Breast Cancer Method of Detection: Screening Associated with Favorable Tumor Characteristics, Treatment, and Survival Across Age Groups
Menée à partir de données portant sur 1 023 femmes atteintes d'un cancer du sein diagnostiqué entre 2019 et 2021 (âge : 40 ans ou plus ; âge moyen : 63,5 ans ; durée maximale de suivi : environ 7,5 ans), cette étude examine l'association entre la méthode de détection de la maladie et les caractéristiques démographiques des patientes, les caractéristiques tumorales, les traitements reçus ainsi que la survie
Objective: Breast cancer method of detection (MOD) describes how a cancer is first identified: through screening or non-screening (symptomatic/incidental) presentation. We examined associations between MOD and patient demographics, tumor characteristics, treatment patterns, and survival.
Methods: This retrospective cohort study included women
≥
40 years diagnosed with breast cancer between 1/2019 and 12/2021, follow-up through 7/2026. MOD was classified as screen-detected or non-screen-detected. Logistic regression and chi-square tests evaluated associations with patient, tumor, and treatment variables. Kaplan-Meier and multivariable Cox regression assessed all-cause survival.
Results: Among 1,023 women (mean age 63.5 ± 12.1 years), screen-detected cancers (n=710, 69.4%) had more favorable characteristics: earlier T stage (T0: 26.3% vs. 5.4%, p<0.001), negative lymph nodes (N0: 85.5% vs. 59.1%, p<0.001), fewer metastases (M0: 98.6% vs. 82.4%, p<0.001), and lower grade (grade 1: 18.6% vs. 7.4%, p<0.001). More received lumpectomy (72.1% vs. 50.2%, p<0.001) and fewer received neoadjuvant chemotherapy (5.2% vs. 22.5%, p<0.001). Non-screen-detected cancers were more common among the unemployed (21.0% vs. 14.0%, p=0.001), uninsured (3.8% vs. 1.7%, p=0.026), and women
≥
75 years (23.3% vs. 16.1%, p=0.019). Within non-screen-detected cancers, tumor stage worsened with time since last negative screen (p<0.001). Screen-detected cancers showed superior all-cause survival (5-year: 92.9% vs. 73.6%, p<0.001). After Journal Pre-proofadjustment, screen-detection was independently associated with 43% lower mortality (HR=0.57, p=0.003). Significant survival benefit persisted in women
≥
75 years (HR=0.44, p=0.014).
Discussion: Screen-detected breast cancers were associated with favorable biology, less aggressive treatment, and improved survival. These findings can inform screening guidelines and underscore the importance of incorporating MOD into cancer registries.
Journal of the American College of Radiology , article en libre accès, 2026