Grand Rounds

With Mammograms and Improved Treatment, How many Breast Cancer Deaths have Been Averted?

BACKGROUND AND PURPOSE:

Screening mammography
- Widely available during 1980s
- Increased use through to early 2000s with peak estimates in 2000
  - Annual mammogram: 25% of women >40 years
  - Biennial: 25%
  - Irregular or none: 64%
Different models have been used to determine how much of the decline in breast cancer mortality rates are due to screening vs treatment
Hendrick et al. (Cancer, 2019) sought to determine the mortality reduction resulting from the collective effects of mammography and treatment

Age-adjusted female breast cancer mortality rate and population data was collected from Surveillance, Epidemiology, and End Results (SEER) database
Background mortality rates were created using four different assumptions in the absence of screening mammography and improved treatment
Estimated deaths averted was estimated for women aged 40 to 84 years by taking difference between SEER report and background mortality rates for each 5 year age group
Extrapolated SEER data were used to estimate deaths averted in 2018

The number of single-year breast cancer deaths averted ranged from
- 2012: 20,860 to 33,842
- 2015: 23,703 to 39,415
- 2018: 27,083 to 45,726
Breast cancer mortality reductions ranged from
- 2012; 38.6% to 50.5%
- 2015: 41.5% to 54.2%
- 2018: 45.3% to 58.3%
Cumulative breast cancer deaths averted since 1989 ranged from
- 2012: 237,234 to 370,402
- 2015: 305,934 to 483,435
- 2018: 384,046 to 614,484

CONCLUSION:

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