A comparative study of risk factors and prognostic features between symptomatic and screen detected breast cancer

Aims: To compare prognostic factors in screen detected breast cancer (SDBC) and symptomatically presenting breast cancer (SBC). Methods: Data were examined on 100 SDBC and 100 SBC. Multiple clinical patient factors were assessed including histopathological features. Using the Gail model each patient's risk of developing breast cancer was calculated and these data were examined for differences between groups. Results: There was no difference in the mean age of patient presentation or in the risk of breast cancer development between groups (2.2% vs. 2.2%, SDBC vs. SBC, actuarial risk of cancer at 5 years). SDBC patients had a significantly lower grade (1.95 vs. 2.44, SDBC vs. SBC, P < 0.05), a smaller size of tumour (15.4 mm vs. 29.3 mm, SDBC vs. SBC, P < 0.05) and a higher rate of oestrogen (94% vs. 81%, P < 0.05) and progesterone (75% vs. 52%, P < 0.05) receptor positivity. When compared using the Nottingham Prognostic Index, SDBC was associated with a better prognosis (r = -0.444, P < 0.001). Conclusions: Though both groups have similar demographics and risk, SDBC patients appear to have more favourable prognostic features. This has implications for the application of systemic therapy in breast cancer and supports the observation that SDBC is a more indolent form of disease.