Breast cancer screening: Impact on care pathways

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Controversy exists regarding the benefits and risks of cancer screening programs (SPs), including overdiagnosis and impact on survival.
• A key concern is the aggressiveness of treatments associated with SPs.

Purpose of the Study:

• To compare the characteristics and treatment aggressiveness of breast cancer in women diagnosed through screening programs (SP group) versus those diagnosed outside of screening (NSP group).
• To evaluate the impact of SPs on breast cancer treatment and disease stage.

Main Methods:

• Utilized the national "Cancer Cohort" medico-administrative database.
• Compared 23,788 women aged 50-74 treated for incident breast cancer in 2014.
• Differentiated between diagnoses made via mammograms within SPs and those made outside SPs.

Main Results:

• Women in the SP group (57%) had higher rates of in situ or localized invasive breast cancer compared to the NSP group (43%).
• SP group received less aggressive treatments, including higher rates of breast-conserving surgery (82% vs 70%) and lower rates of chemotherapy (34% vs 53%).
• Among women with metastatic cancer, the SP group showed a lower proportion of distant metastases (liver, lung, brain, bone).

Conclusions:

• Breast cancer diagnosed via SP mammograms in France is associated with less advanced disease and less aggressive treatment strategies.
• This observational study provides evidence supporting the benefits of SPs in improving breast cancer outcomes.