Breast cancer in New South Wales in 1972-1995: Tumor size and the impact of mammographic screening

Kricker, Anne; Farac, Katie; Smith, David P.; Sweeny, Amy; McCredie, Margaret; Armstrong, Bruce K.

doi:10.1002/(sici)1097-0215(19990611)81:6<877::aid-ijc7>3.0.co;2-f

Cited by 43 publications

(21 citation statements)

References 11 publications

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“…Spread of cancer at diagnosis was classified as localized to the breast, invading adjacent tissue or regional lymph nodes or distant metastases. Breast cancer size was available for women 40-69 years for the whole of 1992 and for women of all ages in 6 months of 1995 (Kricker et al, 1999) and was grouped into four categories (0.1-0.9 cm, 1.0-1.9 cm, 2.0-2.9 cm and 3.0+ cm).…”

Section: Methodsmentioning

confidence: 99%

Breast conservation, mastectomy and axillary surgery in New South Wales women in 1992 and 1995

Kricker¹,

Haskill²,

Armstrong

2001

Br J Cancer

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SummaryTo measure the increase in uptake of BCT in NSW and its determinants, we examined Cancer Registry records of 2020 women with breast cancer in 1992 and 2883 in 1995 linked to records of their surgical treatment in the NSW Inpatient Statistics' Collection. In parallel, we examined trends and determinants in axillary surgery for breast cancer. Breast conservation increased from 39% of breast cancer in 1992 to 45% in 1995, mainly in women with the smallest cancers. In 1995, mastectomy was still most common in women with larger cancers (OR for breast cancers 3+ cm relative to <1 cm = 5.6, 95% CI 2.9-10.7) and cancers that had spread beyond the breast (OR = 2.0, 95% CI 1.4-2.7 relative to localized to the breast). Urban women had fewer mastectomies than rural women. Axillary surgery, common in 1992 (78%) and 1995 (82%), fell steeply with increasing age and more often accompanied mastectomy (93% in 1995) than BCT (67% in 1995). In 1995 the odds for axillary surgery were some two-fold or more higher for all cancers 1 cm or more in diameter compared with those <1.0 cm and highest for 2.0-2.9 cm cancers (OR = 3.3 95% CI 1.7-6.7 relative to <1.0 cm). Regional spread of the cancer at diagnosis was not a strong predictor. In the absence of collection of treatment data by cancer registries, linkage of cancer registry records with hospital inpatient data is an effective alternative for monitoring breast cancer treatment trends.

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Section: Methodsmentioning

confidence: 99%

Breast conservation, mastectomy and axillary surgery in New South Wales women in 1992 and 1995

Kricker¹,

Haskill²,

Armstrong

2001

Br J Cancer

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“…Various studies described an increase in breast cancer incidence rates in the last two to three decades for both, situations with and without organised mammography screening (Quinn and Allen, 1995;Chu et al, 1996;McCann et al, 1998;Kricker et al, 1999;Paci et al, 2002;Schouten et al, 2002;Botha et al, 2003;Buiatti et al, 2003). Where organised screening has been introduced, this increase is more marked, mainly as a result of the additional detection of early breast cancer stages.…”

Section: %mentioning

confidence: 99%

“…As far as we know, the published reductions of advanced cancer rates in regions with a service screening programme have not reached 30% up to now. New South Wales reported a 20% reduction of large (T3 þ ) cancers in women aged 50 -69 years (Kricker et al, 1999). For the East Anglia region, the estimated reduction of advanced stages II -IV was 7 -19% after 7 years (McCann et al, 1998).…”

Section: %mentioning

confidence: 99%

Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

et al. 2004

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The effect of the implementation of the Dutch breast cancer screening programme during 1990 -1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Netherlands Cancer Registry provided detailed data on breast cancer incidence in 1989 -1997 by tumour stage, age and region. Annual age-adjusted incidence rates of all breast cancers and advanced cancers, defined as large tumours T2 þ with lymph node and/or distant metastases, were compared with rates in 1989. In general, breast cancer incidence rose strongly in the early 1990s, especially in the age category 50 -69 years (estimated annual percentage change (EAPC) 4.25; 95% CI 1.70, 6.86). The increase was mainly due to the increase in small T1 cancers and ductal carcinoma in situ. However, in women aged 50 -69, advanced cancer incidence rates showed a significant decline by 12.1% in 1997 compared with 1989 (EAPC -2.14, 95% CI À3.47, À0.80), followed by a breast cancer mortality reduction of similar size after approximately 2 years. We confirm that breast cancer screening initially leads to a temporary strong increase in the breast cancer incidence, which is followed by a significant decrease in advanced diseases in the women invited for screening. It is evident that breast cancer screening contributes to a reduction in advanced breast cancers and breast cancer mortality.

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“…It has been shown that a shift to smaller tumour size has occurred after introduction of mammography screening (Kricker et al, 1999;Tabar et al, 2003). The studies reporting the significance of mammography screening as an independent prognosticator of survival are contradictory.…”

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confidence: 99%

Role of mammography screening as a predictor of survival in postmenopausal breast cancer patients

2005

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We examined the effect of population-based screening programme on tumour characteristics by comparing carcinomas diagnosed during the prescreening (N ¼ 341) and screening (N ¼ 552) periods. We identified screen detected (N ¼ 224), interval (N ¼ 99) and clinical cancer (N ¼ 229) cases. Median tumour size and proportion of axillary lymph node negative cases were 1.5 cm and 65% in the screen detected group, 2.0 cm and 44% in cases found outside the screening, and 3.2 cm and 41% in the cases from the prescreening period. Survival of the breast cancer patients was 66% (95% CI, 60 -71%) in the prescreening era group and 73% (95% CI, 66 -78%) in the screening era group after 10 years of follow-up. In the screening era group the survival of the screen detected cases was 86% (95% CI, 80 -90%) and that of the clinical cancer cases 73% (95% CI, 66 -78%) after 10 years. In multivariate analysis the risk of breast cancer death was not significantly different between the prescreening and screening periods (HR 0.82; 95% CI 0.59 -1.12, P ¼ 0.21). Detection by screening was not an independent prognostic factor in multivariate analysis (HR 0.75; CI 95% 0.50 -1.12; P ¼ 0.17).

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Breast cancer in New South Wales in 1972-1995: Tumor size and the impact of mammographic screening

Cited by 43 publications

References 11 publications

Breast conservation, mastectomy and axillary surgery in New South Wales women in 1992 and 1995

Breast conservation, mastectomy and axillary surgery in New South Wales women in 1992 and 1995

Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

Role of mammography screening as a predictor of survival in postmenopausal breast cancer patients

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