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. 2005 Oct 27;353(17):1784-92.
doi: 10.1056/NEJMoa050518.

Effect of screening and adjuvant therapy on mortality from breast cancer

Donald A Berry  1 , Kathleen A Cronin, Sylvia K Plevritis, Dennis G Fryback, Lauren Clarke, Marvin Zelen, Jeanne S Mandelblatt, Andrei Y Yakovlev, J Dik F Habbema, Eric J Feuer; Cancer Intervention and Surveillance Modeling Network (CISNET) Collaborators
Affiliations
Free article

Effect of screening and adjuvant therapy on mortality from breast cancer

Donald A Berry et al. N Engl J Med. .
Free article

Abstract

Background: We used modeling techniques to assess the relative and absolute contributions of screening mammography and adjuvant treatment to the reduction in breast-cancer mortality in the United States from 1975 to 2000.

Methods: A consortium of investigators developed seven independent statistical models of breast-cancer incidence and mortality. All seven groups used the same sources to obtain data on the use of screening mammography, adjuvant treatment, and benefits of treatment with respect to the rate of death from breast cancer.

Results: The proportion of the total reduction in the rate of death from breast cancer attributed to screening varied in the seven models from 28 to 65 percent (median, 46 percent), with adjuvant treatment contributing the rest. The variability across models in the absolute contribution of screening was larger than it was for treatment, reflecting the greater uncertainty associated with estimating the benefit of screening.

Conclusions: Seven statistical models showed that both screening mammography and treatment have helped reduce the rate of death from breast cancer in the United States.

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Comment in

  • Film or digital mammographic screening?
    Dershaw DD. Dershaw DD. N Engl J Med. 2005 Oct 27;353(17):1846-7. doi: 10.1056/NEJMe058253. N Engl J Med. 2005. PMID: 16251541 No abstract available.
  • Screening and breast cancer.
    Baker SG. Baker SG. N Engl J Med. 2006 Feb 16;354(7):767-9; author reply 767-9. doi: 10.1056/NEJMc053256. N Engl J Med. 2006. PMID: 16481650 No abstract available.
  • Screening and breast cancer.
    Retsky MW, Demicheli R, Hrushesky WJ. Retsky MW, et al. N Engl J Med. 2006 Feb 16;354(7):767-9; author reply 767-9. N Engl J Med. 2006. PMID: 16482676 No abstract available.
  • Screening and breast cancer.
    Smith DW. Smith DW. N Engl J Med. 2006 Feb 16;354(7):767-9; author reply 767-9. N Engl J Med. 2006. PMID: 16482677 No abstract available.
  • Screening and breast cancer.
    Gøtzsche PC. Gøtzsche PC. N Engl J Med. 2006 Feb 16;354(7):767-9; author reply 767-9. N Engl J Med. 2006. PMID: 16482679 No abstract available.
  • Screening and breast cancer.
    Baglioni P. Baglioni P. N Engl J Med. 2006 Feb 16;354(7):767-9; author reply 767-9. N Engl J Med. 2006. PMID: 16482680 No abstract available.

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