Impact of a Screening Program in the Diagnosis, Surgical Treatm ent and Management of Breast Cancer

Abstract

Introduction: The effects of early detection on treatment need to be evaluated. The objective of this study was to assess the impact of the Basque breast cancer early detection program (BCEDP) on breast cancer surgery in our hospital. Materials and Methods: A retrospective study was conducted of women who underwent surgery for breast cancer between 1 January 2015 and 31 December 2016. Participants were classified into: Group A, those referred from the screening program after routine mammography; or group B, those referred from primary care or other gynecological clinics within our health region. Results: In the study period, 630 women were diagnosed with and treated for breast cancer. Their mean age was 60.2 years (standard deviation 5.4). Out of these, 220 (35%) referred from the BCEDP formed group A, the other 410 women (65%) forming group B. Invasive cancer was diagnosed in 185 women in group A (84%) and in 370 (90.2%) in group B (p=0.02). Regarding treatment, mastectomies were carried out in 47 women (21.4%) in Group A and 225 (54.9%) in group B (p<0.001); axillary lymphadenectomies were performed in 31 women (14.1%) in Group A and 83 (20.2%) in Group B, (p=0.02); and adjuvant chemotherapy was given in 66 women (30%) in Group A and 148 (36.1%) in Group B (p<0.001). Conclusion: In our setting, breast cancer patients referred through the BCEDP have earlier stage cancer, can be expected to benefit from less radical surgery, have lower proportion of axillary lymph node involvement and require less adjuvant chemotherapy.