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1.
《Clinical breast cancer》2020,20(6):e701-e710
BackgroundTwo large randomized trials, CALGB 9343 and PRIME II, support omission of radiotherapy after breast conserving surgery (BCS) in elderly women with favorable-risk early stage breast cancer intending to take endocrine therapy. However, patients with grade 3 histology were underrepresented on these trials. We hypothesized that high-grade disease may be unsuitable for treatment de-escalation and report the oncologic outcomes for elderly women with favorable early stage breast cancer treated with BCS with or without radiotherapy.Materials and MethodsThe Surveillance, Epidemiology, and End Results database was queried for women between 70 and 79 years of age with invasive ductal carcinoma diagnosed between 1998 and 2007. This cohort was narrowed to women with T1mic-T1c, N0, estrogen receptor-positive, invasive ductal carcinoma treated with BCS with or without external beam radiation (EBRT). The primary endpoints were 5- and 10-year cause-specific survival (CSS). Univariate and multivariate analyses were performed. Propensity-score matching of T-stage, year of diagnosis, and age was utilized to reduce selection bias while comparing treatment arms within the grade 3 subgroup.ResultsA total of 12,036 women met inclusion criteria, and the median follow-up was 9.4 years. EBRT was omitted in 22% of patients, including 21% with grade 3 disease. Patients in the EBRT cohort were slightly younger (median, 74 vs. 75 years; P < .01) and had fewer T1a tumors (11% vs. 13%; P = .02). Histologic grades 1, 2, and 3 comprised 36%, 50%, and 14% of the cohort, respectively, and there were no differences in EBRT utilization by grade. Utilization of EBRT decreased following the publication of the CALGB trial in 2004 decreasing from 82% to 85% in 1998 to 2000 to 73% to 75% in 2005 to 2007 (P < .01). Unadjusted outcomes showed that in grade 1 disease, there were no differences in CSS with or without EBRT at 5 (99%) and 10 years (95%-96%). EBRT was associated with an improvement in CSS in grade 2 histology at 5 years (97% vs. 98%) and 10 years (92% vs. 95%) (P = .004). The benefit was more pronounced in grade 3 disease with CSS increasing from 93% to 96% at 5 years and from 87% to 92% at 10 years (P = .02) with EBRT. In the grade 3 subgroup, propensity-score matching confirmed EBRT was associated with superior CSS compared with surgery alone (hazard ratio, 0.58; 95% confidence interval, 0.34-0.98; P = .043).ConclusionIn this database analysis, omission of radiotherapy after BCS in elderly women with favorable-risk, early stage, grade 3 breast cancer was associated with inferior CSS. Further prospective data in this patient population are needed to confirm our findings and conclusions. 相似文献
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Tanapat EngkakulNuntakorn ThnogtangAkarin NimmannitSuebwong ChuthapisithCharuwan Akewanlop 《Asian Pacific journal of cancer prevention》2020,21(4):953-960
Objective: Obesity is increasing worldwide. Previous studies of the impact of obesity on breast cancer outcomes have reported conflicting results. We investigated the association of obesity and breast cancer survival in Thai patients. Methods: Medical records of operable breast cancer patients diagnosed and treated at Siriraj Hospital between January 2004 and December 2011 were reviewed. Demographic data, tumor characteristics, stage, treatment and adverse event were described. Obesity was defined as body mass index (BMI) ≥ 25 kg/m2 using Asian’s cutoff value. Survivals in both obese and non-obese patient groups were analyzed. Results: A total of 400 patients were included, 200 in each group. Obese patients were older and associated with more comorbidity. Obesity was associated with larger tumor size (p = 0.011), greater numbers of lymph node involvement (p = 0.003) and more advanced stage (p = 0.01). Obese patients were more likely to receive less adjuvant chemotherapy and hormonal treatment. There was no statistically significant difference in disease-free survival (DFS) (Hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.46 to 1.13) and overall survival (OS) (HR 0.77, 95% CI 0.43 to 1.39) between obese and non-obese patients. Interestingly, obesity was associated with fewer complications from chemotherapy than non-obese patients (p = 0.047). Conclusion: Obesity had no adverse prognostic impact association on both DFS and OS in Thai patients with operable breast cancer, although obese patients more often presented with larger tumor and higher numbers of lymph node involvement. 相似文献
3.
Kerryn W. Reding Aaron K. Aragaki Richard K. Cheng Ana Barac Sylvia Wassertheil-Smoller Jessica Chubak Marian C. Limacher W. Gregory Hundley Ralph D'Agostino Jr. Mara Z. Vitolins Theodore M. Brasky Laurel A. Habel Eric J. Chow Rebecca D. Jackson Chu Chen April Morgenroth Wendy E. Barrington Matthew Banegas Matthew Barnhart Rowan T. Chlebowski 《The oncologist》2020,25(8):712-721
4.
Lack of Prognostic Impact of Adjuvant Radiation on Oncologic Outcomes in Elderly Women with Breast Cancer
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《Asian Pacific journal of cancer prevention》2015,16(17):7813-7818
Background: Radiotherapy plays an important role as adjuvant treatment in locally advanced breast cancer and in those patients who have undergone breast-conserving surgery. This study aimed to investigate the prognostic impact of adjuvant radiation on oncologic outcomes in elderly women with breast cancer. Materials and Methods: In this retrospective study, we reviewed and analyzed the characteristics, treatment outcome and survival of elderly women (aged ≥ 60 years) with breast cancer who were treated and followed-up between 1993 and 2014. The median follow up for the surviving patients was 38 (range 3-207) months. Results: One hundred and seventy-eight patients with a median age of 74 (range 60-95) years were enrolled in the study. Of the total, 60 patients received postoperative adjuvant radiation (radiation group) and the remaining 118 did not (control group). Patients in the radiation group were significantly younger than those in the control group (P value=0.004). In addition, patients in radiation group had higher node stage (P value<0.001) and disease stage (P=0.003) and tended to have higher tumor grade (P=0.031) and received more frequent (P value <0.001) adjuvant and neoadjuvant chemotherapy compared to those in the control group. There was no statistically significant difference between two groups regarding the local control, disease-free survival and overall survival rates. Conclusions: In this study, we did not find a prognostic impact for adjuvant radiation on oncologic outcomes in elderly women with breast cancer. 相似文献
5.
Bong Kyun Kim Sung Gwe Ahn Se Jeong Oh Hakyoung Kim Eunyoung Kang Yongsik Jung Kyung Do Byun Jina Lee Woo Young Sun Korean Breast Cancer Society 《JOURNAL OF BREAST CANCER》2022,25(1):13
PurposeBreast cancer is mainly diagnosed using core needle biopsy (CNB), although other biopsy methods, including vacuum-assisted biopsy (VAB), may also be used. We compared differences in clinical characteristics and prognoses of patients with breast cancer according to biopsy methods used for diagnosis.MethodsA total of 98,457 patients who underwent various biopsy methods (CNB, fine-needle aspiration [FNA], VAB, and excisional biopsy) for diagnosing breast cancer were recruited. Using CNB as a reference, related clinicopathological factors and prognostic differences between biopsy methods were analyzed retrospectively using large-scale data from the Korean Breast Cancer Society Registration System. The associations between biopsy methods and clinicopathological factors were compared using multinomial logistic regression analysis, and the prognoses of patients undergoing the different biopsy methods, as breast cancer-specific survival (BCSS) and overall survival (OS), were compared using the Kaplan-Meier method and Cox proportional hazard model.ResultsUnivariate and multivariate analyses showed that unlike FNA, both VAB and excisional biopsy were significantly associated with tumor size, palpability, tumor stage, and histologic grade as relatively good prognostic factors compared to CNB. In particular, VAB showed lower odds ratios for these factors than excisional biopsy. In the univariate analysis, the prognosis of patients undergoing VAB was better than that of those undergoing CNB with respect to BCSS (hazard ratio [HR], 0.188, p < 0.001) and OS (HR, 0.359; p < 0.001). However, in the multivariate analysis, there were no significant prognostic differences from CNB in both BCSS and OS; differences were only evident for FNA.ConclusionIn this study, we showed that the characteristics of breast cancer differed according to various biopsy methods. Although VAB is not a standard method for breast cancer diagnosis, it showed no prognostic differences to CNB. 相似文献
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《Clinical breast cancer》2020,20(4):e423-e432
PurposeThe Prosigna-PAM50 risk of recurrence (ROR) score has documented clinical utility for the prediction of 10-year distant recurrence (DR). The present study investigated the value of Prosigna-PAM50 for predicting 10-year DR and overall survival after 5 years of endocrine treatment for postmenopausal patients with invasive lobular carcinoma.Patients and MethodsUsing the Danish Breast Cancer Group database, we identified patients with a diagnosis from 2000 to 2003 of estrogen receptor-positive, human epidermal growth factor receptor 2-negative invasive ductal (n = 1570) or lobular (n = 341) cancer > 20 mm or 1 to 3 positive lymph nodes and applied multivariate Cox models.ResultsThe median follow-up for DR was 9.3 years and for overall survival 15.2 years. Of the 341 lobular and 1570 ductal cases, 140 (41%) and 349 (22%) were classified as low ROR, with a 10-year DR rate of 7.7% (95% confidence interval [CI], 3.7%-13.6%) and 3.5% (95% CI, 1.8%-6.2%), respectively. The 10-year DR rate for the intermediate ROR group for those with lobular cancer was 18% (95% CI, 10.1%-27.9%) compared with 9.7% (95% CI, 6.7%-13.4%) for those with ductal cancer. Luminal B tumors had a significantly worse outcome than luminal A tumors in both lobular (hazard ratio, 1.89; 95% CI, 1.03%-3.45%; P = .04) and ductal (hazard ratio, 3.18; 95% CI, 2.29%-4.43%; P < .0001) cancer.ConclusionProsigna PAM-50 provides significant prognostic information beyond the clinicopathologic factors in patients with invasive lobular breast cancer. Those with lobular cancer had worse 10-year DR rates compared with those with ductal cancer in the same ROR category. Our results could have an effect on the treatment decisions regarding the addition of chemotherapy for those in the intermediate ROR group. 相似文献
8.
《Clinical breast cancer》2022,22(7):e773-e787
BackgroundData guiding radiotherapy (RT) decisions after neoadjuvant chemotherapy (NAC) is largely retrospective, based on older treatment approaches without molecular subtype information. This study evaluated outcomes in breast cancer patients treated with modern NAC by molecular subtype and locoregional treatment.Materials and MethodsThere were 949 patients diagnosed between 2005 and 2016 treated with NAC followed by surgery ± locoregional radiotherapy (LRRT). Outcomes were 7-year locoregional relapse-free survival (LRRFS), breast cancer-specific survival (BCSS), and overall survival (OS).ResultsMedian follow-up was 6.5 years, 92% had cT2-4 and 72% cN1-3 disease. Subtypes were: 21% Luminal A, 18% Luminal B, 35% Her2+, and 21% triple-negative breast cancer (TNBC). Combined taxane and anthracycline-based NAC was used in 91.7% of cases. All patients with Her2+ disease received anti-Her2 therapy. After NAC, the majority (84.9%) underwent mastectomy, and received LRRT (86.1%). Only 11% had mastectomy without RT. Pathologic complete response (pCR) rates were 2.5% for Luminal A, 14.4% Luminal B, 27% TNBC, and 35.1% Her2+. Overall, adjuvant LRRT was associated with improved outcomes but was most significant for improved LRRFS in TNBC (92.5% vs. 68.5%, P < .001; Her2+ 95.4% vs. 93.6%, P = .81; Luminal A 97.4% vs. 100%, P = .49; Luminal B 89.7% vs. 100%, P = .17). On multivariable analysis, factors associated with reduced LRRFS were grade 3 histology (HR 4.96, P = .009) and no pCR (HR 7.0, P = .0008). Predictors of lower BCSS and OS were age >50, grade 3, cT3-4, lack of pCR, LRRT omission, and TNBC and Her2+ subtypes.ConclusionIn this analysis of patients treated with modern NAC, pCR rates varied by molecular subtype. Patients who did not receive LRRT, particularly those with TNBC, had lower survival compared to those treated with LRRT. These findings support the need for prospective studies to evaluate the safety of de-escalating RT after NAC. 相似文献
9.
Laura Rodriguez Kelly Brennan Safiya Karim Sulaiman Nanji Sunil V. Patel Christopher M. Booth 《Clinical colorectal cancer》2018,17(4):e651-e661
Introduction
The incidence of colorectal cancer in young patients has been increasing. We evaluated whether the disease characteristics, management, and outcomes of patients with colon cancer differ among patients aged ≤ 40 years compared with those of older patients.Materials and Methods
Using the Ontario Cancer Registry, all cases of colon cancer (stage I, II, III) treated with surgery in Ontario from 2002 to 2008 were identified. The electronic medical records of treatment were used to identify the use of surgery and adjuvant chemotherapy (ACT). The pathology reports were obtained for a random 25% sample of all cases. A Cox model was used to identify the factors associated with overall (OS) and cancer-specific survival (CSS).Results
The study population included 6775 patients. The age distribution was 2%, 5%, 14%, and 79% for patients aged ≤ 40, 41 to 50, 51 to 60, and > 60 years, respectively. Compared with patients aged > 60 years, younger patients (age ≤ 40 years) were more likely to have lymphovascular invasion (35% vs. 27%; P = .005), T3/T4 tumors (88% vs. 79%; P = .005) and lymph node–positive disease (58% vs. 41%; P < .001). The stage distribution varied by age: stage I, 8% versus 19%; stage II, 34% versus 40%; and stage III, 58% versus 41% for those aged ≤ 40 years versus those aged > 60 years, respectively (P < .001). ACT was delivered more often to patients aged ≤ 40 years than to those aged > 60 years for stage II (50% vs. 13%; P < .001) and stage III (≥ 92% vs. 57%; P < .001) disease. The adjusted OS (hazard ratio [HR], 0.32; 95% confidence interval [CI], 0.21-0.49) and CSS (HR, 0.41; 95% CI, 0.26-0.64) were superior for patients aged ≤ 40 years compared with the OS and CSS for those aged > 60 years.Conclusion
Young patients with colon cancer have more aggressive and advanced disease but improved outcomes compared with older patients. 相似文献10.
Background The aim of the present study was to define the proportion of different levels of family history in a cohort of consecutive breast cancer patients from the Stockholm region, and to assess whether familial breast cancer has phenotypic traits different from those of sporadic patients.Methods All incident breast cancer patients in a 19-month period were eligible for the study and 70% (489/696) participated. The family history and clinical parameters were obtained from questionnaires and medical records.Results In total 35% had a family history. Age at onset was 58.9 years in the familial group vs. 60.7 years in the sporadic patients (P = 0.14) and 8% of the familial patients had bilateral breast cancer compared to 4% in the sporadic group (P = 0.08). There were 31% node positive tumors in the sporadic group vs. 22% in the cases with family history (P = 0.04). Hormonal background, treatment and prognosis (median follow-up 4.7 years) were not related to family history.Conclusion In addition to high-risk familial breast and breast-ovarian cancer, constituting about 10% of all breast cancer cases, another 25% of the breast cancer cases have a family history, a group hypothetically valuable for association studies on low-risk genes. In contrast to previous reports, we did not observe a relationship between family history and phenotypic traits. A possible explanation for this can be different study design. The considerable heterogeneity in familial breast cancer means that different criteria for familiality can influence the result. Furthermore, our study was prospective and population based and included paternal inheritance. 相似文献
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Siddhartha Yadav Rand Ladkany Dhiraj Yadav Omar Alhalabi Sinan Khaddam Daniel Isaac Paola Yumpo Cardenas Dana Zakalik 《Clinical breast cancer》2018,18(5):e1229-e1235
Introduction
The effect of germline BRCA mutations on the outcomes of patients with triple-negative breast cancer (TNBC) is not well understood.Materials and Methods
The present retrospective study included women with newly diagnosed TNBC from January 1, 2004 to December 30, 2013. The demographic and tumor characteristics, genetic testing results, and outcomes were collected by a review of the patients’ medical records. The outcomes were compared between the BRCA+ and BRCA? women. Kaplan-Meier curves were plotted for survival analysis, and Cox proportional hazard regression was used to determine the predictors of recurrence-free survival.Results
A total of 266 TNBC patients who had undergone BRCA testing were included in the final analysis. Of the 266 patients, 72 (27.0%) tested positive for a pathogenic BRCA mutation and 194 (73.0%) tested negative. BRCA+ women were more likely to be diagnosed with breast cancer at a younger age than were the BRCA? women. Mutation carriers were also more likely to undergo bilateral mastectomy and less likely to receive radiation. The 2- and 5-year overall survival in BRCA+ women was 97.1% and 83.1% and was 97.3% and 89.7% in the BRCA? women, respectively. No statistically significant difference was found in overall survival between the BRCA+ and BRCA? group. No statistically significant difference was noted in the rate of locoregional recurrence, distant recurrence, or recurrence-free survival between the BRCA+ and BRCA? women.Conclusion
Our study has demonstrated that BRCA mutation carrier status does not affect overall survival or recurrence-free survival in patients with TNBC. 相似文献13.
Swaroopa Yerrabothala Hamid Shaaban Gerardo Capo Michael Maroules Vincent A. Debari 《Pathology oncology research : POR》2014,20(1):209-214
Diabetes mellitus has been implicated to affect the prognostic outcomes of patients with various types of cancer. This study explores the impact of diabetes mellitus on the survival outcomes of patients with all stages of breast cancer. We performed a retrospective analysis of 255 patients with all stages of breast cancer. Survival outcomes were compared for diabetic and non-diabetic patients. A greater percent of patients in the non-diabetic group (54.1 %) presented with early-stage (stage 0 and 1) cancer than diabetics for which 41.2 % presented with stage 0 or 1 breast cancer; however this difference did not achieve statistical significance (p?=?0.068). Overall, we observed a significant difference in survival between the diabetics and non-diabetic subjects (p?=?0.001). Even after adjustment for all covariates and after stratification for Body Mass Index (BMI), diabetics were found to have a poorer prognosis in terms of survival time. In patients with breast cancer, diabetes mellitus is an independent predictor of lower overall survival rates, even after adjusting for other comorbidities. Primary caregivers and oncologists alike should aggressively screen breast cancer patients for diabetes mellitus and vice versa. 相似文献
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A Self-Help Guided Psychoeducational Intervention for Indonesian Women with Breast Cancer Symptoms: Development and Pilot Feasibility Study
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Hari Setyowibowo Aulia IskandarsyahSawitri S SadarjoenDharmayanti F BaduduDrajat R SuardiJan PasschierJoke A M HunfeldMarit Sijbrandij 《Asian Pacific journal of cancer prevention》2019,20(3):711-722
Background: Delay in the diagnosis of breast cancer (BC) may lead to an advanced stage of the disease and apoor prognosis. A psychoeducational intervention can be crucial in helping women with BC symptoms complete theexamination procedures and reduce diagnosis delay of BC. Objective: To develop a psychoeducational interventionto reduce the delay of BC diagnosis among Indonesian women with BC symptoms. Methods: The development ofthe intervention included an inventory of crucial elements in developing psychoeducation through literature review aswell as consultation with BC patients and healthcare providers. Additionally, we developed PERANTARA as the firstpilot version of the self-help guided psychoeducational intervention. PERANTARA is an abbreviation for “PengantarPerawatan Kesehatan Payadura”, which means an introduction to breast health treatment. The pilot feasibility studycombined an expert review and a pilot testing in hospital settings. A semi-structured interview and the client satisfactioninventory were utilized to measure feasibility and acceptability of the intervention for Indonesian women with BCsymptoms. Results: PERANTARA contained an oncologist’s explanation about BC and the BC survivors’ testimonyto reduce the time to diagnosis. The pilot study results showed that most patients were satisfied with and trusted onPERANTARA. Conclusion: PERANTARA was feasible and acceptable for Indonesian patients with BC symptoms.The development framework suggested in this study can be applied to develop psychoeducational packages for otherpatients group, in particular, those interventional packages aimed at reducing diagnosis and treatment delays and nonadherence. 相似文献
16.
Jianyang Wang Shulian Wang Yu Tang Hao Jing Guangyi Sun Jing Jin Yueping Liu Yongwen Song Weihu Wang Hui Fang Hua Ren Zihao Yu Yexiong Li 《Clinical breast cancer》2018,18(5):e975-e984
Background
To investigate the superiority of breast-conserving surgery (BCS) plus radiotherapy (RT) compared with mastectomy alone for patients with stage I breast cancer in a real-world setting.Patients and Methods
The data from patients with histologically confirmed stage I breast cancer treated from 1999 to 2014 were retrospectively reviewed. The association of outcomes with the choice of treatment (BCS plus RT vs. mastectomy) was evaluated using multivariable proportional hazards regression and further confirmed using propensity score matching methods.Results
Of 6137 eligible patients in the present study, 1296 underwent BCS plus RT and 4841 underwent mastectomy plus axillary lymph node dissection without RT (mastectomy group). Multivariate analysis revealed that BCS plus RT was related to similar locoregional recurrence-free survival but greater distant metastasis-free survival (P = .003) and overall survival (P = .036) compared with mastectomy. For the 1252 pairs of patients matched using propensity score matching, the BCS plus RT groups enjoyed significantly greater 5-year overall survival (99.1% vs. 96.1%; P = .001), distant metastasis-free survival (97.0% vs. 92.2%; P < .001), and disease-free survival (95.3% vs. 90.2%; P = .001) compared with the mastectomy group.Conclusion
BCS plus RT provided better outcomes than mastectomy for eligible patients with stage I breast cancer and should be offered as a preferred treatment option. 相似文献17.
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《Asian Pacific journal of cancer prevention》2013,14(8):4591-4594
Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, thereare no documented population-based survival rates of Malaysian women for breast cancers. This populationbasedretrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre,Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the periodfrom 1st January 2000 to 31st December 2005. Cases were captured by ICD-10 and linked to death certificates toidentify the status. Only complete data were analysed. Survival time was calculated from the estimated date ofdiagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan-Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed.The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survivaltime of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) andMalays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still lowfor the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary toenhance the strategies for early detection and intervention. 相似文献
19.
Michal Staník Alexandr Poprach Michaela Zapletalová Denisa Krejčí Daniel Macík Ivo Čapák Jiří Jarkovský Radek Lakomý Jan Doležel 《Clinical genitourinary cancer》2019,17(4):e759-e767
IntroductionPatients with clinically node-positive bladder cancer were historically considered to have uniformly poor prognosis and were frequently treated with palliative chemotherapy (CHT) only. Although retrospective data show that long-term survival with combined treatment (surgery + CHT) is possible in one-third of these patients, consensus on a treatment algorithm is still lacking. The aim of the study is to compare the efficacy of different treatment modalities based on data from a population-based cancer registry.Patients and MethodsThe study comprises 661 patients identified from the Czech National Cancer Registry (1996-2015) with cTanyN1-3M0 bladder cancer; 195 were treated with CHT alone, 234 underwent radical cystectomy alone (RC), and 232 received a combination of RC and perioperative CHT (RC + CHT). Multivariate Cox proportional hazard regression analyses were used to evaluate the effectiveness of various treatments.ResultsThe 5-year OS for CHT alone, RC alone, and RC + CHT were 21.7% (95% confidence interval [CI], 15.4%-28.0%), 12.1% (95% CI, 7.4%-16.7%), and 25.4% (95% CI, 18.9%-31.9%), respectively (P < .001). The median survivals were 17, 10, and 23 months, respectively. In multivariate analysis, age > 60 years (hazard ratio, 1.29; 95% CI, 1.06-1.56; P = .011) and clinical stage cT3-4 (hazard ratio, 1.39; 95% CI, 1.12-1.71; P = .002) were negative predictors of survival. When compared with CHT, RC + CHT reduced the risk of overall mortality by 21% (P = .044).ConclusionApproximately one-quarter of clinically node-positive patients may achieve long-term survival with combined treatment integrating RC and perioperative CHT. The overall survival of patients is significantly improved with a multimodal approach in comparison to CHT alone. 相似文献
20.
The Impact of Mammographic Breast Cancer Screening in Singapore: A Comparison Between Screen-detected and Symptomatic Women
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《Asian Pacific journal of cancer prevention》2011,12(10):2735-2740
Background: Breast cancer is the leading cause of cancer death amongst Singapore women. There are few studies evaluating the impact of mammographic screening among Asian women. This study aimed to examine differences in disease stage at presentation and outcome between breast cancer patients who were detected by screening (screen-detected) and those who presented symptomatically (symptomatic) from the experience of a regional hospital in Singapore. We also sought to identify the demographic profile of patients who were less likely to be screen detected. Methods: Retrospective data fpr female patients diagnosed with primary breast cancer and treated from January 2002 - December 2008 were analyzed. Univariate and multivariate analyses were performed to examine the profile of symptomatic as opposed to screen-detected patients and factors that influence presentation at an early disease stage. Survival and recurrence rates were computed by Kaplan-Meier method and compared by log rank test. Results: The study population consisted of 82 screen-detected and 679 symptomatic patients. The screen-detected patients were more likely to present at an earlier stage and have better overall cancer-specific survival as compared to symptomatic patients. Malay women and those without a family history of breast cancer were less likely to be detected by screening. Conclusions: Mammographic screening appeared to enable the detection of oncologically more favorable lesions and conferred better overall cancer-specific survival in Singapore women. There is possibly room for more targeted education efforts to reach out to Malay women and those without a family history of breast cancer to enable earlier disease detection among these individuals through regular breast cancer screening. 相似文献