Women Over 80 May Benefit From Mammograms
CancerWise - August 2008
Mammography significantly reduced the risk of advanced stage breast cancer in women 80 years old or older, according to a study that suggests the first screening guidelines for this age group.
Significance of results
About 17% of breast cancers are diagnosed in this older population, and about 20% of women in this age group have routine mammograms say M. D. Anderson researchers, whose study appeared online April 21 in the Journal of Clinical Oncology.
Regular mammograms are recommended for breast cancer screening and early detection in women between the ages of 40 and 80. However, there are no clear, universal guidelines as to the upper age limits of when to stop.
Gildy Babiera, M.D., associate professor in the Department of Surgical Oncology and the study’s senior author, says this study was prompted when she began to notice an increase in the number of women 80 years old and older seeking treatment in M. D. Anderson’s Nellie B. Connally Breast Center.
“More women are living longer now,” Babiera says. “Treating elderly breast cancer patients poses the question of how best to manage their care while being mindful of both their other health conditions and their quality of life.”
Babiera and her colleagues analyzed data from the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) database, which gathers information about cancer patients in the United States.
From 1996 through 2002, information was collected on 12,358 breast cancer patients 80 years old and older who had been diagnosed within the previous five years.
The women were divided into three groups according to how many mammograms they had prior to their diagnosis.
Those categories were:
Regular users — Women who had three or more mammograms before their diagnosis.
Irregular users — Women who had one or two mammograms before their diagnosis.
Nonusers — Women who had not had any mammograms prior to their diagnosis.
Researchers found that among women in this group:
- 22% were regular users
- 29% were irregular users
- 49% were nonusers
Women who had regular mammograms tended to be diagnosed when their cancer was in early stages, when cancer typically can be treated most successfully.
The study showed:
- 68% of regular users had early, stage I disease
- 33% of irregular users had stage II, III or IV cancer
- 56% of nonusers had stage II, III or IV cancer
The five-year survival rate was:
- 94% in regular users
- 88% in irregular users
- 82% in nonusers
Despite these rates, the researchers were not able to prove an increase in overall survival because women who received regular mammograms tended to be healthier in general, and therefore, were more likely to live longer.
Researchers say that physicians with patients 80 years old and older should review each woman's situation to determine if a mammogram is in her best interest. If a patient is found to have breast cancer, her treatment can be managed appropriately, taking into consideration her quality of life.
"Finding breast cancer early in this age group may not help women survive longer, and it may even increase unnecessary distress in elderly women with other ailments,” Babiera says. “However, if a mammogram finds early breast cancer in an otherwise healthy woman, maybe she could be treated with a less invasive treatment and avoid more toxic therapies used to treat advanced breast cancer."
— Adapted by Dawn Dorsey from an M. D. Anderson news release
M. D. Anderson resources:
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