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Epidemiology

Fatal and non-fatal breast cancers in women targeted by BreastScreen Norway: a cohort study

British Journal of Cancer volume 130, pages 99–107 (2024)Cite this article

Subjects

Abstract

Background

Many breast cancer survivors experience anxiety related to dying from their disease even if it is detected at an early stage. We aimed to increase knowledge about fatal and non-fatal breast cancer by describing how histopathological tumour profiles and detection modes were associated with 10-year breast cancer-specific survival.

Methods

This cohort study included data from women targeted by BreastScreen Norway (aged 50–69) and diagnosed with invasive breast cancer during 1996–2011. Breast cancer was classified as fatal if causing death within 10 years after diagnosis and non-fatal otherwise. We described histopathologic characteristics of fatal and non-fatal cancers, stratified by mode of detection. Recursive partitioning identified subgroups with differing survival profiles.

Results

In total, 6.3% of 9954 screen-detected cancers (SDC) were fatal, as were 17.4% of 3205 interval cancers (IC) and 20.9% of 3237 cancers detected outside BreastScreen Norway. Four to five subgroups with differing survival profiles were identified within each detection mode. Women with lymph node-negative SDC or Grade 1–2, node-negative IC without distant metastases had the highest 10-year survival (95–96%).

Conclusions

Two subgroups representing 53% of the cohort had excellent (95–96%) 10-year breast cancer-specific survival. Most women with SDC had excellent survival, as did nearly 40% of women diagnosed with IC.

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Fig. 1: Number of women included and excluded in this study.
Fig. 2: Survival profiles for women diagnosed with screen-detected cancer through BreastScreen Norway.
Fig. 3: Survival profiles for women diagnosed with interval cancer through BreastScreen Norway.
Fig. 4: Survival profiles for women diagnosed outside of BreastScreen Norway.

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Data availability

The data underlying this article cannot be shared publicly due to patient privacy. The data can be shared for research purposes on request to the Cancer Registry of Norway’s data delivery unit via Helsedata.no (https://helsedata.no/).

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Acknowledgements

The authors would like to thank Luca Pestarino for sharing his insights on recursive partitioning.

Funding

The author(s) received no specific funding for this work.

Author information

Authors and Affiliations

  1. Cancer Registry of Norway, Oslo, Norway

    Kaitlyn M. Tsuruda & Solveig Hofvind

  2. Department of Radiology, Ålesund Hospital, Helse Møre og Romsdal, Ålesund, Norway

    Solveig Roth Hoff

  3. Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

    Solveig Roth Hoff

  4. Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Lars A. Akslen

  5. Department of Pathology, Haukeland University Hospital, Bergen, Norway

    Lars A. Akslen

  6. Department of Health and Care Sciences, The Arctic University of Norway, Tromsø, Norway

    Solveig Hofvind

Authors
  1. Kaitlyn M. Tsuruda
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Contributions

Conceptualization: SH, SRH and LAA. Methodology: SH, SRH, LAA and KMT. Software: KMT. Validation: KMT, SH, SRH and LAA. Formal analysis: KMT. Investigation: all authors. Resources: SH. Data curation: KMT and SH. Writing—original draft preparation: KMT, SH and SRH. Writing—review and editing: KMT, SH, SRH and LAA. Visualization: KMT. Supervision: not relevant. Project administration: SH. Funding acquisition: not relevant.

Corresponding author

Correspondence to Solveig Hofvind.

Ethics declarations

Competing interests

SH is the head of BreastScreen Norway. The remaining authors declare no competing interests.

Ethics approval and consent to participate

This study has been reviewed by the privacy ombudsman at the Oslo University Hospital (PVO 20/12601) and was performed in accordance with the Declaration of Helsinki. It has a legal basis in accordance with Articles 6 (1) (e) and 9 (2) (j) of the GDPR. The data were disclosed with legal basis in the Cancer Registry Regulations section 3-1 and the Personal Health Data Filing System Act section 19 a to 19 h.

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Not applicable.

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Tsuruda, K.M., Hoff, S.R., Akslen, L.A. et al. Fatal and non-fatal breast cancers in women targeted by BreastScreen Norway: a cohort study. Br J Cancer 130, 99–107 (2024). https://doi.org/10.1038/s41416-023-02512-7

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  • DOI: https://doi.org/10.1038/s41416-023-02512-7

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