ASBrS 2018: Regular Mammograms May Mean Earlier Breast Cancer Diagnosis and Less Aggressive Treatment

Key Points

  • Patients who had a mammogram within 24 months of diagnosis had smaller tumors and were less likely to have been treated with mastectomy, chemotherapy, and axillary node dissection than those who did not.
  • Those who did not undergo regular screening were 51% more likely to be treated with chemotherapy, 32% more likely to undergo mastectomy, and 66% more likely to have axillary node dissection.

 

Women with breast cancer who underwent regular mammographic screening were diagnosed with earlier-stage disease and treated with significantly less aggressive therapies than those who delayed or never underwent screening, according to new research presented at the American Society of Breast Surgeons (ASBrS) 19th Annual Meeting (Abstract 403820). 

Study Findings

A study of more than 1,000 patients with breast cancer found that those who had a mammogram within 24 months of diagnosis had smaller tumors and were less likely to have been treated with mastectomy, chemotherapy, and axillary node dissection than those who did not.

When stratified by age, patients 40 to 49 years old who never had a mammogram presented with later-stage disease and required more involved treatments. This is significant because recently the age at which to begin screening for breast cancer has become a focus of controversy. Under current American Cancer Society and U.S. Preventive Services Task Force guidelines, mammography is now classified as optional for segments of this age group.

“This study is notable because research on the impact of screening mammography typically focuses on its relationship to breast cancer mortality, not tumor stage and the therapies required,” said researcher Elisa Port, MD, FACS, Chief of Breast Surgery at Mount Sinai Hospital and Director of the Dubin Breast Center. “While regular mammograms unquestionably have been demonstrated to reduce mortality, this study shows that they also are associated with less complex treatment regimens with less risk of undesirable side effects that can diminish a survivor’s ongoing quality of life.”

Dr. Port noted, for example, that more extensive surgery to lymph nodes under the arm may cause lifelong lymphedema, and that the long-term side effects of chemotherapy can include bone loss, heart problems, and risk of other cancers. “With earlier diagnosis, patients may decrease their likelihood of needing these treatments and their associated risks. In addition, more extensive therapies add significantly to costs to the health-care system.”

In the study, researchers examined 1,125 patients diagnosed with cancer between 2008 and 2016 who had background information on their recent mammographic screening. Patients were divided into two groups: those who had undergone mammography within 24 months of diagnosis (73%), and those who had delayed screening for 25 months or more (21%) or had never had a mammogram (6%). Those who did not undergo regular screening were 51% more likely to be treated with chemotherapy, 32% more likely to undergo mastectomy, and 66% more likely to have axillary node dissection.

Women age 40 to 49 who never had a mammogram were more than 2.5 times more likely to require chemotherapy and to undergo mastectomy as well as 3.5 times more likely to have cancer that had spread to the lymph nodes, compared to those screened within 24 months. They also were characterized by larger tumor size (mean 23 mm vs 13 mm). These results were seen to varying degrees within other age groups.

“Today, as more advanced breast cancer therapies continue to increase survivorship, preserving quality-of-life is more important than ever before,” commented Dr. Port.  “However, during the past decade, compliance with screening guidelines has plateaued…and newer guidelines have even moved away from recommending yearly mammograms, especially in certain age groups. This study clearly demonstrates the benefits of regular mammograms. No…patient wants to undergo unnecessarily complex treatment and risk post-therapy complications. A simple exam can help women take better control of their future health.” 

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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