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Adapted from the NCI Cancer Bulletin, vol. 4/no. 20, June 26, 2007 (see the current issue ²).

Annual mammography surveillance for breast cancer survivors older than 65 is associated with a dramatically reduced risk of death from breast cancer, whether by recurrence or another primary tumor.

Results from a study to be published in the July 20, 2007, Journal of Clinical Oncology showed that each successive annual mammogram lowered a woman's breast cancer mortality risk by about 31 percent. Compounding this benefit over a period of four years would cut a woman’s cumulative risk of breast cancer death by 88 percent. (See the journal abstract ³.)

Dr. Timothy L. Lash of Boston University was the lead author of the cohort study, which identified 1,846 breast cancer patients from six Cancer Research Network (CRN) sites chosen to maximize ethnic and geographic diversity.

All women were diagnosed with stage I or II breast cancer between 1990 and 1994, and were designated as "survivors" for the purposes of the study 90 days after finishing their initial breast cancer treatment. The 178 women who died of breast cancer within five years were closely matched to 634 control subjects who were followed at least as long as the women who died. Protective effects of annual mammography were found to be the strongest among women with stage I disease, those who had received mastectomy, and those older than 79.

In an editorial, Dr. Jeanne Mandelblatt from the Lombardi Comprehensive Cancer Center in Washington, DC, commended "this high-quality observational research" that emerged from CRN, a National Cancer Institute-funded collaboration between 12 large managed care systems. The large cohort study provides the best data likely to be developed on this question, because a clinical trial that randomized women to "no mammography" would disregard current guidelines ⁴, which recommend that survivors receive annual surveillance mammograms.

Glossary Terms

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

A research study that compares a particular outcome (such as lung cancer) in groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke compared with those who do not smoke).

In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works.

The use of film or a computer to create a picture of the breast.

Surgery to remove the breast (or as much of the breast tissue as possible).

The original tumor.

A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.