Efficacy of early diagnosis and treatment in women with a family history of breast cancer

P Moller, M M Reis, G Evans, H Vasen, N Haites, E Anderson, C M Steel, J Apold, F Lalloo, L Maehle, P Preece, H Gregory, K Heimdal, European Familial Breast Canc Coll

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Abstract

BACKGROUND: Surveillance programmes for women at increased genetic risk of breast cancer are being established worldwide but little is known of their efficacy in early detection of cancers and hence reduction in mortality.

METHODS: Data were contributed from seven centres participating in the EU Demonstration Programme on Clinical Services for Familial Breast Cancer. All breast tumours (n = 161) detected prospectively, from the time of enrolment of women in a screening programme, were recorded. Analysis took account of age at diagnosis, whether tumours were screen-detected or not, their pathological stage and outcome by Kaplan-Meier survival plots.

RESULTS: Mean age at diagnosis was 48.6 years. Overall; 75% of tumours were detected in the course of planned examinations. For women under age 50 at diagnosis, this figure was 68%. Eighteen percent were mammographically negative, (23% in patients under age 50). At first ("prevalence") round and at follow-up screening, 16% and 22% of tumours respectively were carcinoma in situ (CIS) while 27% and 22% respectively had evidence of nodal or distant spread (CaN+). Comparison of screen-detected and other tumours showed that the latter were more frequently mammogram-negative and CaN+. Overall five-year survival was 89% and five-year event-free survival 86%. Five-year event-free survival was 100% for CIS, 88% for invasive cancer without nodal or distant spread and 67% for CaN+.

CONCLUSIONS: The majority of cancers arising in women at increased genetic risk of breast cancer can be detected by planned screening, even in those under age 50. Surveillance should include regular expert clinical examination and teaching of "breast awareness" as well as mammography. Attention to the logistics of screening programmes may improve still further the proportion of tumours that are screen-detected. The trend towards earlier pathological stage in tumours detected during follow-up rounds and the preliminary findings on survival analysis suggest that this approach will prove to be of long-term benefit for breast cancer families.

Original languageEnglish
Pages (from-to)179-186
Number of pages8
JournalDisease Markers
Volume15
Publication statusPublished - 1999

Keywords

  • inherited
  • familial
  • breast cancer
  • prognosis
  • stage
  • diagnosis
  • survival
  • screening
  • mammography
  • OVARIAN-CANCER
  • KINDREDS
  • BRCA1
  • RISK
  • AGE

Cite this

Moller, P., Reis, M. M., Evans, G., Vasen, H., Haites, N., Anderson, E., ... European Familial Breast Canc Coll (1999). Efficacy of early diagnosis and treatment in women with a family history of breast cancer. Disease Markers, 15, 179-186.

Efficacy of early diagnosis and treatment in women with a family history of breast cancer. / Moller, P ; Reis, M M ; Evans, G ; Vasen, H ; Haites, N ; Anderson, E ; Steel, C M ; Apold, J ; Lalloo, F ; Maehle, L ; Preece, P ; Gregory, H ; Heimdal, K ; European Familial Breast Canc Coll.

In: Disease Markers, Vol. 15, 1999, p. 179-186.

Research output: Contribution to journalArticle

Moller, P, Reis, MM, Evans, G, Vasen, H, Haites, N, Anderson, E, Steel, CM, Apold, J, Lalloo, F, Maehle, L, Preece, P, Gregory, H, Heimdal, K & European Familial Breast Canc Coll 1999, 'Efficacy of early diagnosis and treatment in women with a family history of breast cancer', Disease Markers, vol. 15, pp. 179-186.
Moller P, Reis MM, Evans G, Vasen H, Haites N, Anderson E et al. Efficacy of early diagnosis and treatment in women with a family history of breast cancer. Disease Markers. 1999;15:179-186.
Moller, P ; Reis, M M ; Evans, G ; Vasen, H ; Haites, N ; Anderson, E ; Steel, C M ; Apold, J ; Lalloo, F ; Maehle, L ; Preece, P ; Gregory, H ; Heimdal, K ; European Familial Breast Canc Coll. / Efficacy of early diagnosis and treatment in women with a family history of breast cancer. In: Disease Markers. 1999 ; Vol. 15. pp. 179-186.
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abstract = "BACKGROUND: Surveillance programmes for women at increased genetic risk of breast cancer are being established worldwide but little is known of their efficacy in early detection of cancers and hence reduction in mortality.METHODS: Data were contributed from seven centres participating in the EU Demonstration Programme on Clinical Services for Familial Breast Cancer. All breast tumours (n = 161) detected prospectively, from the time of enrolment of women in a screening programme, were recorded. Analysis took account of age at diagnosis, whether tumours were screen-detected or not, their pathological stage and outcome by Kaplan-Meier survival plots.RESULTS: Mean age at diagnosis was 48.6 years. Overall; 75{\%} of tumours were detected in the course of planned examinations. For women under age 50 at diagnosis, this figure was 68{\%}. Eighteen percent were mammographically negative, (23{\%} in patients under age 50). At first ({"}prevalence{"}) round and at follow-up screening, 16{\%} and 22{\%} of tumours respectively were carcinoma in situ (CIS) while 27{\%} and 22{\%} respectively had evidence of nodal or distant spread (CaN+). Comparison of screen-detected and other tumours showed that the latter were more frequently mammogram-negative and CaN+. Overall five-year survival was 89{\%} and five-year event-free survival 86{\%}. Five-year event-free survival was 100{\%} for CIS, 88{\%} for invasive cancer without nodal or distant spread and 67{\%} for CaN+.CONCLUSIONS: The majority of cancers arising in women at increased genetic risk of breast cancer can be detected by planned screening, even in those under age 50. Surveillance should include regular expert clinical examination and teaching of {"}breast awareness{"} as well as mammography. Attention to the logistics of screening programmes may improve still further the proportion of tumours that are screen-detected. The trend towards earlier pathological stage in tumours detected during follow-up rounds and the preliminary findings on survival analysis suggest that this approach will prove to be of long-term benefit for breast cancer families.",
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TY - JOUR

T1 - Efficacy of early diagnosis and treatment in women with a family history of breast cancer

AU - Moller, P

AU - Reis, M M

AU - Evans, G

AU - Vasen, H

AU - Haites, N

AU - Anderson, E

AU - Steel, C M

AU - Apold, J

AU - Lalloo, F

AU - Maehle, L

AU - Preece, P

AU - Gregory, H

AU - Heimdal, K

AU - European Familial Breast Canc Coll

PY - 1999

Y1 - 1999

N2 - BACKGROUND: Surveillance programmes for women at increased genetic risk of breast cancer are being established worldwide but little is known of their efficacy in early detection of cancers and hence reduction in mortality.METHODS: Data were contributed from seven centres participating in the EU Demonstration Programme on Clinical Services for Familial Breast Cancer. All breast tumours (n = 161) detected prospectively, from the time of enrolment of women in a screening programme, were recorded. Analysis took account of age at diagnosis, whether tumours were screen-detected or not, their pathological stage and outcome by Kaplan-Meier survival plots.RESULTS: Mean age at diagnosis was 48.6 years. Overall; 75% of tumours were detected in the course of planned examinations. For women under age 50 at diagnosis, this figure was 68%. Eighteen percent were mammographically negative, (23% in patients under age 50). At first ("prevalence") round and at follow-up screening, 16% and 22% of tumours respectively were carcinoma in situ (CIS) while 27% and 22% respectively had evidence of nodal or distant spread (CaN+). Comparison of screen-detected and other tumours showed that the latter were more frequently mammogram-negative and CaN+. Overall five-year survival was 89% and five-year event-free survival 86%. Five-year event-free survival was 100% for CIS, 88% for invasive cancer without nodal or distant spread and 67% for CaN+.CONCLUSIONS: The majority of cancers arising in women at increased genetic risk of breast cancer can be detected by planned screening, even in those under age 50. Surveillance should include regular expert clinical examination and teaching of "breast awareness" as well as mammography. Attention to the logistics of screening programmes may improve still further the proportion of tumours that are screen-detected. The trend towards earlier pathological stage in tumours detected during follow-up rounds and the preliminary findings on survival analysis suggest that this approach will prove to be of long-term benefit for breast cancer families.

AB - BACKGROUND: Surveillance programmes for women at increased genetic risk of breast cancer are being established worldwide but little is known of their efficacy in early detection of cancers and hence reduction in mortality.METHODS: Data were contributed from seven centres participating in the EU Demonstration Programme on Clinical Services for Familial Breast Cancer. All breast tumours (n = 161) detected prospectively, from the time of enrolment of women in a screening programme, were recorded. Analysis took account of age at diagnosis, whether tumours were screen-detected or not, their pathological stage and outcome by Kaplan-Meier survival plots.RESULTS: Mean age at diagnosis was 48.6 years. Overall; 75% of tumours were detected in the course of planned examinations. For women under age 50 at diagnosis, this figure was 68%. Eighteen percent were mammographically negative, (23% in patients under age 50). At first ("prevalence") round and at follow-up screening, 16% and 22% of tumours respectively were carcinoma in situ (CIS) while 27% and 22% respectively had evidence of nodal or distant spread (CaN+). Comparison of screen-detected and other tumours showed that the latter were more frequently mammogram-negative and CaN+. Overall five-year survival was 89% and five-year event-free survival 86%. Five-year event-free survival was 100% for CIS, 88% for invasive cancer without nodal or distant spread and 67% for CaN+.CONCLUSIONS: The majority of cancers arising in women at increased genetic risk of breast cancer can be detected by planned screening, even in those under age 50. Surveillance should include regular expert clinical examination and teaching of "breast awareness" as well as mammography. Attention to the logistics of screening programmes may improve still further the proportion of tumours that are screen-detected. The trend towards earlier pathological stage in tumours detected during follow-up rounds and the preliminary findings on survival analysis suggest that this approach will prove to be of long-term benefit for breast cancer families.

KW - inherited

KW - familial

KW - breast cancer

KW - prognosis

KW - stage

KW - diagnosis

KW - survival

KW - screening

KW - mammography

KW - OVARIAN-CANCER

KW - KINDREDS

KW - BRCA1

KW - RISK

KW - AGE

M3 - Article

VL - 15

SP - 179

EP - 186

JO - Disease Markers

JF - Disease Markers

SN - 0278-0240

ER -