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Survival from primary breast cancer after routine clinical use of mammography.
Breast J. 2002 Jul-Aug;8(4):199-208
Publication Type
J. Sun
J. Chapman
R. Gordon
R. Sivaramakrishna
M. Link
E. Fish
Author Affiliation
Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada.
Breast J. 2002 Jul-Aug;8(4):199-208
Publication Type
Age Distribution
Age Factors
Breast Neoplasms - mortality - radiography - therapy
Canada - epidemiology
Cohort Studies
Diagnostic Tests, Routine - standards
Health Services Accessibility
Mammography - standards
Middle Aged
Multivariate Analysis
Neoplasm Staging
Predictive value of tests
Risk factors
Survival Analysis
Clinical trials indicate that mammography provides a substantial breast cancer survival benefit; however, there is a need to demonstrate that this benefit extends to clinical practice and to determine the extent that current reductions in mortality are attributable to regular screening or adjuvant systemic therapy. Mammography was used routinely at our institution across a broad age range, in an era when most patients received no adjuvant systemic therapy. We examined breast cancer survival for a cohort of 678 stage I-III primary invasive breast cancer patients accrued from 1971 to 1990, and followed to 1996; 18% received adjuvant hormonal therapy and 15% received adjuvant chemotherapy. There were 61 women less than 40 years old; 136, 40-49 years; 341, 50-69 years; 140, > or =70 years. Factors available for multivariate investigations were age (years), tumor size (cm), nodal status (N-, Nx, N+), ER (fmol/mg protein), PgR (fmol/mg protein), adjuvant radiotherapy (no, yes), adjuvant hormonal therapy (no, yes), and adjuvant chemotherapy (no, yes). Forward stepwise multivariate regression with log-normal survival analysis was used to examine the effects of these factors on disease-specific survival. Ten-year survival by tumor size was adjusted for the effects of other significant factors. For women less than 40 years of age, 10-year survival at the T1a, T1b, T1c, and T2 cut-points for tumor size is, respectively, 0.77, 0.74, 0.67, 0.44; for 40-49 years it is 0.92, 0.90, 0.85, 0.62; for 50-69 years it is 0.81, 0.79, 0.75, 0.62; for > or =70 years it is 0.84, 0.81, 0.73, 0.44. With routine use of clinical mammography and up to 26 years of follow-up, we found breast cancer survival to be significantly better (p
Comment In: Breast J. 2002 Jul-Aug;8(4):185-612100108
PubMed ID
12100111 View in PubMed
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