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


Por: Baré M, Torà N, Salas D, Sentís M, Ferrer J, Ibáñez J, Zubizarreta R, Sarriugarte G, Barata T, Domingo L, Castells X and Sala M

Fecha de Publicación: 01/11/2015
Resumen:
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.

Direcciones
Baré M: Clinical Epidemiology and Cancer Screening, UDIAT-DC, Corporació Sanitària Parc Taulí, Sabadell, Catalonia, Spain. mbare@tauli.cat; Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Barcelona (UAB), Bellaterra, Barcelona, Spain. mbare@tauli.cat; Research Network on Health Services in Chronic Diseases (REDISSEC), Sabadell, Spain. mbare@tauli.cat
Torà N: Clinical Epidemiology and Cancer Screening, UDIAT-DC, Corporació Sanitària Parc Taulí, Sabadell, Catalonia, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Sabadell, Spain
Salas D: General Directorate Public Health and Centre for Public Health Research (CSISP), FISABIO, Valencia, Spain
Sentís M: Breast Imaging, Department of Radiology, UDIAT-DC, Parc Taulí Sabadell, Sabadell, Spain
Ferrer J: Department of Radiology, Hospital de Santa Caterina, Salt, Girona, Spain
Ibáñez J: General Directorate Public Health and Centre for Public Health Research (CSISP), FISABIO, Valencia, Spain
Zubizarreta R: Galician Breast Cancer Screening Programme, Directorate for Innovation and Management of Public Health, Santiago de Compostela, Spain
Sarriugarte G: Osakidetza Breast Cancer Screening Programme, Basque Country Health Service, Bilbao, Spain
Barata T: General Directorate of Health Care Programmes, Canary Islands Health Service, Las Palmas de Gran Canaria, Spain
Domingo L: Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Castells X: Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Barcelona (UAB), Bellaterra, Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Sabadell, Spain; Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Sala M: Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Barcelona (UAB), Bellaterra, Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Sabadell, Spain; Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
ISSN: 01676806





BREAST CANCER RESEARCH AND TREATMENT
Editorial
Springer Netherlands, Netherlands, Estados Unidos America
Tipo de documento: Article
Volumen: 154 Número: 2
Páginas: 403-415s
WOS: 000365188600018
ID de PubMed: 26531756

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