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Regular Mammography Use Is Associated with Elimination of Age-Related Disparities in Size and Stage of Breast Cancer at Diagnosis

Whitney M. Randolph, PhD; James S. Goodwin, MD; Jonathan D. Mahnken, MS; and Jean L. Freeman, PhD
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From the University of Texas Medical Branch, Galveston, Texas.


Disclaimer: This study used the linked SEER–Medicare Database. The interpretation and reporting of data from this database are the sole responsibility of the authors.

Acknowledgments: The authors thank Dr. Dong Zhang of the Office of Biostatistics, University of Texas Medical Branch, for his contribution in organizing the database and Dr. Daniel H. Freeman Jr., also of the Office of Biostatistics, for expert statistical advice. The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Information Services and the Office of Strategic Planning, Center for Medicare & Medicaid Services; Information Management Services, Inc.; and the Surveillance, Epidemiology, and End Results program tumor registries in the creation of the SEER–Medicare database.

Grant Support: By the National Cancer Institute (CA72076) and the Department of the U.S. Army (BC990990).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Jean L. Freeman, PhD, Sealy Center on Aging, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0460.

Current Author Addresses: Dr. Randolph: National Cancer Institute, Cancer Prevention Fellowship Program, 6130 Executive Boulevard, Suite 3109, Bethesda, MD 20892-7361.

Drs. Goodwin and Freeman and Mr. Mahnken: Sealy Center on Aging, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0460.

Author Contributions: Conception and design: W.M. Randolph, J.S. Goodwin, J.L. Freeman.

Analysis and interpretation of the data: W.M. Randolph, J.S. Goodwin, J.D. Mahnken, J.L. Freeman.

Drafting of the article: W.M. Randolph, J.S. Goodwin, J.L. Freeman.

Critical revision of the article for important intellectual content: W.M. Randolph, J.S. Goodwin, J.D. Mahnken, J.L. Freeman.

Final approval of the article: J.S. Goodwin, J.D. Mahnken, J.L. Freeman.

Statistical expertise: J.D. Mahnken.

Obtaining of funding: W.M. Randolph, J.L. Freeman.

Administrative, technical, or logistic support: J.L. Freeman.


Ann Intern Med. 2002;137(10):783-790. doi:10.7326/0003-4819-137-10-200211190-00006
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Table 1 presents the characteristics of the 11 039 women age 69 years or older for whom data on stage were available and who received a diagnosis of breast cancer in 1995 through 1996, stratified by age. Women 75 years of age or older were more likely to receive a diagnosis of advanced disease than were women 69 to 74 years of age. For example, 44% of women 75 years of age or older received a diagnosis of stage IIa disease or worse compared with 36% of women 69 to 74 years of age (P < 0.001). Women 75 years of age and older were also significantly less likely to be regular users of mammography, that is, to have had at least two screening mammograms obtained at least 11 months apart in the 2 years before diagnosis (P < 0.001). A higher percentage of older women also had no screening mammograms in the 2 years before diagnosis (41% vs. 33%; P < 0.001).

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Grahic Jump Location
Figure.
Percentage of women with high-stage disease (stage IIA or higher at diagnosis), stratified by mammography use and age.

White bars indicate women 69 to 74 years of age; shaded bars represent women at least 75 years of age.

Grahic Jump Location

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Summary for Patients

Relationship of Mammography Use to Size and Stage of Breast Cancer at Diagnosis in Older Women

The summary below is from the full report titled “Regular Mammography Use Is Associated with Elimination of Age-Related Disparities in Size and Stage of Breast Cancer at Diagnosis.” It is in the 19 November 2002 issue of Annals of Internal Medicine (volume 137, pages 783-790). The authors are WM Randolph, JS Goodwin, JD Mahnken, and JL Freeman.

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