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Breast cancer patients enrolled in the Swiss mammography screening program "donna" demonstrate prolonged survival.
Kuklinski, David; Blum, Marcel; Subelack, Jonas; Geissler, Alexander; Eichenberger, Alena; Morant, Rudolf.
Affiliation
  • Kuklinski D; Chair of Health Economics, Policy and Management, School of Medicine, University of St. Gallen, St. Jakobstr. 21, 9000, St. Gallen, Switzerland. David.kuklinski@unisg.ch.
  • Blum M; Cancer League of Eastern Switzerland, St. Gallen, Switzerland.
  • Subelack J; Chair of Health Economics, Policy and Management, School of Medicine, University of St. Gallen, St. Jakobstr. 21, 9000, St. Gallen, Switzerland.
  • Geissler A; Chair of Health Economics, Policy and Management, School of Medicine, University of St. Gallen, St. Jakobstr. 21, 9000, St. Gallen, Switzerland.
  • Eichenberger A; Cancer League of Eastern Switzerland, St. Gallen, Switzerland.
  • Morant R; Cancer League of Eastern Switzerland, St. Gallen, Switzerland.
Breast Cancer Res ; 26(1): 84, 2024 May 27.
Article in En | MEDLINE | ID: mdl-38802897
ABSTRACT
STUDY GOAL We compared the survival rates of women with breast cancer (BC) detected within versus outside the mammography screening program (MSP) "donna".

METHODS:

We merged data from the MSP with the data from corresponding cancer registries to categorize BC cases as within MSP (screen-detected and interval carcinomas) and outside the MSP. We analyzed the tumor stage distribution, tumor characteristics and the survival of the women. We further estimated hazard ratios using Cox-regressions to account for different characteristics between groups and corrected the survival rates for lead-time bias.

RESULTS:

We identified 1057 invasive (ICD-10 C50) and in-situ (D05) BC cases within the MSP and 1501 outside the MSP between 2010 and 2019 in the Swiss cantons of St. Gallen and Grisons. BC within the MSP had a higher share of stage I carcinoma (46.5% vs. 33.0%; p < 0.01), a smaller (mean) tumor size (19.1 mm vs. 24.9 mm, p < 0.01), and fewer recurrences and metastases in the follow-up period (6.7% vs. 15.6%, p < 0.01). The 10-year survival rates were 91.4% for women within and 72.1% for women outside the MSP (p < 0.05). Survival difference persisted but decreased when women within the same tumor stage were compared. Lead-time corrected hazard ratios for the MSP accounted for age, tumor size and Ki-67 proliferation index were 0.550 (95% CI 0.389, 0.778; p < 0.01) for overall survival and 0.469 (95% CI 0.294, 0.749; p < 0.01) for BC related survival.

CONCLUSION:

Women participating in the "donna" MSP had a significantly higher overall and BC related survival rate than women outside the program. Detection of BC at an earlier tumor stage only partially explains the observed differences.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Mammography / Early Detection of Cancer Limits: Aged / Female / Humans / Middle aged Country/Region as subject: Europa Language: En Journal: Breast Cancer Res Journal subject: NEOPLASIAS Year: 2024 Type: Article Affiliation country: Switzerland

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Mammography / Early Detection of Cancer Limits: Aged / Female / Humans / Middle aged Country/Region as subject: Europa Language: En Journal: Breast Cancer Res Journal subject: NEOPLASIAS Year: 2024 Type: Article Affiliation country: Switzerland