Population-based screening for breast cancer with universal biennial mammography resulted in a substantial reduction in breast cancer deaths, while risk-based biennial mammography resulted in only a modest benefit, compared with annual clinical breast examination, a study published in JAMA Oncology has shown.1
Although a variety of screening strategies for breast cancer are available, they have not been evaluated in a population-based study. Therefore, researchers sought to assess the benefits and harms of risk-based and universal mammography screening in comparison with annual clinical breast examination.
For the population-based cohort study, researchers enrolled 1 429 890 asymptomatic women attending outreach screening in the community or undergoing mammography in hospitals into 1 of the 3 screening programs.
Results showed that detection rates were the highest for universal biennial mammography, followed by risk-based mammography, and were lowest for annual clinical breast examination.
Researchers found that compared with annual clinical breast examination, universal biennial mammography screening was associated with a 41% reduction in death and a 30% reduction in the incidence of stage 2+ breast cancer.
Risk-based mammography screening was associated with an 8% reduction of stage 2+ breast cancer; however, this screening method was not associated with a significant reduction in mortality.
In terms of overdiagnosis, annual clinical breast examination and risk-based mammography screening had similar rates, while universal mammography had a 13% higher rate of overdiagnosis.
1. Yen AM, Tsau HS, Fann JC, et al. Population-based breast cancer screening with risk-based and universal mammography screening compared with clinical breast examination [published online ahead of print March 31, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2016.0447.