Fatal and non-fatal breast cancers in women targeted by BreastScreen Norway: a cohort study

Br J Cancer. 2024 Jan;130(1):99-107. doi: 10.1038/s41416-023-02512-7. Epub 2023 Dec 4.

Abstract

Background: Many breast cancer survivors experience anxiety related to dying from their disease even if it is detected at an early stage. We aimed to increase knowledge about fatal and non-fatal breast cancer by describing how histopathological tumour profiles and detection modes were associated with 10-year breast cancer-specific survival.

Methods: This cohort study included data from women targeted by BreastScreen Norway (aged 50-69) and diagnosed with invasive breast cancer during 1996-2011. Breast cancer was classified as fatal if causing death within 10 years after diagnosis and non-fatal otherwise. We described histopathologic characteristics of fatal and non-fatal cancers, stratified by mode of detection. Recursive partitioning identified subgroups with differing survival profiles.

Results: In total, 6.3% of 9954 screen-detected cancers (SDC) were fatal, as were 17.4% of 3205 interval cancers (IC) and 20.9% of 3237 cancers detected outside BreastScreen Norway. Four to five subgroups with differing survival profiles were identified within each detection mode. Women with lymph node-negative SDC or Grade 1-2, node-negative IC without distant metastases had the highest 10-year survival (95-96%).

Conclusions: Two subgroups representing 53% of the cohort had excellent (95-96%) 10-year breast cancer-specific survival. Most women with SDC had excellent survival, as did nearly 40% of women diagnosed with IC.

MeSH terms

  • Breast / diagnostic imaging
  • Breast Neoplasms* / pathology
  • Cohort Studies
  • Early Detection of Cancer
  • Female
  • Humans
  • Mammography
  • Mass Screening
  • Norway / epidemiology