The Benefits of Screening Mammography May be Diminished in Older Women with Functional Limitations
New BCSC study suggests that along with major comorbidities and age, functional limitations should also be considered when offering breast cancer screening to older women
Prior research suggests that screening mammography is a fundamental part of early detection of breast cancer and reduces breast cancer mortality. However, there is little evidence to illustrate how outcomes after screening mammography vary by the burden of functional limitations in women aged 65 years or older.
A new study published in Cancer Epidemiology, Biomarkers & Prevention used data from 238,849 women in the Breast Cancer Surveillance Consortium—Medicare linked database (1999-2015) who had a screening mammogram at ages 66-94 years. We estimated age-adjusted cumulative incidence of invasive breast cancer, ductal carcinoma in situ (DCIS), death due to breast cancer, and death due to other causes. We defined functional limitation burden using a 16-item index reflecting pre-existing functional impairments and illnesses. We found that risk of death from causes other than breast cancer substantially increased with functional limitation burden, whereas risk of breast cancer death was low regardless of functional status. Risk of breast cancer diagnosis was low regardless of functional status, but risk decreased slightly as functional limitations increased. Based on our results, we recommend that healthcare providers consider functional limitations along with major comorbidities and age when offering breast cancer screening to older women. Our study suggests that women should be informed that the benefits of screening mammography may be diminished in women with functional limitations.
Full text citation and Link: Zhang D, Abraham L, Demb J, Miglioretti DL, Advani S, Sprague BL, Henderson LM, Onega T, Wernli KJ, Walter LC, Kerlikowske K, Schousboe JT, O'Meara ES, Braithwaite D. Function-related indicators and outcomes of screening mammography in older women: evidence from the Breast Cancer Surveillance Consortium cohort. Cancer Epidemiol Biomarkers Prev. 2021 Jun 2:cebp.0152.2021. Epub ahead of print. doi: doi.org/10.1158/1055-9965.EPI-21-0152. [Link to article]
Posted by: Dongyu Zhang