Twenty year review of a breast cancer screening project - Ninety-five percent survival of patients with nonpalpable cancers

BACKGROUND. In 1973, the Breast Cancer Detection Demonstration Project at the Georgia Baptist Medical Center began screening supposedly asymptomatic women for breast cancer. The project has been reviewed and now 20 years later, the followup of those women with detected cancer who were matched with a group of the original cohort with negative screens is reported, Early criticism of the project was its ''lead-time bias,'' which, after 20 pears, should pose no problem. METHODS. Approximately 9043 women were screened for 5 years. The remainder of the total of 10,000 women were screened at the Emory University Department of Radiology. The 128 patients who were found to have breast cancer were observed for over 20 years. A matched group of 1609, who had negative results when originally screened, were also observed for 20 years. RESULTS. After 20 years, approximately 86% of the 128 women diagnosed with breast cancer were still free of disease, including 88.3% of women with lesions of less than 1.1 cm and 95.1% of those with nonpalpable carcinomas. CONCLUSIONS. Over 95% of the 67 women with nonpalpable lesions were alive after 20 years of follow-up. Women not screened yearly tend to have larger lesions than those screened on a regular basis. Regular screening is currently the best way to control this disease. (C) 1996 American Cancer Society.