Additional mammography scans between regular screenings may benefit patients and reduce the need for more intense breast cancer treatment after diagnosis, according to a study published in Deutsches Ärzteblatt International.
The Mammography Screening Program (MSP) in Germany is designed not only to detect breast cancer during annually scheduled screenings, but also between the last negative and following screening among survivors; detection in these incidences are referred to as interval cancers.
For this retrospective study, the authors assessed the outcomes of 874 and 657 women diagnosed with invasive and ductal carcinoma in situ (DCIS) breast cancers enrolled in the MSP and non-participants, respectively, in order to compare the clinicopathological breast cancer prognostic markers between the groups. Prognostic marker data, such as tumor stage, histology, grading, and receptor status, were available for evaluation with 95% completeness.
Results showed that MSP participants were more likely to be diagnosed with DCIS compared with non-participants (23% vs 13%) and had smaller invasive carcinomas (74% vs 55% diagnosed in the T1 stage). Women in the MSP also were less likely to be node-positive (25% vs 31), high-grade (19% vs 27%), and triple-negative (7% vs 12%), compared with non-participants of the MSP.
Patients who were diagnosed in the MSP also less frequently received neoadjuvant therapy (2% vs 8%), less frequently had guideline-based indications for adjuvant chemotherapy (46% vs 52%), and underwent breast-conserving surgery (75% vs 62%) more frequently than nonparticipants.
Women diagnosed with breast cancer while participating in the MSP demonstrated improved prognostic factors compared to women who are not, and may undergo less systemic therapies and more sparing surgical treatments. The authors concluded that “future investigations need to show whether the differences in surgery and treatment observed here are also reflected in a comparatively better quality of life following the diagnosis of invasive cancer”
Braun B, Khil L, Tio J, Krause-Bergmann B, Fuhs A, Heidinger O, Hense HW. Differences in breast cancer characteristics by mammography screening participation or non-participation—a retrospective observational study.Dtsch Arztebl Int. 2018;115:520–527.