Breast cancer relapse best caught early

Wed March 18th, 2009

Early detection of second breast tumours in women can dramatically cut death rates, researchers reported today.

If the second breast cancer is picked up before symptoms appear the woman's chances of survival are increased by 27 to 47 per cent, say a group of international researchers led by Dr Nehmat Houssami of the University of Sydney, Australia.

In the Annals of Oncology today (March 18) they explain that the impact of early detection of second breast cancers in women who have survived a previous breast cancer is unknown.

They investigated the benefit of diagnosis in the asymptomatic phase compared with the symptomatic phase among 1,044 women with second breast cancer. Two-thirds of the women were diagnosed before symptoms appeared. These tumours were significantly smaller, more likely to be "early-stage" tumours, and less likely to have spread.

Dr Houssami's team write: "Our work provides additional evidence in showing the impact of asymptomatic relative to symptomatic detection, based on follow-up with mammography and clinical examination.

"The strongest predictors of poor prognosis were age (69 years or above), earlier relative to more recent time period in which the second cancer was diagnosed, and symptom status."

Although mammography identified more cancers than clinical examination, this may be "more a reflection of increasing uptake of mammography in this population than an improvement in mammography sensitivity", they write.

Current recommendations for surveillance of women with a personal history of breast cancer vary substantially between countries due to a lack of evidence.

"I think this work provides a timely reminder of the potential benefit of early detection of second breast cancers and supports ongoing surveillance in this group of women," said Dr Houssami.

Houssami, N. et al. Early detection of second breast cancers improves prognosis in breast cancer survivors. Annals of Oncology, published online March 18, 2009.

Tags: Women’s Health | Cancer | Australia

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