BREAST-CANCER IN WOMEN 65-74 YEARS OLD - EARLIER DETECTION BY MAMMOGRAPHIC SCREENING

OBJECTIVE. Our objective was to investigate the value of screening mam mography in 65- to 74-year-old women by determining differences in var ious prognostic indicators in screened and nonscreened groups. MATERIA LS AND METHODS. We reviewed 103 malignant breast tumors detected in 10 2 women 65-74 years old over a period of 73 consecutive months (Februa ry 1988-March 1994). A screening interval of less than 18 months was c hosen to separate the screened from the nonscreened populations. Mammo graphic, histologic, and clinical features were reviewed. Statisticall y significant differences were calculated using Fisher's exact test an d Wilcoxon's rank sum test. RESULTS. Thirty-two patients were in the s creened population; 70 patients were in the nonscreened population. Ni nety-nine percent (102/103) of the carcinomas were apparent mammograph ically. We found significant differences between the screened and the nonscreened groups with respect to the size of lesions revealed by mam mography (11 mm versus 21 mm; p =.0002) and the incidence of minimal t umors (20/32 (63%) versus 26/70 (37%), p =.0198). The incidence of lym ph node metastases was 3/27 (11%) for the screened group versus 14/47 (30%) for the nonscreened group (p =.0875). The overall positive predi ctive value of mammography for the 65- to 75-year-old patients was hig her than in our general population, 47% versus 28%. CONCLUSION. Screen ing mammography revealed significantly smaller and earlier stage tumor s in 65- to 74-year-old women. This finding inferentially supports the efficacy of screening in this age population.