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