Early Detection of Breast Cancer through Population-Based Mammographic Screening in Asian Women: A Comparison Study between Screen-Detected and Symptomatic Breast Cancers

被引:24
作者
Chuwa, Esther W. L. [2 ]
Yeo, Allen W. Y. [2 ]
Koong, Heng Nung [1 ]
Wong, Chow Yin [2 ]
Yong, Wei Sean [1 ]
Tan, Puay Hoon [3 ]
Ho, Juliana T. S. [4 ]
Wong, Jill S. L. [4 ]
Ho, Gay Hui [1 ]
机构
[1] Natl Canc Ctr, Dept Surg Oncol, Singapore 169610, Singapore
[2] Singapore Gen Hosp, Dept Gen Surg, Singapore 0316, Singapore
[3] Singapore Gen Hosp, Dept Pathol, Singapore 0316, Singapore
[4] Natl Canc Ctr, Dept Oncol Imaging, Singapore, Singapore
关键词
Asian; breast cancer; mammography screening; RANDOMIZED-TRIAL; SINGAPORE; MORTALITY; SURVIVAL; TRENDS; REDUCTION;
D O I
10.1111/j.1524-4741.2009.00687.x
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The first nation-wide mammographic screening program in Asia, BreastScreen Singapore (BSS), was launched in Singapore in January 2002. This study compared the presentation and results of screen-detected breast cancers with symptomatic breast cancers in two affiliated high-volume institutions, one of which was an assessment centre for BSS. The medical records of patients diagnosed with primary breast cancer at the Department of General Surgery, Singapore General Hospital and the Department of Surgical Oncology, National Cancer Centre, Singapore, during the period January 2002 to December 2003 were reviewed. Clinical and pathological comparisons were made between screen-detected lesions and symptomatic lesions. Of a total of 767 cases, 640 (83.4%) were invasive carcinomas and 127 (16.6%) were ductal carcinoma in-situ (DCIS) lesions. Only 13.4% of them were screen-detected. Compared to symptomatic cancers, screen-detected lesions were of smaller size (median size 18 versus 23 mm), a lower stage (stages 0-2, 95 versus 83.2%) and histologic grade (grade 1-2, 71 versus 60%), with a higher incidence of DCIS (31.0 versus 14.3%) and had higher rates of breast conservation (45.6 versus 28.2%) (all p-values < 0.05). By multivariate analysis, tumor palpability, tumor size > 20 mm, nodal involvement, cerbB2 overexpression, and advanced disease stage were independent poor prognostic factors for disease-free survival, whereas nodal involvement, advanced disease, and recurrence predicted poor cancer-specific survival. However, there was no statistically significant difference in disease-free survival or cancer-specific survival between the two groups at a median follow-up of 38 months. Screening mammography has allowed the detection of smaller and hence oncologically more favorable lesions in Asian women. Although no significant survival benefit was demonstrated in our study, a longer period of follow-up is essential before the benefit of mortality reduction, as a result of mammography screening becomes evident in our population.
引用
收藏
页码:133 / 139
页数:7
相关论文
共 22 条
[1]  
American Joint Committee on Cancer (AJCC), 2002, JAMA-J AM MED ASSOC, V6th
[2]   COMPARATIVE PATHOLOGY OF BREAST-CANCER IN A RANDOMIZED TRIAL OF SCREENING [J].
ANDERSON, TJ ;
LAMB, J ;
DONNAN, P ;
ALEXANDER, FE ;
HUGGINS, A ;
MUIR, BB ;
KIRKPATRICK, AE ;
CHETTY, U ;
HEPBURN, W ;
SMITH, A ;
PRESCOTT, RJ ;
FORREST, P .
BRITISH JOURNAL OF CANCER, 1991, 64 (01) :108-113
[3]   Mammographic breast cancer screening: after the dust has settled [J].
Boyle, P .
BREAST, 2003, 12 (06) :351-356
[4]  
Chia KS, 2002, ANN ACAD MED SINGAP, V31, P745
[5]   Reduction in breast cancer mortality from organized service screening with mammography:: 1.: Further confirmation with extended data [J].
Duffy, SW ;
Tabár, L ;
Chen, THH ;
Smith, RA ;
Holmberg, L ;
Jonsson, H ;
Lenner, P ;
Nyström, L ;
Törnberg, S .
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 2006, 15 (01) :45-51
[6]   BREAST SCREENING, PROGNOSTIC FACTORS AND SURVIVAL - RESULTS FROM THE SWEDISH 2 COUNTY STUDY [J].
DUFFY, SW ;
TABAR, L ;
FAGERBERG, G ;
GAD, A ;
GRONTOFT, O ;
SOUTH, MC ;
DAY, NE .
BRITISH JOURNAL OF CANCER, 1991, 64 (06) :1133-1138
[7]  
FIEG SA, 1988, RADIOLOGY, V167, P659
[8]   REPORT OF THE INTERNATIONAL WORKSHOP ON SCREENING FOR BREAST-CANCER [J].
FLETCHER, SW ;
BLACK, W ;
HARRIS, R ;
RIMER, BK ;
SHAPIRO, S .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1993, 85 (20) :1644-1656
[9]   Detection by screening mammography is a powerful independent predictor of survival in women diagnosed with breast cancer [J].
Gill, PG ;
Farshid, G ;
Luke, CG ;
Roder, DM .
BREAST, 2004, 13 (01) :15-22
[10]   A comparison of the performance and impact of breast cancer screening programmes in East Anglia, UK and Bouches du Rhone, France [J].
McCann, J ;
Wait, S ;
Seradour, B ;
Day, N .
EUROPEAN JOURNAL OF CANCER, 1997, 33 (03) :429-435