Breast Cancer in Asymptomatic Older Women: Mammographic and Histological Findings

Abstract

INTRODUCTION: The objective is to describe the mammographic and histological findings of breast cancer detected in Brazilian asymptomatic women aged over sixty-five years. METHODS: we reviewed the mammographic and histological findings in 96 women older than sixty-five years with the diagnosis of breast cancer. These patients were treated at the Breast Clinic of the Women s Health Center for Integral Attention (CAISM) at the State University of Campinas (UNICAMP) between the years 1998 and 2009. RESULTS: from a total of 96 women, 19 were asymptomatic patients (20%) diagnosed with breast cancer on mammograms. The minimum age of these women was 66 years and maximum age was 84 years, mean of 73 years. The evaluation of the breast composition on the mammograms showed that 84% of the women had almost entirely fat or scattered fibroglandular densities. The most common mammographic findings were masses in 74% of the cases and suspicious microcalcifications in 26%. The masses had irregular shape and spiculated margins in almost 65%, and in 29% they were associated with microcalcifications. The diameter of the masses ranged from 1. 0 to 2. 0 centimeters (mean 1. 4 cm). All mammograms were classified according to BI-RADS, with final assessment categories being 26% in category 4 and 74% in category 5. The predominant histological type was invasive ductal carcinoma in 63% of the cases, ductal carcinoma in situ in 21% and invasive lobular carcinoma or other types in 16%. We observed a predominance of radical breast surgery in 58% of women and conservative treatment in 42%. DISCUSSION: in our population of Brazilian asymptomatic women older than 65 years with breast cancer we observed the most common situation being women with meaning age of 74 years, BI- RADS final assessment category 5, tumors with mean diameter of 1. 4 centimeters and invasive ductal carcinoma in 63% of the cases. CONCLUSION: With increasing life expectancy in our population probably the age group of women undergoing mammographic screening should be review in the future, so it is important to know the current characteristics of the cases of breast cancer in older women to draw strategies to address this population.