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01-11-2015 | Epidemiology

Mammographic and clinical characteristics of different phenotypes of screen-detected and interval breast cancers in a nationwide screening program

Authors: Marisa Baré, Núria Torà, Dolores Salas, Melchor Sentís, Joana Ferrer, Josefa Ibáñez, Raquel Zubizarreta, Garbiñe Sarriugarte, Teresa Barata, Laia Domingo, Xavier Castells, Maria Sala

Published in: Breast Cancer Research and Treatment | Issue 2/2015

Abstract

In the context of a population-based screening program, we aimed to evaluate the major mammographic features and clinicopathological characteristics of breast tumors at diagnosis and the associations between them, focusing on tumors with the worst prognosis. We analyzed cancers diagnosed in a cohort of 645,764 women aged 45–69 years participating in seven population-based screening programs in Spain, between January 1, 2000 and December 31, 2006 and followed up until June 2009. We included all interval cancers and a sample of screen-detected cancers, whether invasive or in situ. We compared tumor-related information and breast density for different phenotypes (Triple-negative (TN), HER2+, Luminal B and Luminal A) in screen-detected and interval cancers. We used Chi-square or Fisher’s exact test to compare major mammographic features of invasive versus in situ tumors, of screen-detected versus interval cancers, and of different types of interval cancers. We included 2582 tumors (1570 screen-detected and 1012 interval cancers). There were significant differences in the distribution of most clinicopathological variables between screen-detected and interval cancers. Invasive TN interval tumors were more common than other phenotypes in breasts with low mammographic density; three-quarters of these tumors presented as masses without associated calcifications. HER2+ tumors were more common in denser breasts and were associated with calcifications and multifocality. Architectural distortion was more common in Luminal A and Luminal B tumors. Certain radiologic findings are associated with pre-invasive lesions; these differ among invasive tumor phenotypes. We corroborate that TN and HER2+ cancers have distinctive appearances also in the context of population-based screening programs. This information can be useful for establishing protocols for diagnostic strategies in screening units.

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Title: Mammographic and clinical characteristics of different phenotypes of screen-detected and interval breast cancers in a nationwide screening program
Authors: Marisa Baré
Núria Torà
Dolores Salas
Melchor Sentís
Joana Ferrer
Josefa Ibáñez
Raquel Zubizarreta
Garbiñe Sarriugarte
Teresa Barata
Laia Domingo
Xavier Castells
Maria Sala
Publication date: 01-11-2015
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2015
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-015-3623-9

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