More Mammograms for Seniors?

Breast cancer more advanced and deadly in women over age 75 who have infrequent mammograms

April 7, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Mammograms to screen for breast cancer are no longer recommended for women over the age of 75. But there is new research suggesting that could be risky guidance.

If it's been five or more years since her last mammogram, a woman over the age of 75 may be more likely to be diagnosed with advanced breast cancer, according to a recent study.

This same woman also may be three times more likely to die from the disease than a woman who was diagnosed within six months to a year of her last mammogram.

As a result of these findings, authors of this study are suggesting that women over the age of 75 may need to continue to get mammograms every year or two.

"Ask an oncologist about mammography frequency."

Michael S. Simon, MD, MPH, leader of the breast multidisciplinary team at Barbara Ann Karmanos Cancer Institute in Detroit, Michigan and professor of internal medicine and oncology at Wayne State University School of Medicine, led the study.

“We found that for women age 75 and older, a longer time interval between the last mammogram and the date of breast cancer diagnosis was associated with a greater chance for dying from breast cancer,” Dr. Simon said.

In 2009, the US Preventive Services Task Force (USPSTF) recommended against mammograms for women over the age of 75. The rationale was that cancers found in women in this age range tended to be more slow growing and may never cause a problem.

To revisit this question, Dr. Simon and colleagues scrutinized data from 8,663 Women’s Health Initiative study participants who had been diagnosed with breast cancer during 12 years of follow-up.

Women who had never had a mammogram or had not had one in five or more years had a 300 percent greater risk of dying from breast cancer than women who had been screened within a year of diagnosis.

These findings did not apply to younger women between the ages of 50 and 74, the study found.

“It should be no surprise that delaying the time between screens can result in worse outcomes as was found in this study, even among older women,” Daniel B. Kopans, MD, professor of radiology at Harvard Medical School and senior radiologist in the Breast Imaging Division of Massachusetts General Hospital, told dailyRx News.

“Cancer does not sit around and wait for us to find it. Suggestions that lengthening the time between screens is not detrimental should be questioned. The death rate from breast cancer has declined in the United States in direct relationship to the start of screening."

"Therapy has improved, but therapy saves lives when cancers are found earlier,” Dr. Kopans said.

He added, “Among the Harvard Medical School Teaching Hospitals, approximately 70 percent of breast cancer deaths were among the 25 percent of women not having mammograms.”

Dr. Simon said, “Our findings suggest that regular mammography should be continued for older women every one or two years; however, as with younger women, mammography screening should be considered in light of the overall health of the individual woman.”

Results from this study were presented at the American Association for Cancer Research (AACR) Annual Meeting 2013. All research is considered preliminary before it is published in a peer-reviewed journal.