Mammograms Not Necessary in Older Women With Chronic Comorbidities

A study published in the Journal of the National Cancer Institute found that mammograms do not provide a benefit for women aged 75 and older with chronic health conditions (such as diabetes or heart disease) that are likely to result in death prior to cancer.

Researchers assessed data from the Medicare-linked Breast Cancer Surveillance Consortium on 222,088 women who had at least one screening mammogram between 1999 and 2010 when they were aged 66 to 94 years. Most women were followed for nine or more years.

Death from other causes significantly higher

During the study, 7,583 women (~3%) were diagnosed with invasive breast cancer and 1,742 (<1%) were diagnosed with ductal carcinoma in situ. A total of 471 women died from breast cancer during the study, while 42,229 died from other causes—making these women 90 times more likely to die from other causes rather than breast cancer. Women aged 75 to 84 years were 123 times more likely to die of causes other than breast cancer.

The 10-year cumulative incidence of invasive breast cancer did not change with increasing Charlson Comorbidity Index (CCI), but it decreased slightly with age. The 10-year cumulative incidence of other cause death increased with increasing CCI and age.

“This is a big deal because, while younger women might have a more justifiable reason to undergo screening mammograms to detect breast cancer because their risk of dying from other causes is relatively low, this is not the case in older women, particularly those with one or more chronic illnesses,” senior author Dejana Braithwaite, PhD, of the Lombardi Comprehensive Cancer Center at Georgetown University in Washington, D.C., told Reuters.

“Older women with increased comorbidity may experience diminished benefit from continued screening,” the authors concluded.