An important study published in JAMA Network Open explores the implications of mammography screening for women aged 75 and older. Conducted by researchers at the Yale School of Public Health (YSPH), this research provides evidence supporting the continuation of regular mammograms in this age group, revealing potential benefits that may save lives.

Understanding the Context of Mammography

For women aged 40 to 74, the recommendation for breast cancer screening is clear: regular mammograms should be conducted annually or biennially. These screenings are crucial since they significantly decrease the chances of late-stage breast cancer and improve survival rates. However, guidelines regarding screening for women aged 75 and older have been less definitive, prompting concerns regarding overdiagnosis versus the benefits of early detection.

Key Findings from the Study

The researchers analyzed data from over 13,000 women aged 70 and older who were diagnosed with breast cancer. The study revealed that women who had undergone regular mammograms prior to their diagnosis exhibited:

  • Earlier-stage diagnoses: Regular screenings were associated with the detection of cancer at earlier stages.
  • Improved survival rates: Women who continued to receive regular mammograms had better outcomes, including reduced mortality rates.

According to Sida (Stark) Huang, the lead author and a second-year MPH candidate at YSPH, "Our findings suggest that continued screening could yield significant benefits for older women." This sentiment is echoed by Dr. Michaela Dinan, co-leader of the Cancer Prevention and Control Research Program, emphasizing that regular screening may augment the detection of disease at more treatable stages.

Mammography and Overdiagnosis Concerns

Despite the promising findings, the study raises important concerns regarding the risk of overdiagnosis. Overdiagnosis can lead to unnecessary interventions, including biopsies, which may cause complications such as:

  • Infections: Due to surgical procedures following biopsies.
  • Emotional distress: Resulting from false alarms associated with overdiagnosis.
  • Ignoring other health issues: Some breast cancers in older women may be indolent or overshadowed by concurrent health problems, like cardiovascular diseases.

Statistical Insights

The data indicates that about one-third of the women studied were diagnosed with later-stage breast cancer. Notably, approximately three-quarters had undergone a mammogram in the five years preceding their diagnosis. The relationship between prior screening and health outcomes is compelling:

Aspect Outcome Statistical Advantage
Higher screening frequency Reduced odds of late-stage diagnosis By approximately 50%
Prior mammogram history Lower risk of death from breast cancer By about 33%
Number of previous mammograms Breast cancer mortality One-third less for those with three or four screenings

Limitations of the Study

The researchers acknowledge several limitations in their findings:

  • The analysis was based on specific datasets, limiting the generalizability of the results.
  • There was insufficient data to fully assess the impact of socioeconomic factors or engagement with primary care.
  • Focus was primarily on the most common form of breast cancer, possibly reducing applicability to less common variants.

Ultimately, these insights stress the necessity for individualized decision-making when considering routine screenings for older women.

Conclusion

This pivotal study suggests that regular mammograms post-75 could facilitate earlier diagnoses and improve survival rates for breast cancer among older women. Nevertheless, each woman should consult her healthcare provider to weigh the risks and benefits based on her personal health circumstances.

Additional Information

For more detailed insights, refer to the original study by Sida Huang et al titled "Screening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer," available in JAMA Network Open (2025). Read the full article here.

References

[1] Huang, S. et al. (2025). Screening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer. JAMA Network Open.

[2] American Cancer Society. Breast Cancer Screening Guidelines.

[3] National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program.