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Does screening mammo improve outcomes for breast cancer?

by Thomas Dworetzky, Contributing Reporter | October 28, 2015
Rad Oncology Population Health Risk Management Women's Health
A recent study published in the British Medical Journal, showed that, in recent years, cancer stage still has an important role in survival rates after breast cancer diagnosis. The study looked at nearly 174,000 Dutch women. Forbes contributor Elaine Schattner reported on the study and noted that "the findings run counter to a press-popular view that early breast cancer detection has little value in the modern oncology era."

Commenting on the study in the same September, 2015, issue of the BMJ, authors Dr. Ines Vaz-Luis and Dr. Harold J Burstein, both of the Dana Farber Cancer Institute in Boston, Massachusetts, wrote, "There are powerful takeaway lessons from this extensive, population-based report."

They stated that one major lesson is that ongoing refinements in breast cancer treatment, such as the use of trastuzumab, taxane-based chemotherapy, and the adjuvant use of aromatase inhibitors, are providing persistent, incremental improvement in outcomes, according to Medscape.

"Secondly, certain cohorts of patients are achieving astonishingly good outcomes," wrote the two doctors. "Women with small, node-negative breast cancers now have a five year survival rate close to that of the general population."

The study, according to authors Dr. Sepideh Saadatmand, Reini Bretveld, Professor Sabine Siesling and Dr. Madeleine M. A. Tilanus-Linthorst, from Erasmus University Medical Centre, the Netherlands Comprehensive Cancer Organization and the University of Twente, "is the first to use such recent data to assess the effect of traditional prognostic factors such as tumor size and nodal status on survival." The authors stressed that, "our results emphasize the importance of tumor stage at diagnosis of breast cancer, as it still greatly affects overall survival."

The results revealed that 5-year survival improved from 91 percent in the earlier period to 96 percent in the later period. Both relative and overall survival rates rose for the 2006-12 cohort for all tumor and nodal stages, "especially in women who were older than 75 years," reported the medical news organization.

This contrasts with some earlier headlines about cancer screening. For example, a New York Times article by Peggy Orenstein in 2012, that stated, "a survey of three decades of screening published in November [2012] in The New England Journal of Medicine found that mammography’s impact is decidedly mixed: it does reduce, by a small percentage, the number of women who are told they have late-stage cancer, but it is far more likely to result in overdiagnosis and unnecessary treatment, including surgery, weeks of radiation and potentially toxic drugs," she stated.

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