| Title |
Treatment Intensity Differences After Early-Stage Breast Cancer (ESBC) Diagnosis Depending on Participation in a Screening Program
|
|---|---|
| Published in |
Annals of Surgical Oncology, May 2018
|
| DOI | 10.1245/s10434-018-6469-7 |
| Pubmed ID | |
| Authors |
Kenneth Elder, Carolyn Nickson, Melinda Pattanasri, Samuel Cooke, Dorothy Machalek, Allison Rose, Arlene Mou, John Paxton Collins, Allan Park, Richard De Boer, Claire Phillips, Vicki Pridmore, Helen Farrugia, G. Bruce Mann |
| Abstract |
While population mammographic screening identifies early-stage breast cancers (ESBCs; ductal carcinoma in situ [DCIS] and invasive disease stages 1-3A), commentaries suggest that harms from overdiagnosis and overtreatment may outweigh the benefits. Apparent benefits to patients with screen-detected cancers may be due to selection bias from exclusion of interval cancers (ICs). Treatment intensity is rarely discussed, with an assumption that all ESBCs are treated similarly. We hypothesized that women diagnosed while in a screening program would receive less-intense treatment than those never or not recently screened (NRS). This was a retrospective analysis of all women aged 50-69 years managed for ESBC (invasive or DCIS) during the period 2007-2013 within a single service, comparing treatment according to screening status. Data on demographics, detection, pathology, and treatment were derived from hospital, cancer registry, and screening service records. Overall, 622 patients were active screeners (AS) at diagnosis (569 screen-detected and 53 ICs) and 169 patients were NRS. AS cancers were smaller (17 mm vs. 26 mm, p < 0.0001), less likely to involve nodes (26% vs. 48%, p < 0.0001), and lower grade. For invasive cancer, NRS patients were more likely to be recommended for mastectomies [35% vs. 16%; risk ratio(RR) 2.2, p < 0.0001], axillary dissection (43% vs. 19%; RR 2.3, p < 0.0001), adjuvant chemotherapy (65% vs. 37%; RR 1.7, p < 0.0001), and postmastectomy radiotherapy (58% vs. 39%; RR 1.5, p = 0.04). Participants in population screening diagnosed with ESBC receive substantially less-intense treatment than non-participants. Differences persist when potential overdiagnosis is taken into account; these differences should be factored into debates around mammographic screening. |
X Demographics
The data shown below were collected from the profiles of 8 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 25% |
| Mexico | 1 | 13% |
| Italy | 1 | 13% |
| Unknown | 4 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 75% |
| Science communicators (journalists, bloggers, editors) | 1 | 13% |
| Scientists | 1 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 27 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 4 | 15% |
| Student > Master | 4 | 15% |
| Student > Doctoral Student | 2 | 7% |
| Researcher | 2 | 7% |
| Student > Ph. D. Student | 2 | 7% |
| Other | 3 | 11% |
| Unknown | 10 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 4 | 15% |
| Social Sciences | 3 | 11% |
| Biochemistry, Genetics and Molecular Biology | 2 | 7% |
| Engineering | 2 | 7% |
| Nursing and Health Professions | 2 | 7% |
| Other | 3 | 11% |
| Unknown | 11 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 August 2018.
All research outputs
#6,231,094
of 23,305,591 outputs
Outputs from Annals of Surgical Oncology
#2,022
of 6,608 outputs
Outputs of similar age
#107,116
of 326,858 outputs
Outputs of similar age from Annals of Surgical Oncology
#58
of 104 outputs
Altmetric has tracked 23,305,591 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 6,608 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one has gotten more attention than average, scoring higher than 69% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 326,858 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 104 others from the same source and published within six weeks on either side of this one. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.