Although guidelines keep changing regarding screening mammography in elderly patients, those older than 70 years old continue to benefit from this exam, showing that with frequent mammograms breast cancers can be found sooner, according to a recent study conducted by researchers at Jacobi Medical Center and Albert Einstein College of Medicine, in Bronx, NY.
Our initial interest was sparked by the changing mammographic guidelines in the elderly age group and the differences in the guidelines between organizations including the American Cancer Society and American College of Radiology, said Jason Salsamendi, MD, lead author of the study. We also noticed that we were performing a significant number of screening mammograms in elderly patients at our institution and became curious about the incidence of occult breast cancer in this age group, he said.
The study consisted of the review of 24 cases of breast cancer in 22 elderly patients age 70-89.
The researchers evaluated the mammograms for masses and calcifications and correlated the results to surgically proven histology, lymph node involvement and initial surgical management.
According to the study, 19 of the 24 cases of breast malignancy were initially identified on screening mammography. The study showed that mammographic findings in these 19 cases included 12 masses, 4 suspicious calcifications and 3 masses with calcifications. Of these, surgical management was available in 18 cases with 15 being treated by lumpectomy and 3 being treated with mastectomy. The study also showed that the average time interval from most recent prior mammogram to diagnosis was 2.6 years.
During our study, we found that five patients never had a prior mammogram. Their breast cancer was detected on a baseline study. These five patients included three cases of infiltrating ductal carcinoma, said Dr. Salsamendi. Perhaps with more frequent mammographic screening, more breast cancers can be found earlier, at a noninvasive stage. This would result in a less extensive surgical procedure and improve prognosis. Our results encourage clinicians to continue to order screening mammography in elderly patients at yearly intervals, he said.
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