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The prognosis of screen detected invasive breast cancers is good.1,2 However a proportion of women with screen detected disease do die of breast cancer, and identifying which of these women are at increased risk of breast cancer death would enable the use of adjuvant hormone and chemotherapy to be limited to such a group while avoiding the cost and morbidity of using such therapies in women at minimal risk.
The three established breast cancer prognostic factors are size, lymph node stage and histological grade.3e5 However these factors