Regular mammography among women 80 years of age and older is associated with earlier disease stage, although improved survival remains difficult to demonstrate, according to study published in the April 21 issue of the Journal of Clinical Oncology.
Brian D. Badgwell, MD, and colleagues from the departments of surgical oncology and breast medical oncology at The University of Texas MD Anderson Cancer Center in Houston, undertook the study to determine “the effect of mammography use on stage at breast cancer diagnosis and survival among women of this age range.”
The American Cancer Society recommends yearly mammograms when women reach age 40 with no upper age limit for those in good health. However, surveys have shown that as women age, they are less likely to obtain regular mammograms.
The MD Anderson researchers examined the linked Surveillance, Epidemiology and End Results–Medicare database to evaluate 12,358 women 80 years of age and older, who were diagnosed with breast cancer between 1996 and 2002. The investigators then grouped the patients according to number of mammograms during the 60 months before diagnosis: nonusers (zero mammograms), irregular users (one to two mammograms) and regular users (three or more mammograms).
Badgwell and colleagues found that the percentages of women with nonuse, irregular use and regular use of mammography during the five years preceding diagnosis were 49 percent, 29 percent and 22 percent, respectively.
On multivariate analysis, the researchers found that the patients were 0.37 times less likely to present with late-stage cancer for each mammogram obtained. Breast cancer–specific five-year survival among nonusers was 82 percent, that among irregular users was 88 percent and that among regular users was 94 percent.
However, the authors noted that survival from causes other than breast cancer was also associated with mammography use, suggesting a bias for healthier patients to undergo mammography.
“This study suggests that mammography benefits may have no age limit and that women should consider being screened on a regular basis, even into their 80s and possibly 90s, depending on their current health status,” said Badgwell.
Badgwell and colleagues recommended that healthcare providers should consider discussing the potential benefits of screening mammography with their older patients, particularly for those without significant comorbidity.