Diane Bula-Ibula1,2, Birgit Carly3, Serge Rozenberg3. 1. ISALA Breast Unit and Prevention Centre, Department of Obstetrics and Gynaecology, University Hospital Saint-Pierre, Université Libre de Bruxelles and Vrije Universiteit Brussel), Rue Haute 290, 1000, Brussels, Belgium. diane.bula-ibula@ulb.be. 2. Gynecology, Université Libre de Bruxelles, Brussels, Belgium. diane.bula-ibula@ulb.be. 3. ISALA Breast Unit and Prevention Centre, Department of Obstetrics and Gynaecology, University Hospital Saint-Pierre, Université Libre de Bruxelles and Vrije Universiteit Brussel), Rue Haute 290, 1000, Brussels, Belgium.
Abstract
INTRODUCTION: Breast cancer (BC) screening has been associated with reduced mortality and morbidity. This study compares tumor characteristics and treatment morbidity in screened versus diagnosed women. MATERIALS AND METHODS: This retrospective study, conducted between 2010 and 2013, included 666 BC screened or diagnosed patients. We compared patients and tumors characteristics and received treatments. We also analyzed the results after excluding patients at risk of BC and conducted a multivariate analysis to assess odds ratios (OR). RESULTS: Screened women had smaller tumors (16,5 vs 22,6 mm, p < 0.001), of lower grade (p < 0.001) with a lower proliferation index (PI) (p < 0.001) than diagnosed women. Screened women were more frequently treated using conservative surgery (82.8% vs 59.7%, p < 0.001), needed less often axillary dissection (15.1% vs 35.4%, p < 0.001) and less often chemotherapy (20.8% vs 48.3% p < 0.001) than diagnosed women. In the multivariate analysis after adjustment for age and BC history, diagnosed women had increased (OR: 4.79, 95% IC: 3.19-7,18) risk to be administered chemotherapy and to undergo axillary dissection (OR: 4.18, 95% IC: 1.56-11.17) than screened women. CONCLUSION: Patients should be informed about the benefits in terms of morbidity that screening confers to them.
INTRODUCTION: Breast cancer (BC) screening has been associated with reduced mortality and morbidity. This study compares tumor characteristics and treatment morbidity in screened versus diagnosed women. MATERIALS AND METHODS: This retrospective study, conducted between 2010 and 2013, included 666 BC screened or diagnosed patients. We compared patients and tumors characteristics and received treatments. We also analyzed the results after excluding patients at risk of BC and conducted a multivariate analysis to assess odds ratios (OR). RESULTS: Screened women had smaller tumors (16,5 vs 22,6 mm, p < 0.001), of lower grade (p < 0.001) with a lower proliferation index (PI) (p < 0.001) than diagnosed women. Screened women were more frequently treated using conservative surgery (82.8% vs 59.7%, p < 0.001), needed less often axillary dissection (15.1% vs 35.4%, p < 0.001) and less often chemotherapy (20.8% vs 48.3% p < 0.001) than diagnosed women. In the multivariate analysis after adjustment for age and BC history, diagnosed women had increased (OR: 4.79, 95% IC: 3.19-7,18) risk to be administered chemotherapy and to undergo axillary dissection (OR: 4.18, 95% IC: 1.56-11.17) than screened women. CONCLUSION: Patients should be informed about the benefits in terms of morbidity that screening confers to them.
Authors: Marije F Bakker; Stéphanie V de Lange; Ruud M Pijnappel; Ritse M Mann; Petra H M Peeters; Evelyn M Monninkhof; Marleen J Emaus; Claudette E Loo; Robertus H C Bisschops; Marc B I Lobbes; Matthijn D F de Jong; Katya M Duvivier; Jeroen Veltman; Nico Karssemeijer; Harry J de Koning; Paul J van Diest; Willem P T M Mali; Maurice A A J van den Bosch; Wouter B Veldhuis; Carla H van Gils Journal: N Engl J Med Date: 2019-11-28 Impact factor: 91.245
Authors: Herman Depypere; Joelle Desreux; Faustino R Pérez-López; Iuliana Ceausu; C Tamer Erel; Irene Lambrinoudaki; Karin Schenck-Gustafsson; Yvonne T van der Schouw; Tommaso Simoncini; Florence Tremollieres; Margaret Rees Journal: Maturitas Date: 2014-09-16 Impact factor: 4.342