The natural history of breast carcinoma : What have we learned from screening?

The availability of breast carcinoma data from trials of mammographic screening provides an opportunity to study the natural history of breast carcinoma. The Swedish Two-County study is a randomized, controlled trial of mammographic screening for breast carcinoma in which 77,080 women were randomize...

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Bibliographic Details
Published in:Cancer 1999-08, Vol.86 (3), p.449-462
Main Authors: TABAR, L, DUFFY, S. W, VITAK, B, CHEN, H.-H, PREVOST, T. C
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Biological and medical sciences
Breast Neoplasms - epidemiology
Breast Neoplasms - mortality
Breast Neoplasms - pathology
Disease Progression
Female
Gynecology. Andrology. Obstetrics
Humans
Lymph Nodes - pathology
Lymphatic Metastasis - prevention & control
Mammary gland diseases
Mass Screening - methods
Mass Screening - statistics & numerical data
Medical sciences
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Patient Selection
Survival Rate
Sweden - epidemiology
Tumors
Citations: Items that this one cites
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Summary:The availability of breast carcinoma data from trials of mammographic screening provides an opportunity to study the natural history of breast carcinoma. The Swedish Two-County study is a randomized, controlled trial of mammographic screening for breast carcinoma in which 77,080 women were randomized to receive an invitation to mammographic screening and 55,985 were randomized to receive no invitation. During the trial, a total of 2468 breast carcinoma cases were diagnosed. The authors examined the effect of screening on the pathologic attributes of the tumors diagnosed, mortality and survival from breast carcinoma, and the consequences of arresting tumor development by screening. Screening reduces mortality from breast carcinoma largely through its effect in detecting tumors at a smaller size, decreasing the probability of lymph node metastases, and reducing the opportunity for worsening of the grade of malignancy of the tumor. Breast carcinoma is not a systemic disease at its inception, but is a progressive disease and its development can be arrested by screening. The point at which the tumor's progression is arrested is crucial. Detection of small (
ISSN:0008-543X
1097-0142
DOI:10.1002/(SICI)1097-0142(19990801)86:3<449::AID-CNCR13>3.0.CO;2-Q