Breast Cancer in the Elderly: An Observational Study Investigating Compliance of Screening Mammography in an Underserved Community
Bibliographic record
Abstract
BACKGROUND: The incidence of breast cancer increases with age. Individuals living in higher socioeconomic communities also have higher incidence secondary to early detection of breast cancer from increased accessibility to mammograms. This retrospective study studied the percentage of new breast cancer cases in the elderly between 2010 and 2019, and investigated the compliance of screening mammography in some of the medically underserved suburbs of southern Chicago. METHODS: The parameters used to power this study include "age greater than 70" and "2010 to present" at the time the study was first initiated. The final data set contained 381 electronic health records (EMRs) that met the parameters of interest. We specifically looked at method of diagnosis, stage at diagnosis, date of last normal screening mammogram, hormone status, histology, race, and smoking history. RESULTS: Thirty percent of the breast cancer patients diagnosed at our institution were over 70 years of age between 2010 and 2019. Of the 381 patients included in the overall sample, 45% were diagnosed with breast cancer by screening mammogram, and 52% of individuals in the 70 - 75 age group were diagnosed with breast cancer by screening mammography. Only 40% of individuals in the 75+ age group were diagnosed with breast cancer by screening mammogram (P = 0.0234). Furthermore, in the overall sample, 63% had a normal screening mammogram at some time prior to their breast cancer diagnosis. In the 70 - 75 age group, 76% had a normal screening mammogram at some time prior to their breast cancer diagnosis. In the 75+ age group, only 54% had a normal screening mammogram at some time prior to their breast cancer diagnosis (P < 0.0001). Individuals in both age groups were more likely to have early-stage breast cancers and luminal A hormone expression. CONCLUSIONS: Decreased compliance to screening mammography is observed in the elderly living in underserved communities. Since the elderly are underrepresented in research, organizations do not have sufficient information to recommend screening mammography in the elderly. With increasing life expectancy, observational studies have demonstrated a mortality benefit with screening mammography by early detection of breast cancer, favorable breast cancer characteristics and potentially higher cure rates. Socioeconomic factors also affect screening compliance and likely influenced the results of our study. Future studies should investigate how individual factors influence screening mammography compliance in the elderly in underserved communities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".