Symptom-detected breast cancers nearly 7 times more likely to be diagnosed at advanced stage
Advances in treatment are often credited with the improvement of breast cancer outcomes, but new findings suggest that the decrease in mortality may actually be due to screening efforts.
A new study published in Radiology: Imaging Cancer suggests that women with screen-detected cancer are more likely to have favorable outcomes in comparison to those whose cancer is diagnosed after they reported having symptoms. This is likely because women who present for consult after they notice symptoms, such as pain, swelling or palpable lumps, are more likely to be diagnosed at a later stage when cancer is more difficult to treat.
Considering that neither the United States nor Canada track the method of detection in their cancer registries, experts involved in this latest research suggest that their findings could have important implications for cancer screening guidelines.
Lead study author Jean M. Seely, MD, a professor in the department of radiology at the University of Ottawa, says she has seen firsthand how the method of detection directly affects patients’ diagnosis and treatment.
“I observed a marked difference in the way breast cancers were being detected in my clinical practice,” Seely said. “I noted that many women under the age of 50 and older than 75 were diagnosed because of symptomatic presentation.”
To determine how mode of detection affects outcomes, Seely and colleagues analyzed data from 821 patients over 40 who were diagnosed with breast cancer in 2016. They took note whether patients presented for routine screening or with concerns about physical symptoms, with the research tracking their treatment and outcomes for a little over six years.
Of the 821 cancers diagnosed during the study, 50.1% were after symptoms emerged, rather than via screening. Symptom-detected cancers occurred most frequently in age groups that have historically been excluded from screening recommendations—between 40 and 49, or older than 75. These patients had significantly higher odds of being diagnosed at a later stage and requiring a mastectomy. They also had a 63% higher likelihood of dying, researchers reported.
The United States Preventive Services Task Force (USPSTF) updated its breast cancer screening guidance in 2024, lowering the recommended screening age from 50 to 40 for women at average risk. However, in Canada, the recommendation remains at 50. Seely believes these new study results could change that.
“The results of this study will likely support the move to reduce the breast cancer screening age to 40 in Canada,” Seely said. “We have lowered the screening age in many provincial and territorial screening programs in Canada and are aiming to establish a single national policy for screening.”
Learn more about the team’s findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.