Impact of mammography screening programme in the breast cancer population of the Region of Valencia (Spain)

“…Locally residing patients included some who were diagnosed when palliation was the only care possible. The 50% stage III/IV disease observed in patients living within 20 km is a more advanced stage distribution than that seen in some, mostly non‐African, unscreened populations or unscreened age groups in which less than 20% stage III/IV has been observed . Nevertheless, worse stage distributions (60–90% stage III/IV) exist in many other African settings .…”

Section: Discussionmentioning

confidence: 85%

“…The 50% stage III/IV disease observed in patients living within 20 km is a more advanced stage distribution than that seen in some, mostly non-African, unscreened populations or unscreened age groups in which less than 20% stage III/IV has been observed. [19][20][21] Nevertheless, worse stage distributions (60-90% stage III/IV) exist in many other African settings. [22][23][24] Further, we have previously documented how the stage distribution has improved from 70 to 50% stage III/IV in just 5 years.…”

Section: Late Stage At Diagnosismentioning

confidence: 99%

Stage at breast cancer diagnosis and distance from diagnostic hospital in a periurban setting: A South African public hospital case series of over 1,000 women

Dickens

Joffe

Jacobson

et al. 2014

Intl Journal of Cancer

108

102

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Advanced stage at diagnosis contributes to low breast cancer survival rates in sub-Saharan Africa. Living far from health services is known to delay presentation, but the effect of distance, the radius at which the effect sets in and the women most affected has not been quantified. In a peri-urban South African setting, we examined the effect of a GIS-measured straight-line distance, from a patient’s residence to diagnostic hospital, on stage at diagnosis in 1071 public-sector breast cancer patients diagnosed during 2006–12. Generalized linear models were used to estimate risk ratios for late stage (stage III/IV vs stage I/II) associated with distance, adjusting for year of diagnosis, age, race and socioeconomic indicators. Mean age of patients was 55 years, 90% were Black African, and diagnoses were at stages I (5%), II (41%), III (46%) and IV (8%). 62% of patients with distances >20 km (n=347) had a late stage at diagnosis compared to 50% with distances <20 km (n=724, p=0.02). Risk of late stage at diagnosis was 1.25-fold higher (95% CI: 1.09, 1.42) per 30 km. Effects were pronounced in an under-represented group of patients over age 70. This positive stage-distance association held to 40 km, and plateaued or slightly reversed in patients (9%) living beyond this distance. Studies of woman and the societal and healthcare-level influences on these delays and on the late stage at diagnosis distribution are needed to inform interventions that improve diagnostic stage and breast cancer survival rates in this and similar settings.

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“…Proportions up to 50% or more of breast cancer diagnosed in stage I have been reported [173]. The number of antiestrogen drugs available and active with different mechanisms is increasing.…”

Section: Perspectivesmentioning

confidence: 99%

“…This can be a very important issue. In fact the number of patients with this type of early diagnosed cancer is increasing due to the above mentioned screening programs [173][174][175]. The prognosis of these patients is so good that some studies have questioned the use of adjuvant chemotherapy which worsens quality of life of the majority of patients and improves survival only in a very small proportion of patients [176,177].…”

Section: Perspectivesmentioning

confidence: 99%

Cytokines in the Management of High Risk or Advanced Breast Cancer: An Update and Expectation

Carpi¹,

Nicolini²,

Antonelli³

et al. 2009

CCDT

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Some cytokines (interleukin (IL)-2, IL-11, transforming growth factor(TGF)beta) stimulate, while others (IL-12, IL-18, Interferons (IFNs)) inhibit breast cancer proliferation and/or invasion. So far IL-2, IFNalpha, IFNbeta and occasionally IFNgamma, IL-6, IL-12 have been used for the treatment of advanced breast cancer either to induce or increase hormone sensitivity and/or to stimulate cellular immunity. Only two long term pilot studies suggest that IL-2 and IFNbeta can improve clinical benefit and/or overall survival of metastatic breast cancer patients with minimal residual disease after chemotherapy or with disseminate disease non progressing during endocrine therapy. These results have been interpreted assuming that tumour microenvironment impairs the immune system of the host. Consequently, minimal disease or intense cytostatic effects following chemo or endocrine therapy, respectively, permit the patient's immune system to respond to the stimulatory effect of the cytokines. Therefore a prospective, phase III, randomised, simple blind trial has been planned. The aim is to assess whether the addition of IFNbeta and IL-2 to standard hormone therapy in postmenopausal patients with metastatic breast cancer and positive or unknown positive receptors prolongs the clinical benefit and survival since the metastatic diagnosis and the beginning of first line salvage antiestrogen therapy, compared with the results achieved with standard hormone therapy alone. If this immunotherapy prolongs survival of endocrine dependent metastatic breast cancer patients, IL-2 and IFNbeta can also be evaluated as adjuvant treatment of patients with positive estrogen receptors.

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Impact of mammography screening programme in the breast cancer population of the Region of Valencia (Spain)

Cited by 8 publications

References 18 publications

Deprivation and mass screening: Survival of women diagnosed with breast cancer in France from 2008 to 2010

Deprivation and mass screening: Survival of women diagnosed with breast cancer in France from 2008 to 2010

Stage at breast cancer diagnosis and distance from diagnostic hospital in a periurban setting: A South African public hospital case series of over 1,000 women

Cytokines in the Management of High Risk or Advanced Breast Cancer: An Update and Expectation

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