Primary and adjuvant therapy, prognostic factors and survival in 1053 breast cancers diagnosed in a trial of mammography screening

Background: As mammographic screening becomes more widespread, larger numbe rs of tumours are diagnosed while small and node negative. Methods: We examined detection mode, tumour size, node status, histological type, therapy and outcome in 1053 breast cancers diagnosed in one county o f the Swedish Two-County Trial of mammographic screening for breast cancer. Results: Of patients undergoing total mastectomy with axillary dissection, 65% were found to be node negative. For tumours of size 1-9 mm, 95% were no de negative, The major effects on survival were tumour size, node status an d histological type, Primary adjuvant therapy had no significant associatio n with survival. Conclusions: The advent of mammography has substantially enhanced the possi bilities for less radical treatment. There is an urgent need for therapeuti c trials utilizing mammographic-pathological correlations to ascertain in a dvance which tumours can and which cannot benefit from more radical therapy .