Screening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer

作者：Sida Huang, Sarah J. Westvold, Pamela R. Soulos, Jane Fan, Eric P. Winer, Haiying Zhan, Maryam B. Lustberg, John Lewin, Timothy J. Robinson, Michaela Ann Dinan · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.5322 · 被引用次数：18 · 研究领域：Global Cancer Incidence and Screening、BRCA gene mutations in cancer、Breast Cancer Treatment Studies

Importance: Screening mammography promotes early detection of breast cancer and is associated with reduced breast cancer mortality. Screening history prior to diagnosis may impact stage at diagnosis and breast cancer mortality but has not been comprehensively examined within a diverse US cohort. Objective: To determine whether having a prior screening is associated with earlier stage at breast cancer diagnosis and lower breast cancer-specific mortality. Design, Setting, and Participants: This cohort study used linked Surveillance, Epidemiology, and End Results-Medicare data of women aged at least 70 years, diagnosed with estrogen receptor-positive or human epidermal growth factor receptor 2-negative breast cancer from 2010 to 2017, and enrolled in fee-for-service Medicare Parts A and B from 5 years prior to through 1 year after diagnosis. Data were analyzed from March 1 to September 18, 2024. Exposure: Presence of 1 or more screening mammograms during the 5 years prior to the mammogram at breast cancer diagnosis. Main Outcomes and Measures: Outcomes of interest were stage of breast cancer at diagnosis, dichotomized into very early (T1N0) vs later stage (T2+ or N1+) and breast cancer-specific mortality. Results: Among 13 028 included women, most had at least 1 prior screening (10 094 women [77.5%]) and were aged between 70 and 79 years (9034 women [69.4%]) and not dual-eligible for Medicare and Medicaid (11 475 women [88.1%]). Additionally, 3812 women (29.3%) were diagnosed wi...