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Aggressive primary treatments with favourable 5-year survival for screen-interval breast cancers.

Aggressive primary treatments with favourable 5-year survival for screen-interval breast cancers.
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Defossez G, Quillet A, Ingrand P,


Defossez G, Quillet A, Ingrand P, (click to view)

Defossez G, Quillet A, Ingrand P,

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BMC cancer 2018 04 0618(1) 393 doi 10.1186/s12885-018-4319-4
Abstract
BACKGROUND
To assess the impact of the participation in screening programme according to the mode of detection on the early diagnosis, treatment, and specific survival outcomes in women with breast cancer.

METHODS
Women diagnosed with invasive breast cancer in Poitou-Charentes region (France) between 2008 and 2009 were classified into three groups, using data linkage of cancer registry, vital statistics and French organized screening programme: the screening programme (SP), interval cancer (IC), and non-screening programme detected cancer (NSP) groups. Specific survival rates were analysed using the Kaplan-Meier method and Cox proportional hazard models.

RESULTS
Among 1613 patients, 65.7% (n = 1059) participated in a screening programme. The interval cancer rate was 17.1% (n = 181). Tumours in the IC group were diagnosed at a more advanced stage, i.e. with further regional lymph node metastasis or local spread, than those in the SP group (p < 0.001), but with significantly fewer metastases at diagnosis than in the NSP group (p < 0.001). ICs underwent more aggressive primary treatments than the two other groups, with 28% of radical mastectomy and 67% undergoing chemotherapy. The five-year survival rate for IC group were 92.0% (95% CI, 89.9-94.0%). CONCLUSIONS
Interval cancers had more aggressive features than screen-detected cancers but were diagnosed at a less advanced stage compared to non-screen detected cancers. Despite having cancers missed by the screening programme, women who participate in the screening process seem to benefit from early treatment. These results must be confirmed with long-term follow-up.

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