Screening mammography beyond the limit recommended in a Portuguese Primary Care Centre: a cross-sectional study

Background
Despite the imminent change and controversy around screening mammography, many women are still screened beyond the recommended age.

Objectives
This study aims to characterise these women and to identify factors associated with this decision.

Material and methods
A cross-sectional study including women who attended a Portuguese primary health care centre and who performed at least one mammography after turning 70 from March 2007 until July 2019. Data was collected by accessing the electronic health records.

Results
Among all women who underwent mammography after the age of 50, 5.5% were 70 years of age and older. The main risk factor for breast cancer (BC) identified was the presence of other breast abnormalities (46.3%). Most requests in the screening group were for women under 75 years of age (79.2%) and were performed by the family physician (76.9%). Adherence to the BC national screening programme was lower in the screening group (73.3% vs 84.8%). After logistic regression, age at the time of request (OR = 0.815, 95% CI: 0.720–0.922, p = 0.001) and initiative of the request (OR = 0.176, 95% CI: 0.044–0.707, p = 0.014) of the last mammography added significantly to the model.

Conclusions
Only a small proportion of screening mammographs were performed on women beyond the recommended age limit, which complied with the National Cancer Plan currently implemented in Portugal. Patients’ age, presence of arterial hypertension or osteoporosis or hip fracture, number of comorbidities and the initiative of the request may have contributed to the decision to continue screening. Our study provides important clues for under-standing factors associated with prolonging BC screening. However, further research is still needed.