Advanced Cancer Definition Improves Breast Cancer Mortality Prediction
BCSC study determines advanced cancer definition that accurately predicts breast cancer mortality, which is useful for evaluating screening effectiveness.
Advanced breast cancer is a surrogate measure of breast cancer mortality and is an outcome used to evaluate the effectiveness of screening mammograms. The advanced breast cancer definition resulting in the best discrimination of breast cancer death has not been established.
A study published in the Journal of the National Cancer Institute suggests using the American Joint Committee on Cancer prognostic pathologic stage II or higher is the optimal definition of advanced breast cancer because it most accurately predicts breast cancer death. The study used Breast Cancer Surveillance Consortium data to examine different staging systems and definitions of advanced cancer to determine which definition best predicts breast cancer death. The study examined 3 staging systems, the American Joint Committee on Cancer anatomic and prognostic pathologic stages and Tomosynthesis Mammographic Imaging Screening Trial (TMIST) tumor categories. The study found that the American Joint Committee on Cancer prognostic pathologic staging system most accurately predicts breast cancer death and the TMIST tumor categories least accurately predict breast cancer death. Use of prognostic pathologic stage II or higher by investigators to define advanced cancer will facilitate comparing breast cancer screening effectiveness studies of different screening modalities.
Full Text Citation and Link: Kerlikowske, K., Bissell, M.C.S., Sprague, B.L., Buist, D.S.M., Henderson, L.M., Lee, J.M., & Miglioretti, D.L. (2020). Advanced Breast Cancer Definitions by Staging System Examined in the Breast Cancer Surveillance Consortium. Journal of the National Cancer Institute. November 10 2020. Epub ahead of print. doi.org/10.1093/jnci/djaa176 [Link to Article]
Posted by: Karla Kerlikowske, MD