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Breast Cancer Research and Treatment

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01-04-2019 | Epidemiology

The mammography screening detection of ductal carcinoma in situ and invasive breast cancer according to women’s characteristics: is it the same?

Authors: Isabelle Théberge, Nathalie Vandal, Marie-Hélène Guertin, Linda Perron

Published in: Breast Cancer Research and Treatment | Issue 2/2019

Abstract

Purpose

Detection of ductal carcinoma in situ (DCIS) has increased with the mammography dissemination. Given the potential role of DCIS as a precursor of invasive breast cancer (IBC), we aimed to assess whether women’s characteristics have a different effect on the DCIS compared to IBC detection rate.

Methods

This study included 3,609,569 screening mammograms performed from 2002 to 2015 in our organized breast cancer screening program, which actively invites women 50–69 years of age. The association between women’s characteristics and the DCIS detection rate, the IBC detection rate and the odds ratio of DCIS among screen-detected cancers was assessed by logistic regression and generalized estimating equations with independent correlation matrix and sandwich estimator.

Results

A total of 4173 DCIS and 15,136 IBC were screen-detected. Increasing women’s age, current hormone replacement therapy use and higher body mass index were less associated with the DCIS than with IBC detection rates (p value for the odds of DCIS among screen-detected cancers of, respectively, < 0.0001, 0.0244 and < 0.0001). In contrast, having a previous breast aspiration or biopsy and increasing breast density were more strongly associated with DCIS than with IBC detection rates (p value of, respectively, 0.0050 and < 0.0001).

Conclusion

The results suggest that some women’s characteristics could be playing a role in the initiation and other in the progression from in situ to invasive breast cancer. These characteristics can also affect the screening sensitivity, and this effect may differ depending on whether screen-detected cases were DCIS or IBC.

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Title: The mammography screening detection of ductal carcinoma in situ and invasive breast cancer according to women’s characteristics: is it the same?
Authors: Isabelle Théberge
Nathalie Vandal
Marie-Hélène Guertin
Linda Perron
Publication date: 01-04-2019
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-05095-7

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