English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Lead time, the interval between screen detection and when a disease would have become clinically evident, has been cited to explain longer survival times in mammography detected breast cancer cases (BC).    Methods  An institutional retrospective cohort study of BC outcomes related to detection method (mammography (MamD) vs. patient (PtD)). Cases were first primary invasive stage I-III BC, age 40–74 years ( n  = 6603), 1999–2016. Survival time was divided into 1) distant disease-free interval (DDFI) and 2) distant disease-specific survival (DDSS) as two separate time interval outcomes. We measured statistical association between detection method and diagnostic, treatment and outcome variables using bivariate comparisons, Cox proportional hazards analyses and mean comparisons. Outcomes were distant recurrence ( n  = 422), DDFI and DDSS.    Results  39% of cases were PtD ( n  = 2566) and 61% were MamD ( n  = 4037). MamD cases had a higher percentage of Stage I tumors [MamD 69% stage I vs. PtD 31%,  p  < .001]. Rate of distant recurrence was 11% among PtD BC cases ( n  = 289) vs. 3% of MamD ( n  = 133) ( p  < .001). Order of factor entry into the distant recurrence time interval (DDFI) model was 1) TNM stage ( p  < .001), 2) HR/HER2 status ( p  < .001), 3) histologic grade ( p  = .005) and 4) detection method ( p  < .001). Unadjusted PtD DDFI mean time was 4.34 years and MamD 5.52 years ( p  < .001), however when stratified by stage, the most significant factor relative to distant recurrence, there was no significant difference between PtD and MamD BC. Distant disease specific survival time did not differ by detection method.    Conclusion  We observed breast cancer distant disease-free interval to be primarily associated with stage at diagnosis and tumor characteristics with less contribution of detection method to the full model. Patient and mammography detected breast cancer mean lead time to distant recurrence differed significantly by detection method for all stages but not significantly within stage with no difference in time from distant recurrence to death. Lead time difference related to detection method appears to be present but may be less influential than other factors in distant disease-free and disease specific survival.

Breast cancer distant recurrence lead time interval by detection method in an institutional cohort