The impact of XXXX screening on survival. A 5- to 10-year follow-up study.

@entity5 @entity1 @entity204 @entity0
The Missouri Breast @entity5 Detection Demonstration Project (BCDDP) at the @entity5 Research Center in Columbia, Missouri, detected 136 malignant lesions among 10,187 asymptomatic @entity1 between 1974 and 1980. Mammography was the sole detection modality in 76 or 56% of cases (Group 1). Mammography combined with physical examination revealed 41 (30%) additional cases (Group 2). Physical examination alone detected 19 (14%) cases (Group 3). Follow-up was complete in all cases. There were 26 (19%) noninvasive and 110 (81%) invasive lesions. Positive axillary nodes were found in 34 (25%) cases, and 102 (75%) @entity1 had negative nodes. The overall 5-year survival was 84.5%. After a minimum follow-up of 5 years and a median follow-up of 8.5 years, 108 @entity1 are alive, 5 of whom have recurrences. Among 28 deceased @entity1 , 9 died of causes unrelated to @entity0 . The 5-year survival of Group 1 was 95% (72/76). Among this group of @entity1 , 84% (64/76) had negative lymph nodes. At 5 to 10 years follow-up, there have been no @entity0 -related @entity204 among this group, and only one @entity1 has recurrent disease 91 months after mastectomy. Furthermore, 85% (22/26) of all noninvasive lesions were found in this group. Of the remaining 12 @entity1 diagnosed by mammography alone but who had positive nodes, the 5-year survival was 75% (9/12). By contrast, @entity1 diagnosed by mammography plus physical examination (Group 2) experienced a survival of 71% (29/41) at 5 years. Sixty-three percent of @entity1 diagnosed by physical examination had negative lymph nodes. Their 5-year survival was 84%, which contrasts with a 50% 5-year survival for @entity1 with positive nodes. In Group 3, 79% (15/19) had negative nodes. The 5-year survival rate of this group was 74% (14/19), and the 5-year survival rate of the node-negative @entity1 with invasive disease in this group was 29% and 21% lower than that of the node-negative @entity1 with invasive disease of Groups 1 and 2, respectively (P less than 0.01). This study suggests that improved survival in @entity0 screening program is in large measure dependent on the ability to detect lesions before they become palpable. The authors conclude that mammography is a determining factor in early diagnosis, and at 5 to 10 years contributes significantly to improved 5- and 10-year survival rates.
