Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012

Sylvia K. Plevritis, Diego Munoz, Allison W. Kurian, Natasha K. Stout, Oguzhan Alagoz, Aimee M. Near, Sandra J. Lee, Jeroen J. Van Den Broek, Xuelin Huang, Clyde B. Schechter, Brian L. Sprague, Juhee Song, Harry J. De Koning, Amy Trentham-Dietz, Nicolien T. Van Ravesteyn, Ronald Gangnon, Young Chandler, Yisheng Li, Cong Xu, Mehmet Ali ErgunHui Huang, Donald A. Berry, Jeanne S. Mandelblatt

Research output: Contribution to journalReview article

37 Citations (Scopus)

Abstract

IMPORTANCE Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate and combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden. OBJECTIVE To evaluate the contributions associated with screening and treatment to breast cancer mortality reductions by molecular subtype based on estrogen-receptor (ER) and human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu). DESIGN, SETTING, AND PARTICIPANTS Six Cancer Intervention and Surveillance Network (CISNET) models simulated US breast cancer mortality from 2000 to 2012 using national data on plain-film and digital mammography patterns and performance, dissemination and efficacy of ER/ERBB2-specific treatment, and competing mortality. Multiple US birth cohorts were simulated. EXPOSURES Screening mammography and treatment. MAIN OUTCOMES AND MEASURES The models compared age-adjusted, overall, and ER/ERBB2-specific breast cancer mortality rates from 2000 to 2012 for women aged 30 to 79 years relative to the estimated mortality rate in the absence of screening and treatment (baseline rate); mortality reductions were apportioned to screening and treatment. RESULTS In 2000, the estimated reduction in overall breast cancer mortality rate was 37% (model range, 27%-42%) relative to the estimated baseline rate in 2000 of 64 deaths (model range, 56-73) per 100 000 women: 44% (model range, 35%-60%) of this reduction was associated with screening and 56% (model range, 40%-65%) with treatment. In 2012, the estimated reduction in overall breast cancer mortality rate was 49% (model range, 39%-58%) relative to the estimated baseline rate in 2012 of 63 deaths (model range, 54-73) per 100 000 women: 37% (model range, 26%-51%) of this reduction was associated with screening and 63% (model range, 49%-74%) with treatment. Of the 63% associated with treatment, 31% (model range, 22%-37%) was associated with chemotherapy, 27% (model range, 18%-36%) with hormone therapy, and 4% (model range, 1%-6%) with trastuzumab. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2?, 36% (model range, 24%-50%) vs 64% (model range, 50%-76%); for ER+/ERBB2+, 31% (model range, 23%-41%) vs 69% (model range, 59%-77%); for ER?/ERBB2+, 40% (model range, 34%-47%) vs 60% (model range, 53%-66%); and for ER?/ERBB2?, 48% (model range, 38%-57%) vs 52% (model range, 44%-62%). CONCLUSIONS AND RELEVANCE In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype.

Original languageEnglish (US)
Pages (from-to)154-164
Number of pages11
JournalJAMA - Journal of the American Medical Association
Volume319
Issue number2
DOIs
StatePublished - Jan 9 2018

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Breast Neoplasms
Mortality
Estrogen Receptors
Therapeutics
Mammography
Multiple Birth Offspring
Hormones
Drug Therapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Plevritis, S. K., Munoz, D., Kurian, A. W., Stout, N. K., Alagoz, O., Near, A. M., ... Mandelblatt, J. S. (2018). Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012. JAMA - Journal of the American Medical Association, 319(2), 154-164. https://doi.org/10.1001/jama.2017.19130

Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012. / Plevritis, Sylvia K.; Munoz, Diego; Kurian, Allison W.; Stout, Natasha K.; Alagoz, Oguzhan; Near, Aimee M.; Lee, Sandra J.; Van Den Broek, Jeroen J.; Huang, Xuelin; Schechter, Clyde B.; Sprague, Brian L.; Song, Juhee; De Koning, Harry J.; Trentham-Dietz, Amy; Van Ravesteyn, Nicolien T.; Gangnon, Ronald; Chandler, Young; Li, Yisheng; Xu, Cong; Ali Ergun, Mehmet; Huang, Hui; Berry, Donald A.; Mandelblatt, Jeanne S.

In: JAMA - Journal of the American Medical Association, Vol. 319, No. 2, 09.01.2018, p. 154-164.

Research output: Contribution to journalReview article

Plevritis, SK, Munoz, D, Kurian, AW, Stout, NK, Alagoz, O, Near, AM, Lee, SJ, Van Den Broek, JJ, Huang, X, Schechter, CB, Sprague, BL, Song, J, De Koning, HJ, Trentham-Dietz, A, Van Ravesteyn, NT, Gangnon, R, Chandler, Y, Li, Y, Xu, C, Ali Ergun, M, Huang, H, Berry, DA & Mandelblatt, JS 2018, 'Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012', JAMA - Journal of the American Medical Association, vol. 319, no. 2, pp. 154-164. https://doi.org/10.1001/jama.2017.19130
Plevritis, Sylvia K. ; Munoz, Diego ; Kurian, Allison W. ; Stout, Natasha K. ; Alagoz, Oguzhan ; Near, Aimee M. ; Lee, Sandra J. ; Van Den Broek, Jeroen J. ; Huang, Xuelin ; Schechter, Clyde B. ; Sprague, Brian L. ; Song, Juhee ; De Koning, Harry J. ; Trentham-Dietz, Amy ; Van Ravesteyn, Nicolien T. ; Gangnon, Ronald ; Chandler, Young ; Li, Yisheng ; Xu, Cong ; Ali Ergun, Mehmet ; Huang, Hui ; Berry, Donald A. ; Mandelblatt, Jeanne S. / Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012. In: JAMA - Journal of the American Medical Association. 2018 ; Vol. 319, No. 2. pp. 154-164.
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title = "Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012",
abstract = "IMPORTANCE Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate and combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden. OBJECTIVE To evaluate the contributions associated with screening and treatment to breast cancer mortality reductions by molecular subtype based on estrogen-receptor (ER) and human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu). DESIGN, SETTING, AND PARTICIPANTS Six Cancer Intervention and Surveillance Network (CISNET) models simulated US breast cancer mortality from 2000 to 2012 using national data on plain-film and digital mammography patterns and performance, dissemination and efficacy of ER/ERBB2-specific treatment, and competing mortality. Multiple US birth cohorts were simulated. EXPOSURES Screening mammography and treatment. MAIN OUTCOMES AND MEASURES The models compared age-adjusted, overall, and ER/ERBB2-specific breast cancer mortality rates from 2000 to 2012 for women aged 30 to 79 years relative to the estimated mortality rate in the absence of screening and treatment (baseline rate); mortality reductions were apportioned to screening and treatment. RESULTS In 2000, the estimated reduction in overall breast cancer mortality rate was 37{\%} (model range, 27{\%}-42{\%}) relative to the estimated baseline rate in 2000 of 64 deaths (model range, 56-73) per 100 000 women: 44{\%} (model range, 35{\%}-60{\%}) of this reduction was associated with screening and 56{\%} (model range, 40{\%}-65{\%}) with treatment. In 2012, the estimated reduction in overall breast cancer mortality rate was 49{\%} (model range, 39{\%}-58{\%}) relative to the estimated baseline rate in 2012 of 63 deaths (model range, 54-73) per 100 000 women: 37{\%} (model range, 26{\%}-51{\%}) of this reduction was associated with screening and 63{\%} (model range, 49{\%}-74{\%}) with treatment. Of the 63{\%} associated with treatment, 31{\%} (model range, 22{\%}-37{\%}) was associated with chemotherapy, 27{\%} (model range, 18{\%}-36{\%}) with hormone therapy, and 4{\%} (model range, 1{\%}-6{\%}) with trastuzumab. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2?, 36{\%} (model range, 24{\%}-50{\%}) vs 64{\%} (model range, 50{\%}-76{\%}); for ER+/ERBB2+, 31{\%} (model range, 23{\%}-41{\%}) vs 69{\%} (model range, 59{\%}-77{\%}); for ER?/ERBB2+, 40{\%} (model range, 34{\%}-47{\%}) vs 60{\%} (model range, 53{\%}-66{\%}); and for ER?/ERBB2?, 48{\%} (model range, 38{\%}-57{\%}) vs 52{\%} (model range, 44{\%}-62{\%}). CONCLUSIONS AND RELEVANCE In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype.",
author = "Plevritis, {Sylvia K.} and Diego Munoz and Kurian, {Allison W.} and Stout, {Natasha K.} and Oguzhan Alagoz and Near, {Aimee M.} and Lee, {Sandra J.} and {Van Den Broek}, {Jeroen J.} and Xuelin Huang and Schechter, {Clyde B.} and Sprague, {Brian L.} and Juhee Song and {De Koning}, {Harry J.} and Amy Trentham-Dietz and {Van Ravesteyn}, {Nicolien T.} and Ronald Gangnon and Young Chandler and Yisheng Li and Cong Xu and {Ali Ergun}, Mehmet and Hui Huang and Berry, {Donald A.} and Mandelblatt, {Jeanne S.}",
year = "2018",
month = "1",
day = "9",
doi = "10.1001/jama.2017.19130",
language = "English (US)",
volume = "319",
pages = "154--164",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "2",

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TY - JOUR

T1 - Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012

AU - Plevritis, Sylvia K.

AU - Munoz, Diego

AU - Kurian, Allison W.

AU - Stout, Natasha K.

AU - Alagoz, Oguzhan

AU - Near, Aimee M.

AU - Lee, Sandra J.

AU - Van Den Broek, Jeroen J.

AU - Huang, Xuelin

AU - Schechter, Clyde B.

AU - Sprague, Brian L.

AU - Song, Juhee

AU - De Koning, Harry J.

AU - Trentham-Dietz, Amy

AU - Van Ravesteyn, Nicolien T.

AU - Gangnon, Ronald

AU - Chandler, Young

AU - Li, Yisheng

AU - Xu, Cong

AU - Ali Ergun, Mehmet

AU - Huang, Hui

AU - Berry, Donald A.

AU - Mandelblatt, Jeanne S.

PY - 2018/1/9

Y1 - 2018/1/9

N2 - IMPORTANCE Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate and combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden. OBJECTIVE To evaluate the contributions associated with screening and treatment to breast cancer mortality reductions by molecular subtype based on estrogen-receptor (ER) and human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu). DESIGN, SETTING, AND PARTICIPANTS Six Cancer Intervention and Surveillance Network (CISNET) models simulated US breast cancer mortality from 2000 to 2012 using national data on plain-film and digital mammography patterns and performance, dissemination and efficacy of ER/ERBB2-specific treatment, and competing mortality. Multiple US birth cohorts were simulated. EXPOSURES Screening mammography and treatment. MAIN OUTCOMES AND MEASURES The models compared age-adjusted, overall, and ER/ERBB2-specific breast cancer mortality rates from 2000 to 2012 for women aged 30 to 79 years relative to the estimated mortality rate in the absence of screening and treatment (baseline rate); mortality reductions were apportioned to screening and treatment. RESULTS In 2000, the estimated reduction in overall breast cancer mortality rate was 37% (model range, 27%-42%) relative to the estimated baseline rate in 2000 of 64 deaths (model range, 56-73) per 100 000 women: 44% (model range, 35%-60%) of this reduction was associated with screening and 56% (model range, 40%-65%) with treatment. In 2012, the estimated reduction in overall breast cancer mortality rate was 49% (model range, 39%-58%) relative to the estimated baseline rate in 2012 of 63 deaths (model range, 54-73) per 100 000 women: 37% (model range, 26%-51%) of this reduction was associated with screening and 63% (model range, 49%-74%) with treatment. Of the 63% associated with treatment, 31% (model range, 22%-37%) was associated with chemotherapy, 27% (model range, 18%-36%) with hormone therapy, and 4% (model range, 1%-6%) with trastuzumab. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2?, 36% (model range, 24%-50%) vs 64% (model range, 50%-76%); for ER+/ERBB2+, 31% (model range, 23%-41%) vs 69% (model range, 59%-77%); for ER?/ERBB2+, 40% (model range, 34%-47%) vs 60% (model range, 53%-66%); and for ER?/ERBB2?, 48% (model range, 38%-57%) vs 52% (model range, 44%-62%). CONCLUSIONS AND RELEVANCE In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype.

AB - IMPORTANCE Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate and combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden. OBJECTIVE To evaluate the contributions associated with screening and treatment to breast cancer mortality reductions by molecular subtype based on estrogen-receptor (ER) and human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu). DESIGN, SETTING, AND PARTICIPANTS Six Cancer Intervention and Surveillance Network (CISNET) models simulated US breast cancer mortality from 2000 to 2012 using national data on plain-film and digital mammography patterns and performance, dissemination and efficacy of ER/ERBB2-specific treatment, and competing mortality. Multiple US birth cohorts were simulated. EXPOSURES Screening mammography and treatment. MAIN OUTCOMES AND MEASURES The models compared age-adjusted, overall, and ER/ERBB2-specific breast cancer mortality rates from 2000 to 2012 for women aged 30 to 79 years relative to the estimated mortality rate in the absence of screening and treatment (baseline rate); mortality reductions were apportioned to screening and treatment. RESULTS In 2000, the estimated reduction in overall breast cancer mortality rate was 37% (model range, 27%-42%) relative to the estimated baseline rate in 2000 of 64 deaths (model range, 56-73) per 100 000 women: 44% (model range, 35%-60%) of this reduction was associated with screening and 56% (model range, 40%-65%) with treatment. In 2012, the estimated reduction in overall breast cancer mortality rate was 49% (model range, 39%-58%) relative to the estimated baseline rate in 2012 of 63 deaths (model range, 54-73) per 100 000 women: 37% (model range, 26%-51%) of this reduction was associated with screening and 63% (model range, 49%-74%) with treatment. Of the 63% associated with treatment, 31% (model range, 22%-37%) was associated with chemotherapy, 27% (model range, 18%-36%) with hormone therapy, and 4% (model range, 1%-6%) with trastuzumab. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2?, 36% (model range, 24%-50%) vs 64% (model range, 50%-76%); for ER+/ERBB2+, 31% (model range, 23%-41%) vs 69% (model range, 59%-77%); for ER?/ERBB2+, 40% (model range, 34%-47%) vs 60% (model range, 53%-66%); and for ER?/ERBB2?, 48% (model range, 38%-57%) vs 52% (model range, 44%-62%). CONCLUSIONS AND RELEVANCE In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype.

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