Mammography benefits may have no age limit
NEW YORK (Reuters Health) - Women aged 80 and older who have regular mammograms significantly reduce their chances of being diagnosed with late-stage breast cancer, according to a new study. Yet only about 20 percent of women in this age group get mammograms regularly.
"This study suggests that mammography benefits may have no age limit and that women should consider being screened on a regular basis, even into their 80s and possibly 90s, depending on their current health status," study chief Dr. Brian D. Badgwell, MD, of the University of Texas M.D. Anderson Cancer Center said in a written statement.
"Mammography has been shown to be an excellent means of detecting breast cancer early, when it is most likely to be cured," he added. "We found that when breast cancer was diagnosed, it was more likely to be found at an early stage when a woman had at least three mammograms in the five-year period before diagnosis."
The American Cancer Society recommends annual mammograms beginning at age 40, with no upper age limit for women in good health. However, research has shown that women are less likely to get regular mammograms as they age.
Badgwell and colleagues examined mammography use in the five-year period before breast cancer was diagnosed in 12,358 women age 80 and older.
They found that only 22 percent of women were regular users of mammography, which they defined as having had three or more mammograms during the five-year study period. Twenty-nine percent were irregular users -- defined as having had one or two mammograms during the study -- and 49 percent of the women had no mammograms in the five years before their diagnosis.
Regular users were more likely to be diagnosed with early or "stage I" breast cancer, while stage II to IV breast cancers were more commonly found among the nonusers and irregular users.
Specifically, 68 percent of regular users were found to have stage I breast cancer, compared with 56 percent of irregular users and 33 percent of nonusers. On the other hand, only 32 percent of regular users had stage II-IV breast tumors, compared with 44 percent of irregular users and 67 percent of nonusers.
Ninety-four percent of women who got regular mammograms were alive at five years compared with 88 percent of irregular users and 82 percent of nonusers.
However, in their report in the Journal of Clinical Oncology, Badgwell and colleagues cautioned against linking mammography use to better survival, because survival from diseases other than breast cancer was also better among women who had regular mammography compared with irregular users and nonusers. This suggests, the researchers say, that women who got regular mammograms may be in a better state of health compared with women who don't get regular mammography.
It is estimated that about 17 percent of all breast cancer cases in the United States are found in women aged 80 and older. Badgwell and colleagues urge elderly women, particularly those in reasonably good health, and their health care providers to discuss the benefits of mammography.
SOURCE: Journal of Clinical Oncology, online April 21, 2008.
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What breastcancer.org says about this article…
Mammography benefits may have no age limit
Screening mammograms are one of the best ways to diagnose breast cancer early, when it's most treatable. The large study reviewed here confirmed the benefits of regular mammograms. This study also emphasized that there is no upper age limit for mammograms.
More than 12,000 women age 80 or older participated in this study. Of the women diagnosed with breast cancer, those who had regular mammograms (at least three mammograms in the 5 years before being diagnosed) were more likely to be diagnosed with early-stage disease. Women who did not have regular mammograms (zero, one or two mammograms in the 5 years before diagnosis) were more likely to be diagnosed with later-stage disease.
- 68% of women who had regular mammograms were diagnosed with stage I breast cancer
- 56% of women who got mammograms irregularly and 33% of women who DIDN'T get mammograms were diagnosed with stage I disease
- 32% of women who had regular mammograms were diagnosed with stage II, III or IV breast cancer
- 44% of women who got mammograms irregularly and 67% of women who DIDN'T get mammograms were diagnosed with stage II, III or IV disease
Women older than 80 who got regular mammograms also were more likely to be living 5 years after being diagnosed compared to women who didn't get regular mammograms.
Despite the benefits of regular mammograms for women age 80 and older, the researchers found that only about 20% of these women actually got regular mammograms. These results agree with other research showing that women are less likely to get annual mammograms as they age.
There probably are many reasons why older women get fewer mammograms:
- An overall decline in health, as well as other medical problems that may seem more serious. This may make it harder for older women to schedule and get to a mammogram facility. It also may make mammograms seem less important. The researchers found that women over 80 who didn't get regular mammograms were more likely to die from causes other than breast cancer than women who got regular mammograms. This suggests that those who didn't get mammograms may have had other serious medical problems.
- Decreased mobility. Transportation problems or physical limitations may make it hard to get to and from a mammogram center.
- Real or perceived financial barriers. For women on a fixed income, the cost of transportation and parking can make it hard to get regular mammograms.
- A lack of knowledge. Women over 80 may think that if they haven't been diagnosed with breast cancer yet they probably won't be. This is not true. Almost 20% of all breast cancer diagnoses in the United States are in women over 80.
- A loss of hope. Women over 80 may believe they only have a few years left to live, so detecting breast cancer early won't mean much for them. Other women might think that they wouldn't want to have treatment at their age or that treatment wouldn't work, so see no need to be screened for breast cancer.
If you (or someone you love) are age 80 or older and haven't been getting regular mammograms, you might want to think about why. Some of the obstacles may be valid, but many of them can overcome with help. Remember:
- Breast cancer can and does happen in older women.
- Breast cancer can be treated effectively in older women.
- No matter how old you are, mammograms, along with breast self-exams and exams by a doctor, can diagnose breast cancer early, when it's most treatable.
- Age shouldn't be why you don't do all that you can to stay as healthy as possible.
If you're having problems getting regular mammograms, talk to your doctor or another member of your healthcare team to see how you can get back on track. There's only one of you and you deserve the best care possible for your entire life.