"In our study, women aged 40 to 49 whose breast cancer was detected by mammography were easier to treat and had less recurring disease and mortality, because their cancer was found at an earlier stage," said Judith A. Malmgren, Ph.D., president of HealthStat Consulting, Inc.
Dr. Malmgren and a team of researchers reviewed breast cancer patient data from a dedicated registry at the Swedish Cancer Institute's community cancer center. The researchers analyzed data on 1,977 breast cancer patients between the ages of 40 and 49 who were treated between 1990 and 2008. The researchers looked at method of diagnosis (detected by mammography, patient or physician), stage at diagnosis (0-IV, confirmed by biopsy), treatment, and annual follow-up information, including recurrence of disease.
"Our goal was to assess the differences between mammography and non-mammography detected breast cancer, to determine whether earlier detection confers a treatment and morbidity advantage because the disease is found at an earlier stage," Dr. Malmgren said.
The data analysis revealed a significant increase in the percentage of mammography-detected breast cancer over the 18-year period: from 28 percent in 1990 to 58 percent in 2008. Over the same period, patient- and physician-detected breast cancer declined from 73 percent of all cases in 1990 to 42 percent in 2008.
"The shift toward more mammography-detected breast cancer cases was accompanied by a shift toward diagnosis at an earlier stage of disease that required less treatment," Dr. Malmgren said.
Over the 18-year period, the number of breast cancers diagnosed at Stage 0 increased by 66 percent, while the number of Stage III breast cancers decreased by 66 percent. The majority of Stage 0 cancer cases were ductal carcinoma in situ (DCIS), a non-invasive cancer that is confined to a milk duct. The treatment of DCIS remains controversial, because not all experts agree that it is potentially life threatening.
Dr. Malmgren said another key finding of the study was the extent of treatment patients received. Compared with women whose cancer was self-detected or discovered by a physician, patients whose cancer was detected using mammography were more likely to have breast-conserving treatment and less likely to have chemotherapy. Specifically, they were more likely to undergo lumpectomy (67 percent versus 48 percent), less likely to undergo modified radical mastectomy (25 percent versus 47 percent), and less likely to die of breast cancer (4 percent versus 11 percent).
"The benefits of breast cancer treatment are accompanied by significant harms," Dr. Malmgren said. "Chemotherapy may have long-lasting toxic effects on a woman's body, and mastectomy and reconstructive surgery are difficult and expensive operations that can have a significant effect on body image."
The American Cancer Society and other medical organizations recommend that women should begin receiving annual mammograms to screen for breast cancer beginning at age 40. In 2009, the U.S. Preventive Services Task Force issued controversial new guidelines that eliminated the longstanding recommendation for routine mammography screening for women between the ages of 40 and 49, stating that the benefits of screening were potentially outweighed by the harms of screening, such as false-positive results.
"The objective of screening is to detect disease at an earlier, more treatable stage, which—based on our review—mammography accomplishes," Dr. Malmgren said.
"Impact of Mammography Detection on the Course of Breast Cancer in Women Aged 40 Years." Collaborating with Dr. Malmgren were Jay Parikh, M.D., Mary K. Atwood, C.T.R., and Henry G. Kaplan, M.D.
The study was funded by the Kaplan Cancer Research Fund and the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)
RSNA is an association of more than 48,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on mammography, visit RadiologyInfo.org.
Linda Brooks | EurekAlert!
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
Researchers from the University of Miami (UM) Rosenstiel School of Marine and Atmospheric Science, the Italian Space Agency (ASI), and the Instituto Geofisico--Escuela Politecnica Nacional (IGEPN) of Ecuador, showed an increasing volcanic danger on Cotopaxi in Ecuador using a powerful technique known as Interferometric Synthetic Aperture Radar (InSAR).
The Andes region in which Cotopaxi volcano is located is known to contain some of the world's most serious volcanic hazard. A mid- to large-size eruption has...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
16.08.2017 | Physics and Astronomy
16.08.2017 | Materials Sciences
16.08.2017 | Interdisciplinary Research