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.”