By Stephen Beech
Screening dramatically increases the survival rate for breast cancer patients, according to new research.
Women with stage IV breast cancer detected through screening have a 60% chance of still being alive 10 years after diagnosis, say scientists.
But they found that the survival rate is less than 20% among those with stage IV breast cancer whose disease wasn’t detected through screening.
Stage 4 breast cancer, also known as metastatic or advanced breast cancer, is cancer that has spread from the breast to other parts of the body, most often the bones, lungs, liver, or brain.
While not curable, it is treatable.
The new study – by researchers at King’s College London, Queen Mary University London, and the University of Southern Denmark – aimed to find out if the method by which breast cancer is detected impacts survival rates at different stages of the cancer.
The findings suggest that even at the most serious stage of the disease, where cancer has spread from its original site to other parts of the body, screening may not have come too late to treat successfully.
The study found that cancers diagnosed by screening at this stage had a greater likelihood of surgical intervention.
That suggests that although they had spread, that spread was limited and complete surgical removal could be attempted.
Breast cancer screening programs provide women with national access to mammograms, which are X-rays that looks for cancers that have not yet led to symptoms.
The mammogram is followed by a diagnostic assessment for abnormal screens.
But, until now, there have been few studies which have examined survival differences stage-for-stage by screening status.
Study lead author Dr. Amy Tickle said: “Our results show that how breast cancer is detected could impact the patient’s survival chances.
“There is understandably a lot of fear around cancer being found late, but our findings provide reassurance that long-term survival is still possible when it is found during screening.
“Our research highlights the importance of screening programs and we hope this encourages everyone who is invited to attend their appointment.”
She said the findings, published in the Journal of the National Cancer Institute (JNCI), highlight the importance of promoting screening.
Dr. Tickle, who undertook the study while doing her PhD at King’s College London, (KCL) added: “Further research is now needed to better understand the reasons behind this improved survival.”
The researchers linked Danish breast screening records between 2010 and 2019 with national death records from 2010 and 2022.
They then compared the mortality in women with breast cancer with that in women without breast cancer to estimate the excess mortality resulting from the cancer.
Uniquely mortality in women without breast cancer was looked at separately for women depending on their previous breast screening history, removing biases associated with breast screening participation.
Professor Peter Sasieni, Dr. Tickle’s PhD supervisor at KCL, said: “We looked at survival in women with screened detected breast cancer, in women who had never been screening and in women who had been screened previously but whose cancer was not detected through screening.
“For women with Stages I, II and III breast cancer, survival did not vary by screening history.
“But for stage IV breast cancer, we were surprised to see that prognosis for those whose cancer was screened detected resembled that of women with stage III breast cancer – they were three times more likely to live for another 10 years than other women with stage IV breast cancer.”
In the UK, the NHS offers breast cancer screening to women aged 50 to 70 every three years to detect early signs of cancer.
Invitations are sent automatically to those registered with a GP, with the first appointment usually by the age of 53.
The research team suggest that they also enable the monitoring of breast screening programs through predicting the impact on breast cancer mortality by tracking the stage at diagnosis.
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