A new study published in the journal Annals of Internal Medicine offers strong if indirect evidence for recommending routine mammography screening to women over age 75.
Researchers at the University of Texas Medical Branch at Galveston (UTMB) examined data on 12,038 female Medicare beneficiaries who were at least 69 years old and had received a new diagnosis of breast cancer between 1995 and 1996.
According to the researchers' analysis, American women 75 years of age and older tend to have fewer mammograms-special X-rays of the breast that can detect breast cancer before lumps are felt-and more breast cancers that are larger and at a more advanced stage at time of diagnosis than do women in the younger group, ages 69-74.
But when the researchers adjusted for the number of screening mammograms the women had in the two years before diagnosis, they found that those older women who had two or more mammograms at least 11 months apart had cancers similar in size and stage to those in the younger group, suggesting a benefit of mammography in women after age 75.
"We know that one major factor contributing to the poor survival of older women with breast cancer is delay in diagnosis," said one author of the study, Dr. James S. Goodwin, professor of geriatric medicine and director of the Sealy Center on Aging at UTMB. "These results suggest that regular screening mammography in women 75 years of age and older helps diagnose breast cancer when it is smaller and at an earlier stage."
Goodwin stressed that he and his fellow authors-Whitney M. Randolph, Jonathan D. Mahnken and Jean L. Freeman-found that regular mammography actually seemed to have a bigger effect on women over age 75 than it did in younger women. That is, in women over age 75 who failed to receive regular mammograms, the average size of the diagnosed cancer was greater than it was in younger women who did not receive mammograms regularly.
SOURCES:
Annals of Internal Medicine, November 19, 2002
University of Texas Medical Branch at Galveston (http://www.utmb.edu)
