Surveillance Mammography by Life Expectancy in Older Breast Cancer Survivors

Key Points

  • In many older breast cancer survivors, annual mammography was reported by 57% of patients with a life expectancy ≤ 5 years.
  • No recent mammography was reported by 14% of patients with a life expectancy > 10 years.

In a study reported in the Journal of Clinical Oncology, Freedman et al found that many older breast cancer survivors with a limited life expectancy still undergo annual surveillance mammography despite the absence of known benefits.

Study Details

The study involved analysis of National Health Interview Study data from 2000, 2005, 2008, 2010, 2013, and 2015 to determine surveillance mammography use among women aged ≥ 65 years with a history of breast cancer. Of 1,040 patients identified, 33.7% were aged ≥ 80 years, 88.6% were white, 8.6% had an estimated life expectancy of ≤ 5 years, and 35.1% had an estimated life expectancy of ≤ 10 years.

Surveillance Rates by Life Expectancy

In total, 78.9% of patients reported routine surveillance mammography in the prior 12 months. Decreasing life expectancy was associated with a reduced likelihood of mammography (P < .001 overall; odds ratios of 0.4 and 0.4 for a life expectancy of ≤ 5 and ≤ 10 years vs a greater life expectancy in adjusted analysis). However, mammography within the prior year was still reported by 56.7% of those with a life expectancy ≤ 5 years and 65.9% of those with a life expectancy ≤ 10 years. No recent surveillance mammography was reported by 14.1% of patients with a life expectancy > 10 years.

The investigators concluded: “Many (57%) older breast cancer survivors with an estimated short life expectancy (≤ 5 years) receive annual surveillance mammography despite unknown benefits, whereas 14% with an estimated life expectancy > 10 years did not report mammography. Practice guidelines are needed to optimize and tailor follow-up care for older patients.”

The study was supported by grants from the American Cancer Society, Susan G. Komen, the National Cancer Institute, and the National Institute on Aging.

Rachel A. Freedman, MD, MPH, of the Dana-Farber Cancer Institute, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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