Regular mammograms in women over the age of 75 should be considered, new research suggests.

According to US scientists, the use of mammography in older women has been hotly debated in recent years, with some insisting that it does not increase the detection of breast cancer cases in this age group and others insisting that it should be recommended for healthy women.

Currently in Ireland, only women aged between 50 and 64 are offered free mammograms through BreastCheck, the National Breast Screening Programme.

As a result of the lack of research in this area, the scientists decided to look into it further. They studied data relating to over 14,000 breast cancer cases, including 1,600 patients over the age of 75.

"There are no studies on women aged 75 and older, despite the fact that they are at the highest risk for breast cancer. Breast cancer survival in younger women has improved dramatically over the last 20 years, but that improvement has not been seen in older women," commented Dr Judith Malmgren of the University of Washington in Seattle.

The study found that overall, most mammography-detected cases of breast cancer were early stage. Doctor or patient-detected cancers tended to be in the advanced stage.

It also found that cancers detected by mammogram were more likely to be treated with a lumpectomy and radiation than doctor or patient-detected cases. Doctor and patient-detected cases tended to require more chemotherapy and mastectomies.

Meanwhile, with mammography, the five-year invasive cancer survival rate after five years was 97%, compared with 87% for doctor or patient-detected invasive cancers.

"Mammography enables detection when breast cancer is at an early stage and is easier to treat with more tolerable options. In this study, older women with mammography-detected invasive cancer had a 10% reduction in breast cancer disease-specific mortality after five years," Dr Malmgren noted.

She insisted that early detection of breast cancer is especially important in older women because it is harder for them to tolerate the chemotherapy that is used to treat advanced breast cancer.

While she acknowledged that the potential costs of mammography, such as those linked with false-positive results, must be taken into account, she pointed out that false-positive results are less commonly found in older women.
"It's easy to detect a cancer earlier in older women because breast density is not an issue. And mammography is not expensive, so doing it every other year would not add a lot of cost to healthcare," Dr Malmgren added.

Details of these findings are published in the journal, Radiology.