Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia

2020 ◽  
pp. 096914132095077
Author(s):  
Nathan Dunn ◽  
Philippa Youl ◽  
Julie Moore ◽  
Hazel Harden ◽  
Euan Walpole ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Proportional Hazards ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Mammographic Screening ◽  
Cox Proportional Hazards ◽  
Long Term Results ◽  
Prior History ◽  
Population Based Study

Objective In the context of a mature mammographic screening programme, the aim of this population-based study was to estimate rates of breast-cancer mortality among participants versus non-participants in Queensland, Australia. Methods The Queensland Electoral Roll was used to identify women aged 50–65  in the year 2000 (n = 269,198). Women with a prior history of invasive or in situ breast cancer were excluded (n = 6,848). The study population was then linked to mammography records from BreastScreen Queensland together with the Wesley Breast Screening Clinic (the largest provider of private screening in Queensland) to establish a screened cohort (n = 187,558) and an unscreened cohort (n = 74,792). Cohort members were matched and linked to cancer notifications and deaths through the state-based Queensland Oncology Repository. Differences in breast-cancer mortality between the two cohorts were measured using Cox proportional hazards regression. Results After 16 years of follow-up, women in the screened cohort showed a 39% reduction in breast-cancer mortality compared to the unscreened cohort (HR = 0.61, 95%CI = 0.55–0.68). Cumulative mortality over the same period was 0.47% and 0.77% in the screened and unscreened cohorts, respectively. Conclusions This study found a significant reduction in breast-cancer mortality for women who participated in mammographic screening compared to unscreened women. Our findings of a breast-cancer mortality benefit for women who have mammographic screening are in line with other observational studies.

Use and Outcomes of Adjuvant Chemotherapy in Older Women With Breast Cancer

2006 ◽  
Vol 24 (18) ◽  
pp. 2750-2756 ◽  
Author(s):  
Sharon H. Giordano ◽  
Zhigang Duan ◽  
Yong-Fang Kuo ◽  
Gabriel N. Hortobagyi ◽  
James S. Goodwin
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Older Women ◽  
Proportional Hazards ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Significant Shift ◽  
Breast Cancer Chemotherapy ◽  
Cox Proportional Hazards Models

Purpose This study was undertaken to determine patterns and outcomes of adjuvant chemotherapy use in a population-based cohort of older women with primary breast cancer. Patients and Methods Women were identified from the Surveillance, Epidemiology, and End Results–Medicare-linked database who met the following criteria: age ≥ 65 years, stage I to III breast cancer, and diagnosis between 1991 and 1999. Adjuvant chemotherapy use was ascertained by Common Procedural Terminology J codes. Logistic regression analysis was performed to determine factors associated with chemotherapy use. Multivariate Cox proportional hazards models were used to calculate the hazard of death for women with and without chemotherapy. Results A total of 41,390 women met study criteria, of whom 4,500 (10.9%) received chemotherapy. The use of adjuvant chemotherapy more than doubled during the 1990s, from 7.4% in 1991 to 16.3% in 1999 (P < .0001), with a significant shift toward anthracycline use. Women who were younger, white, with lower comorbidity scores, more advanced stage disease, and estrogen receptor (ER) –negative disease were significantly more likely to receive chemotherapy. Chemotherapy was not associated with improved survival among women with lymph node–negative (LN) disease or LN-positive, ER-positive disease (hazard ratio [HR], 1.05; 95% CI, 0.85 to 1.31). However, among women with LN-positive, ER-negative breast cancer, chemotherapy was associated with a significant reduction in breast cancer mortality (HR, 0.72; 95% CI, 0.54 to 0.96). A similar significant benefit of chemotherapy was seen in the subset of women age 70 years or older (HR, 0.74; 95% CI, 0.56 to 0.97). Conclusion In this observational cohort, chemotherapy was associated with a significant reduction in mortality among older women with ER-negative, LN-positive breast cancer.

scholarly journals Tumor expression of environmental chemical-responsive genes and breast cancer mortality

2019 ◽  
Vol 26 (12) ◽  
pp. 843-851 ◽  
Author(s):  
Vasily N Aushev ◽  
Kalpana Gopalakrishnan ◽  
Susan L Teitelbaum ◽  
Humberto Parada Jr ◽  
Regina M Santella ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Progression ◽  
Cancer Mortality ◽  
Cancer Survival ◽  
Proportional Hazards ◽  
Breast Cancer Mortality ◽  
Cox Proportional Hazards ◽  
Environmental Chemical ◽  
Hormonal Receptor ◽  
Tumor Expression

Environmental phenols and phthalates are common ingredients in personal care products and some have been implicated in breast cancer progression. We have previously identified genes differentially expressed in response to low-dose exposure to diethyl phthalate (DEP) and methyl paraben (MPB) in a rat model. Herein we explore if these genes are associated with breast cancer mortality in humans. We profiled MPB- and DEP-responsive genes in tumors by NanoString® from a population-based cohort of 606 women with first primary breast cancer among whom 119 breast cancer-specific deaths occurred within 15+ years of follow-up. For each gene, Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results were validated in two publicly available datasets. The following results were obtained. From 107 DEP- and 77 MPB-responsive genes profiled, 44 and 30 genes, respectively, were significantly associated with breast cancer-specific mortality. Some top DEP-responsive genes are novel for breast cancer mortality, such as ABHD14B (for high-vs-low expression, HR 0.36, 95% CI: 0.2–0.5) and TMC4 (HR 0.37, 95% CI: 0.3–0.5); top hits for MPB (SLC40A1 (HR 0.37, 95% CI: 0.3–0.5) and NTN4 (HR 0.39, 95% CI: 0.3–0.6)) are well-known predictors of breast cancer survival. PLEKHA6 was another novel survival predictor, sensitive to hormonal receptor status (HR 0.5, 95% CI 0.3–0.9 for hormonal receptor-positive and HR 3.2, 95% CI 1.7–6.2 for -negative group). In conclusion, tumor expression of DEP- and MPB-responsive genes is associated with breast cancer mortality, supporting that exposure to these chemicals may influence the progression of breast cancer.

Current Trends and Future Burden of Breast Cancer Mortality in Brazil: A Population-Based Study

2015 ◽  
Vol 21 (5) ◽  
pp. 567-569 ◽  
Author(s):  
Isabelle Ribeiro Barbosa ◽  
María Milagros Bernal ◽  
Íris do Céu Clara Costa ◽  
Dyego Leandro Bezerra de Souza
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Population Based Study ◽  
Current Trends ◽  
Future Burden

scholarly journals High intakes of choline and betaine reduce breast cancer mortality in a population‐based study

2009 ◽  
Vol 23 (11) ◽  
pp. 4022-4028 ◽  
Author(s):  
Xinran Xu ◽  
Marilie D. Gammon ◽  
Steven H. Zeisel ◽  
Patrick T. Bradshaw ◽  
James G. Wetmur ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Population Based Study
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