Survival experience in the Breast XXXX Detection Demonstration Project.

@entity1 @entity5 @entity0 @entity3
Very high survival rates have been observed in four through 11 years of follow-up in 4,240 @entity1 with a histologically confirmed diagnosis of @entity0 in the Breast @entity5 Detection Demonstration Project (BCDDP). The relative five, eight, and 10-year survival rates were 88, 83, and 79 percent, respectively. Allowances were made for lead-time bias among @entity5 detected through screening, and the validity of the findings was supported by internal analyses, which showed that length-time bias was of little, if any, importance, and that any possible "overdiagnosis" of @entity5 cases was also of small relevance. In view of current interest in the value of screening @entity1 before age 50, intensive analyses were made comparing the BCDDP data for @entity1 in their 40s with @entity1 in their 50s. In terms of kinds of @entity0 found, modality of finding them, and survival rates once they have been found, the parallel results for the two groups show that screening was virtually as effective in the younger as in the older @entity1 . Some authorities are of the opinion that the benefits of mammography after age 50 are well documented, but at younger ages the evidence is still inconclusive. The findings in this study show there is no doubt of the very successful results of screening for @entity0 with mammography in younger as well as older @entity1 . In comparing relative five-year and eight-year survival rates for @entity1 with invasive @entity0 detected through screening in the BCDDP, with those for cases diagnosed in the National @entity5 Institute's Surveillance, Epidemiology and End Results (NCI SEER) program from 1977 to 1982, it is seen that for individual subcategories by @entity5 size and nodal class, the survival rates are about the same. However, for @entity3 , the five-year and eight-year survival rates were 87 and 81 percent, respectively, for the BCDDP compared with 74 and 65 percent for SEER. Thus the substantial gains in survival followed the large shift toward a high proportion of @entity5 being diagnosed and treated in more favorable stages through the screening accomplishments. With respect to the relative case fatality rates, the complements of the relative survival rates, the eight-year rate of 19 percent for the BCDDP versus that of 35 percent for SEER connotes 46 percent fewer @entity1 dying in the BCDDP group.
