Journal Article
. 2019 Sep;8(15).
doi: 10.1002/cam4.2488.

Impact of adjuvant chemotherapy on the survival of patients with breast cancer diagnosed by screening

Irene Zarcos-Pedrinaci 1 Maximino Redondo 1 Javier Louro 2 Francisco Rivas-Ruiz 1 Teresa Téllez 1 Diego Pérez 3 Francisco Medina Cano 4 Kenza Machan 5 Laia Domingo 2 Maria Mar Vernet 6 Maria Padilla-Ruiz 1 Xavier Castells 2 Antonio Rueda 7 María Sala 2 REDISSEC-CaMISS Group  
Affiliations
  • PMID: 31549794
  •     26 References
  •     1 citations

Abstract

The aim of this study is to determine the survival of patients with breast cancer treated with adjuvant chemotherapy (ACh) after the diagnosis by screening, taking comorbidity into account. This multicenter cohort study examined a population of patients taking part in four national screening programs for the early detection of breast cancer (localized or locally advanced), during the period 2000-2008. Of the 1248 cancers detected, 266 were prevalent (21.3%), 633 were incident (50.7%), and 349 were interval (27.9%). No significant differences were detected between the three groups in terms of the distribution of comorbidity according to the CCI. After a median follow-up of 102 months, 22.1% of the patients with interval cancer had died. The corresponding figures for the incident and prevalent cancers were 10.4% and 7.9%, respectively (P < .001). The adjusted Cox regression analysis by the stage, CCI and group revealed no differences in the risk of recurrence between the different groups according to the ACh performed. However, there were significant differences in the overall survival; for the interval cancer group without ACh, the risk of death was higher (Hazard ratio: 2.5 [1.0-6.2]) than for the other two groups. However, for the prevalent and incident groups that did not receive ACh, there was no greater risk of death. This study shows that adjuvant chemotherapy seems to benefit patients with interval breast cancer, who have a poorer prognosis than those with prevalent or incident cancer. However, the role of ACh is unclear with respect to prevalent and incident cancers when comorbidity is taken into account.

Keywords: adjuvant chemotherapy; breast cancer; breast screening; survival.

Long-term risk of screen-detected and interval breast cancer after false-positive results at mammography screening: joint analysis of three national cohorts.
Marta Román, Solveig Hofvind, My von Euler-Chelpin, Xavier Castells.
Br J Cancer, 2018 Dec 20; 120(2). PMID: 30563993    Free PMC article.
Over-diagnosis in breast cancer screening.
Henrik Møller, Elizabeth Davies.
BMJ, 2006 Mar 07; 332(7543). PMID: 16517549    Free PMC article.
Breast cancer incidence and mortality trends in 16 European countries.
J L Botha, F Bray, R Sankila, D M Parkin.
Eur J Cancer, 2003 Jul 31; 39(12). PMID: 12888367
Pathologic findings from the Breast Cancer Surveillance Consortium: population-based outcomes in women undergoing biopsy after screening mammography.
Donald L Weaver, Robert D Rosenberg, +8 authors, Rachel Ballard-Barbash.
Cancer, 2006 Jan 18; 106(4). PMID: 16411214
Molecular characteristics of screen-detected vs symptomatic breast cancers and their impact on survival.
S J Dawson, S W Duffy, +7 authors, G C Wishart.
Br J Cancer, 2009 Sep 24; 101(8). PMID: 19773756    Free PMC article.
The effect of comorbidity on the use of adjuvant chemotherapy and type of regimen for curatively resected stage III colon cancer patients.
Mei-Chin Hsieh, Trevor Thompson, +4 authors, Vivien W Chen.
Cancer Med, 2016 Jan 17; 5(5). PMID: 26773804    Free PMC article.
Screening histories of invasive breast cancers diagnosed 1989-2006 in the West Midlands, UK: variation with time and impact on 10-year survival.
Gill Lawrence, Emma O'Sullivan, +3 authors, Matthew Wallis.
J Med Screen, 2010 Jan 08; 16(4). PMID: 20054093
Estimates of the cancer incidence and mortality in Europe in 2006.
J Ferlay, P Autier, +3 authors, P Boyle.
Ann Oncol, 2007 Feb 09; 18(3). PMID: 17287242
Highly Cited.
Predictive value of the Age-Adjusted Charlson Comorbidity Index on perioperative complications and survival in patients undergoing primary debulking surgery for advanced epithelial ovarian cancer.
Rudy S Suidan, Mario M Leitao, +9 authors, Dennis S Chi.
Gynecol Oncol, 2015 Jun 04; 138(2). PMID: 26037900    Free PMC article.
Screening for breast cancer with mammography.
Peter C Gøtzsche, Margrethe Nielsen.
Cochrane Database Syst Rev, 2011 Jan 21; (1). PMID: 21249649
Highly Cited. Systematic Review.
Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update.
Neelima Denduluri, Mariana Chavez-MacGregor, +12 authors, Sharon H Giordano.
J Clin Oncol, 2018 May 23; 36(23). PMID: 29787356
Survival from invasive breast cancer among interval cases in the mammography screening programmes of northern Sweden.
P Bordás, H Jonsson, L Nyström, P Lenner.
Breast, 2006 Aug 01; 16(1). PMID: 16875820
Risk for distant recurrence of breast cancer detected by mammography screening or other methods.
Heikki Joensuu, Tiina Lehtimäki, +7 authors, Johan Lundin.
JAMA, 2004 Sep 02; 292(9). PMID: 15339900
Validation of a combined comorbidity index.
M Charlson, T P Szatrowski, J Peterson, J Gold.
J Clin Epidemiol, 1994 Nov 01; 47(11). PMID: 7722560
Highly Cited.
Screen-detected vs symptomatic breast cancer: is improved survival due to stage migration alone?
G C Wishart, D C Greenberg, +4 authors, S W Duffy.
Br J Cancer, 2008 May 29; 98(11). PMID: 18506175    Free PMC article.
St. Gallen/Vienna 2017: A Brief Summary of the Consensus Discussion about Escalation and De-Escalation of Primary Breast Cancer Treatment.
Michael Gnant, Nadia Harbeck, Christoph Thomssen.
Breast Care (Basel), 2017 Jun 01; 12(2). PMID: 28559767    Free PMC article.
Highly Cited. Review.
Impact of oncotype DX recurrence score in the management of breast cancer cases.
Michaela T Nguyen, Alexander Stessin, +5 authors, Sandra J Shin.
Clin Breast Cancer, 2014 Feb 04; 14(3). PMID: 24486121
Survival and Disease-Free Survival by Breast Density and Phenotype in Interval Breast Cancers.
Maria Sala, Laia Domingo, +9 authors, CAMISS Study Group.
Cancer Epidemiol Biomarkers Prev, 2018 Jun 02; 27(8). PMID: 29853482
Prognostic value of histologic grade and proliferative activity in axillary node-positive breast cancer: results from the Eastern Cooperative Oncology Group Companion Study, EST 4189.
J F Simpson, R Gray, +6 authors, N J Robert.
J Clin Oncol, 2000 May 16; 18(10). PMID: 10811671
Screening interval breast cancers: mammographic features and prognosis factors.
H C Burrell, D M Sibbering, +7 authors, J F Robertson.
Radiology, 1996 Jun 01; 199(3). PMID: 8638010
Detection methods predict differences in biology and survival in breast cancer patients.
Maximino Redondo, Rafael Funez, +11 authors, Antonio Rueda.
BMC Cancer, 2012 Dec 19; 12. PMID: 23244222    Free PMC article.
Role of detection method in predicting breast cancer survival: analysis of randomized screening trials.
Yu Shen, Ying Yang, +3 authors, Donald A Berry.
J Natl Cancer Inst, 2005 Aug 18; 97(16). PMID: 16106024
Differences in subtype distribution between screen-detected and symptomatic invasive breast cancer and their impact on survival.
N Kobayashi, M Hikichi, +4 authors, T Utsumi.
Clin Transl Oncol, 2017 Apr 15; 19(10). PMID: 28409323
Trastuzumab--mechanism of action and use in clinical practice.
Clifford A Hudis.
N Engl J Med, 2007 Jul 06; 357(1). PMID: 17611206
Highly Cited. Review.
Clinical relevance of the 21-gene Recurrence Score® assay in treatment decisions for patients with node-positive breast cancer in the genomic era.
Eleftherios P Mamounas, Christy A Russell, +2 authors, Kathy S Albain.
NPJ Breast Cancer, 2018 Aug 30; 4. PMID: 30155517    Free PMC article.
Review.
Impact of adjuvant chemotherapy on the survival of patients with breast cancer diagnosed by screening.
Irene Zarcos-Pedrinaci, Maximino Redondo, +12 authors, REDISSEC-CaMISS Group.
Cancer Med, 2019 Sep 25; 8(15). PMID: 31549794    Free PMC article.
Impact of adjuvant chemotherapy on the survival of patients with breast cancer diagnosed by screening.
Irene Zarcos-Pedrinaci, Maximino Redondo, +12 authors, REDISSEC-CaMISS Group.
Cancer Med, 2019 Sep 25; 8(15). PMID: 31549794    Free PMC article.