title: Mammography interval and breast cancer mortality in women over the age of 75.
abstract: The purpose of this study is to evaluate the relationship between mammography interval and breast cancer mortality among older women with breast cancer. The study population included 1,914 women diagnosed with invasive breast cancer at age 75 or later during their participation in the Women's health initiative, with an average follow-up of 4.4 years (3.1 SD). Cause of death was based on medical record review. Mammography interval was defined as the time between the last self-reported mammogram 7 or more months prior to diagnosis, and the date of diagnosis. Multivariable adjusted hazard ratios (HR) and 95 % confidence intervals (CIs) for breast cancer mortality and all-cause mortality were computed from Cox proportional hazards analyses. Prior mammograms were reported by 73.0 % of women from 7 months to ≤2 year of diagnosis (referent group), 19.4 % (>2 to <5 years), and 7.5 % (≥5 years or no prior mammogram). Women with the longest versus shortest intervals had more poorly differentiated (28.5 % vs. 22.7 %), advanced stage (25.7 % vs. 22.9 %), and estrogen receptor negative tumors (20.9 % vs. 13.1 %). Compared to the referent group, women with intervals of >2 to <5 years or ≥5 years had an increased risk of breast cancer mortality (HR 1.62, 95 % CI 1.03-2.54) and (HR 2.80, 95 % CI 1.57-5.00), respectively, p trend = 0.0002. There was no significant relationship between mammography interval and other causes of death. These results suggest a continued role for screening mammography among women 75 years of age and older.
authors.affiliation: Department of Oncology, Karmanos Cancer Institute, Wayne State University, 4100 John R HW4HO, Detroit, MI, 48201, USA, simonm@karmanos.org.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Simon
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Thomson
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Ray
authors.forename: F Allan
authors.initials: FA
authors.lastname: Hubbell
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lessin
authors.forename: Dorothy S
authors.initials: DS
authors.lastname: Lane
authors.forename: Lew H
authors.initials: LH
authors.lastname: Kuller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D016016:Proportional Hazards Models; D013997:Time Factors