Impact of overdiagnosis on long-term breast cancer survival
Journal
Cancers
Journal Volume
11
Journal Issue
3
Pages
325
Date Issued
2019
Author(s)
Fann J.C.
Hsu C.-Y.
Yen A.M.
Yu C.-P.
Chen S.L.
Tab?r L.
Abstract
Elucidating whether and how long-term survival of breast cancer is mainly due to cure after early detection and effective treatment and therapy or overdiagnosis resulting from the widespread use of mammography provides a new insight into the role mammography plays in screening, surveillance, and treatment of breast cancer. Given information on detection modes, the impact of overdiagnosis due to mammography screening on long-term breast cancer survival was quantitatively assessed by applying a zero (cured or overdiagnosis)-inflated model design and analysis to a 15-year follow-up breast cancer cohort in Dalarna, Sweden. The probability for non-progressive breast cancer (the zero part) was 56.14% including the 44.34% complete cure after early detection and initial treatment and a small 11.80% overdiagnosis resulting from mammography screening program (8.94%) and high awareness (2.86%). The 15-year adjusted cumulative survival of breast cancer was dropped from 88.25% to 74.80% after correcting for the zero-inflated part of overdiagnosis. The present findings reveal that the majority of survivors among women diagnosed with breast cancer could be attributed to the cure resulting from mammography screening and accompanying effective treatment and therapy and only a small fraction of those were due to overdiagnosis. ? 2019 by the authors. Licensee MDPI, Basel, Switzerland.
SDGs
Other Subjects
tamoxifen; adult; aged; Article; breast cancer; cancer chemotherapy; cancer radiotherapy; cancer screening; early diagnosis; female; follow up; human; long term survival; major clinical study; mammography; mastectomy; partial mastectomy; probability; prognosis; Sweden
Publisher
MDPI AG
Type
journal article