis in women 80 years of age and older, but most are not being screened. Study results show that only about one fifth of those patients undergo regular mammography, even though screening once every year or two appears to be beneficial.
Because screening mammography guidelines for women older than 80 years are variable, senior study author Gildy Babiera, MD, and colleagues from the MD Anderson Cancer Center in Houston analyzed the effect of mammography use on stage at breast cancer diagnosis and survival among such patients (J Clin Oncol. 2008;26:2482-2488). Using the linked Surveillance, Epidemiology, and End Results-Medicare database, they evaluated the cases of 12,358 women 80 and older who were diagnosed with breast cancer over a recent six-year period.
The investigators found that in the five years preceding diagnosis:
• 49% had had no mammograms (nonusers)
• 29% had had one or two mammograms (irregular users)
• 22% had had three or more mammograms obtained at least 11 months apart (regular users)
In addition, the women who did undergo regular mammography were diagnosed at an earlier disease stage; they had fewer positive lymph nodes at surgery.
Although the researchers note that “improved survival remains difficult to demonstrate,” they advise health-care providers to consider discussing the potential benefits of screening mammography with their older patients.
They point out that their findings support “an interval of annual to biennial screening.”