Women whose advanced breast cancer is detected through routine screening have a higher chance of surviving ten years after diagnosis compared to women whose cancer at the same stage was found another way, according to a study published in the journal JNCI.
A team of researchers from King’s College London, Queen Mary University London and the University of Southern Denmark, looked at whether the way breast cancer is detected (through screening or through symptoms) affects a patient’s chances of survival at each stage of the disease.
The results are particularly striking for stage IV breast cancer, the most serious form, where the cancer has spread from its original site to other parts of the body. This stage is often associated with poor outcomes, yet the study found that women whose stage IV cancer was picked up through screening had survival rates more closely resembling those seen in stage III, an earlier, and less advanced stage of the disease.
The authors suspect that the likely reason is that, while these cancers had spread, the spread was limited enough that surgery to remove the cancer could still be attempted. Screened-detected cancers at this stage were indeed more likely to be treated surgically, suggesting they were caught before the disease had progressed too far.
“Our results show that how breast cancer is detected could impact the patient’s survival chances. There is understandably a lot of fear around cancer being found late, but our findings provide reassurance that long-term survival is still possible when it is found during screening. Our research highlights the importance of screening programmes and we hope this encourages everyone who is invited to attend their appointment. Further research is now needed to better understand the reasons behind this improved survival,” said lead author Dr Amy Tickle.
The study was based on Danish breast screening records from 2010 to 2019, linked with national death records up to 2022, covering more than a decade of data. The researchers considered who participated in the screening and compared mortality separately among women depending on their screening history.
“We looked at survival in women with screened detected breast cancer, in women who had never been screened and in women who had been screened previously but whose cancer was not detected through screening. For women with Stages I, II and III breast cancer, survival did not vary by screening history. But for stage IV breast cancer, we were surprised to see that prognosis for those whose cancer was screened detected resembled that of women with stage III breast cancer – they were three times more likely to live for another 10 years than other women with stage IV breast cancer,” said Professor Peter Sasieni.
In the UK, the NHS invites women aged 50 to 70 for a mammogram every three years. Invitations are sent automatically to those registered with a GP, with most women receiving their first appointment by age 53.
The researchers believe their findings make a strong case for promoting uptake of screening appointments and suggest that tracking the stage at which cancers are diagnosed could allow health services to assess whether changes to screening programmes are working years earlier than previously possible.
Amy Tickle, Judith Offman, Bernard North, Susanne Fogh Jørgensen, Sisse Njor, Peter Sasieni, Improved stage-specific survival in screen-detected breast cancer in Denmark: a cohort study, JNCI: Journal of the National Cancer Institute, 2026;, djaf377, https://doi.org/10.1093/jnci/djaf377