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Breast cancer incidence and death rates increase with age, with more than 50 percent of all breast cancers diagnosed in women 65 years of age and older. Unfortunately, elderly women are less inclined to get mammograms than younger women. Mammograms increase early detection of breast cancer, and they are associated with an increased likelihood that women will receive breast-conserving surgery (BCS) and radiation instead of mastectomy.
In a recent study supported in part by the Agency for Healthcare Research and Quality (HS08395), Jeanne S. Mandelblatt, M.D., of Georgetown University, and her colleagues analyzed data on 718 elderly breast cancer patients newly diagnosed with Stage I and II disease (cancer is still localized) at 29 hospitals in 5 U.S. regions to examine the impact of mammography screening on treatment.
Mammography resulted in detection of earlier stage breast cancer. For example, 96 percent of women with cancer diagnosed via mammogram had Stage I lesions compared with 81 percent of women diagnosed by other means. Women who had lesions detected through mammography were more likely to have ductal cancer (cancer involving the milk ducts) and to be referred to radiation oncologists than women diagnosed by other means. Even after controlling for cancer stage and histology, screening remained associated with a higher likelihood of receiving BCS with radiation than other local therapies.
Possible explanations for the relationship between mammography and breast cancer treatment include differences in patient behavior and/or variability in physician response to management of different tumor types, note the researchers. They conclude that further research is needed to fully understand the mechanisms by which mammography screening affects breast cancer treatment options above and beyond finding cancer at an earlier stage of development.
See "Screening mammography and breast cancer treatment patterns in older women," by Jon F. Kerner, Ph.D., Dr. Mandelblatt, Rebecca A. Silliman, M.D., M.P.H., Ph.D., and others, in Breast Cancer Research and Treatment 69(1), pp. 81-91, 2001.
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