For decades, the question of whether elderly women should continue routine breast cancer screening has lingered in medical and public health discussions. While consensus exists around recommending regular mammograms for women up to the age of 74, there has been notable ambiguity concerning the benefits for women aged 75 and older. This uncertainty primarily stems from the limited data focusing on this older population, with practices often varying widely among healthcare providers. However, a recent groundbreaking study conducted by researchers affiliated with the UCLA Health Jonsson Comprehensive Cancer Center sheds new light on this vital issue, revealing that regular mammograms can confer significant survival advantages even for women in their 80s.
Published in the peer-reviewed Annals of Surgical Oncology, the study represents one of the most comprehensive analyses to date exploring the tangible effects of continued breast cancer screening among octogenarians. The researchers retrospectively examined the medical outcomes of 174 women diagnosed with breast cancer at UCLA between 2013 and 2020, all aged 80 years or older. By scrutinizing the details of their screening histories, tumor characteristics, treatment regimens, and survival rates, the investigators were able to discern distinct patterns that strongly favor ongoing mammographic surveillance well beyond the current guideline age threshold.
Central to the findings was the observation that women who received mammograms within two years prior to their cancer diagnosis demonstrated significantly earlier detection of tumors, most commonly at stage 1 or 2. These cancers were predominantly estrogen receptor-positive and HER2-negative, molecular subtypes known to be more responsive to less aggressive treatments. Early-stage diagnosis, facilitated by regular screening, correlated with a markedly reduced need for extensive interventions such as chemotherapy and radiation, underscoring the clinical advantages of prompt tumor identification in this demographic.
Dr. Nimmi Kapoor, an associate professor of surgery and senior study author, highlighted the evolving paradigm of breast cancer management: “In postmenopausal women with the most common hormone-sensitive breast cancers, it is often possible to omit sentinel lymph node biopsy, chemotherapy, and sometimes even radiation. Our era of treatment de-escalation underscores the critical importance of screening, since detecting cancer early allows clinicians to implement safer, less intensive therapeutic strategies without compromising outcomes.” This commentary poignantly encapsulates the shift towards personalized oncology care, where balancing treatment efficacy and quality of life becomes increasingly salient, particularly in older patients.
Conversely, patients who did not undergo regular mammography were more frequently diagnosed with advanced, high-grade tumors that were palpable on physical examination. This delayed detection commonly necessitated more aggressive treatments, which are inherently riskier and less tolerable in the elderly due to their comorbid conditions and declining physiological reserves. Moreover, some in this unscreened cohort even forewent surgical tumor removal altogether, potentially due to frailty or the advanced stage of the disease at diagnosis, factors that conferred poorer prognoses.
Analyzing survival outcomes over a median follow-up period of 55 months, the research team uncovered that screened women had a 55% lower risk of cancer recurrence and an astonishing 74% reduction in overall mortality relative to their unscreened counterparts. Importantly, these survival benefits persisted after adjusting for confounding variables including age, tumor biology, and whether surgery was performed. Such compelling data challenge prior assumptions that mammography offers limited or negligible benefit to older women and strongly advocate for more inclusive screening policies.
The demographic shift in the United States, characterized by a burgeoning population of older adults, further accentuates the urgency to refine cancer screening guidelines. Since age is a principal risk factor for breast cancer, the number of new diagnoses in elderly women is expected to rise, placing greater emphasis on optimizing early detection strategies. Yet, current recommendations remain vague and often defer decision-making to individual providers, resulting in heterogeneous clinical practices and patient experiences. This study’s robust evidence therefore has the potential to influence national screening protocols and reduce uncertainty in this critical aspect of women’s health.
Despite its robust insights, the study was not without limitations. Being a retrospective review constrained the ability to assess potential harms of screening such as false positives, overdiagnosis, and the psychological or financial burdens imposed on patients and their families. Overdiagnosis, which refers to the detection of indolent cancers unlikely to impact lifespan, is a particularly contentious issue in older populations where competing health risks may supersede breast cancer mortality. Thus, the authors emphasize the necessity for larger, prospective clinical trials to evaluate a comprehensive risk-benefit profile before widespread recommendations can be definitively established.
This pioneering research also underscores the importance of individualized decision-making in geriatric oncology. While the data support continued mammography in the absence of significant comorbidities, providers should weigh each patient’s overall health status, life expectancy, and personal values. The notion that “age alone should not determine screening cessation” resonates strongly with contemporary approaches that advocate tailoring medical interventions to the unique circumstances of older adults.
The study’s first author, Dr. Siu-Yuan Huang, recently completed the UCLA Health Breast Surgical Oncology Fellowship and contributed significantly to the analysis and interpretation of the data. Collaborators included Makaelah Murray, Angelique Rubio, Nneoma Okoro, Dr. Mina S. Sedrak, Dr. Susan A. McCloskey, Dr. Nicholas Jackson, and Dr. Mediget Teshome, all affiliated with UCLA. Together, this multidisciplinary team brought expertise spanning surgical oncology, geriatrics, and epidemiology, enabling a nuanced examination of breast cancer screening in an underrepresented cohort.
Beyond the clinical implications, these findings invite renewed conversations around healthcare resource allocation and policy, as the aging population grows. Determining the cost-effectiveness of extended mammography programs amidst concerns about overdiagnosis and overtreatment will be critical. Yet, the demonstrable survival improvements associated with continued screening outlined in this analysis make a compelling case for revisiting current age cutoffs and reconsidering the potential benefits of personalized screening regimens.
In summary, this landmark study advocates for the reconsideration of breast cancer screening paradigms for women in their 80s, demonstrating that regular mammograms can facilitate earlier diagnosis, less intensive and safer treatments, and substantially improved survival outcomes. As geriatric medicine and oncology evolve, such evidence-based insights are pivotal in shaping guidelines that respect the complexity and heterogeneity of aging populations, ultimately striving for enhanced quality of care and longevity.
Subject of Research: Breast cancer screening and outcomes in women aged 80 and older
Article Title: Regular Mammograms Show Significant Survival Benefits for Women in Their 80s, UCLA Study Finds
News Publication Date: Not specified (study published in Annals of Surgical Oncology)
Web References:
UCLA Health Jonsson Comprehensive Cancer Center: https://www.uclahealth.org/cancer
Journal DOI: http://dx.doi.org/10.1245/s10434-025-18288-4
References: Published study in Annals of Surgical Oncology
Image Credits: Not specified
Keywords: Mammography, Breast cancer, Oncology, Cancer screening
Tags: Annals of Surgical Oncology study findingsbenefits of mammograms in octogenariansbreast cancer detection in older adultsbreast cancer outcomes in older womenbreast cancer screening for women over 80healthcare guidelines for elderly womenlong-term benefits of mammographyroutine mammograms for older womenscreening practices for elderly patientssignificance of mammographic surveillance for seniorssurvival advantages of mammogramsUCLA study on mammograms for elderly women
