Women aged 80 years and older who underwent screening mammography had improved overall survival, with an unadjusted hazard ratio of 0.275 and an adjusted hazard ratio of 0.417 compared with unscreened patients, according to a recent study.
Researchers conducted a retrospective cohort study to evaluate the association between screening mammography and breast cancer outcomes in women aged 80 years and older. The study, published in Annals of Surgical Oncology, analyzed patients diagnosed with breast cancer between 2013 and 2020. Women were included if they were 80 years of age or older at diagnosis, with exclusions for prior breast cancer or incomplete clinical data. Screening was defined as undergoing mammography within 2 years before diagnosis.
A total of 174 patients met eligibility criteria, with 98 (56.3%) in the screened cohort and 76 (43.7%) in the unscreened cohort. The median age was 83 years. The cohort was majority White (70%) and not Hispanic or Latino (89%), which may limit generalizability of the findings. Demographic variables, comorbidities, and tumor receptor subtype distribution were similar between groups. However, unscreened women were significantly more likely to present with symptomatic disease (88% vs. 34%), palpable tumors (79% vs. 25%), larger tumor size (median 3.1 cm vs. 1.7 cm), higher grade, and more advanced stage. Screened patients were more frequently diagnosed with ductal carcinoma in situ.
Treatment patterns also differed. Breast-conserving surgery was performed more often in the screened group (82.4% vs. 60.6%), while unscreened patients more often underwent mastectomy or no surgery (38.8% vs 17.6%). Radiation therapy was delivered to 43% of screened patients compared with 20% of unscreened patients.
With a median follow-up of 55 months, there were 29 recurrences (16.7%) and 36 deaths (20.7%). Kaplan–Meier analysis demonstrated improved disease-free survival in the screened cohort (hazard ratio [HR], 0.439) as well as overall survival (HR, 0.275). After adjustment for age, invasive tumor subtype, and surgery, these associations remained significant, with adjusted HRs of 0.376 for disease-free survival and 0.417 for overall survival.
“Breast cancer patients diagnosed at ≥ 80 years of age who received screening mammography presented with earlier-stage disease and had improved DFS and OS compared with the unscreened cohort,” concluded the lead researcher Siu-Yuan Huang, MD, of the Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles, California, and colleagues.
Full disclosures can be found in the published study.
Source: Annals of Surgical Oncology
