Study finds breast cancer screening beneficial in older patients

Patients aged 80 years and older may benefit from annual or biennial mammography screening, according to data published in the Journal of Clinical Oncology.

Researchers from the University of Texas M.D. Anderson Cancer Center aimed to determine the effect of mammography screening and stage at breast cancer diagnosis among older women. Using the Surveillance, Epidemiology and End Results-Medicare database, they identified 12,358 women aged ≥80 years diagnosed with breast cancer between 1996 and 2002.

During the five years prior to diagnosis, 49% of the women did not have any mammograms (nonusers), 29% had one or two mammograms (irregular users) and 22% had three or more mammograms (regular users). For each mammogram obtained, patients were 0.37 times less likely to present with late-stage disease (OR=0.63; 95% CI, 0.63 to 0.67), according to the researchers.

Survival specific to breast cancer was 82% for nonusers, 88% for irregular users and 94% for regular users. Though regular mammography screening was associated with earlier stage disease in older patients, the researchers concluded that improved survival is difficult to confirm. – by Stacey L. Adams

J Clin Oncol. 2008;doi:10.1200/JCO.2007.12.8058.

The key thing is that, as with everything in medicine, age should not be the sole criterion; heath status should be. There is no number cut-off for these kinds of things. If you are an 80-year-old running marathons, you should probably still be getting annual mammograms. If you are an 80-year-old with end stage dementia whose kidneys do not work, whose heart does not work and whose lungs do not work, from those things you are probably only going to live a short period of time, so you probably do not need to be getting mammograms. That is the bottom line; look at the patient, not just at the number, and that should apply everywhere in medicine.

– Timothy J. Moynihan, MD

Assistant Professor of Oncology
Mayo Clinic, Rochester, Minn.