Breast cancer: are mammograms beneficial after age 75 years?

  • J Natl Cancer Inst

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A large U.S.-based cohort study finds that breast cancer incidence decreases after age 75 years.
  • Cumulative incidence of death from other causes is far greater than that from breast cancer.

Why this matters

  • Findings suggest that older women with higher comorbidity scores may have little benefit from continued screening mammography.

Study design

  • 222,088 women aged 66-94 years in the Medicare-linked Breast Cancer Surveillance Consortium with ≥1 screening mammogram.
  • Funding: None disclosed.

Key results

  • Over a median of 107 months, 7583 were diagnosed with invasive breast cancer and 1742 with ductal carcinoma in situ.
  • 471 died from breast cancer, whereas 42,229 died from other causes.
  • 10-year cumulative breast cancer incidence decreased after age 75 years:
    • Age 66-74 years: 4.0% (95% CI, 3.9%-4.1%).
    • Age 75-84 years: 3.6% (95% CI, 3.5%-3.8%).
    • Age 86-94 years: 2.7% (95% CI, 2.4%-3.0%).
  • 10-year cumulative incidence of breast cancer death was very small and did not vary by age:
    • Age 66-74 years: 0.2% (95% CI, 0.2%-0.3%).
    • Age 75-84 years: 0.29% (95% CI, 0.25%-0.34%).
    • Age 86-94 years: 0.3% (95% CI, 0.2%-0.4%).
  • 10-year cumulative incidence of other causes of death increases from 10.4% to 84.8%, depending on comorbidities and age, far in excess of likelihood of death from breast cancer.

Limitations

  • May not be nationally representative.