Screening Mammography: There Is Value in Screening Women Aged 75 Years and Older

Abstract

Abstract Objective Patient screening mammography records performed in women aged 75 years and older were reviewed to evaluate the value of screening in this population, by determining the incidence of cancer diagnosed and associated outcomes. Methods Data from patients aged 75 years and older who presented for screening mammography and underwent biopsy with resultant malignant pathology were retrospectively collected and analyzed to record patient demographics and outcomes. Results From 2007–2017, there were 763,256 screening mammography appointments in 130,232 patients, with 3716 patients diagnosed with 4412 screen-detected malignancies (5.8 per 1000 cancers). In women aged 75 years and older, 76,885 (76,885 per 130,232, 10.1%) screening mammograms were performed in 18,497patients, with 643 malignancies diagnosed in 614 women eligible for study inclusion (8.4 per 1000 cancers). Lesions frequently presented as a mass with or without calcifications (472 per 643, 73%). A majority (529 per 643, 82%) was invasive; 79% (507 per 643) stage 0 or 1, and 63% (407 per 643) grade 2 or 3. Lymph node–positive status was confirmed in 7% of patients (46 per 614). Surgical intervention was pursued by 98% of patients (599 per 614). Conclusion Screening mammograms in women aged 75 years and older comprise a small percentage of the total screening examinations; however, they represented a significant portion of all patients diagnosed with screen-detected cancers, showing a substantial cancer detection rate. Most tumors were low stage, intermediate to high grade, and invasive. The majority had treatment involving surgery, suggesting these women are in good health and want to pursue surgical intervention. Screening mammography should be performed in this age group.