Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients
Abstract Background Early detection of breast cancer (BC) through mammography screening (MAM) is known to reduce mortality. We examined the differential effect that mammography has on BC characteristics and overall survival and the sociodemographic determinants of MAM utilization in a multi-ethnic A...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-08-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-022-02440-y |
| _version_ | 1818505236894973952 |
|---|---|
| author | Zi Lin Lim Peh Joo Ho Alexis Jiaying Khng Yen Shing Yeoh Amanda Tse Woon Ong Benita Kiat Tee Tan Ern Yu Tan Su-Ming Tan Geok Hoon Lim Jung Ah Lee Veronique Kiak-Mien Tan Jesse Hu Jingmei Li Mikael Hartman |
| author_facet | Zi Lin Lim Peh Joo Ho Alexis Jiaying Khng Yen Shing Yeoh Amanda Tse Woon Ong Benita Kiat Tee Tan Ern Yu Tan Su-Ming Tan Geok Hoon Lim Jung Ah Lee Veronique Kiak-Mien Tan Jesse Hu Jingmei Li Mikael Hartman |
| author_sort | Zi Lin Lim |
| collection | DOAJ |
| description | Abstract Background Early detection of breast cancer (BC) through mammography screening (MAM) is known to reduce mortality. We examined the differential effect that mammography has on BC characteristics and overall survival and the sociodemographic determinants of MAM utilization in a multi-ethnic Asian population. Methods This study included 3739 BC patients from the Singapore Breast Cancer Cohort (2010–2018). Self-reported sociodemographic characteristics were collected using a structured questionnaire. Clinical data were obtained through medical records. Patients were classified as screeners (last screening mammogram ≤ 2 years before diagnosis), non-screeners (aware but did not attend or last screen > 2years), and those unaware of MAM. Associations between MAM behaviour (MB) and sociodemographic factors and MB and tumour characteristics were examined using multinomial regression. Ten-year overall survival was modelled using Cox regression. Results Patients unaware of screening were more likely diagnosed with late stage (ORstage III vs stage I (Ref) [95% CI]: 4.94 [3.45–7.07], p < 0.001), high grade (ORpoorly vs well-differentiated (reference): 1.53 [1.06–2.20], p = 0.022), nodal-positive, large size (OR>5cm vs ≤2cm (reference): 5.06 [3.10–8.25], p < 0.001), and HER2-positive tumours (ORHER2-negative vs HER2-positive (reference): 0.72 [0.53–0.97], p = 0.028). Similar trends were observed between screeners and non-screeners with smaller effect sizes. Overall survival was significantly shorter than screeners in the both groups (HRnon-screeners: 1.89 [1.22–2.94], p = 0.005; HRunaware: 2.90 [1.69–4.98], p < 0.001). Non-screeners and those unaware were less health conscious, older, of Malay ethnicity, less highly educated, of lower socioeconomic status, more frequently ever smokers, and less physically active. Among screeners, there were more reported personal histories of benign breast surgeries or gynaecological conditions and positive family history of breast cancer. Conclusions Mammography attendance is associated with more favourable BC characteristics and overall survival. Disparities in the utility of MAM services suggest that different strategies may be needed to improve MAM uptake. |
| first_indexed | 2024-12-10T21:47:58Z |
| format | Article |
| id | doaj.art-e03983852e9340cdad3977127b36f817 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-10T21:47:58Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-e03983852e9340cdad3977127b36f8172022-12-22T01:32:19ZengBMCBMC Medicine1741-70152022-08-0120111910.1186/s12916-022-02440-yMammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patientsZi Lin Lim0Peh Joo Ho1Alexis Jiaying Khng2Yen Shing Yeoh3Amanda Tse Woon Ong4Benita Kiat Tee Tan5Ern Yu Tan6Su-Ming Tan7Geok Hoon Lim8Jung Ah Lee9Veronique Kiak-Mien Tan10Jesse Hu11Jingmei Li12Mikael Hartman13Genome Institute of Singapore, Laboratory of Women’s Health & GeneticsGenome Institute of Singapore, Laboratory of Women’s Health & GeneticsGenome Institute of Singapore, Laboratory of Women’s Health & GeneticsDepartment of Surgery, Yong Loo Lin School of Medicine, National University of SingaporeDepartment of Surgery, National University HospitalDepartment of General Surgery, Sengkang General HospitalDepartment of General Surgery, Tan Tock Seng HospitalDivision of Breast Surgery, Changi General HospitalBreast Department, KK Women’s and Children’s HospitalDuke-NUS Medical SchoolDepartment of Breast Surgery, Singapore General HospitalDepartment of General Surgery, Ng Teng Fong General HospitalGenome Institute of Singapore, Laboratory of Women’s Health & GeneticsSaw Swee Hock School of Public Health, National University of SingaporeAbstract Background Early detection of breast cancer (BC) through mammography screening (MAM) is known to reduce mortality. We examined the differential effect that mammography has on BC characteristics and overall survival and the sociodemographic determinants of MAM utilization in a multi-ethnic Asian population. Methods This study included 3739 BC patients from the Singapore Breast Cancer Cohort (2010–2018). Self-reported sociodemographic characteristics were collected using a structured questionnaire. Clinical data were obtained through medical records. Patients were classified as screeners (last screening mammogram ≤ 2 years before diagnosis), non-screeners (aware but did not attend or last screen > 2years), and those unaware of MAM. Associations between MAM behaviour (MB) and sociodemographic factors and MB and tumour characteristics were examined using multinomial regression. Ten-year overall survival was modelled using Cox regression. Results Patients unaware of screening were more likely diagnosed with late stage (ORstage III vs stage I (Ref) [95% CI]: 4.94 [3.45–7.07], p < 0.001), high grade (ORpoorly vs well-differentiated (reference): 1.53 [1.06–2.20], p = 0.022), nodal-positive, large size (OR>5cm vs ≤2cm (reference): 5.06 [3.10–8.25], p < 0.001), and HER2-positive tumours (ORHER2-negative vs HER2-positive (reference): 0.72 [0.53–0.97], p = 0.028). Similar trends were observed between screeners and non-screeners with smaller effect sizes. Overall survival was significantly shorter than screeners in the both groups (HRnon-screeners: 1.89 [1.22–2.94], p = 0.005; HRunaware: 2.90 [1.69–4.98], p < 0.001). Non-screeners and those unaware were less health conscious, older, of Malay ethnicity, less highly educated, of lower socioeconomic status, more frequently ever smokers, and less physically active. Among screeners, there were more reported personal histories of benign breast surgeries or gynaecological conditions and positive family history of breast cancer. Conclusions Mammography attendance is associated with more favourable BC characteristics and overall survival. Disparities in the utility of MAM services suggest that different strategies may be needed to improve MAM uptake.https://doi.org/10.1186/s12916-022-02440-yBreast cancerMammography screeningCancer survivalSociodemographics and health outcomes |
| spellingShingle | Zi Lin Lim Peh Joo Ho Alexis Jiaying Khng Yen Shing Yeoh Amanda Tse Woon Ong Benita Kiat Tee Tan Ern Yu Tan Su-Ming Tan Geok Hoon Lim Jung Ah Lee Veronique Kiak-Mien Tan Jesse Hu Jingmei Li Mikael Hartman Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients BMC Medicine Breast cancer Mammography screening Cancer survival Sociodemographics and health outcomes |
| title | Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients |
| title_full | Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients |
| title_fullStr | Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients |
| title_full_unstemmed | Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients |
| title_short | Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients |
| title_sort | mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival case only analysis of 3739 asian breast cancer patients |
| topic | Breast cancer Mammography screening Cancer survival Sociodemographics and health outcomes |
| url | https://doi.org/10.1186/s12916-022-02440-y |
| work_keys_str_mv | AT zilinlim mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT pehjooho mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT alexisjiayingkhng mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT yenshingyeoh mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT amandatsewoonong mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT benitakiatteetan mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT ernyutan mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT sumingtan mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT geokhoonlim mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT jungahlee mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT veroniquekiakmientan mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT jessehu mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT jingmeili mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients AT mikaelhartman mammographyscreeningisassociatedwithmorefavourablebreastcancertumourcharacteristicsandbetteroverallsurvivalcaseonlyanalysisof3739asianbreastcancerpatients |