News
Mammograms may benefit women well into their 80s, study finds
Women in their 80s who had regular mammograms showed a 74 per cent lower risk of dying from breast cancer compared with those who did not undergo screening in a recent study.
The study also found screened women had a 55 per cent lower risk of recurrence, were more likely to be diagnosed at an earlier stage and often required less aggressive treatment.
Most guidelines recommend screening up to age 74, but advice for women older than this has been unclear, leaving both patients and doctors uncertain about whether to continue.
Researchers at UCLA Health Jonsson Comprehensive Cancer Center reviewed medical records from 174 women aged 80 and above who were diagnosed with breast cancer between 2013 and 2020.
Of these, 98 had a mammogram within two years before diagnosis and 76 did not.
After a median follow-up of 55 months, outcomes including stage at diagnosis, treatment intensity and survival were compared.
Women without screening were more likely to have advanced, high-grade tumours noticeable by touch.
Screened women more often had surgery to remove the tumour, while some unscreened patients did not undergo surgery.
Most cancers were oestrogen receptor-positive (growing in response to oestrogen) and HER2-negative (lacking high levels of the HER2 protein), and were mainly stage 1 or 2.
Dr Nimmi Kapoor, associate professor of surgery at the David Geffen School of Medicine at UCLA, senior author and investigator at the UCLA Health Jonsson Comprehensive Cancer Center, said early detection can mean less invasive treatment.
“When cancer is found on screening, it is often early stage.
“In postmenopausal women with the most common hormone-sensitive breast cancers, we can often omit sentinel lymph node biopsy, chemotherapy, and sometimes even radiation.
“Screening is especially important in this era of de-escalation because early detection allows us to safely reduce the intensity of treatment while still achieving excellent outcomes.”
Sentinel lymph node biopsy is a procedure testing nearby lymph nodes to see if cancer has spread.
The survival benefit remained after accounting for age, tumour type and whether patients had surgery.
Kapoor said: “We were surprised to see such a significant survival difference among these women in their 80s.
“Our findings underscore the importance of encouraging breast cancer screening in elderly patients, regardless of age, unless they have more pressing health issues.
“Current guidelines are vague and often left to the provider’s discretion, so studies like ours help provide much-needed data for this underrepresented population.”
Diagnosis
Lung cancer drug shows breast cancer potential
Ovarian cancer cells quickly activate survival responses after PARP inhibitor treatment, and a lung cancer drug could help block this, research suggests.
PARP inhibitors are a common treatment for ovarian cancer, particularly in tumours with faulty DNA repair. They stop cancer cells fixing DNA damage, which leads to cell death, but many tumours later stop responding.
Researchers identified a way cancer cells may survive PARP inhibitor treatment from the outset, pointing to a potential way to block that response. A Mayo Clinic team found ovarian cancer cells rapidly switch on a pro-survival programme after exposure to PARP inhibitors. A key driver is FRA1, a transcription factor (a protein that turns genes on and off) that helps cancer cells adapt and avoid death.
The team then tested whether brigatinib, a drug approved for certain lung cancers, could block this response and boost the effect of PARP inhibitors. Brigatinib was chosen because it inhibits multiple signalling pathways involved in cancer cell survival.
In laboratory studies, combining brigatinib with a PARP inhibitor was more effective than either treatment alone. Notably, the effect was seen in cancer cells but not normal cells, suggesting a more targeted approach.
Brigatinib also appeared to act in an unexpected way. Rather than working through the usual DNA repair routes, it shut down two signalling molecules, FAK and EPHA2, that aggressive ovarian cancer cells rely on. FAK and EPHA2 are proteins that relay survival signals inside cells. Blocking both at once weakened the cells’ ability to adapt and resist treatment, making them more vulnerable to PARP inhibitors.
Tumours with higher levels of FAK and EPHA2 responded better to the drug combination. Other data link high levels of these molecules to more aggressive disease, pointing to potential benefit in harder-to-treat cases.
Arun Kanakkanthara, an oncology investigator at Mayo Clinic and a senior author of the study, said: “This work shows that drug resistance does not always emerge slowly over time; cancer cells can activate survival programmes very early after treatment begins.”
John Weroha, a medical oncologist at Mayo Clinic and a senior author of the study, said: “From a clinical perspective, resistance remains one of the biggest challenges in treating ovarian cancer. By combining mechanistic insights from Dr Kanakkanthara’s laboratory with my clinical experience, this preclinical work supports the strategy of targeting resistance early, before it has a chance to take hold. This strategy could improve patient outcomes.”
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