Clinical and radiological features of breast tumors according to history of false-positive results in mammography screening


Por: Domingo, L, Romero, A, Blanch, J, Salas, D, Sanchez, M, Rodriguez-Arana, A, Ferrer, J, Ibanez, J, Vega, A, Laso, M, Castells, X and Sala, M

Fecha de Publicación: 01/10/2013
Resumen:
Background: Women with a false-positive result after a screening mammogram have an increased risk of cancer detection in subsequent participations, especially after assessments involving cytology or biopsy. We aimed to compare women's personal characteristics, tumoral features and the radiological appearance of cancers with and without a previous false-positive result generated by additional imaging or invasive procedures. Methods: From 1996 to 2007, 111,098 women aged 45-69 years participated in four population-based breast cancer screening programs in Spain, and 1281 cancers were detected. We included all cancers detected in subsequent screenings (n = 703) and explored the occurrence of previous false-positive results. We identified false-positives requiring additional imaging or invasive procedures. Differences on tumoral features (invasiveness, tumor size, and lymph node status) and radiological appearance were assessed by Chi-square test, and agreement between the location of cancer and prior suspicious by Cohen's kappa coefficient. A multivariate analysis was preformed to evaluate the effect of previous screening results and age on the odds of presenting an in situ carcinoma. Results: Among the 703 cancers detected in subsequent screenings, 148 women (21.1%) had a previous false-positive result. Of these, 105 were by additional imaging and 43 by invasive procedures. Women with prior false-positive result requiring invasive assessment, compared to women with negative tests, and women with prior false-positive requiring additional imaging, had a higher proportion of in situ carcinomas (31.7%, 15.3%, 12.9%, respectively; p = 0.014) and microcalcifications (37.2%, 20.2%, 9.5%, respectively; p = 0.003). The proportion of in situ carcinomas was even higher in women over 60 years (39.2%, 12.5%, 13.0%, respectively; p = 0.001). Ipsilateral cancer was observed in 65.7% of cases with prior cytology or biopsy (k = 0.479; 95% CI: 0.330-0.794). Conclusion: A large number of in situ malignancies and calcification patterns were found among women with prior false-positive result in mammography screening requiring cytology or biopsies, suggesting progression from a previously benign lesion. (C) 2013 Elsevier Ltd. All rights reserved.

Direcciones
Domingo, L: Hosp Mar, Dept Epidemiol & Evaluat, IMIM, Res Inst, Barcelona 08003, Spain; Red Invest Serv Salud Enfermedades Cron REDISSEC, Barcelona, Spain
Romero, A: Hosp Mar, Dept Epidemiol & Evaluat, IMIM, Res Inst, Barcelona 08003, Spain
Blanch, J: Hosp Mar, Dept Epidemiol & Evaluat, IMIM, Res Inst, Barcelona 08003, Spain; Red Invest Serv Salud Enfermedades Cron REDISSEC, Barcelona, Spain
Salas, D: DIRECCIÓN GENERAL DE SALUD PÚBLICA, Valencia, Spain; CENTRO SUPERIOR DE INVESTIGACIÓN EN SALUD PÚBLICA (CSISP), Valencia, Spain
Sanchez, M: Govt Cantabria, Gen Directorate Publ Hlth, Dept Hlth, Santander 39009, Spain
Rodriguez-Arana, A: Hosp Mar, Radiol & Nucl Med Serv, Barcelona 08003, Spain
Ferrer, J: Hosp Santa Caterina, Radiol Unit, Girona 17190, Spain
Ibanez, J: DIRECCIÓN GENERAL DE SALUD PÚBLICA, Valencia, Spain; CENTRO SUPERIOR DE INVESTIGACIÓN EN SALUD PÚBLICA (CSISP), Valencia, Spain
Vega, A: Hosp Univ Marques de Valdecilla, Radiol Unit, Santander 39008, Spain
Laso, MS: CENTRO SUPERIOR DE INVESTIGACIÓN EN SALUD PÚBLICA (CSISP), Valencia, Spain
Castells, X: Hosp Mar, Dept Epidemiol & Evaluat, IMIM, Res Inst, Barcelona 08003, Spain; Red Invest Serv Salud Enfermedades Cron REDISSEC, Barcelona, Spain; Breast Canc Screening Unit Burjassot, Valencia 46100, Spain
Sala, M: Hosp Mar, Dept Epidemiol & Evaluat, IMIM, Res Inst, Barcelona 08003, Spain; Red Invest Serv Salud Enfermedades Cron REDISSEC, Barcelona, Spain
ISSN: 18777821





CANCER EPIDEMIOLOGY
Editorial
ELSEVIER SCI LTD, THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND, Países Bajos
Tipo de documento: Article
Volumen: 37 Número: 5
Páginas: 660-665s
WOS: 000325369800023
ID de PubMed: 23962702

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