Primary and Adjuvant Therapy, Prognostic Factors and Survival in 1053 Breast Cancers Diagnosed in a Trial of Mammography Screening

BACKGROUND: As mammographic screening becomes more widespread, larger numbers of tumours are diagnosed while small and node negative. METHODS: We examined detection mode, tumour size, node status, histological type, therapy and outcome in 1053 breast cancers diagnosed in one county of the Swedish Two-County Trial of mammographic screening for breast cancer. RESULTS: Of patients undergoing total mastectomy with axillary dissection, 65% were found to be node negative. For tumours of size 1-9 mm, 95% were node negative. The major effects on survival were tumour size, node status and histological type. Primary adjuvant therapy had no significant association with survival. CONCLUSIONS: The advent of mammography has substantially enhanced the possibilities for less radical treatment. There is an urgent need for therapeutic trials utilizing mammographic-pathological correlations to ascertain in advance which tumours can and which cannot benefit from more radical therapy.