Women who don’t get mammograms most likely to die of breast cancer

A new multicenter analysis shows that most deaths from invasive breast cancer occur in women who don’t get routine mammograms. The findings, published in Cancer, point to a need to encourage routine screening in women younger than age 50.

The study included data on women diagnosed with invasive breast cancer between 1990 and 1999, with follow-up through 2007. Researchers looked at demographics, mammography use, surgical and pathology reports, and rates of recurrence and death in more than 7,000 breast cancer patients in Boston.

Analysis of the women’s medical records showed a total of 1705 deaths, 609 of which were from breast cancer and 905 of other causes. Of the 609 women who died of breast cancer, 29% had undergone screening for the disease whereas 65% had never been screened and 6% had not been screened in more than 2 years.  Mammograms were categorized as screening or diagnostic based on absence or presence of breast signs or symptoms, and substantiated by medical records from Massachusetts General or Brigham and Women’s Hospital in Boston.

Median age at breast cancer diagnosis was 49, compared with 72 in women whose deaths were caused by something other than breast cancer.

The study adds to the body of literature on mortality reduction and mammographic screening, which remains controversial. 

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