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BMC Cancer
Published in: BMC Cancer 1/2008

Open Access 01-12-2008 | Research article

Increase in mammography detected breast cancer over time at a community based regional cancer center: a longitudinal cohort study 1990–2005

Authors: Judith A Malmgren, Mary K Atwood, Henry G Kaplan

Published in: BMC Cancer | Issue 1/2008

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Abstract

Background

Coincident with the advent of mammography screening, breast carcinoma in situ has increased in the US population.

Methods

We conducted a prospective cohort study of all women presenting with primary breast cancer, aged 21–94, and biopsy confirmed Stage 0-IV from 1990–2005 identified and tracked by our registry. Clinical presentation characteristics including age, race, TNM stage, family and pregnancy history, histologic type and method of detection by patient (PtD), physician (PhysD) or mammography (MgD) were chart abstracted at time of diagnosis. Cases with unknown or other method of detection (n = 84), or unusual cell types (n = 26) were removed (n = 6074).

Results

From 1990 to 1998 the percentage of PtD and MgD cases was roughly equivalent. In 1999 the percentage of MgD cases increased to 56% and PtD dropped to 37%, a significant 20% differential, constant to 2005 (Pearson chi square = 120.99, p < .001). Overall, percent TNM stage 0 (breast carcinoma in situ) cases increased after 1990, percent stage I and III cases declined, and stage II and IV cases remained constant (Pearson chi square = 218.36, p < .001). Increase in MgD over time differed by age group with an 8.5% increase among women age 40–49 and 12% increase among women age 50–95. Women age 21–39 rarely had MgD BC. In forward stepwise logistic regression modeling, significant predictors of MgD BC by order of entry were TNM stage, age at diagnosis, diagnosis year, and race (chi square = 1867.56, p < .001).

Conclusion

In our cohort the relative proportion of mammography detected breast cancer increased over time with a higher increase among women age 50+ and an increase of breast carcinoma in situ exclusively among MgD cases. The increase among women currently targeted by mammography screening programs (age ≥ 50) combined with an increase of breast carcinoma in situ most often detected by mammography screening indicates a possible incidence shift to lower stage breast cancer as a result of mammographic detection.
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Metadata
Title
Increase in mammography detected breast cancer over time at a community based regional cancer center: a longitudinal cohort study 1990–2005
Authors
Judith A Malmgren
Mary K Atwood
Henry G Kaplan
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2008
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-8-131

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