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  • Annual screening with mammography and breast examination did not reduce breast cancer mortality in women 40–49 years of age

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Therapeutics
Annual screening with mammography and breast examination did not reduce breast cancer mortality in women 40–49 years of age

https://doi.org/10.1136/ebm.8.2.44

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    (2002) Ann Intern Med 137, 305. Miller AB, To T, Baines CJ, et al.. The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up. A randomized screening trial of mammography in women age 40 to 49 years.. ;. :. –12.

    
 
 QUESTION: In women 40–49 years of age, does annual screening with mammography, clinical breast examination (CBE), and breast self examination (BSE) instruction reduce breast cancer mortality to a greater extent than a single CBE and BSE instruction?

    Design

    Randomised (allocation concealed*), blinded (outcome assessors),* controlled trial with mean 13 years of follow up.

    Setting

    15 centres in Canada.

    Patients

    50 489 women who were 40–49 years of age and had no previous diagnosis of breast cancer, were not pregnant, and had not had mammography in the previous 12 months. 50 430 (99.9%) were included in the analysis.

    Intervention

    All women received an initial CBE and instruction on BSE and were allocated to annual screening comprising mammography, CBE, and instruction and evaluation on BSE (n=25 214) or to usual care (n=25 216).

    Main outcome measure

    Breast cancer mortality.

    Main results

    Analysis was by intention to treat. During the first 5 years after study entry, the groups did not differ for breast cancer mortality rates and did not differ at each successive year of follow-up …

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    Footnotes

    • For correspondence: Dr A B Miller, Deutsches Krebsforschungszentrum, Heidelberg, Germany. a.miller{at}dkfz-heidelberg.de

    • Abstract and commentary also appear in ACP Journal Club.

    • Sources of funding: 10 Canadian funding agencies.

    • ↵*See glossary. Therapeutics