Skip to main content

Advertisement

SpringerLink
Log in

Improving size, lymph node metastatic rate, breast conservation, and mortality of invasive breast cancer in Rhode Island women, a well-screened population

  • Clinical Trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

The beneficial impact of screening mammography on breast cancer outcome continues to be debated as demonstrated by guidelines published by the United States Preventive Services Task Force. A previous report from Rhode Island, which has a very high rate of mammographic screening, demonstrated significant improvements in invasive breast cancer presentation and mortality through 2001. This report updates data through 2008 to determine whether previous favorable trends continued. Rhode Island Cancer Registry data regarding invasive breast cancer presentation and mortality in 17,522 female residents diagnosed between 1987 and 2008, inclusive, were analyzed for demographic and pathological factors. Data were analyzed by four time periods: 1987–1992, 1993–1998, 1999–2003, and 2004–2008 and overall. Statistically significant improvements occurred over the four successive time periods, in mean cancer size (23.7, 20.9, 19.6, and 19.3 mm, p < 0.0001), pathologic grade (Grade I: 12, 15, 19, and 17 %; Grade III 57, 41, 36, and 35 %, p < 0.0001), breast conserving surgery (38, 56, 67, and 71 %, p < 0.0001) and mortality (37.3, 31.4, 25.1, and 22.6 per 100,000/year, p < 0.0001). The results showed that high screening rates favorably impacted presentation of and mortality from invasive breast cancer in Rhode Island. From 1987 to 2008, there has been a 39 % decline in breast cancer mortality considering 5 year periods (37.3 vs. 22.6 deaths per 100,000) and 41 % comparing the period from 1990 to 2008, which may exceed the goal of 50 % mortality reduction by 2015 established by the American Cancer Society.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Smith RA, Duffy SW, Gabe R, Tabar L, Yen AM, Chen TH (2004) The randomized trials of breast cancer screening: what have we learned? Radiol Clin N Am 42(5):793–806 v

    Article  PubMed  Google Scholar 

  2. Gotzsche PC (2011) Relation between breast cancer mortality and screening effectiveness: systematic review of the mammography trials. Dan Med Bull 58(3):CD001877A4246

    Google Scholar 

  3. Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L (2009) Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med 151(10):727–737 W237–742

    PubMed  Google Scholar 

  4. Smith RA, Cokkinides V, Eyre HJ (2007) Cancer screening in the United States, 2007: a review of current guidelines, practices, and prospects. CA Cancer J Clin 57(2):90–104

    Article  PubMed  CAS  Google Scholar 

  5. Chung MA, Fulton JP, Cady B (1999) Trends in breast cancer incidence and presentation in a population screened for breast cancer. Semin Breast Dis 2(1):55–63

    Google Scholar 

  6. Coburn NG, Chung MA, Fulton J, Cady B (2004) Decreased breast cancer tumor size, stage, and mortality in Rhode Island: an example of a well-screened population. Cancer Control 11(4):222–230

    PubMed  Google Scholar 

  7. Spencer DB, Potter JE, Chung MA, Fulton J, Hebert W, Cady B (2004) Mammographic screening and disease presentation of breast cancer patients who die of disease. Breast J 10(4):298–303

    Article  PubMed  Google Scholar 

  8. Hellma S (1994) Karnofsky Memorial Lecture. Natural history of small breast cancers. J Clin Oncol 12(10):2229–2234

    Google Scholar 

  9. Chung MA, Steinhoff MM, Cady B (2002) Clinical axillary recurrence in breast cancer patients after a negative sentinel node biopsy. Am J Surg 184(4):310–314

    Article  PubMed  Google Scholar 

  10. Cady B, Stone MD, Schuler JG, Thakur R, Wanner MA, Lavin PT (1996) The new era in breast cancer. Invasion, size, and nodal involvement dramatically decreasing as a result of mammographic screening. Arch Surg 131(3):301–308

    Article  PubMed  CAS  Google Scholar 

  11. Beahrs OH (1980) Early detection of breast cancer: results of a screening programme. Ann R Coll Surg Engl 62(1):38–40

    PubMed  CAS  Google Scholar 

  12. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ (2003) Cancer statistics. CA Cancer J Clin 53(1):5–26

    Article  PubMed  Google Scholar 

  13. Gohagan JK, Darby WP, Spitznagel EL, Monsees BS, Tome AE (1986) Radiogenic breast cancer effects of mammographic screening. J Natl Cancer Inst 77(1):71–76

    PubMed  CAS  Google Scholar 

  14. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics. CA Cancer J Clin 57(1):43–66

    Article  PubMed  Google Scholar 

  15. Seidman H, Gelb SK, Silverberg E, LaVerda N, Lubera JA (1987) Survival experience in the Breast Cancer Detection Demonstration Project. CA Cancer J Clin 37(5):258–290

    Article  PubMed  CAS  Google Scholar 

  16. Shapiro S, Venet W, Steax P et al (1988) Periodic screening for breast cancers. The HIP. John Hopkins University Press, Baltimore

    Google Scholar 

  17. Fisher B, Costantino JP, Wickerham DL et al (1998) Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 90(18):1371–1388

    Article  PubMed  CAS  Google Scholar 

  18. Nystrom L, Rutqvist LE, Wall S et al (1993) Breast cancer screening with mammography: overview of Swedish randomised trials. Lancet 341(8851):973–978

    Article  PubMed  CAS  Google Scholar 

  19. Roberts MM, Alexander FE, Elton RA, Rodger A (1990) Breast cancer stage, social class and the impact of screening. Eur J Surg Oncol 16(1):18–21

    PubMed  CAS  Google Scholar 

  20. Autier P, Boniol M, LaVecchia C, et al (2010) Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database. BMJ 341:c3620:1–7

    Google Scholar 

  21. Tabar L, Yen MF, Vitak B, Chen HH, Smith RA, Duffy SW (2003) Mammography service screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening. Lancet 361(9367):1405–1410

    Article  PubMed  Google Scholar 

  22. Hunt KA, Rosen EL, Sickles EA (1999) Outcome analysis for women undergoing annual versus biennial screening mammography: a review of 24,211 examinations. AJR Am J Roentgenol 173(2):285–289

    PubMed  CAS  Google Scholar 

  23. Blanchard K, Colbert JA, Puri D et al (2004) Mammographic screening: patterns of use and estimated impact on breast carcinoma survival. Cancer 101(3):495–507

    Article  PubMed  Google Scholar 

  24. Berry DA, Inoue L, Shen Y et al (2006) Modeling the impact of treatment and screening on U.S. breast cancer mortality: a Bayesian approach. J Natl Cancer Inst Monogr 36:30–36

    Article  PubMed  Google Scholar 

  25. Otto SJ, Fracheboud J, Looman CW et al (2003) Initiation of population-based mammography screening in Dutch municipalities and effect on breast-cancer mortality: a systematic review. Lancet 361(9367):1411–1417

    Article  PubMed  Google Scholar 

  26. Vervoort MM, Draisma G, Fracheboud J, van de Poll-Franse LV, de Koning HJ (2004) Trends in the usage of adjuvant systemic therapy for breast cancer in the Netherlands and its effect on mortality. Br J Cancer 91(2):242–247

    PubMed  CAS  Google Scholar 

  27. van Schoor G, Moss SM, Otten JDM et al (2011) Increasingly strong reduction in breast cancer mortality due to screening. Br J Cancer 104(6):910–914

    Article  PubMed  Google Scholar 

  28. Braun S, Vogl FD, Naume B et al (2005) A pooled analysis of bone marrow micrometastasis in breast cancer. N Engl J Med 353(8):793–802

    Article  PubMed  CAS  Google Scholar 

  29. Adair F, Berg J, Joubert L, Robbins GF (1974) Long-term followup of breast cancer patients: the 30-year report. Cancer 33(4):1145–1150

    Article  PubMed  CAS  Google Scholar 

  30. Tubiana-Hulin M, Le Doussal V, Hacene K, Rouesse J, Brunet M (1993) Sequential identification of factors predicting distant relapse in breast cancer patients treated by conservative surgery. Cancer 72(4):1261–1271

    Article  PubMed  CAS  Google Scholar 

  31. Chia SK, Speers CH, Bryce CJ, Hayes MM, Olivotto IA (2004) Ten-year outcomes in a population-based cohort of node-negative, lymphatic, and vascular invasion-negative early breast cancers without adjuvant systemic therapies. J Clin Oncol 22(9):1630–1637

    Article  PubMed  Google Scholar 

  32. Purc-Stephenson RJ, Gorey KM (2008) Lower adherence to screening mammography guidelines among ethnic minority women in America: a meta-analytic review. Prev Med 46(6):479–488

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors acknowledge the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC) for their support of the Rhode Island Cancer Registry (Cooperative Agreement NPCR RI DP000830), from which most of the data for this study were obtained. Drs. Calvin Law and Natalie Coburn are supported by Ministry of Health and Long Term Care Career Scientist Awards.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, USA

    Natalie G. Coburn & Calvin Law

  2. Department of Surgery, Cambridge Hospital, Cambridge, MA, USA

    Blake Cady

  3. Rhode Island Department of Health, Providence, RI, USA

    John P. Fulton

  4. John Wayne Cancer Center, Santa Monica, CA, USA

    Maureen A. Chung

  5. 24 Walnut Place, Brookline, MA, 02445, USA

    Blake Cady

Authors
  1. Natalie G. Coburn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Blake Cady
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John P. Fulton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Calvin Law
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maureen A. Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Blake Cady.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Coburn, N.G., Cady, B., Fulton, J.P. et al. Improving size, lymph node metastatic rate, breast conservation, and mortality of invasive breast cancer in Rhode Island women, a well-screened population. Breast Cancer Res Treat 135, 831–837 (2012). https://doi.org/10.1007/s10549-012-2215-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-012-2215-1

Keywords

Search

Navigation