title: A comparison of clinicopathological characteristics and long-term survival outcomes between symptomatic and screen-detected breast cancer in Japanese women.
abstract: BACKGROUND
  Several studies from other countries have reported that patients with screen-detected breast cancer have better survival than those with symptomatic breast cancer. However, no such comparison has been performed in Japan. Therefore, we aimed to compare the clinicopathological characteristics and survival rates between symptomatic and screen-detected breast cancer in Japanese women.
  
  
  METHODS
  From January 2000 to December 2004, 977 and 182 women with symptomatic or screen-detected breast cancer, respectively, underwent surgery at a single Japanese hospital. We retrospectively reviewed these patients' clinicopathological data. Likelihood of death was estimated using the Kaplan-Meier method and the log-rank test. Multivariate analysis including mode of detection, tumor size, lymph node status, hormone receptor status, and adjuvant therapy administration was performed using the Cox proportional hazards model.
  
  
  RESULTS
  Screen-detected breast cancer was associated with increased rate of breast-conserving surgery, non-invasive carcinoma, smaller tumor size, decreased lymph node involvement, increased hormone receptor positivity, and decreased adjuvant chemotherapy administration. Compared to women with symptomatic tumors, those with screen-detected tumors had improved overall and breast cancer-specific survival rates. Factors associated with survival in univariate analysis were screen detection, tumor size, lymph node status, progesterone receptor status, and adjuvant chemotherapy administration.
  
  
  CONCLUSIONS
  Breast cancer screening in Japanese women has led to increases in the rates of breast-conserving surgery, hormone receptor positivity, and survival rates along with reductions in axillary lymph node dissection and adjuvant chemotherapy administration.
authors: Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, 232 Nakao, Asahi-ku, Yokohama, Japan. inari-hitoshi@nifty.com.
authors: Hitoshi
authors: H
authors: Inari
authors: Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, 232 Nakao, Asahi-ku, Yokohama, Japan.
authors: Satoru
authors: S
authors: Shimizu
authors: Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, 232 Nakao, Asahi-ku, Yokohama, Japan.
authors: Nobuyasu
authors: N
authors: Suganuma
authors: Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, 232 Nakao, Asahi-ku, Yokohama, Japan.
authors: Tatsuya
authors: T
authors: Yoshida
authors: Department of Surgery, Yokohama City University, 39 Fukuura, Kanazawa-ku, Yokohama, Japan.
authors: Hirotaka
authors: H
authors: Nakayama
authors: Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, 232 Nakao, Asahi-ku, Yokohama, Japan.
authors: Takashi
authors: T
authors: Yamanaka
authors: Department of Surgery, Yokohama City University, 39 Fukuura, Kanazawa-ku, Yokohama, Japan.
authors: Ayumi
authors: A
authors: Yamanaka
authors: Department of Surgery, Yokohama City University, 39 Fukuura, Kanazawa-ku, Yokohama, Japan.
authors: Yasushi
authors: Y
authors: Rino
authors: Department of Surgery, Yokohama City University, 39 Fukuura, Kanazawa-ku, Yokohama, Japan.
authors: Munetaka
authors: M
authors: Masuda
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data*; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D008875:Middle Aged; D016016:Proportional Hazards Models; D015996:Survival Rate
keywords: Breast cancer; Clinicopathological characteristics; Mode of detection; Screening; Survival