Performance of digital screening mammography among older women in the United States. Issue 9 (23rd December 2014)

• Record Type: Journal Article
• Authors: Henderson, Louise M.; O'Meara, Ellen S.; Braithwaite, Dejana; Onega, Tracy; for the Breast Cancer Surveillance Consortium
• Is Part Of: Cancer. Volume 121:Issue 9(2015)
• Page Start: 1379
• Page End: 1386
• Publication Date: 2014-12-23
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.29214
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr29214-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Although healthy women aged 65 years have a life expectancy of 20 years, there is a paucity of data on the performance of digital screening mammography among these women. The authors examined the performance and outcomes of digital screening mammography among a national group of women aged ≥65 years.</p> </sec> <sec id="cncr29214-sec-0002" sec-type="section"> <title>METHODS</title> <p>From Breast Cancer Surveillance Consortium data for the years 2005 to 2011, the authors included 296, 496 full‐field digital screening mammograms among 133, 042 women ages ≥65 years without a history of breast cancer. Sensitivity, specificity, positive predictive value (PPV<sub>1</sub>), recall rates, and 95% confidence intervals (95% CIs) were calculated across the spectrum of age and breast density. Multivariate logistic regression was used to compare mammography accuracy, cancer‐detection rates (CDRs), and tumor characteristics by age and breast density.</p> </sec> <sec id="cncr29214-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Multivariate analyses revealed a significant decrease in the recall rate with age (<italic>P</italic> for linear trend [<italic>P</italic><sub>trend</sub>] < .001) and significant increases in specificity, PPV<sub>1</sub>, and CDR with age (<italic>P</italic><sub>trend</sub> < .001, <italic>P</italic><sub>trend</sub> < .001, and <italic>P</italic><sub>trend</sub> = .01, respectively). Sensitivity did not vary significantly with age. Among women with cancer, the proportion with invasive disease increased with age from 76% at ages 65 to 74 years to 81% at ages ≥80 years. There was a higher proportion of late stage cancers and positive lymph nodes among women ages 65 to 74 years compared with women in the older age groups.</p> </sec> <sec id="cncr29214-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>The specificity, PPV<sub>1</sub>, recall rate, and CDR of digital screening mammography improved with increased age. In addition, as age increased, the proportion of women with invasive versus ductal carcinoma in situ rose, whereas the proportion of women with positive lymph nodes decreased. <bold><italic>Cancer</italic> 2015;121:1379–1386.</bold> © <italic>2014 American Cancer Society</italic>.</p> </sec> </abstract>