PMID: 11336243May 5, 2001Paper

Premenopausal status accelerates relapse in node positive breast cancer: hypothesis links angiogenesis, screening controversy

Breast Cancer Research and Treatment
M W RetskyW J M Hrushesky

Abstract

Much attention has been given to determining the benefit of mammographic screening to reduce breast cancer mortality. Eight randomized clinical trials have been conducted in four countries: the US, Canada, Scotland and Sweden. Trials report an early and stable 30% reduction in breast cancer mortality for women aged 50-59. For women under 50, unexpectedly, the early years of screening produce a disadvantage to the screened population. Only in later years does an advantage appear. To help understand this, we studied relapse patterns using a breast cancer database of 1,173 pre- and postmenopausal, node negative and positive patients treated with surgery only and having 16-20 years of follow-up. This approach is relevant since at least five of the eight screening trials began before the widespread use of adjuvant chemotherapy in the 1980s. Surgical cure rates were independent of menopausal status. However, a major difference in early relapse rate was found. In premenopausal and node positive patients, 27% of all distant relapses occurred within the first 10 months following resection. This is twice the early relapse frequency of any other clinical group. Using computer simulation, we interpret that these early relapses probably res...Continue Reading

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Citations

Dec 19, 2013·Cancer Metastasis Reviews·Carlos M GalmariniFelipe C Galmarini
Sep 24, 2002·Breast Cancer Research and Treatment·R DemicheliG Bonadonna
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