Breast cancer screening and cancer prognosis in patients with Alzheimer’s disease and related dementias
Menée à partir des données 1999-2019 des registres américains des cancers et de la base Medicare portant sur 8 739 patientes avec maladie d'Alzheimer ou démences apparentées et cancer du sein diagnostiqué à l'âge de 67 ans ou plus, cette étude évalue l'effet du dépistage sur le stade de la tumeur au diagnostic et la survie
Background : Breast cancer screening is crucial for early detection and improved survival in Alzheimer’s Disease and Related Dementias (ADRD) patients, but real-world evidence of its effects on survival and prognosis remains insufficient.
Methods : We conducted a retrospective cohort study using Surveillance, Epidemiology, and End Results-Medicare data (1999 to 2019) to analyze the impact of breast cancer screening on prognosis (ie cancer stage) and survival in ADRD women with breast cancer diagnosed
≥
67 years. Logistic and Cox regression models were employed to assess the relationship between screening and risk of advanced stage at diagnosis, and length of survival, adjusted for relevant covariates (e.x. marital status, comorbidities, age at screening).
Results : The cohort included 8,739 ADRD patients with breast cancer, with 4,483 completed at least one screening between their ADRD and first breast cancer diagnosis. The cohort completed screening had significant lower rates of advanced-stage diagnosis (22.2% vs 42.6%) and longer survival (65.9 vs 45.7 months) compared to the cohort without any screening history. Unscreened patients had 2.7 times higher odds of advanced-stage diagnosis, and 2 times higher hazard of death than patients with at least one screening completed before breast cancer diagnosis. Effects of comorbidities, age, and race were significant on both diagnosis stage and survival in breast cancer patients.
Conclusion : Our study demonstrated the benefit of screening in early diagnosis and longer survival in ADRD patients with breast cancer, which advocates for an expansion of current breast cancer screening recommendations to more effectively guide cancer care for ADRD patients.
JNCI Cancer Spectrum , article en libre accès, 2026