ArticleJournal of the National Cancer Institute2014
Effects of screening and systemic adjuvant therapy on ER-specific US breast cancer mortality.
Open access · bronzeAbstract readComparative Study
In one paragraph
Article in Journal of the National Cancer Institute, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 2 pooled it
3.4field-weighted citation impact, top 6% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
83 citing papers in PubMed, 2 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025Pooled it
- The impact of mandatory mammographic breast density notification on supplemental screening practice in the United States: a systematic review.Breast cancer research and treatment · 2021Pooled it
- Investigation of the effectiveness of cooling spray on mammography comfort.Scientific reports · 2025Trial
- Comparison of ultrasound and mammography for early diagnosis of breast cancer among Chinese women with suspected breast lesions: A prospective trial.Thoracic cancer · 2022Trial
- Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer.The New England journal of medicine · 2018Trial
- Prospective Validation of a 21-Gene Expression Assay in Breast Cancer.The New England journal of medicine · 2015Trial
- US cancer deaths prevented due to survival improvements stratified by extent of disease, 2010-2019.Journal of the National Cancer Institute · 2025Article
- Navigating precision: the crucial role of next-generation sequencing recurrence risk assessment in tailoring adjuvant therapy for hormone receptor-positive, human epidermal growth factor Receptor2-negative early breast cancer.Cancer biology & therapy · 2024Review
- Changes in body composition in early breast cancer patients treated with aromatase inhibitors.Journal of endocrinological investigation · 2024Observational
- Assessment of Hematological Toxicity of Adjuvant Chemotherapy in the Complex Therapy of Breast Cancer.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients.Medicina (Kaunas, Lithuania) · 2024Article
- The diagnostic value of multimodal imaging based on MR combined with ultrasound in benign and malignant breast diseases.Clinical and experimental medicine · 2024Article
- Hypoxia-inducible factor in breast cancer: role and target for breast cancer treatment.Frontiers in immunology · 2024Review
- Article
- Population simulation modeling of disparities in US breast cancer mortality.Journal of the National Cancer Institute. Monographs · 2023Article
- Mild Cardiotoxicity and Continued Trastuzumab Treatment in the Context of HER2-Positive Breast Cancer.Journal of clinical medicine · 2023Article
- Biologically Based Complementary and Alternative Medicine Use in Breast Cancer Patients and Possible Drug-Drug Interactions.Breast care (Basel, Switzerland) · 2023Article
- Opportunities for Achieving the Cancer Moonshot Goal of a 50% Reduction in Cancer Mortality by 2047.Cancer discovery · 2023Article
- Identification of Breast Cancer Subtypes by Integrating Genomic Analysis with the Immune Microenvironment.ACS omega · 2023Article
- Hypothyroidism Evaluation after Radiotherapy of Breast and Supraclavicular in Patients with Breast Cancer.Advanced biomedical research · 2023Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 11 institutions in 2 countries.
Diego MunozDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Aimee M NearDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Nicolien T van RavesteynDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Sandra J LeeDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Clyde B SchechterDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Oguzhan AlagozDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Donald A BerryDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Elizabeth S BurnsideDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Yaojen ChangDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Gary ChisholmDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Harry J de KoningDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Mehmet Ali ErgunDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Eveline A M HeijnsdijkDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Hui HuangDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Natasha K StoutDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Brian L SpragueDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Amy Trentham-DietzDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Jeanne S MandelblattDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS).
Sylvia K PlevritisDivision of Biomedical Informatics Research (DM) and Department of Radiology (DM, SKP), School of Medicine, Stanford University, Stanford, CA (DM); Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC (AMN, YC, JSM); Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands (NTvR, HJdK, EAMH); Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute and Harvard Medical School Boston, MA (SJL, HH); Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (CBS); Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI (OA, MAE); Carbone Cancer Center, University of Wisconsin, Madison, WI (ESB, ATD); University of Texas M.D. Anderson Cancer Center, Houston, TX (DAB, GC); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (NKS); Department of Surgery, College of Medicine, University of Vermont, VT (BLS). sylvia.plevritis@stanford.edu.
Erasmus MC · NLGeorgetown University · USThe University of Texas MD Anderson Cancer Center · USUniversity of Wisconsin–Madison · USAlbert Einstein College of Medicine · USDana-Farber Cancer Institute · USGeorgetown University Medical Center · USHarvard Pilgrim Health Care · USHarvard University · USStanford University · USUniversity of Wisconsin Carbone Cancer Center · US
Funding
Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8MComparative Modeling: Informing Breast Cancer Control Practice & PolicyU01CA152958 · NCI · GEORGETOWN UNIVERSITY · PI BERRY, DONALD A, DE KONING, HARRY J · 2010 to 2015
$7.6MAnalytical Investigation of Breast Cancer Progression: DCIS, OverdiagnosisR01CA164301 · NCI · DANA-FARBER CANCER INST · PI LEE, SANDRA J · 2012 to 2016
$1.9MNCI NIH HHS HHSN261201100031CNCI NIH HHS P30 CA016672NCI NIH HHS R01 CA164301NCI NIH HHS U01 CA152958
Abstract
backgroundMolecular characterization of breast cancer allows subtype-directed interventions. Estrogen receptor (ER) is the longest-established molecular marker.
methodsWe used six established population models with ER-specific input parameters on age-specific incidence, disease natural history, mammography characteristics, and treatment effects to quantify the impact of screening and adjuvant therapy on age-adjusted US breast cancer mortality by ER status from 1975 to 2000. Outcomes included stage-shifts and absolute and relative reductions in mortality; sensitivity analyses evaluated the impact of varying screening frequency or accuracy.
resultsIn the year 2000, actual screening and adjuvant treatment reduced breast cancer mortality by a median of 17 per 100000 women (model range = 13-21) and 5 per 100000 women (model range = 3-6) for ER-positive and ER-negative cases, respectively, relative to no screening and no adjuvant treatment. For ER-positive cases, adjuvant treatment made a higher relative contribution to breast cancer mortality reduction than screening, whereas for ER-negative cases the relative contributions were similar for screening and adjuvant treatment. ER-negative cases were less likely to be screen-detected than ER-positive cases (35.1% vs 51.2%), but when screen-detected yielded a greater survival gain (five-year breast cancer survival = 35.6% vs 30.7%). Screening biennially would have captured a lower proportion of mortality reduction than annual screening for ER-negative vs ER-positive cases (model range = 80.2%-87.8% vs 85.7%-96.5%).
conclusionAs advances in risk assessment facilitate identification of women with increased risk of ER-negative breast cancer, additional mortality reductions could be realized through more frequent targeted screening, provided these benefits are balanced against screening harms.
Indexed as
Early Detection of CancerMass ScreeningModels, StatisticalAdultAgedAntineoplastic Combined Chemotherapy ProtocolsBiomarkers, TumorBreast NeoplasmsChemotherapy, AdjuvantFemaleHumansMammographyMiddle AgedMortalityNeoplasm StagingPopulation SurveillanceBiomarkers, TumorReceptors, Estrogen
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