BACKGROUND.
Although the benefits of mammography are established in women age ี 50 years, its use in women age ฯฝ 50 years is controversial. It is the purpose of this study to determine whether the better outcome in mammographically detected breast carcinoma compared with clinically detected breast carcinoma observed in women age ี 50 years also is observed in women age ฯฝ 50 years.
METHODS. The authors analyzed 869 cases of Stage I and II breast carcinoma in
women treated with breast-conserving therapy between 1984-1994. The median follow-up was 43 months (range, 3-128 months). Three hundred and eighteen patients (37%) presented with mammographic abnormalities without clinical signs of disease and 551 patients (63%) presented with clinical signs of disease. The median age of the patients was 56 years (range, 22-88 years). Three hundred and four patients (35%) were age ฯฝ 50 years.
RESULTS.
Mammographically detected tumors in women age ฯฝ 50 years were of similar size to those in women age ี 50 years (median 1.1 cm vs. 1.0 cm). Axillary lymph node involvement and tumor grade were not significantly different between these two groups. However, in women age ฯฝ 50 years the clinically detected tumors were found to be significantly larger, more likely to be axillary lymph node positive, and of higher grade compared with tumors in older women. Consequently, in patients with mammographically detected tumors, there was no significant difference in recurrence free survival (RFS) between women age ฯฝ 50 years compared with women age ี 50 years (90% and 92%, respectively; P ฯญ 0.4), whereas in patients with clinically detected tumors there was a significant difference in 5-year RFS (77% vs. 87%, respectively; P ฯญ 0.02).