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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2005 > January
Breast cancers detected by mammography require less toxic therapy
Will Boggs, MD
Last Updated: 2005-01-28 9:05:16 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Women whose breast cancer is detected by screening mammography are more likely to be treated with breast conservation and without chemotherapy, according to a report in the January American Journal of Radiology.
"If you are unlucky enough to develop breast cancer, it would be best if you could be treated with effective therapy that is minimally toxic," Dr. Richard J. Barth, Jr. from Dartmouth Medical School and the Norris Cotton Cancer Center, Lebanon, New Hampshire told Reuters Health. "Annual mammography increases the chances that women in all age groups who develop breast cancer will be able to be treated with minimally toxic therapy."
Dr. Barth and colleagues used data from 992 women with invasive breast cancer to investigate the effect of the mode of breast cancer detection on treatment decisions. In 532 women, the breast cancer was detected by physical examination, and in 460 women, the cancer was detected by screening mammography.
Tumors detected by screening mammography were half the size and less than half as likely to be node-positive as tumors detected by physical examination, the authors report. Only 7% of the tumors detected by physical examination were smaller than those for which chemotherapy is recommended, compared with one third of those detected by screening mammography.
Only 28% of women whose breast cancer was detected by screening mammography received chemotherapy, the report indicates, compared with 56% of women whose breast cancer was detected by physical examination (p < 0.0001).
Women whose cancer was detected by screening mammography were almost twice as likely to be treated with breast conservation versus mastectomy as women whose cancer was detected by physical examination, the researchers note.
Results were similar for the 40- to 49-year-old age group and the over-70 age group when they were analyzed separately. The greatest relative differences were noted in the oldest age group.
"I do not think that there should be any upper age limit to screening mammography as long as the patient is generally healthy," Dr. Barth said.
In multivariate analyses, women whose tumors were detected by physical examination were almost 3 times as likely to be treated with chemotherapy and 2.5 times as likely to be treated with mastectomy rather than breast conservation, compared with women whose tumors were detected by screening mammography.
"Screening mammography for the detection of invasive breast cancer allows tumors to be diagnosed at an earlier stage, thereby allowing patients who have developed breast cancer to be treated adequately with less-toxic therapy," the authors conclude.]
"I think it is very important that internists and family physicians hear about these research findings, because they are the ones who are ordering [treatments and] counseling patients about this," Dr. Barth added.
AJR 2005;184:324-329.
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