title: Regular mammography use is associated with elimination of age-related disparities in size and stage of breast cancer at diagnosis.
abstract: BACKGROUND
  There is little consensus about recommending mammography for women 75 years of age and older. These women have mammography less frequently and are more likely to receive a diagnosis of advanced breast cancer.
  
  
  OBJECTIVE
  To examine the relationship between use of screening mammography and size and stage of cancer at diagnosis in older women.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tumor registries in the Surveillance, Epidemiology, and End Results (SEER) program.
  
  
  METHODS
  12 038 women who were Medicare beneficiaries, were at least 69 years of age, resided in a SEER area, and received a new diagnosis of breast cancer in 1995 through 1996.
  
  
  METHODS
  Screening mammograms obtained in the 2 years before breast cancer diagnosis (none, one, or at least two) and stage and size of tumor at diagnosis.
  
  
  RESULTS
  Older women (> or =75 years of age) had larger tumors at diagnosis and were less likely to have undergone screening mammography than younger women (69 to 74 years of age). The association between increased mammography use and smaller tumor size and stage was significantly greater in older women than in younger women (P = 0.010 for stage; P = 0.001 for size). The percentage of regular mammography users who received a diagnosis of high-stage disease (28% vs. 26%; P > 0.2) and the mean size of the tumors (15.0 mm vs. 15.1 mm; P > 0.2) did not significantly differ between younger and older women, respectively. These findings remained constant after controlling for factors that might contribute to biases.
  
  
  CONCLUSIONS
  Mammography in older women is associated with elimination of age-related disparities in size and stage of breast cancer at diagnosis.
authors.affiliation: University of Texas Medical Branch, Galveston, Texas 77555-0460, USA.
authors.forename: Whitney M
authors.initials: WM
authors.lastname: Randolph
authors.forename: James S
authors.initials: JS
authors.lastname: Goodwin
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Mahnken
authors.forename: Jean L
authors.initials: JL
authors.lastname: Freeman
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States / Q000453:epidemiology