Buckle Up for Breast Cancer—Deaths from Breast Cancer Can Be Analyzed in the Same Way as Deaths in Automobile Accidents

2010 ◽  
Vol 06 ◽  
pp. 36
Author(s):  
Matthew L Webb ◽  
Blake Cady ◽  
James S Michaelson ◽  
◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Limited Data ◽  
Women Studies ◽  
Large Hospital ◽  
Regular Screening ◽  
The Us ◽  
Screening Mammograms

Background:Randomized population mammographic screening trials demonstrated a statistically significant mortality reduction in screened women. Studies in Sweden and The Netherlands show that screening is the main reason that the death rate has decreased in the general population, but ony limited data are available to assess this in the US. In a previous report, 75% of breast cancer deaths occurred in the small proportion of unscreened women. This conclusion needs confirmation.Methods:In a large hospital consortium, 6,997 invasive breast cancer diagnoses occurred between 1990 and 1999. Among all subsequent deaths through 2007, breast cancer deaths in Massachusetts women were documented by review of hospital and outpatient records. Regular screening was defined as two or more screening mammograms at intervals of two years or less in asymptomatic women.Results:After 12.5 (range: eight to 17) years of median follow-up, 461 deaths from breast cancer were confirmed. Seventy-two deaths (15.6%) resulted from non-palpable screen-detected cancers, 44 deaths (9.6%) resulted from palpable interval cancers, and a total of 116 deaths (25.2%) occurred in regularly screened women. Three hundred and twenty-two deaths (69.9%) occurred in women who had never had screening mammography, and 23 deaths (5%) occurred after one or more previous mammograms, none within two years of diagnosis. Thus, 345 breast cancer deaths (74.8%) occurred in women who were not regularly screened.Conclusion:The most effective method of avoiding death from breast cancer is for women to participate in regular screening mammography.

Real-world starting dose and outcomes of palbociclib plus an aromatase inhibitor for metastatic breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13021-e13021
Author(s):  
Debra A. Patt ◽  
Xianchen Liu ◽  
Benjamin Li ◽  
Lynn McRoy ◽  
Rachel M. Layman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Aromatase Inhibitor ◽  
Real World ◽  
Metastatic Breast ◽  
Routine Practice ◽  
First Line ◽  
Starting Dose ◽  
The Us

e13021 Background: Palbociclib (PA) has been approved for HR+/HER2–advanced/metastatic breast cancer (mBC) in combination with an aromatase inhibitor (AI) or fulvestrant for more than 6 years. Regardless of the labeled recommended starting dose of 125mg/day, some patients initiate palbociclib at lower doses in routine practice. This study described real-world starting dose, patient characteristics, and effectiveness outcomes of first line PA+ AI for mBC in the US clinical setting. Methods: We conducted a retrospective analysis of Flatiron Health’s nationwide longitudinal electronic health records, which came from over 280 cancer clinics representing more than 2.2 million actively treated cancer patients in the US. Between February 2015 and September 2018, 813 HR+/HER2– mBC women initiated PA+AI as first-line therapy and had ≥ 3 months of potential follow-up. Patients were followed from start of PA+AI to December 2018, death, or last visit, whichever came first. Real-world progression-free survival (rwPFS) was defined as the time from the start of PA+AI to death or disease progression. Real-world tumor response (rwTR) was assessed based on the treating clinician’s assessment of radiologic evidence for change in burden of disease over the course of treatment. Multivariate analyses were performed to adjust for demographic and clinical characteristics. Results: Of 813 eligible patients, 68.3% were white, median age was 65.0 years, and 42.9% had visceral disease (lung and/or liver). Median duration of follow-up was 21.0 months. 805 patients had records of PA starting dose, with 125mg and 75/100mg/day being 86.5% and 13.5%, respectively. Patients who started at 75/100mg/day were more likely to be ≥75 years than those who started at 125mg/day (38.5% vs 17.1%). Other baseline and disease characteristics were generally evenly distributed. Patients who started at 125mg/day had longer median rwPFS (27.8 vs 18.6 months, adjusted HR=0.74, 95%CI=0.52-1.05) and higher rwTR (54.0% vs. 40.4%) than those patients who started 100/75mg/day (adjusted OR=1.76, 95%CI=1.13-2.74). Table presents results in detail. Conclusions: Most patients in this study initiated palbociclib at 125mg/day and dose adjustment was similar regardless of starting dose. These real-world findings may support initiation of palbociclib at a dose of 125mg/day in combination with AI for the first-line treatment of HR+/HER2- mBC. [Table: see text]

Mammographic Screening at Age 40 or 45? What Difference Does it Make? the Potential Impact of American Cancer Society Mammography Screening Guidelines

2017 ◽  
Vol 83 (8) ◽  
pp. 847-849
Author(s):  
Crystal E. Fancher ◽  
Anthony Scott ◽  
Ahkeel Allen ◽  
Paul Dale
Keyword(s):  
Breast Cancer ◽  
Mammography Screening ◽  
Disease Free Survival ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Cancer Society ◽  
Free Survival ◽  
Screening Guidelines ◽  
Potential Impact ◽  
Disease Free

This is a 10-year retrospective chart review evaluating the potential impact of the most recent American Cancer Society mammography screening guidelines which excludes female patients aged 40 to 44 years from routine annual screening mammography. Instead they recommend screening mammography starting at age 45 with the option to begin screening earlier if the patient desires. The institutional cancer registry was systematically searched to identify all women aged 40 to 44 years treated for breast cancer over a 10-year period. These women were separated into two cohorts: screening mammography detected cancer (SMDC) and nonscreening mammography detected cancer (NSMDC). Statistical analysis of the cohorts was performed for lymph node status (SLN), five-year disease-free survival, and five-year overall survival. Women with SMDC had a significantly lower incidence of SLN positive cancer than the NSMDC group, 9 of 63 (14.3%) versus 36 of 81 (44 %; P < 0.001). The five-year disease-free survival for both groups was 84 per cent for SMDC and 80 per cent for NSMDC; this was not statistically significant. The five-year overall survival was statistically significant at 94 per cent for the SMDC group and 80 per cent for the NSMDC group (P < 0.05). This review demonstrates the significance of mammographic screening for early detection and treatment of breast cancer. Mammographic screening in women aged 40 to 44 detected tumors with fewer nodal metastases, resulting in improved survival and reaffirming the need for annual mammographic screening in this age group.

Examining the impact of frequent versus infrequent screenings for breast cancer on employer costs.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16550-e16550
Author(s):  
Kavita V. Nair ◽  
Vahram Ghushchyan ◽  
Lisa A Thompson ◽  
Cindy L. O'Bryant ◽  
Richard Read Allen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Chronic Condition ◽  
Linear Models ◽  
Breast Cancer Mortality ◽  
Condition Index ◽  
Baseline Period ◽  
Mammographic Screening ◽  
Index Number ◽  
The Impact

e16550 Background: Studies have shown an effective way to reduce breast cancer mortality is through early detection with periodic mammographic screening. Screening can increase the likelihood that cancer is detected at an earlier stage when treatment can be more effective and less expensively. Employers may be motivated to improve screening efforts if it results in improved survival and lower healthcare costs. We estimated differences in breast cancer and all cause related costs for women between 40-65 years who received regular screenings compared to those who did not. Methods: Data obtained from the LifeLink™ Health Plan Claims Database (2000 – 2010). ICD-9 codes (174.xx and 233.xx) were used to identify women between 40-65 with a diagnosis for breast cancer, who had an mammogram in the 6 months prior to diagnosis (baseline period) and had a minimum of 12 months following the diagnosis. Two cohorts were created. Those with at least one additional mammogram in the 12 months prior to the start of the baseline period (frequent mammogram group) and those with no additional mammograms (infrequent group). Both groups were followed for a minimum of 12 months and a maximum of 10 years. Adjusted differences in breast cancer and all cause costs were examined controlling for age, chronic condition index, number of mammograms in the baseline period, region and years of follow up using generalized linear models. Results: Mean age was 54 in the frequent (n=1582) and 56 in the infrequent (n=1379) group. Infrequent group had 29.7% of women between 40-49 years compared to 23.6% in the frequent group. Majority of the frequent group (85%) had one additional mammogram in the 12 months preceding the baseline period while 15% had > 2 mammograms. Infrequent group incurred on average $5715 higher breast cancer costs in year one compared to the frequent group (p <0.001). All cause costs in year one were also $6222 higher in the infrequent group (p<0.001). Similar trends were seen in years 2-5 for breast cancer and years 2-3 for all cause costs. Differences were consistent for each year of age from 40-65. Conclusions: Our findings suggest that efforts to improve screening rates can affect employer costs for treating breast cancer between 1-5 years following diagnosis.

scholarly journals Rate of over-diagnosis of breast cancer 15 years after end of Malmö mammographic screening trial: follow-up study

BMJ ◽  
2006 ◽  
Vol 332 (7543) ◽  
pp. 689-692 ◽  
Author(s):  
Sophia Zackrisson ◽  
Ingvar Andersson ◽  
Lars Janzon ◽  
Jonas Manjer ◽  
Jens Peter Garne
Keyword(s):  
Breast Cancer ◽  
Mammographic Screening ◽  
Follow Up Study ◽  
Screening Trial

scholarly journals Overview in Breast Cancer Screening in Lebanon

2021 ◽  
Vol 28 ◽  
pp. 107327482110394
Author(s):  
Eman Sbaity ◽  
Rachelle Bejjany ◽  
Malek Kreidieh ◽  
Sally Temraz ◽  
Ali Shamseddine
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Breast Cancer Diagnosis ◽  
Mammographic Screening ◽  
Early Stage Disease ◽  
Western Countries ◽  
Attitudes And Practices ◽  
Awareness Campaigns ◽  
Screening Mammograms ◽  
The Impact

Breast cancer (BC) is the most common cancer in women and men combined, and it is the second cause of cancer deaths in women after lung cancer. In Lebanon, the same epidemiological profile applies where BC is the leading cancer among Lebanese females, representing 38.2% of all cancer cases. As per the Center for Disease Control, there was a decline in BC mortality rate from 2003 to 2012 reflecting the adoption of national mammographic screening as the gold standard for BC detection by Western countries. The aim of this review study is to summarize current recommendations for BC screening and the available modalities for detecting BC in different countries, particularly in Lebanon. It also aims at exploring the impact of screening campaigns on BC early stage diagnosis in Lebanon. Despite the considerable debates whether screening mammograms provides more harm than benefits, screening awareness should be stressed since its benefits far outweigh its risks. In fact, the majority of BC mortality cases in Western countries are non-preventable by the use of screening mammograms alone. As such, Lebanon adopted a public focus on education and awareness campaigns encouraging early BC screening. Several studies showed the impact of early detection that is reflected by an increase in early stage disease and a decrease in more aggressive stages. Further studies should shed the light on the effect of awareness campaigns on early breast cancer diagnosis and clinical down staging at a national scope; therefore, having readily available data on pre- and post-adoption of screening campaigns is crucial for analyzing trends in mortality of breast cancer origin and reduction in advanced stages diseases. There is still room for future studies evaluating post-campaigns knowledge, attitudes, and practices of women having participated, emphasizing on the barriers refraining Lebanese women to contribute in BC screening campaigns.

Annual Mammography Screening: Is it Necessary?

2012 ◽  
Vol 78 (1) ◽  
pp. 104-106
Author(s):  
Veronica Hegar ◽  
Kristin Oliveira ◽  
Bharat Kakarala ◽  
Alicia Mangram ◽  
Ernest Dunn
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Task Force ◽  
Treatment Options ◽  
Retrospective Chart Review ◽  
Breast Cancer Diagnosis ◽  
Screening Mammography ◽  
Screening Mammograms ◽  
System 1 ◽  
Preventative Services

Recent recommendations from the U.S. Preventative Services Task Force suggest that screening mammography for women should be biennial starting at age 50 years and continue to age 74 years. With these recommendations in mind, we proposed a study to evaluate women at our institution in whom breast cancer is diagnosed within 1 year of a previously benign mammogram. A retrospective chart review was performed over a 4-year period. Only patients who had both diagnostic mammograms and previous mammograms performed at our institution and a pathologic diagnosis of breast cancer were included. Benign mammograms were defined as either Breast Imaging Reporting And Data System 1 or 2. Analysis of the time elapse between benign mammogram and subsequent mammogram indicative of the diagnosis of breast cancer was performed. A total of 205 patients were included. The average age was 64 years. From our results, 48 patients, 23 per cent of the total, had a documented benign mammogram at 12 months or less before a breast cancer diagnosis. One hundred forty-three (70%) patients had a benign mammogram at 18 months or less prior. This study raises concern that 2 years between screening mammograms may delay diagnosis and possible treatment options for many women.

Routine imaging studies for the posttreatment surveillance of breast and colorectal carcinoma.

1991 ◽  
Vol 9 (5) ◽  
pp. 837-842 ◽  
Author(s):  
A R Kagan ◽  
R J Steckel
Keyword(s):  
Laboratory Tests ◽  
Asymptomatic Patient ◽  
Screening Mammography ◽  
Imaging Studies ◽  
Patients With Cancer ◽  
Regular Screening ◽  
Asymptomatic Patients ◽  
Routine Surveillance ◽  
Autopsy Data

Current recommendations on follow-up procedures for patients who have been treated for cancer include imaging studies and other laboratory tests at relatively frequent intervals. At least two questions should be asked to evaluate the benefits of this practice for patients: Do frequent routine surveillance tests detect recurrences "earlier" in asymptomatic patients? and Does earlier treatment of these recurrences reduce morbidity or prolong survival? The practical import of surveillance with imaging and laboratory tests for recurrence in patients with cancer of the breast and colon is discussed. Reported autopsy data, findings at elective reoperation, and clinical data have been examined to ascertain the justification for routine periodic tests in the treated but asymptomatic patient. It is concluded that earlier detection of a local recurrence or of metastatic disease through periodic tests in the asymptomatic patient with breast or colon cancer rarely alters the treatment or the outcome. A notable exception is regular screening mammography following treatment for adenocarcinoma of the breast.

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