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CA: A Cancer Journal for Clinicians, Vol 47, Issue 3 134-149, Copyright © 1997 by American Cancer Society
C. R. Smart, C. Byrne, R. A. Smith, L. Garfinkel, A. H. Letton, G. D. Dodd and O. H. Beahrs
This study reports on the 20-year follow-up of the women diagnosed with
breast cancer in the Breast Cancer Detection Demonstration Project (BCDDP)
between 1973 and 1980. This project provided 5 years of screening with
physical examination and two-view mammography for 280,000 volunteer women
across the United States. Based on a 96% follow-up from 1993 to 1995 of the
4,051 women with breast cancer available for analysis, 2,658 (66%) were
alive and 1,393 (34%) were dead. A high proportion of the cancers were
detected by mammography alone, and 28.6% of all the cancers were smaller
than 1.0 cm. Survival rates were calculated by life table method with
deaths from breast cancer as the outcome. The adjusted survival rate for
the entire group was 80.5%, and the observed survival rate was 61.7%.
Adjusted and observed survival rates were 97.2% and 78.5%, respectively,
for women with non-invasive cancers and 78.2% and 59.3%, respectively, for
those with invasive cancers. Lymph node status and the size of the cancer
at diagnosis were prognostic indicators of survival in the BCDDP Women with
invasive cancers and negative lymph nodes had an 85.5% breast cancer
survival rate and a 65.6% observed survival rate. Adjusted survival rates
for women with invasive breast cancers were 90.2% for cancers smaller than
1 cm, 80.5%, for cancers 1.0 to 1.9 cm, 70.5% for cancers 2.0 to 4.9 cm,
and 60.6% for cancers larger than 5 cm. Women 40 to 49 years of age
demonstrated a greater survival with noninvasive or invasive cancers
smaller than 5.0 cm compared with women 50 to 59 and 60 to 69 years of age
at diagnosis. These results from the BCDDP are discussed in the context of
the recent decline in breast cancer incidence and mortality in the United
States.
ARTICLES
Twenty-year follow-up of the breast cancers diagnosed during the Breast Cancer Detection Demonstration Project
National Cancer Institute Early Detection Branch, USA.
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