Do older women benefit from mammograms?

According to a recent study in Radiology, women older than age 75 may still derive benefits from mammography screening.

Resident's Blog: "Doctor, what would you do?"

Led by researchers at the University of Washington’s School of Public Health and Community Medicine, investigators performed a Health Insurance Portability and Accountability Act-compliant, prospective cohort study with a waiver of informed consent in patients who had primary breast cancer and were aged 75 years or older. The 1162 women represented had stage 0 to IV disease between 1990 and 2011 and had been identified and tracked with a registry database.

Information in patient charts from the time of diagnosis that was accessed included stage, treatment, outcomes, and whether the disease was detected by the patient, a physician, or on mammography. Disease-specific survival rates were compared using Kaplan-Meier estimation.

Among the cohort, mammographic detection of cancers increased over time from 49% to 70% (P<.001) and was most common with stage I disease (62%). Detection was most often by a patient or a physician when disease was stage II and III (59%). Over the course of the study, the incidence of stage 0 cancers increased by 15% (P<.001); however the incidence of stage II and III cancer decreased by 8%.

Lumpectomy and radiation were common and mastectomies and chemotherapy less common in women who had mammography-detected disease than those with cancer found by the patient or her physician (P<.001). In addition, 5-year disease-specific survival was better in women with invasive breast cancer detected by mammography (97% vs 87% for patient- and physician-detected cancer [P< .001], respectively).

Investigators concluded that women who had mammography-detected cancer were diagnosed at earlier stages, required less overall treatment, and had better disease-specific survival rates than women with cancer detected by self or a physician. They also believe that the findings indicate that mammography benefits found in younger women are also applicable to older patients.

To get weekly advice for today's Ob/Gyn, subscribe to the Contemporary OB/GYN Special Delivery.