Screening, as informed by the Optimal Care Pathways (OCP), is important in improving patient outcomes in breast cancer through early detection. This study investigated whether Victorian breast cancer patients who aligned with screening recommendations had better outcomes than those who were not.
Data used were obtained from a linked dataset that included the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, BreastScreen Victoria (BSV), Victorian Admitted Episodes Dataset, Victorian Radiotherapy Minimum Data Set and Victorian Cancer Registry (VCR). Women aged between 50 and 69 years diagnosed with invasive breast cancer between 2011 and 2019 (n = 20,069) were identified from the VCR. Alignment with the early detection phase was defined as being diagnosed through BSV or having a non-BSV mammogram from 3 years to 90 days prior to diagnosis. Odds ratios were calculated using logistic regressions and hazard ratios from Cox hazard model.
11,517 of 20,069 (57%) aligned with screening recommendations (45% through BSV and 12% through non-BSV mammography). Alignment was similar between SES quintiles and remoteness. The proportion of women who were stage 1 at diagnosis was higher for the cohort who aligned (63% compared with 30%). Alignment was associated with earlier stage at diagnosis (OR = 0.26, 95% CI 0.25 to 0.28) after adjusting for age. A higher proportion of women who aligned received breast conserving surgery (82% compared with 61%), which persisted after adjusting for age and stage (OR: 0.59, 95% CI: 0.55 to 0.64). There was a survival improvement for those aligned with the early detection phase after adjusting for age and stage (HR: 0.52, 95% CI: 0.43 to 0.64).
Alignment with screening recommendations from the OCP was associated with better outcomes in women of screening age who were diagnosed with breast cancer.