Comparison of outcome data for screen-detected and symptomatic breast cancers diagnosed in the West Midlands region in 2002
© BioMed Central 2006
Published: 10 July 2006
Annually since 1996, screen-detected breast cancers within the NHS Breast Screening Programme have been audited at a national level.
The Breast Cancer Clinical Outcome Measures (BCCOM) Project aims to conduct a similar audit for symptomatic breast cancers. The first round of the BCCOM Project audited cancers diagnosed in 2002. For the West Midlands region, the 949 cases included in the national audit of screen-detected breast cancers and the 2,504 symptomatic cases included in the BCCOM Project were compared.
Non-invasive breast cancers formed 5% of the symptomatic cohort, compared with 23% for screening. Symptomatic cancers were larger (mean size 24.5 mm vs 16.6 mm) and more likely to be node-positive (42.7% vs 27.5%). Forty per cent of the symptomatic breast cancers had mastectomy compared with 27% of the screen-detected cohort, and small (diameter <15 mm) invasive symptomatic cancers were more likely to receive a mastectomy than comparable screening cases (31% vs 16%).
For invasive cancers with a known Nottingham Prognostic Index score, 20% of the symptomatic cancers fell into the excellent and good prognostic groups compared with 58% of screen-detected cancers. For women aged under 65, the proportion with screen-detected cancers receiving chemotherapy was lower than those with symptomatic cancer (20% vs 36%). Screening cases were also less likely to receive radiotherapy (48% vs 63%).