According to a new study, for women over 75 years old who had mammograms, breast cancer was found at an earlier stage than in women who had not had mammograms within the past two years.

Reporting in the Annals of Internal Medicine (Vol. 137, No. 10: 783-792), researchers said when breast cancer was found in older women who were screened with mammography the cancers tended to be small.

This is similar to what is found in younger women who have mammograms. Older women diagnosed with breast cancer who were not screened had larger tumors.

"We know that one major factor contributing to the poor survival of older women with breast cancer is delay in diagnosis," said James S. Goodwin, MD, a co-author of the study and director of the Sealy Center on Aging at the University of Texas Medical Branch at Galveston.

"These results suggest that regular screening mammography in women 75 years of age and older helps diagnose breast cancer when it is smaller and at an earlier stage," he said.

Goodwin and colleagues looked at data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI). They studied 12,038 women who were older than age 69 and had a breast cancer diagnosis between 1995 and 1996.

The researchers compared the size and stage of cancer in women age 69 to 74 years with those in women 75 years of age and older They then collected information on screening mammograms that these women had in the two years before diagnosis (none, one, or two or more).

Goodwin found that not only did mammography find breast cancer earlier in women over 75, the cancers were even smaller than those found with mammography in younger women. The authors concluded by saying that women over 75 should continue to have mammograms.

Researchers from Boston University and University of California Los Angeles reported in the journal Cancer (Vol. 95, No. 12: 2465-2472) that women over age 80 benefited from tamoxifen used as adjuvant therapy after breast cancer treatment.

The authors studied 92 women with primary, early stage breast cancer. They found that women age 85 to 92 years were about 25% less likely to receive a prescription for tamoxifen than younger women, 80 to 84 years old.

Rebecca A. Silliman, MD, Patricia A. Ganz, MD, and co-authors said, "With increasingly longer life expectancies, even the oldest breast cancer patients will live longer lives during which they are at risk of disease recurrence and breast cancer mortality."

The authors said that under-treating with adjuvant tamoxifen may put older breast cancer patients at an increased risk of disease recurrence and death.

"Our findings may reflect the attitudes of breast carcinoma physicians who may believe that as age increases, tamoxifen's risks or side effects outweigh its benefits, or that very old women will not live long enough to realize its benefits."

The authors concluded that until doctors find a way to more accurately predict treatment effectiveness, adjuvant tamoxifen will continue to offer patients their best chance for disease-free survival.