Outcomes of Screening Mammography in Elderly Women

There is uncertainty about whether women older than age 65 should undergo screening mammography. Although screening mammography may benefit some elderly women through the detection of early breast cancers, it may harm other women through the detection of early breast cancers, it may harm other women through false positive diagnoses and the detection of clinically insignificant lesions. This research study involves the design and implementation of a data analysis of HCFA Medicare billing claims linked with national tumor registry data from the Surveillance Epidemiology and End Results (SEER) program. The specific aims of this research will evaluate 1) differences in breast cancer mortality, 2) differences in breast cancer treatment and 3) differences in breast cancer tumor attributes between women who were screened and those who were not. In the second year of this grant the PI focused on validating that the Medicare claims are accurate for determining screening mammography. She obtained data form the three Breast Cancer SurVeillance Consortium Registries (New Mexico, Seattle, and San Francisco) that prospectively collect screening information, has linked this with the Medicare/SEER data, and is currently determining whether Medicare claims accurately assess mammography utilization. Following completion of this validation study, the PI will analyze differences in breast cancer treatments, tumor characteristics and mortality based on screening.