Solveig Hofvind1, Åsne Holen2, Marta Román3, Sofie Sebuødegård2, Montse Puig-Vives4, Lars Akslen5. 1. Department of Screening - Cancer Registry of Norway, Oslo Oslo and Akershus University College of Applied Sciences - Department of Radiography Solveig.Hofvind@kreftregisteret.no. 2. Department of Screening - Cancer Registry of Norway, Oslo. 3. Department of Screening - Cancer Registry of Norway, Oslo National Advisory Unit for Women's Health - Oslo University Hospital. 4. Epidemiology Unit and Girona Cancer Registry (UERCG)/University of Girona, Economics Campus Montilivi, Spain. 5. University of Bergen Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, Norway/Haukeland University Hospital, Department of Pathology, Bergen, Norway.
Abstract
OBJECTIVES: To investigate breast cancer survival and risk of breast cancer death by detection mode (screen-detected, interval, and detected outside the screening programme), adjusting for prognostic and predictive tumour characteristics. METHODS: Information about detection mode, prognostic (age, tumour size, histologic grade, lymph node status) and predictive factors (molecular subtypes based on immunohistochemical analyses of hormone receptor status (estrogen and progesterone) and Her2 status) were available for 8344 women in Norway aged 50-69 at diagnosis of breast cancer, 2005-2011. A total of 255 breast cancer deaths were registered by the end of 2011. Kaplan-Meier method was used to estimate six years breast cancer specific survival and Cox proportional hazard model to estimate hazard ratio (HR) for breast cancer death by detection mode, adjusting for prognostic and predictive factors. RESULTS: Women with screen-detected cancer had favourable prognostic and predictive tumour characteristics compared with interval cancers and those detected outside the screening programme. The favourable characteristics were present for screen-detected cancers, also within the subtypes. Adjusted HR of dying from breast cancer was two times higher for women with symptomatic breast cancer (interval or outside the screening), using screen-detected tumours as the reference. CONCLUSIONS: Detection mode is an independent prognostic factor for women diagnosed with breast cancer. Information on detection mode might be relevant for patient management to avoid overtreatment.
OBJECTIVES: To investigate breast cancer survival and risk of breast cancer death by detection mode (screen-detected, interval, and detected outside the screening programme), adjusting for prognostic and predictive tumour characteristics. METHODS: Information about detection mode, prognostic (age, tumour size, histologic grade, lymph node status) and predictive factors (molecular subtypes based on immunohistochemical analyses of hormone receptor status (estrogen and progesterone) and Her2 status) were available for 8344 women in Norway aged 50-69 at diagnosis of breast cancer, 2005-2011. A total of 255 breast cancer deaths were registered by the end of 2011. Kaplan-Meier method was used to estimate six years breast cancer specific survival and Cox proportional hazard model to estimate hazard ratio (HR) for breast cancer death by detection mode, adjusting for prognostic and predictive factors. RESULTS:Women with screen-detected cancer had favourable prognostic and predictive tumour characteristics compared with interval cancers and those detected outside the screening programme. The favourable characteristics were present for screen-detected cancers, also within the subtypes. Adjusted HR of dying from breast cancer was two times higher for women with symptomatic breast cancer (interval or outside the screening), using screen-detected tumours as the reference. CONCLUSIONS: Detection mode is an independent prognostic factor for women diagnosed with breast cancer. Information on detection mode might be relevant for patient management to avoid overtreatment.
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