The utility of control mammograms performed prior to breast cancer diagnosis at ages over 70

What did the researchers want to find out?

A team of researchers wanted to understand if regular mammograms (X-rays of the breasts) help older women (over 70) who are diagnosed with a specific type of breast cancer. Specifically, they wanted to see if mammograms performed before being diagnosed with cancer have any effect on the stage at which the cancer is discovered and on the risk of death from this disease.

 

Who participated in the study?

The study analyzed data from over 13,000 women, all aged 70 or older. These women were diagnosed with a specific type of breast cancer (hormone receptor-positive and HER2-negative) between 2010 and 2017. All participants had medical insurance through the Medicare program (a US health insurance program) for at least five years before diagnosis and one year after.

 

What information did the researchers analyze?

Previous mammograms: The researchers checked how many screening mammograms each woman had done in the years before the cancer diagnosis.

• Approximately 3 out of 4 women (77.5%) had undergone at least one mammogram before.
• Just under one-third (31%) had undergone two mammograms.
• Nearly half (45.6%) had undergone three or four mammograms.
• Just over 1 in 5 women (22.5%) had not undergone any mammogram before diagnosis.

Cancer stage at diagnosis: They analyzed how advanced the cancer was at the time of discovery. This was classified as:

• Very early stage: The cancer was small and had not spread to the lymph nodes.
• Later stage (more advanced): The cancer was larger or had spread to the lymph nodes.

Deaths caused by breast cancer: They tracked how many women died from breast cancer.

 

What did the researchers discover?

Discovering cancer at a less advanced stage:

• Most women (approximately 7 out of 10) were diagnosed at a very early stage.
• Women who had undergone mammograms before diagnosis were much less likely to be diagnosed with advanced-stage disease. Specifically, only 1 in 4 women with previous mammograms was diagnosed at an advanced stage, compared to nearly half (over 4 out of 10) of women who had not undergone mammograms.
• Statistically, women with previous mammograms had a 54% lower risk of being diagnosed with a more advanced stage of cancer.

Risk of death from breast cancer:

• Overall, a small number of women in the study (approximately 4.4%) died from breast cancer.
• However, the difference was significant between the two groups: approximately 8% of women without previous mammograms died from cancer, compared to only 3.3% of women who had undergone mammograms.
• Undergoing mammograms before diagnosis was linked to a significant reduction in the risk of death from breast cancer (risk reduced by approximately one-third).
• Furthermore, women who had undergone three or four mammograms before had an even lower risk of death compared to those who had undergone only one mammogram.
• Age also mattered: women aged 85 and older had a higher risk of death from breast cancer than those aged between 70 and 74.

 

What do these findings mean for you?

The researchers concluded that regular screening mammograms can help improve the health outcomes of older women who develop breast cancer. This is because mammograms can help detect cancer at an earlier stage, when it is easier to treat and the chances of recovery are higher. The study highlights the importance of doctors considering a patient’s mammography history when evaluating the risks and benefits of continuing screening at older ages.

 

Are there also limitations to the study?

Yes, like any study, this one also has some limitations. For example:

• It is possible that some mammograms may not have been recorded correctly.
• The study did not consider certain factors that could influence the risk of breast cancer or treatment outcomes, such as breast density or family history of breast cancer.

Even with these limitations, the study provides important information suggesting that regular mammograms can be beneficial for older women. It is important to discuss your personal health history and the appropriate screening recommendations for you with your doctor.

Source Medscape