M Újhelyi1, D Pukancsik2, P Kelemen2, E Kovács3, I Kenessey4, N Udvarhelyi5, M Bak6, T Kovács7, Z Mátrai2. 1. National Institute of Oncology, Department of Breast and Sarcoma Surgery, Ráth György str. 7-9, 1122 Budapest, Hungary. Electronic address: ujmisi@gmail.com. 2. National Institute of Oncology, Department of Breast and Sarcoma Surgery, Ráth György str. 7-9, 1122 Budapest, Hungary. 3. National Institute of Oncology, Department of Radiological Diagnostics, Ráth György str. 7-9, 1122 Budapest, Hungary. 4. National Institute of Oncology, National Cancer Registry, Ráth György str. 7-9, 1122 Budapest, Hungary. 5. National Institute of Oncology, Surgical and Molecular Tumor Pathology Centre, Ráth György str. 7-9, 1122 Budapest, Hungary. 6. National Institute of Oncology, Department of Cytopathology, Ráth György str. 7-9, 1122 Budapest, Hungary. 7. Guy's Hospital, Breast Unit, Great Maze Pond, London SE1 9RT, United Kingdom.
Abstract
INTRODUCTION: Mammography screening reduces breast cancer mortality by up to 32%. However, some recent studies have questioned the impact of non-palpable breast cancer detection on mortality reduction. The aim of this study was to analyse the clinicopathological and long-term follow-up data of early stage screened and symptomatic breast cancer patients. PATIENTS AND METHOD: The institutional prospectively led database was systematically analysed for breast cancer cases diagnosed via the mammography screening program from 2002 to 2009. As a control group, symptomatic early stage breast cancer patients were collected randomly from the same database and matched for age and follow-up period. All medical records were reviewed retrospectively. RESULTS: Data from 298 breast cancer patients were collected from 47,718 mammography screenings. In addition, 331 symptomatic breast cancer patients were randomly selected. The screened group presented a significantly lower median tumour size (P < 0.00001). The incidence of negative regional lymph nodes was significantly higher in the screened group (P < 0.0006). The incidence of chemotherapy was 17% higher in the symptomatic group (P = 4*10-5). At the median follow-up of 65 and 80 months, the screened group did not exhibit better overall (P = 0.717) or disease-free survival (P = 0.081) compared to the symptomatic group. CONCLUSION: Our results do not suggest that mammography screening does not reduce breast cancer mortality but the mammography screening did not bring any significant improvement in patient overall or disease-free survival for the early stage breast cancer patients compared to the symptomatic group. The drawback of symptomatic early stage tumours compared to non-palpable tumours could be equalized by modern multimodality oncology treatments.
INTRODUCTION: Mammography screening reduces breast cancer mortality by up to 32%. However, some recent studies have questioned the impact of non-palpable breast cancer detection on mortality reduction. The aim of this study was to analyse the clinicopathological and long-term follow-up data of early stage screened and symptomatic breast cancerpatients. PATIENTS AND METHOD: The institutional prospectively led database was systematically analysed for breast cancer cases diagnosed via the mammography screening program from 2002 to 2009. As a control group, symptomatic early stage breast cancerpatients were collected randomly from the same database and matched for age and follow-up period. All medical records were reviewed retrospectively. RESULTS: Data from 298 breast cancerpatients were collected from 47,718 mammography screenings. In addition, 331 symptomatic breast cancerpatients were randomly selected. The screened group presented a significantly lower median tumour size (P < 0.00001). The incidence of negative regional lymph nodes was significantly higher in the screened group (P < 0.0006). The incidence of chemotherapy was 17% higher in the symptomatic group (P = 4*10-5). At the median follow-up of 65 and 80 months, the screened group did not exhibit better overall (P = 0.717) or disease-free survival (P = 0.081) compared to the symptomatic group. CONCLUSION: Our results do not suggest that mammography screening does not reduce breast cancer mortality but the mammography screening did not bring any significant improvement in patient overall or disease-free survival for the early stage breast cancerpatients compared to the symptomatic group. The drawback of symptomatic early stage tumours compared to non-palpable tumours could be equalized by modern multimodality oncology treatments.