Breast cancer: treatment and screening improve survivalBreast cancer survival has improved hugely since 1975. But what is it that has made the difference? Is it screening, the treatment of early stage cancer, or the management of metastatic cancer? And as treatment improves, does screening still have a place?This study used four simulation CISNET models to estimate the relative impact of interventions at each stage. Overall, improvements in mammographic screening and treatment of breast cancer in the US between 1975 and 2019 were associated with a 58% reduction in breast cancer mortality (from an estimated 64 deaths without intervention to 27 per 100 000 women after adjustment for age). Of this reduction in mortality, about 29% was associated with treating metastatic breast cancer, 25% with screening, and 47% with treating stage I to III breast cancer. Median survival improved more for oestrogen receptor-positive breast cancer than receptor-negative cancers (2.5 v 0.5…
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