Surveillance mammography and the risk of death among elderly breast cancer patients

Purpose To examine the benefits of mammography for elderly breast cancer survivors in community settings. Methods Using the 1991–1999 linked SEER-Medicare data, we examined if mammography reduced the risk of breast-cancer-specific and all-cause mortality among women age 66 or older who were diagnosed with first primary breast cancer (FPBC) at stages 0–III and survived at least 30 months. To analyze the influence of mammography (both within one year and within two years prior to death/censoring) on the risk of breast-cancer-specific mortality, we compared women who died of breast cancer (cases) with women who died of other causes or were censored (controls). For an analysis of all-cause mortality, we compared women who died from any cause (cases) with women who were censored (controls). Propensity scores were used to adjust for tumor-related, treatment-related, and sociodemographic confounders. Results Among 1351 breast cancer deaths (cases) and 5,262 controls, women who had a mammogram during a one or two-year time interval were less likely to die from breast cancer than women who did not have any mammograms during this time period in propensity-score-adjusted analysis (within one year odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.72–0.95; within two years OR: 0.80, 95% CI: 0.70–0.92). Similarly, risk of all-cause mortality was reduced among women who had mammograms during one- or two-year intervals. Conclusions In community settings, mammography use during a one- or two-year time interval was associated with a small-reduced risk of breast-cancer-specific and all-cause mortality among elderly breast cancer survivors.