Department of Community Internal Medicine, Mayo Clinic Health System at Austin and Albert Lea, Albert Lea, MN 56007, USA.
Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN 55905, USA.
J Geriatr Oncol. 2022 Sep;13(7):1038-1042. doi: 10.1016/j.jgo.2022.07.003. Epub 2022 Jul 16.
Although the benefits of surveillance mammography for older breast cancer survivors have not been quantified prospectively, it is unlikely that mammography provides substantial benefit (and possible that mammography is harmful) to women with limited life expectancy and a low risk for in-breast cancer events.
We identified 1268 women aged 77 and older with a history of Stage I-III breast cancer, who did not undergo bilateral mastectomy, were diagnosed with cancer at least three years prior to study entry, and who had consented to be surveyed as part of the Mayo Clinic Breast Disease Registry. We mailed them a one-time survey asking about their experiences with surveillance mammography. Women with metastatic disease were excluded. The primary endpoint was whether or not women reported at least one mammogram since breast cancer surgery.
Eight hundred forty-six of 1268 (67%) returned the survey, 734 of whom were eligible for analysis. The median age at the time of survey was 82, and the median time since cancer diagnosis was 12 years. Ninety-three percent reported having had at least one mammogram since their initial breast cancer surgery. Seventy-nine percent reported that they had surveillance mammography annually over the prior three years, including 76% of the 491 aged 80+ and 64% of the 189 aged 85 + .
Most older breast cancer survivors who have residual breast tissue are undergoing annual mammograms. Additional educational materials may be beneficial for patients and clinicians to better individualize plans for surveillance mammography in older breast cancer survivors.
尽管前瞻性地量化了监测乳房 X 光检查对老年乳腺癌幸存者的益处，但对于预期寿命有限且乳腺癌事件风险较低的女性，乳房 X 光检查不太可能提供实质性益处（并且可能有害）。
我们确定了 1268 名年龄在 77 岁及以上、患有 I-III 期乳腺癌但未接受双侧乳房切除术、在研究入组前至少三年被诊断患有癌症且同意作为梅奥诊所乳房疾病登记处调查一部分的女性。我们向她们发送了一次性调查，询问她们接受乳房 X 光检查监测的经历。患有转移性疾病的女性被排除在外。主要终点是女性是否报告自乳腺癌手术后至少进行过一次乳房 X 光检查。
1268 名女性中有 846 名（67%）返回了调查，其中 734 名符合分析条件。调查时的中位年龄为 82 岁，癌症诊断后的中位时间为 12 年。93%的女性报告自初始乳腺癌手术后至少进行过一次乳房 X 光检查。79%的女性报告在过去三年中每年都进行乳房 X 光检查监测，其中 491 名 80 岁以上的女性中有 76%，189 名 85 岁以上的女性中有 64%。
大多数仍有乳房组织残留的老年乳腺癌幸存者都在接受年度乳房 X 光检查。对于患者和临床医生来说，额外的教育材料可能有助于更好地个体化制定老年乳腺癌幸存者的乳房 X 光检查监测计划。
