Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients

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Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients
Title:
Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients
Journal Title:
BMC Medicine
Publication Date:
04 August 2022
Citation:
Lim, Z. L., Ho, P. J., Khng, A. J., Yeoh, Y. S., Ong, A. T. W., Tan, B. K. T., Tan, E. Y., Tan, S.-M., Lim, G. H., Lee, J. A., Tan, V. K.-M., Hu, J., Li, J., & Hartman, M. (2022). Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients. BMC Medicine, 20(1). https://doi.org/10.1186/s12916-022-02440-y
Abstract:
Early detection of breast cancer (BC) through mammography screening (MAM) is known to reduce mortality. We examined the differential effect that mammography has on BC characteristics and overall survival and the sociodemographic determinants of MAM utilization in a multi-ethnic Asian population.MethodsThis study included 3739 BC patients from the Singapore Breast Cancer Cohort (2010–2018). Self-reported sociodemographic characteristics were collected using a structured questionnaire. Clinical data were obtained through medical records. Patients were classified as screeners (last screening mammogram ≤ 2 years before diagnosis), non-screeners (aware but did not attend or last screen > 2years), and those unaware of MAM. Associations between MAM behaviour (MB) and sociodemographic factors and MB and tumour characteristics were examined using multinomial regression. Ten-year overall survival was modelled using Cox regression.ResultsPatients unaware of screening were more likely diagnosed with late stage (ORstage III vs stage I (Ref)[95% CI]: 4.94 [3.45–7.07],p< 0.001), high grade (ORpoorly vs well-differentiated (reference): 1.53 [1.06–2.20],p= 0.022), nodal-positive, large size (OR>5cm vs ≤2cm (reference): 5.06 [3.10–8.25],p< 0.001), and HER2-positive tumours (ORHER2-negative vs HER2-positive (reference): 0.72 [0.53–0.97],p= 0.028). Similar trends were observed between screeners and non-screeners with smaller effect sizes. Overall survival was significantly shorter than screeners in the both groups (HRnon-screeners: 1.89 [1.22–2.94],p= 0.005; HRunaware: 2.90 [1.69–4.98],p< 0.001).Non-screeners and those unaware were less health conscious, older, of Malay ethnicity, less highly educated, of lower socioeconomic status, more frequently ever smokers, and less physically active. Among screeners, there were more reported personal histories of benign breast surgeries or gynaecological conditions and positive family history of breast cancer.ConclusionsMammography attendance is associated with more favourable BC characteristics and overall survival. Disparities in the utility of MAM services suggest that different strategies may be needed to improve MAM uptake.
License type:
Attribution 4.0 International (CC BY 4.0)
Funding Info:
This research / project is supported by the National Research Foundation Singapore - NRF Fellowship
Grant Reference no. : NRF-NRFF2017-02

This research / project is supported by the Biomedical Research Council - BMRC Central Research Fund (Applied Translational Research)
Grant Reference no. : NA

This research / project is supported by the PRECISION Health Research, Singapore - Clinical Implementation Pilot (PRECISE CIP) Fund
Grant Reference no. : NA

This research / project is supported by the Agency for Science, Technology and Research - A*STAR SST HTPO Seed Fund
Grant Reference no. : C211618001

This research / project is supported by the National University of Singapore - NUS Start-Up Grant
Grant Reference no. : NA

This research / project is supported by the National Medical Research Council - Centre Grant Programme
Grant Reference no. : NMRC/CG/NCIS/2010

This research / project is supported by the National Medical Research Council - Centre Grant Programme
Grant Reference no. : NMRC/CG/012/2013

This research / project is supported by the National University Cancer Institute Singapore (NCIS) - Centre Grant Programme
Grant Reference no. : CGAug16M005

This research / project is supported by the National University Cancer Institute Singapore and Ng Teng Fong General Hospital - NCIS-NTFGH Centre Grant
Grant Reference no. : CGAug16C002

This research / project is supported by the National Medical Research Council - NMRC Clinician Scientist Award (Senior Investigator Category)
Grant Reference no. : NMRC/CSA-SI/0015/2017

This research / project is supported by the Saw Swee Hock School of Public Health - Research Programme of Research Seed Funding (Breast Cancer Prevention Program)
Grant Reference no. : N.A

This research / project is supported by the Yong Loo Lin School of Medicine - Breast Cancer Screening Prevention Programme
Grant Reference no. :
Description:
ISSN:
1741-7015
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