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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Aggressive primary treatments with favourable 5-year survival for screen-interval breast cancers

Authors: Gautier Defossez, Alexandre Quillet, Pierre Ingrand

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

To assess the impact of the participation in screening programme according to the mode of detection on the early diagnosis, treatment, and specific survival outcomes in women with breast cancer.

Methods

Women diagnosed with invasive breast cancer in Poitou-Charentes region (France) between 2008 and 2009 were classified into three groups, using data linkage of cancer registry, vital statistics and French organized screening programme: the screening programme (SP), interval cancer (IC), and non-screening programme detected cancer (NSP) groups. Specific survival rates were analysed using the Kaplan–Meier method and Cox proportional hazard models.

Results

Among 1613 patients, 65.7% (n = 1059) participated in a screening programme. The interval cancer rate was 17.1% (n = 181). Tumours in the IC group were diagnosed at a more advanced stage, i.e. with further regional lymph node metastasis or local spread, than those in the SP group (p < 0.001), but with significantly fewer metastases at diagnosis than in the NSP group (p < 0.001). ICs underwent more aggressive primary treatments than the two other groups, with 28% of radical mastectomy and 67% undergoing chemotherapy. The five-year survival rate for IC group were 92.0% (95% CI, 89.9–94.0%).

Conclusions

Interval cancers had more aggressive features than screen-detected cancers but were diagnosed at a less advanced stage compared to non-screen detected cancers. Despite having cancers missed by the screening programme, women who participate in the screening process seem to benefit from early treatment. These results must be confirmed with long-term follow-up.
Literature
1.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–86.CrossRefPubMed
2.
Sant M, Allemani C, Capocaccia R, Hakulinen T, Aareleid T, Coebergh JW, et al. Stage at diagnosis is a key explanation of differences in breast cancer survival across Europe. Int J Cancer. 2003;106:416–22.CrossRefPubMed
3.
4.
Lauby-Secretan B, Loomis D, Straif K. Breast-Cancer screening--viewpoint of the IARC working group. N Engl J Med. 2015;373:1479.PubMed
5.
Paci E, EUROSCREEN Working Group. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet. J Med Screen. 2012;19(Suppl 1):5–13.CrossRefPubMed
6.
Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review. Lancet Lond. Engl. 2012;380:1778–86.CrossRef
7.
Sarkeala T, Heinävaara S, Anttila A. Organised mammography screening reduces breast cancer mortality: a cohort study from Finland. Int J Cancer. 2008;122:614–9.CrossRefPubMed
8.
9.
Moss SM, Nyström L, Jonsson H, Paci E, Lynge E, Njor S, et al. The impact of mammographic screening on breast cancer mortality in Europe: a review of trend studies. J Med Screen. 2012;19(Suppl 1):26–32.CrossRefPubMed
10.
Puliti D, Duffy SW, Miccinesi G, de Koning H, Lynge E, Zappa M, et al. Overdiagnosis in mammographic screening for breast cancer in Europe: a literature review. J Med Screen. 2012;19(Suppl 1):42–56.CrossRefPubMed
11.
Moss SM, Cuckle H, Evans A, Johns L, Waller M, Bobrow L, et al. Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years’ follow-up: a randomised controlled trial. Lancet Lond Engl. 2006;368:2053–60.CrossRef
12.
Harding C, Pompei F, Burmistrov D, Welch HG, Abebe R, Wilson R. Breast Cancer screening, incidence, and mortality across US counties. JAMA Intern Med. 2015;175:1483–9.CrossRefPubMed
13.
Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348:g366.CrossRefPubMedPubMedCentral
14.
15.
16.
Domingo L, Blanch J, Servitja S, Corominas JM, Murta-Nascimento C, Rueda A, et al. Aggressiveness features and outcomes of true interval cancers: comparison between screen-detected and symptom-detected cancers. Eur J Cancer Prev Off J Eur Cancer Prev Organ ECP. 2013;22:21–8.CrossRef
17.
Caumo F, Vecchiato F, Strabbioli M, Zorzi M, Baracco S, Ciatto S. Interval cancers in breast cancer screening: comparison of stage and biological characteristics with screen-detected cancers or incident cancers in the absence of screening. Tumori. 2010;96:198–201.CrossRefPubMed
18.
Rayson D, Payne JI, Abdolell M, Barnes PJ, MacIntosh RF, Foley T, et al. Comparison of clinical-pathologic characteristics and outcomes of true interval and screen-detected invasive breast cancer among participants of a Canadian breast screening program: a nested case-control study. Clin Breast Cancer. 2011;11:27–32.CrossRefPubMed
19.
Bordás P, Jonsson H, Nyström L, Lenner P. Survival from invasive breast cancer among interval cases in the mammography screening programmes of northern Sweden. Breast Edinb Scotl. 2007;16:47–54.CrossRef
20.
Holmberg LH, Tabar L, Adami HO, Bergström R. Survival in breast cancer diagnosed between mammographic screening examinations. Lancet Lond Engl. 1986;2:27–30.CrossRef
21.
Brekelmans CT, Peeters PH, Deurenberg JJ, Collette HJ. Survival in interval breast cancer in the DOM screening programme. Eur J Cancer Oxf Engl 1990. 1995;31A:1830–5.
22.
Fracheboud J, de Koning HJ, Beemsterboer PM, Boer R, Verbeek AL, Hendriks JH, et al. Interval cancers in the Dutch breast cancer screening programme. Br J Cancer. 1999;81:912–7.CrossRefPubMedPubMedCentral
23.
Zackrisson S, Janzon L, Manjer J, Andersson I. Improved survival rate for women with interval breast cancer - results from the breast cancer screening programme in Malmö, Sweden 1976-1999. J Med Screen. 2007;14:138–43.CrossRefPubMed
24.
Kalager M, Tamimi RM, Bretthauer M, Adami H-O. Prognosis in women with interval breast cancer: population based observational cohort study. BMJ. 2012;345:e7536.CrossRefPubMedPubMedCentral
25.
Delacour-Billon S, Mathieu-Wacquant AL, Campone M, Auffret N, Amossé S, Allioux C, et al. Short-term and long-term survival of interval breast cancers taking into account prognostic features. Cancer Causes Control CCC. 2017;28:69–76.CrossRefPubMed
26.
Jensen O, Parkin D, MacLennan R, Muir C, Skeet RG. Cancer Registration: Principles and Methods. International Agency for Research on Cancer; 1991.
27.
Defossez G, Rollet A, Dameron O, Ingrand P. Temporal representation of care trajectories of cancer patients using data from a regional information system: an application in breast cancer. BMC Med Inform Decis Mak. 2014;14:24.CrossRefPubMedPubMedCentral
28.
Quillet A, Defossez G, Ingrand P. Surveillance of waiting times for access to treatment: a registry-based computed approach in breast cancer care. Eur J Cancer Care (Engl). 2016;25:764–73.CrossRef
29.
Wishart GC, Greenberg DC, Britton PD, Chou P, Brown CH, Purushotham AD, et al. Screen-detected vs symptomatic breast cancer: is improved survival due to stage migration alone? Br J Cancer. 2008;98:1741–4.CrossRefPubMedPubMedCentral
30.
Shen Y, Yang Y, Inoue LYT, Munsell MF, Miller AB, Berry DA. Role of detection method in predicting breast cancer survival: analysis of randomized screening trials. J Natl Cancer Inst. 2005;97:1195–203.CrossRefPubMed
31.
Duffy SW, Nagtegaal ID, Wallis M, Cafferty FH, Houssami N, Warwick J, et al. Correcting for lead time and length bias in estimating the effect of screen detection on cancer survival. Am J Epidemiol. 2008;168:98–104.CrossRefPubMed
32.
Vanier A, Leux C, Allioux C, Billon-Delacour S, Lombrail P, Molinié F. Are prognostic factors more favorable for breast cancer detected by organized screening than by opportunistic screening or clinical diagnosis? A study in Loire-Atlantique (France). Cancer Epidemiol. 2013;37:683–7.CrossRefPubMed
Metadata
Title
Aggressive primary treatments with favourable 5-year survival for screen-interval breast cancers
Authors
Gautier Defossez
Alexandre Quillet
Pierre Ingrand
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4319-4

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