A comparison of clinicopathological characteristics and survival outcomes between symptomatic and screen detected breast cancer in Japanese women.

Abstract

4 Background: In Japan from 2000, mammography screening has been introduced into the breast cancer screening for women aged 50 or above, however in the early 2000s, breast cancer screening involved palpation only and mammography combined. Only a few studies have been reported clinicopathological characteristics and survival outcomes of this screening detected breast cancer in Japan. This study evaluated effectiveness of this screening by comparing symptomatic and screen detected breast cancer Methods: From January 2000 to December 2004, 1159 patients were underwent surgery for treatment of breast cancer at single hospital in Japan. Among them, 977 patients were symptomatic and 182 patients were this screen detected, and follow-up was performed from the date of the diagnosis until the date of death or the end of follow-up, March 2015. We retrospectively reviewed the clinical and pathologic data. Results: Screen detected breast cancer was associated with more breast conservation surgery, smaller tumor size, less lymph node involvement, more hormone receptor positive, more non-invasive carcinoma and less adjuvant chemotherapy compared with symptomatic breast cancer (P < 0.05). In univariate analyses, women with screen-detected tumors had improved overall survival compared to women with tumors that were detected symptomatically (10-year OS: 90.6% vs.80.4%, P = 0.01). According to ages, in women older than 50 years women with screen-detected tumors had improved overall survival compared to women with tumors that were detected symptomatically (10-year OS:87.7%vs.76.7%, P = 0.006). Screen detection of all patients was independently associated with improved overall survival outcomes (HR 0.47, P = 0.002, respectively), screen detection in women older than 50 years was also similar (HR 0.494, P = 0.007, respectively). Conclusions: This study showed that early detection in breast cancer screening had led to increase in breast conservation rate, avoidance of axillary lymph node dissection, more hormone receptor positive, avoidance of adjuvant chemotherapy, and improvement of survival rate.