Speakers - Annual Scientific Meeting
Andy Evans
Andy Evans is consultant breast radiologist at Royal Derby Hospital and emeritus professor of breast imaging at Dundee University. He is a world leading authority on shear-wave elastography of the breast. Other fields of expertise include breast cancer screening and ductal carcinoma in situ. He is a past chairman of the British society of breast radiology, a member of the scientific committee of the European Society of Breast Imaging. He has research outputs include 200 peer reviewed publications, 17 book chapters and 3 books. He also plays the French horn and is a successful composer of classical music.
Title: Mammo 50 trial results: implications for clinical practice
Annual surveillance mammograms for an unspecified time are widely practised and represent a significant healthcare cost. Current UK guidelines recommend annual mammograms up to 5-years and then reverts to 3-year screening without specified risk stratification. Further evidence is needed to determine the optimum frequency and duration of mammographic surveillance.
Mammo-50 is a multi-centre, randomised controlled, phase III trial of annual mammography versus 2-yearly for conservation surgery and 3-yearly mammograms for mastectomy patients. Women were eligible if aged 50 years or over at initial diagnosis of breast cancer (invasive or DCIS), and recurrence free 3 years post curative surgery.
Primary outcome was breast cancer specific survival (BCSS). Secondary outcomes include recurrence free interval (RFI) and overall survival (OS). BCSS event was defined as deaths from breast cancer and RFI defined as any invasive recurrence or new breast primary. 5000 women were needed to detect a 3% absolute non-inferiority (NI) margin for BCSS with 2.5% one-sided alpha and at least 85% power. Analyses were carried out on intention-to-treat basis.
5235 women were randomised between April 2014 and September 2018. 4203 (80%) had undergone conservation surgery, 4564 (87%) had invasive disease, 4347 (83%) were aged 55-75 years, 4330 (83%) were ER positive and 3812 (73%) were taking hormone therapy at the time of randomisation. Patient characteristics were balanced across arms.
With a median of 5.4 years follow-up (interquartile range 4.6-5.9), 319 women have died. The definitive results of the trial will be presented and discussed.
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