Early detection of second breast cancers improves prognosis in breast cancer survivors
N. Houssami, S. Ciatto, F. Martinelli, R. Bonardi, and S. W. Duffy
Advanced access to the publication of this paper, published online March 19, 2009
The impact of early detection of second breast cancers in women who have survived a primary breast cancer is unknown.
The researchers looked at information on 1,044 women who were seen at a medical center in Florence, Italy, between 1980 and 2005 and who had developed a second breast cancer -- 455 with cancer in the same breast (ipsilateral) and 589 with cancer in the opposite breast (contralateral). Of the second breast cancers, 67 percent were asymptomatic, and 33 percent were symptomatic.
The study found that chances of survival improved between 27 percent and 47 percent if the second breast cancer was detected in the early, asymptomatic stage rather than at a later stage when women started to experience symptoms.
The researchers also found that mammography
was more sensitive than clinical examination for detecting second breast cancers -- 86 percent vs. 57 percent. However, 14 percent of the cancers were detected only by clinical examination.
Asymptomatic cancers were smaller than symptomatic cancers, and early-stage cancers were more common in asymptomatic women (58 percent) than in symptomatic women (23 percent). Fewer women with asymptomatic than symptomatic contralateral cancer had node metastases, an indication the cancer may have spread.
Take home message:
Early detection of second breast cancers can reduce the risk of death by as much as half
