Skip to main content
NCBI home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1991 Jul;64(1):108–113. doi: 10.1038/bjc.1991.251

Comparative pathology of breast cancer in a randomised trial of screening.

T J Anderson 1, J Lamb 1, P Donnan 1, F E Alexander 1, A Huggins 1, B B Muir 1, A E Kirkpatrick 1, U Chetty 1, W Hepburn 1, A Smith 1, et al.
PMCID: PMC1977297  PMID: 1854609

Abstract

In the Edinburgh Randomised Breast Screening Project (EBSP) to December 1988 there were 500 cancers in the study population invited to screening and 340 cancers identified in the control population. The size and negative lymph node status characteristics of invasive cancers from the two populations were significantly different (P less than 0.05). The cancers detected by screening were predominantly 'early stage', with 16% noninvasive (PTIS) and 42% invasive stage I (pT1 node negative), whereas cancers were frequently 'late stage' (more than pT2) and inoperable in nonattenders (44%) and controls (36%). Grouped according to customary size ranges of invasive cancers, the proportion of cases lymph node positive differed in those screen detected compared with controls, but the benefit in favour of screen detection was not constant. In comparisons of cancers detected at prevalence and incidence screens, as a test of conformity with screening theory, no significant differences were apparent according to size and lymph node status, yet the characteristics of histological type of cancer discriminated significantly (P less than 0.05). When these same histological characteristics were used to compare survival, the capacity to separate invasive cancers into two groups having good and poor survival probabilities was evident, with a significant improvement for the screen detected poor survival group compared with controls (P less than 0.05).

Full text

PDF
108

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson T. J., Lamb J., Alexander F., Lutz W., Chetty U., Forrest A. P., Kirkpatrick A., Muir B., Roberts M. M., Huggins A. Comparative pathology of prevalent and incident cancers detected by breast screening. Edinburgh Breast Screening Project. Lancet. 1986 Mar 8;1(8480):519–523. doi: 10.1016/s0140-6736(86)90882-2. [DOI] [PubMed] [Google Scholar]
  2. Carter C. L., Allen C., Henson D. E. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer. 1989 Jan 1;63(1):181–187. doi: 10.1002/1097-0142(19890101)63:1<181::aid-cncr2820630129>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  3. Chetty U., Kirkpatrick A. E., Anderson T. L., Lamb J., Roberts M. M., Humeniuk V., Forrest A. P. Localization and excision of occult breast lesions. Br J Surg. 1983 Oct;70(10):607–610. doi: 10.1002/bjs.1800701013. [DOI] [PubMed] [Google Scholar]
  4. Cole P., Morrison A. S. Basic issues in population screening for cancer. J Natl Cancer Inst. 1980 May;64(5):1263–1272. [PubMed] [Google Scholar]
  5. Collette H. J., Day N. E., Rombach J. J., de Waard F. Evaluation of screening for breast cancer in a non-randomised study (the DOM project) by means of a case-control study. Lancet. 1984 Jun 2;1(8388):1224–1226. doi: 10.1016/s0140-6736(84)91704-5. [DOI] [PubMed] [Google Scholar]
  6. Dawson P. J., Ferguson D. J., Karrison T. The pathological findings of breast cancer in patients surviving 25 years after radical mastectomy. Cancer. 1982 Nov 15;50(10):2131–2138. doi: 10.1002/1097-0142(19821115)50:10<2131::aid-cncr2820501027>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  7. Day N. E., Williams D. R., Khaw K. T. Breast cancer screening programmes: the development of a monitoring and evaluation system. Br J Cancer. 1989 Jun;59(6):954–958. doi: 10.1038/bjc.1989.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dixon J. M., Page D. L., Anderson T. J., Lee D., Elton R. A., Stewart H. J., Forrest A. P. Long-term survivors after breast cancer. Br J Surg. 1985 Jun;72(6):445–448. doi: 10.1002/bjs.1800720614. [DOI] [PubMed] [Google Scholar]
  9. Frisell J., Eklund G., Hellström L., Somell A. Analysis of interval breast carcinomas in a randomized screening trial in Stockholm. Breast Cancer Res Treat. 1987;9(3):219–225. doi: 10.1007/BF01806383. [DOI] [PubMed] [Google Scholar]
  10. Hatschek T., Fagerberg G., Stål O., Sullivan S., Carstensen J., Gröntoft O., Nordenskjöld B. Cytometric characterization and clinical course of breast cancer diagnosed in a population-based screening program. Cancer. 1989 Sep 1;64(5):1074–1081. doi: 10.1002/1097-0142(19890901)64:5<1074::aid-cncr2820640519>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  11. Hutter R. V. The influence of pathologic factors on breast cancer management. Cancer. 1980 Aug 15;46(4 Suppl):961–976. doi: 10.1002/1097-0142(19800815)46:4+<961::aid-cncr2820461319>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  12. Palli D., Del Turco M. R., Buiatti E., Carli S., Ciatto S., Toscani L., Maltoni G. A case-control study of the efficacy of a non-randomized breast cancer screening program in Florence (Italy). Int J Cancer. 1986 Oct 15;38(4):501–504. doi: 10.1002/ijc.2910380408. [DOI] [PubMed] [Google Scholar]
  13. Peeters P. H., Verbeek A. L., Hendriks J. H., Holland R., Mravunac M., Vooijs G. P. The occurrence of interval cancers in the Nijmegen screening programme. Br J Cancer. 1989 Jun;59(6):929–932. doi: 10.1038/bjc.1989.196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Roberts M. M., Alexander F. E., Anderson T. J., Chetty U., Donnan P. T., Forrest P., Hepburn W., Huggins A., Kirkpatrick A. E., Lamb J. Edinburgh trial of screening for breast cancer: mortality at seven years. Lancet. 1990 Feb 3;335(8684):241–246. doi: 10.1016/0140-6736(90)90066-e. [DOI] [PubMed] [Google Scholar]
  15. Rosen P. P., Groshen S., Saigo P. E., Kinne D. W., Hellman S. Pathological prognostic factors in stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma: a study of 644 patients with median follow-up of 18 years. J Clin Oncol. 1989 Sep;7(9):1239–1251. doi: 10.1200/JCO.1989.7.9.1239. [DOI] [PubMed] [Google Scholar]
  16. Shapiro S. Evidence on screening for breast cancer from a randomized trial. Cancer. 1977 Jun;39(6 Suppl):2772–2782. doi: 10.1002/1097-0142(197706)39:6<2772::aid-cncr2820390665>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  17. Tabar L., Duffy S. W., Krusemo U. B. Detection method, tumour size and node metastases in breast cancers diagnosed during a trial of breast cancer screening. Eur J Cancer Clin Oncol. 1987 Jul;23(7):959–962. doi: 10.1016/0277-5379(87)90341-5. [DOI] [PubMed] [Google Scholar]
  18. Tabár L., Fagerberg C. J., Gad A., Baldetorp L., Holmberg L. H., Gröntoft O., Ljungquist U., Lundström B., Månson J. C., Eklund G. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985 Apr 13;1(8433):829–832. doi: 10.1016/s0140-6736(85)92204-4. [DOI] [PubMed] [Google Scholar]
  19. Verbeek A. L., Hendriks J. H., Holland R., Mravunac M., Sturmans F., Day N. E. Reduction of breast cancer mortality through mass screening with modern mammography. First results of the Nijmegen project, 1975-1981. Lancet. 1984 Jun 2;1(8388):1222–1224. doi: 10.1016/s0140-6736(84)91703-3. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES