Original StudyType of Breast Cancer Diagnosis, Screening, and Survival
Introduction
Because of the detection of early-stage tumors, breast cancer screening reduced breast cancer mortality in Europe by 25%-31% in patients who were invited for screening and by 38%-48% in those who were actually screened during the last decade of the twentieth century and the first decade of the twenty-first.1 In our region of Italy, an organized breast cancer screening was firstly introduced in 2005, but despite the high compliance of invited women (which progressively increased after the screening introduction), a high prevalence still exists of women who have their breast cancer diagnosed by extrascreening objective examination or imaging.2, 3
In the present study, analyzed, among breast cancer patients treated in our department, the prevalence of breast cancers detected through the invitational screening, and the overall survival of these patients in comparison with that of women with an extrascreening imaging-detected breast cancer or those with palpable breast cancers.
Section snippets
Materials and Methods
We collected retrospective data for about 2811 women who underwent a breast operation following breast cancer diagnosis or suspicion in our clinic between January 2001 and April 2008, in order to have a follow-up of ≥ 5 years for every patient. Then, we excluded women with a diagnosis of benign lesion (471 patients), intralobular neoplasia (22 patients), or intraductal neoplasia (248 patients). Intraductal neoplasia represented the 17.6% of screen-detected and the 14.4% of extrascreening
Results
Among 2070 considered invasive breast cancers operated in our Clinic between January 2001 and April 2008, 247 were detected by the regional, organized, mammographic screening (group A), 1176 by extrascreening breast imaging (group B: 768 by mammography and 408 by ultrasound), and 1393 by extrascreening breast objective examination (group C). Interventions made in patients with breast cancer diagnosed through screening began in 2006. Before and after screening introduction the number of
Discussion
Breast cancer screening in our population succeeded in detecting early-stage tumors with favorable tumor characteristics, which have been consequently treated more frequently with breast and axillary conservative surgery, complementary breast irradiation and eventual hormonal therapy. Women with a screen-detected breast cancer had a significantly higher 5-years overall survival than women who had their breast cancer diagnosed by extrascreening objective examination or imaging, as well as a
Conclusion
In conclusion, breast cancer screening in our population resulted in a significant survival gain at 5 years from the diagnosis, but a longer follow up should be necessary to confirm this data, and further studies are required in order to evaluate interval cancers in order to better assess breast screening effectiveness in our population.
Disclosure
The authors have stated that they have no conflicts of interest.
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