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Study Finds Early Detection Key to Breast Cancer Survival

The smaller the tumor at diagnosis, the better the results

A study of 174,000 Dutch women diagnosed with breast cancer between 2006 and 2012 has found that a woman’s chances of surviving still depend partly on early detection. The study, published in BMJ, found that survival rates increased from 1999 to 2012 and included women with more advanced cancer.

Dr. Madeleine Tilanus-Linthorst of Erasmus University Medical Center in the Netherlands and her team found that among women diagnosed with breast cancer between 2006 and 2012, the five-year survival rate was 88%. That compared with 83% among women diagnosed with the cancer between 1999 and 2005, the study said.

The brighter outlook extended to women with more advanced cancer, HealthDay reported. Among those with larger tumors — more than 2 inches across — the research revealed that the five-year survival rate rose from 63% to 73%. However, the smaller a woman's tumor at diagnosis, the better the outlook.

Of women diagnosed in more recent years, nearly all survived at least five years if their tumor was caught when it was less than three-quarters of an inch across, the study found. In fact, their five-year survival rates were comparable to those of an average woman their age who had never been diagnosed with breast cancer, the study showed. Of the women diagnosed between 2006 and 2012, she noted, 65% had their tumors caught when they were still less than three-quarters of inch in size.

Dr. Harold Burstein cowrote an editorial published with the study. "The cancers caught these days are smaller and better-behaved when you look at them under a microscope," said Burstein, an oncologist at the Dana-Farber Cancer Institute in Boston. "And this study shows that even with the treatment advances of recent years, tumor size still matters." That might sound unsurprising, Burstein noted. But the substantial improvements in breast cancer treatment in the past decade or so have raised the question: Is early detection as important as it used to be?

In this study, women diagnosed with breast cancer in more recent years were more likely to receive those treatments. They were also more likely to receive "breast conserving" surgery, in which only the tumor and some surrounding tissue are removed, and they were less likely to undergo a mastectomy, the study found.

The study did not actually look at the effects of breast cancer screening, Burstein pointed out. "But," he said, "I think this indirectly supports mammography screening." That's important, he said, because the benefits of mammography screening have been debated in recent years, especially when it comes to women younger than 50 years of age.

In the United States, mammography guidelines vary. The American Cancer Society and some other groups suggest yearly mammograms starting at age 40. However, the U.S. Preventive Services Task Force (USPSTF) suggests that women begin screening at age 50, and continue every two years. Women in their 40s are advised to weigh the pros and cons of screening. The "cons" include false-positive mammography results that lead to invasive testing — as well as unnecessary treatment of tiny tumors that would never progress to threaten a woman's life, according to the USPSTF. The "pros," Burstein noted, include catching and treating tiny tumors that would have threatened a woman's life.

Source: Health Day, October 7, 2015.

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