Women older than 75 are not typically included in studies to determine whether mammograms are an effective breast cancer screening method.
A recent study compared the outcomes of women in this age group whose cancer was detected by mammography to breast cancers found by the patient or doctor examination.
The newly published research reported that breast cancer found by mammography in women older than 75 was more likely to be found at an earlier stage.
Women in this age group with mammogram-detected breast cancer were less apt to receive chemotherapy or to be treated with removal of the breast. They also had better five-year survival rates.
"Get screened for breast and other cancers regularly."
The study was conducted by Judith A. Malmgren, PhD, from HealthStat Consulting and the School of Public Health at the University of Washington in Seattle, and colleagues.
According to Daniel B. Kopans, MD, Professor of Radiology at Harvard Medical School, the findings of this study are not surprising. "There is no reason to expect that finding breast cancers in older women will not save lives," he told dailyRx News.
Dr. Kopans explained that for various reasons, randomized controlled trials on mammography have not included women younger than age 40 and older than age 74. "Consequently, there is no 'proof' that earlier detection saves lives for younger and older women. That said, the fundamental biology remains. Finding cancers ealier will reduce deaths," he said.
"Since there is no 'proof,' most experts will agree that the decision to participate in screening for 'older' women should involve their fundamental underlying health issues," Dr. Kopans said.
"If an 'older' woman is healthy with a greater than five-year life expectancy, finding breast cancer ealier could prevent her from dying prematurely from these malignancies. This paper supports these principles. All women should be encouraged to participate in screening as long as they have fairly good health and life expectancy," he said.
For this study, Dr. Malmgren and team collected data on women who had a breast cancer biopsy that was confirmed to be breast cancer stages 0 through 4. These researchers gathered data from the breast cancer registry database from 1990 to 2011.
Breast cancer stages indicate the extent to which the cancer has invaded other tissues or spread to other parts of the body, with higher numbers indicating more advanced cancer.
The main goal of the research was to compare the outcomes of women older than 75 whose breast cancer was detected on mammograms with those whose cancer was detected by the patient or doctor. The research studied 1,162 women older than 75.
In a mammogram, a doctor takes an X-ray of the breast to look for any abnormalities like tumors.
The researchers compared the stage of breast cancer at detection, treatments and survival of the women in the mammogram and non-mammogram groups.
The results of the study showed that mammograms detected 64 percent of the breast cancers in women 75 and older — compared to 36 percent detected by the patient or doctor.
Patients with breast cancer detected by mammogram were younger and more likely to have smaller tumors and early-stage breast cancers than those with breast cancer found by the patient or doctor.
Breast cancer was found by mammogram at stages 2 through 4 in 20 percent of the women — compared to 64 percent of the women whose cancer was found by a doctor or the patient.
Mammogram-detected breast cancers were less likely to be treated with surgical removal of the breast or chemotherapy than breast cancers found by the patient or her doctor.
Women in the study with stages 1 to 3 invasive breast cancer found by mammograms had a 96 percent chance of being cancer-free in five years — compared to an 87 percent chance in those with cancer found through self-examination or a doctor.
The study authors said women older than 75 would likely benefit from regular mammograms.
“It’s easy to detect a cancer earlier in older women because breast density is not an issue," Dr. Malmgren said in a press release. "And mammography is not expensive, so doing it every other year would not add a lot of cost to healthcare."
The research was published Aug. 5 in the online version of Radiology.
The authors declared no conflict of interest.