Women offered screening mammography experience a higher rate of diagnosis of invasive breast cancer, without a corresponding reduction in subsequent symptomatic breast cancer. OR in other words, Many screen-detected invasive cancers would not have grown. - PowerPoint PPT Presentation

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Women offered screening mammography experience a higher rate of diagnosis of invasive breast cancer, without a corresponding reduction in subsequent symptomatic breast cancer. OR in other words, Many screen-detected invasive cancers would not have grown.

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Title: Women offered screening mammography experience a higher rate of diagnosis of invasive breast cancer, without a corresponding reduction in subsequent symptomatic breast cancer. OR in other words, Many screen-detected invasive cancers would not have grown.


1
Women offered screening mammography experience a
higher rate of diagnosis of invasive breast
cancer, without a corresponding reduction in
subsequent symptomatic breast cancer.OR in other
words,Many screen-detected invasive cancers
would not have grown.
  • Jayant S Vaidya

2
Screening mammography aims to detect breast
cancer at an earlier more curable
stage. Therefore, in the years immediately after
screening , the women who have been screened
should enjoy a lower incidence of breast cancer.
3
Data sourcewww.isdscotland.org
These graphs are plotted in a rather unusual
way
4
In Scotland, some regions are attended by a
screening van for 1 year every 3 years, with no
screening occurring in the interim 2 years. For
example, in the regions of Borders, Fife and
Forth valley, the screening van visits every 3
years from 1990, 1991 and 1992, respectively.
In Fife, the screening year corresponds most
closely to the calendar year
5
Invasive breast cancer incidence in Fife
6
Incidence is higher in the screening year because
of detection of earlier cancers
Invasive breast cancer incidence in Fife
7
Incidence is higher in the screening year because
of detection of earlier cancers
Invasive breast cancer incidence in Fife
8
Invasive breast cancer incidence in Borders
Incidence is higher in the screening year because
of detection of earlier cancers
9
Incidence is higher in the screening year because
of detection of earlier cancers
Invasive breast cancer incidence in Forth valley
Breast Cancer incidence age standardised rate
10
Invasive breast cancer incidence in Scotland
85
75-79
65-69
45-49
Each line represents a single cohort of women
35-39
25-29
11
Invasive breast cancer incidence in Scotland
12
Invasive breast cancer incidence in Scotland
65-69
50-55
45-49
13
Invasive breast cancer incidence in Scotland
85
65-69
75-79
55-59
65-69
45-49
55-59
45-49
35-39
25-29
14
Invasive breast cancer incidence in Scotland
Incidence of breast cancer in those too young to
have screening has remained constant
45-49
45-49
45-49
35-39
35-39
25-29
15
Invasive breast cancer incidence in Scotland
Incidence of breast cancer in those too old to
have screening has remained constant this group
(light brown line) probably had one round of
screening
65-69
65-69
16
Invasive breast cancer incidence in Scotland
85
This group had the benefit of the whole package
of screening for 5 rounds over 15 years
65-69
55-59
65-69
45-49
45-49
35-39
25-29
17
Invasive breast cancer incidence in Scotland
85
Screening stopped when they reached the age group
of 65-69 between 2001 to 2003
Screening stopped
65-69
55-59
65-69
45-49
45-49
35-39
25-29
18
Invasive breast cancer incidence in Scotland
In 2004, despite NOT screening, the incidence
remains high and much higher than that 20, or
10 years ago
85
Screening stopped
65-69
55-59
65-69
65-69
45-49
45-49
35-39
25-29
19
Conclusion
Women who undergo regular screening mammography
raise their incidence of invasive breast cancer
by 30 to 60. In the years between consecutive
screens, the incidence is not correspondingly
reduced. And, after stopping screening, rather
than enjoying a reduced incidence, these women
continue to experience a higher risk of invasive
breast cancer
20
Conclusion
These data demonstrate the dormancy of invasive
breast cancer very elegantly, in the real
world. It suggests that a much higher (up to a
third) than currently believed proportion
invasive breast cancers detected by screening
mammography would not have grown . Further
research should focus on studying how so many
women manage to keep their invasive cancers in a
state of dormancy
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