Participants in the German mammography screening program (MSP) who have invasive breast cancer—including interval cancers—can on the whole undergo more sparing surgical treatment compared with non-participants. This is demonstrated by a study in the current issue of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2018; 115: 520-7). The tumor characteristics and prognostic markers of breast cancers detected in MSP participants at screening, in the interval following negative screening, as well as in non-participants were compared.
Data on 1531 newly diagnosed cases of invasive and in situ breast cancer (DCIS, ductal carcinoma in situ) were evaluated in two certified breast care centers in Münster, Germany. Comprehensive information on tumor characteristics, tumor biology, and primary surgical treatment was available for all cases. In their retrospective observational study, Bettina Braun and co-authors conclude that breast cancer was still at an early stage (DCIS) more frequently in screening participants compared with non-participants (23% versus 31%). Invasive cancers were smaller in participants (74% versus 55% in the T1 stage), could be operated on more frequently in a breast-conserving manner (75% versus 62%), and a guideline-based indication for adjuvant chemotherapy was less common in these patients (46% versus 52%). The authors emphasize that one can assume comparable figures in other screening regions.