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Screen detection associated with reduction in 10-year breast cancer-specific mortality
Mook S. J Natl Cancer Inst. 2011;103:1-13.
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Women with invasive breast cancer whose tumors were mammographically screen-detected had superior all-cause and disease-specific mortality compared with women with nonscreening-related carcinomas, according to results from a Dutch study.
Researchers included 2,592 women aged 50 to 69 years who were treated for invasive breast cancer at the Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital from 1990 to 2000. Women aged 70 to 75 years became eligible for screening in 1998.
Women were segregated into three groups, based on method of detection: screen-detected carcinomas, defined as carcinomas that were mammographically detected in the first or subsequent screening rounds (n=958); interval carcinomas, defined as symptomatic carcinomas that were diagnosed within 24 months of a negative screening (n=417); and nonscreening-related carcinomas, defined as symptomatic carcinomas in patients who were not participating in the Dutch national screening program (n=1,217).
Compared with patients with nonscreening-related carcinomas, patients in the screen-detected group had superior all-cause mortality (HR=0.6; 95% CI, 0.51-0.69) and breast cancer-specific mortality (HR=0.43; 95% CI, 0.34-0.53) throughout the study period. Researchers observed similar results in patients diagnosed between 1990 and 1996 and between 1997 and 2000.
When researchers adjusted for age at diagnosis, tumor size, tumor grade, lymph node status, ER status and adjuvant systemic therapy, multivariate analysis showed that screen detection was still independently associated with increased all-cause mortality (HR=0.77; 95% CI, 0.64-0.92) and disease-specific mortality (HR=0.66; 95% CI, 0.5-0.86) for patients diagnosed with breast cancer between 1990 and 1996.
At 10-years of follow-up, the absolute reduction in disease-specific mortality between the two groups was 7%, with an 86% adjusted survival rate for patients with screen-detected carcinomas vs. 79% for nonscreening-related carcinomas.
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