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Song H, Tran TXM, Kim S, Park B. Risk Factors and Mortality Among Women With Interval Breast Cancer vs Screen-Detected Breast Cancer. JAMA Netw Open 2024; 7:e2411927. [PMID: 38767918 PMCID: PMC11107304 DOI: 10.1001/jamanetworkopen.2024.11927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/17/2024] [Indexed: 05/22/2024] Open
Abstract
Importance The risk factors for interval breast cancer (IBC) compared with those for screen-detected breast cancer (SBC) and their association with mortality outcomes have not yet been evaluated among Korean women. Objective To evaluate risk factors associated with IBC and survival among Korean women with IBC compared with those with SBC. Design, Setting, and Participants This retrospective cohort study used data from the Korean National Health Insurance Service Database. Women who participated in a national mammographic breast cancer screening program between January 1, 2009, and December 31, 2012, were included. Mortality outcomes were calculated from the date of breast cancer diagnosis to the date of death or December 31, 2020. Data were analyzed from March 1 to June 30, 2023. Exposure Breast cancer diagnosed within 6 to 24 months after a negative screening result (ie, IBC) or within 6 months after a positive screening result (ie, SBC). Main Outcomes and Measures Risk factors and survival rates for IBC and SBC. Results This study included 8702 women with IBC (mean [SD] age, 53.3 [8.6] years) and 9492 women with SBC (mean [SD] age, 54.1 [9.0] years). Compared with SBC, the probability of IBC decreased as mammographic density increased. Lower body mass index, menopausal status, hormone replacement therapy (HRT) use, and lack of family history of breast cancer were associated with a higher likelihood of IBC. When stratified by detection time, younger age at breast cancer diagnosis and family history of breast cancer were associated with an increased likelihood of IBC diagnosed at 6 to 12 months but a decreased likelihood of IBC diagnosed at 12 to 24 months. Overall mortality of IBC was comparable with SBC, but total mortality and cancer-related mortality of IBC diagnosed between 6 and 12 months was higher than that of SBC. Conclusions and Relevance The findings of this cohort study suggest that breast density, obesity, and HRT use were associated with IBC compared with SBC. These findings also suggest that higher supplemental breast ultrasound use among Korean women, especially those with dense breasts, could be attributed to a lower incidence of IBC among women with dense breasts compared with women with SBC, due to greater detection. Finally, overall mortality of IBC was comparable with that of SBC.
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Affiliation(s)
- Huiyeon Song
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Soyeoun Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea
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Majid SZ, Senapati GM, Lacson R, Chikarmane SA, Giess CS. Imaging characteristics of interval cancers detected on Full Field Digital Mammography (FFDM) versus Digital Breast Tomosynthesis (DBT). Clin Imaging 2024; 107:110063. [PMID: 38232642 DOI: 10.1016/j.clinimag.2023.110063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/26/2023] [Accepted: 12/10/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVE To compare imaging features of interval cancers detected in patients screened with full field digital mammography (FFDM) versus digital breast tomosynthesis (DBT). MATERIALS/METHODS This retrospective observational study consisted of female patients undergoing screening DM or FFDM at an academic medical center and two outpatient imaging facilities between January 2012 and June 2017. A natural language processing algorithm queried breast imaging reports for breast density and BI-RADS category. This was cross-referenced to an institutional breast cancer registry to identify interval cancers. Retrospective consensus review of the cases was done to categorize imaging features of interval cancers on FFDM vs DBT. RESULTS The rate of interval cancers was comparable in patients screened with FFDM (30/39793) and DBT (29/32180) (p = 0.58). There was no significant difference in the rate, histopathology, or imaging features of interval cancers in patients screened with FFDM versus DBT. The most common mammographic features on diagnostic imaging across both groups was the presence of a mass (13/47). Almost equally common was negative diagnostic mammogram with mass detected only on ultrasound (11/47). The rate of interval cancers detected by high-risk surveillance breast MRI was increased in patients who previously had screening with DBT relative to those who had screening with FFDM (p = 0.0419). CONCLUSION There is no significant difference in rate of detection, histopathology, or imaging features of interval cancers in patients screened with FFDM versus DBT. However, across both cohorts, the most common features on diagnostic mammogram were either the presence of a mass or a negative mammogram.
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Affiliation(s)
- Sana Z Majid
- Brigham and Women's Hospital, Boston, MA 02115, United States of America.
| | - Gunjan M Senapati
- Brigham and Women's Hospital, Boston, MA 02115, United States of America
| | - Ronilda Lacson
- Brigham and Women's Hospital, Boston, MA 02115, United States of America
| | - Sona A Chikarmane
- Brigham and Women's Hospital, Boston, MA 02115, United States of America
| | - Catherine S Giess
- Brigham and Women's Hospital, Boston, MA 02115, United States of America
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3
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Çelik L, Güner DC, Özçağlayan Ö, Çubuk R, Arıbal ME. Diagnostic performance of two versions of an artificial intelligence system in interval breast cancer detection. Acta Radiol 2023; 64:2891-2897. [PMID: 37722761 DOI: 10.1177/02841851231200785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
BACKGROUND Various versions of artificial intelligence (AI) have been used as a diagnostic tool aid in the diagnosis of breast cancer. One of the most important problems in breast screening progmrams is interval breast cancer (IBC). PURPOSE To compare the diagnostic performance of Transpara v1.6 and v1.7 in the detection of IBC. MATERIAL AND METHODS Reports of screening mammograms of a total 2,248,665 of women were evaluated retrospectively. Of 2,129,486 mammograms reported as Breast Imaging Reporting and Data System (BIRADS) 1 and 2, the IBC group consisted of 323 cases who were diagnosed as having cancer on mammography and were correlated with pathology in second mammogram taken >30 days after first mammogram. Four hundred and forty-one were defined as the control group because they did not change over 2 years. Cancer risk scores of both groups were determined from 1 to 10 with Tranpara v1.6 and v1.7. Diagnostic performances of both versions were evaluated by the receiver operating characteristic curve. RESULTS Cancer risk scores 1 and 10 in v1.7 increased compared to v1.6 (P < 0.001). In all cases, sensitivity for v1.6 was 56.6%, specificity was 90%, and, for v1.7, sensitivity was 65.9% and specificity was 90%, respectively. In all cases, area under the curve values were 0.812 for v1.6 and 0.856 for v1.7, which was higher in v1.7 (P < 0.001). Diagnostic performance of v1.7 was higher than v1.6 at the 7-12-month period (P < 0.001). CONCLUSION The present study showed that Tranpara v1.7 has a higher specificity, sensitivity and diagnostic performance in IBC determination than v1.6. AI systems can be used in breast screening as a secondary or third reader in screening programs.
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Affiliation(s)
- Levent Çelik
- Department of Radiology, Maltepe University, School of Medicine, Istanbul, Turkey
| | - Davut Can Güner
- Department of Radiology, Maltepe University, School of Medicine, Istanbul, Turkey
| | - Ömer Özçağlayan
- Department of Radiology, Maltepe University, School of Medicine, Istanbul, Turkey
| | - Rahmi Çubuk
- Department of Radiology, Maltepe University, School of Medicine, Istanbul, Turkey
| | - Mustafa Erkin Arıbal
- Deparment of Radiology, Acıbadem University, School of Medicine, Istanbul, Turkey
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Bernhardt SM, Mitchell E, Stamnes S, Hoffmann RJ, Calhoun A, Klug A, Russell TD, Pennock ND, Walker JM, Schedin P. Isogenic Mammary Models of Intraductal Carcinoma Reveal Progression to Invasiveness in the Absence of a Non-Obligatory In Situ Stage. Cancers (Basel) 2023; 15:2257. [PMID: 37190184 PMCID: PMC10136757 DOI: 10.3390/cancers15082257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
In breast cancer, progression to invasive ductal carcinoma (IDC) involves interactions between immune, myoepithelial, and tumor cells. Development of IDC can proceed through ductal carcinoma in situ (DCIS), a non-obligate, non-invasive stage, or IDC can develop without evidence of DCIS and these cases associate with poorer prognosis. Tractable, immune-competent mouse models are needed to help delineate distinct mechanisms of local tumor cell invasion and prognostic implications. To address these gaps, we delivered murine mammary carcinoma cell lines directly into the main mammary lactiferous duct of immune-competent mice. Using two strains of immune-competent mice (BALB/c, C57BL/6), one immune-compromised (severe combined immunodeficiency; SCID) C57BL/6 strain, and six different murine mammary cancer cell lines (D2.OR, D2A1, 4T1, EMT6, EO771, Py230), we found early loss of ductal myoepithelial cell differentiation markers p63, α-smooth muscle actin, and calponin, and rapid formation of IDC in the absence of DCIS. Rapid IDC formation also occurred in the absence of adaptive immunity. Combined, these studies demonstrate that loss of myoepithelial barrier function does not require an intact immune system, and suggest that these isogenic murine models may prove a useful tool to study IDC in the absence of a non-obligatory DCIS stage-an under-investigated subset of poor prognostic human breast cancer.
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Affiliation(s)
- Sarah M. Bernhardt
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Elizabeth Mitchell
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Stephanie Stamnes
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Reuben J. Hoffmann
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrea Calhoun
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Alex Klug
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Tanya D. Russell
- Center for Advancing Professional Excellence, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Nathan D. Pennock
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Joshua M. Walker
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Pepper Schedin
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Young Women’s Breast Cancer Translational Program, University of Colorado Cancer Center, Aurora, CO 80045, USA
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Anandarajah A, Chen Y, Colditz GA, Hardi A, Stoll C, Jiang S. Studies of parenchymal texture added to mammographic breast density and risk of breast cancer: a systematic review of the methods used in the literature. Breast Cancer Res 2022; 24:101. [PMID: 36585732 PMCID: PMC9805242 DOI: 10.1186/s13058-022-01600-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
This systematic review aimed to assess the methods used to classify mammographic breast parenchymal features in relation to the prediction of future breast cancer. The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov were searched through October 2021 to extract published articles in English describing the relationship of parenchymal texture features with the risk of breast cancer. Twenty-eight articles published since 2016 were included in the final review. The identification of parenchymal texture features varied from using a predefined list to machine-driven identification. A reduction in the number of features chosen for subsequent analysis in relation to cancer incidence then varied across statistical approaches and machine learning methods. The variation in approach and number of features identified for inclusion in analysis precluded generating a quantitative summary or meta-analysis of the value of these features to improve predicting risk of future breast cancers. This updated overview of the state of the art revealed research gaps; based on these, we provide recommendations for future studies using parenchymal features for mammogram images to make use of accumulating image data, and external validation of prediction models that extend to 5 and 10 years to guide clinical risk management. Following these recommendations could enhance the applicability of models, helping improve risk classification and risk prediction for women to tailor screening and prevention strategies to the level of risk.
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Affiliation(s)
- Akila Anandarajah
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Yongzhen Chen
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Angela Hardi
- Bernard Becker Medical Library, Washington University School of Medicine, MSC 8132-12-01, 660 S Euclid Ave, Saint Louis, MO, 63110, USA
| | - Carolyn Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA
| | - Shu Jiang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave MSC 8100-0094-2200, Saint Louis, MO, 63110, USA.
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Contrast-enhanced spectral mammography without and with a delayed image for diagnosing malignancy among mass lesions in dense breast. Contemp Oncol (Pozn) 2021; 25:17-22. [PMID: 33911977 PMCID: PMC8063896 DOI: 10.5114/wo.2021.105030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/27/2021] [Indexed: 11/20/2022] Open
Abstract
Aim of the study To analyse the diagnostic performance of contrast-enhanced spectral mammography (CESM) based on morphologic and enhancement patterns of mass lesions in dense breast using different protocols: CESM without delayed image and CESM with delayed image. Material and methods A total of 151 informed women with suspicious for malignancy mass lesions in dense breast were included in this study. All of them underwent CESM using 2 protocols. A total of 155 lesions were pathomorphologically verified. We analysed morphologic patterns on low-energy (LE) images and recombined images (RI) by defining the shape, margin, and dynamic patterns based on delayed images. Results The comparative analysis revealed that the shape and margins on RI were more significant than those on LE images. The dynamic indicators of CESM were found to be highly significant in dense breasts. The correlation between kinetic curve and histological results demonstrated that a persistent type of curve was common for benign lesions, accounting for 15/22 (68.1%); plateau and washout – for malignant lesions, accounting for 24/89 (26.9%) and 61/89 (68.5%), respectively. Delayed image leads to an increase of specificity up to 12.4%, which is statistically significant. The area under the curve (AUC) in CESM with delayed image is larger than that in CESM without delayed image (p < 0.01). Conclusions CESM is sensitive for the differential diagnosis of breast lesions. CESM with delayed image has higher specificity than CESM without delayed image. Delayed images with plateau and washout are typical for malignancy.
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7
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Corradini AG, Cremonini A, Cattani MG, Cucchi MC, Saguatti G, Baldissera A, Mura A, Ciabatti S, Foschini MP. Which type of cancer is detected in breast screening programs? Review of the literature with focus on the most frequent histological features. Pathologica 2021; 113:85-94. [PMID: 34042090 PMCID: PMC8167395 DOI: 10.32074/1591-951x-123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/12/2020] [Indexed: 12/20/2022] Open
Abstract
Breast cancer is the most frequent type of cancer affecting female patients. The introduction of breast cancer screening programs led to a substantial reduction of mortality from breast cancer. Nevertheless, doubts are being raised on the real efficacy of breast screening programs. The aim of the present paper is to review the main pathological type of cancers detected in breast cancer screening programs. Specifically, attention will be given to: in situ carcinoma, invasive carcinoma histotypes and interval cancer.
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Affiliation(s)
- Angelo G Corradini
- Unit of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Anna Cremonini
- Unit of Anatomic Pathology, Department of Oncology, Bellaria Hospital, Bologna, Italy
| | - Maria G Cattani
- Unit of Anatomic Pathology, Department of Oncology, Bellaria Hospital, Bologna, Italy
| | - Maria C Cucchi
- Unit of Breast Surgery, Department of Oncology, Bellaria Hospital, Bologna Italy
| | - Gianni Saguatti
- Unit of Senology, Department of Oncology, Bellaria Hospital, Bologna, Italy
| | | | - Antonella Mura
- Department of Medical Oncology, Azienda USL, Bologna, Italy; IRCCS Institute of Neurological Sciences, Bologna, Italy
| | | | - Maria P Foschini
- Unit of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Unit of Anatomic Pathology, Department of Oncology, Bellaria Hospital, Bologna, Italy
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8
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Lee JS, Oh M. Breast Cancer Screening in Asian Women with Dense Breast by Mammography: A Cross-Sectional Observational Study. Asian Pac J Cancer Prev 2021; 22:1165-1170. [PMID: 33906309 PMCID: PMC8325126 DOI: 10.31557/apjcp.2021.22.4.1165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Indexed: 12/29/2022] Open
Abstract
Objective: Mammography density of Asian women is known to be higher than Western women. After 2009, the Korean National Cancer Screening Program (NCSP) has started to notify mammography density (MD). To investigate the effect of MD notification, we integrated screening results with national health insurance claim data from 2009 to 2013. Patients and Methods: We performed a cross-sectional observational study which investigated the crude detection rate (CDR), positive predictive value (PPV), and incidence rate of Interval Cancer (IC). IC was defined as breast cancer, where the interval between the screening date and date of diagnosis was more than 12 months and less than 24 months among participants with previous normal results. Results: CDR and PPV per 100,000 results increased from 510.9 to 756.2 and from 1842.5 to 3364.9, respectively. The incidence rate of IC per 100,000 negative results increased from 623.3 to 676.2. Women younger than 50 years had a high incidence of ICs. Conclusion: After notifying MD, the incidence rate of IC less increased comparing with CDR or PPV. Screening mammography could be more useful to Asian women when reporting MD.
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Affiliation(s)
- Jung Sun Lee
- Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Minkyung Oh
- Department of Pharmacology, Inje University College of medicine, Clinical Trial Center, Inje University Busan Paik Hospital, Busan, Korea
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Irvin VL, Zhang Z, Simon MS, Chlebowski RT, Luoh SW, Shadyab AH, Krok-Schoen JL, Tabung FK, Qi L, Stefanick ML, Schedin P, Jindal S. Comparison of Mortality Among Participants of Women's Health Initiative Trials With Screening-Detected Breast Cancers vs Interval Breast Cancers. JAMA Netw Open 2020; 3:e207227. [PMID: 32602908 PMCID: PMC7327543 DOI: 10.1001/jamanetworkopen.2020.7227] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
IMPORTANCE Interval breast cancers (IBCs) are cancers that emerge after a mammogram with negative results but before the patient's next scheduled screening. Interval breast cancer has a worse prognosis than cancers detected by screening; however, it is unknown whether the length of the interscreening period is associated with prognostic features and mortality. OBJECTIVE To compare the prognostic features and mortality rate of women with IBCs diagnosed within 1 year or between 1 and 2.5 years of a mammogram with negative results with the prognostic features and mortality rate of women with breast cancers detected by screening. DESIGN, SETTING, AND PARTICIPANTS This cohort study used mammography data, tumor characteristics, and patient demographic data from the Women's Health Initiative study, which recruited participants from 1993 to 1998 and followed up with participants for a median of 19 years. The present study sample for these analyses included women aged 50 to 79 years who participated in the Women's Health Initiative study and includes data collected through March 31, 2018. There were 5455 incidents of breast cancer; only 3019 women compliant with screening were retained in analyses. Statistical analysis was performed from October 25, 2018, to November 24, 2019. Breast cancers detected by screening and IBCs were defined based on mammogram history, date of last mammogram, type of visit, and results of examination. Interval breast cancers were subdivided into those occurring within 1 year or between 1 and 2.5 years after the last protocol-mandated mammogram with negative results. MAIN OUTCOMES AND MEASURES The primary outcome of this study was breast cancer-specific mortality for each case of breast cancer detected by screening and IBCs detected within 1 year or between 1 and 2.5 years from a mammogram with negative results. Secondary outcomes included prognostic and tumor characteristics for each group. Comparisons between groups were made using the t test, the χ2 test, and Fine-Gray multivariable cumulative incidence regression analyses. RESULTS Among the 3019 participants in this analysis, all were women with a mean (SD) age of 63.1 (6.8) years at enrollment and 68.5 (7.1) years at diagnosis. A total of 1050 cases of IBC were identified, with 324 (30.9%) diagnosed within 1 year from a mammogram with negative results and 726 (69.1%) diagnosed between 1 and 2.5 years after last mammogram with negative results. The remaining 1969 cases were breast cancers detected by screening. Interval breast cancers diagnosed within 1 year from a mammogram with negative results had significantly more lobular histologic characteristics (13.0% vs. 8.1%), a larger tumor size (1.97 cm vs 1.43 cm), a higher clinical stage (28.4% vs 17.3% regional and 3.7% vs 0.6% distant), and more lymph node involvement (27.1% vs 17.0%) than cancers detected by screening. Unadjusted breast cancer-specific mortality hazard ratios were significantly higher for IBCs diagnosed within 1 year from a mammogram with negative results compared with breast cancers detected by screening (hazard ratio, 1.92; 95% CI, 1.39-2.65). Higher breast cancer-specific mortality remained statistically significant for IBCs diagnosed within 1 year after adjusting for trial group, molecular subtype, waist to hip ratio, histologic characteristics, and either tumor size (hazard ratio, 1.46; 95% CI, 1.03-2.08) or lymph node involvement (hazard ratio, 1.44; 95% CI, 1.03-2.01). However, significance was lost when tumor size and lymph node involvement were both included in the model (hazard ratio, 1.34; 95% CI, 0.96-1.88). Interval breast cancers diagnosed between 1 and 2.5 years from a mammogram with negative results were not different from breast cancers detected by screening based on prognostic factors or mortality. CONCLUSIONS AND RELEVANCE Women with IBCs diagnosed within 1 year of negative mammogram results overall were associated with worse survival than women with breast cancers detected by screening. These differences in survival may be due to a uniquely aggressive biology among IBC cases.
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Affiliation(s)
- Veronica L. Irvin
- College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Zhenzhen Zhang
- Division of Oncological Sciences, Oregon Health & Science University, Portland
- Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Michael S. Simon
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, Michigan
| | - Rowan T. Chlebowski
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
| | - Shiuh-Wen Luoh
- Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Aladdin H. Shadyab
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla
| | | | - Fred K. Tabung
- College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis
| | - Marcia L. Stefanick
- Department of Medicine (Stanford Prevention Research Center), School of Medicine, Stanford University, Stanford, California
| | - Pepper Schedin
- Knight Cancer Institute, Oregon Health & Science University, Portland
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland
| | - Sonali Jindal
- Knight Cancer Institute, Oregon Health & Science University, Portland
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland
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Bovbjerg ML. Current Resources for Evidence-Based Practice, November 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:693-704. [PMID: 31629697 DOI: 10.1016/j.jogn.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A review of new resources to support the provision of evidence-based care for women and infants.
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Bellio G, Marion R, Giudici F, Kus S, Tonutti M, Zanconati F, Bortul M. Interval Breast Cancer Versus Screen-Detected Cancer: Comparison of Clinicopathologic Characteristics in a Single-Center Analysis. Clin Breast Cancer 2017; 17:564-571. [PMID: 28456487 DOI: 10.1016/j.clbc.2017.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 04/01/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The introduction of breast screening programs has raised the problem of interval breast cancers (IBC). The aims of this study were to analyze the impact of IBC on the screening program, to compare IBC and screen-detected cancers (SDC), and to identify possible predictors of mortality. PATIENTS AND METHODS Patients with breast cancer diagnosed during the regional breast screening program between January 2008 and December 2013 at a single center in Italy were included. Demographic, preoperative, and postoperative data were prospectively collected and retrospectively analyzed. RESULTS Five hundred thirty-four patients were enrolled; 106 women (19.9%) had IBC and 428 women (80.1%) SDC. IBC presented more aggressive features compared to SDC, such as tumor invasiveness (95% vs. 85%; P = .005), tumor size (≥ pT2 37% vs. 21%; P = .001), grade (G3 39% vs. 17%; P < .001), and St Gallen molecular subtype (triple negative 22% vs. 7%; P < .001), resulting in higher distant recurrence rate (8% vs. 2%; P = .009) and worse overall and disease-free survival (P = .03 and P = .001, respectively). Cox multivariate regression analysis identified St Gallen molecular subtype as the only predictor of mortality in patients with breast cancer (P = .03). CONCLUSION IBC accounted for one-fifth of all breast cancers diagnosed in women who followed the regional screening program. Furthermore, IBC appeared to have more aggressive features compared to SDC, leading to worse survival. These worse survivals depended on St Gallen molecular subtype.
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Affiliation(s)
- Gabriele Bellio
- Department of General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste, Italy.
| | - Riccardo Marion
- Department of General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste, Italy
| | - Fabiola Giudici
- Breast Unit, Azienda Sanitaria Universitaria Integrata di Trieste, Italy
| | - Sara Kus
- Department of Radiology, Azienda Sanitaria Universitaria Integrata di Trieste, Italy
| | - Maura Tonutti
- Breast Unit, Azienda Sanitaria Universitaria Integrata di Trieste, Italy; Department of Radiology, Azienda Sanitaria Universitaria Integrata di Trieste, Italy
| | - Fabrizio Zanconati
- Breast Unit, Azienda Sanitaria Universitaria Integrata di Trieste, Italy; Department of Histopathology, Azienda Sanitaria Universitaria Integrata di Trieste, Italy
| | - Marina Bortul
- Department of General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste, Italy; Breast Unit, Azienda Sanitaria Universitaria Integrata di Trieste, Italy
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Frequency and Outcomes of Incidental Breast Lesions Detected on Abdominal MRI Over a 7-Year Period. AJR Am J Roentgenol 2017; 208:107-113. [DOI: 10.2214/ajr.16.16683] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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13
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Lee K, Kim H, Lee JH, Jeong H, Shin SA, Han T, Seo YL, Yoo Y, Nam SE, Park JH, Park YM. Retrospective observation on contribution and limitations of screening for breast cancer with mammography in Korea: detection rate of breast cancer and incidence rate of interval cancer of the breast. BMC WOMENS HEALTH 2016; 16:72. [PMID: 27863517 PMCID: PMC5116177 DOI: 10.1186/s12905-016-0351-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/03/2016] [Indexed: 12/19/2022]
Abstract
Background The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography. Methods Descriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rate of interval cancer of the breast were calculated. Results The crude detection rate of breast cancer screening per 100,000 participants increased from 126.3 in 2009 to 182.1 in 2014. The positive predictive value of breast cancer screening per 100,000 positives increased from 741.2 in 2009 to 1,367.9 in 2014. The incidence rate of interval cancer of the breast per 100,000 negatives increased from 51.7 in 2009 to 76.3 in 2014. The sensitivities of screening for breast cancer were 74.6% in 2009 and 75.1% in 2014 and the specificities were 83.1% in 2009 and 85.7% in 2014. Conclusions To increase the detection rate of breast cancer by breast cancer screening using mammography, the participation rate should be higher and an environment where accurate mammography and reading can be performed and reinforcement of quality control are required. To reduce the incidence rate of interval cancer of the breast, it will be necessary to educate women after their 20s to perform self-examination of the breast once a month regardless of participation in screening for breast cancer.
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Affiliation(s)
- Kunsei Lee
- Departments of Preventive Medicine, School of Medicine, Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Seoul, 143-701, South Korea
| | - Hyeongsu Kim
- Departments of Preventive Medicine, School of Medicine, Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Seoul, 143-701, South Korea.
| | - Jung Hyun Lee
- Departments of Preventive Medicine, School of Medicine, Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Seoul, 143-701, South Korea
| | - Hyoseon Jeong
- Departments of Preventive Medicine, School of Medicine, Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Seoul, 143-701, South Korea
| | - Soon Ae Shin
- Bigdata Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Taehwa Han
- Yonsei University Health System, College of Medicine, Yonsei University, Seoul, South Korea
| | - Young Lan Seo
- Department of Radiology, Kangdong Seong-Sim Hospital, College of Medicine, Hallym University, Seoul, South Korea
| | - Youngbum Yoo
- Departments of Surgery, School of Medicine, Konkuk University, Seoul, South Korea
| | - Sang Eun Nam
- Departments of Surgery, School of Medicine, Konkuk University, Seoul, South Korea
| | - Jong Heon Park
- Bigdata Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Yoo Mi Park
- Medical and Health Policy Division, Seoul Metropolitan Government, Seoul, South Korea
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14
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Mao X, He J, Li T, Lu Z, Sun J, Meng Y, Abliz Z, Chen J. Application of imaging mass spectrometry for the molecular diagnosis of human breast tumors. Sci Rep 2016; 6:21043. [PMID: 26868906 PMCID: PMC4751527 DOI: 10.1038/srep21043] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/15/2016] [Indexed: 01/02/2023] Open
Abstract
Distinguishing breast invasive ductal carcinoma (IDC) and breast ductal carcinoma in situ (DCIS) is a key step in breast surgery, especially to determine whether DCIS is associated with tumor cell micro-invasion. However, there is currently no reliable method to obtain molecular information for breast tumor analysis during surgery. Here, we present a novel air flow-assisted ionization (AFAI) mass spectrometry imaging method that can be used in ambient environments to differentiate breast cancer by analyzing lipids. In this study, we demonstrate that various subtypes and histological grades of IDC and DCIS can be discriminated using AFAI-MSI: phospholipids were more abundant in IDC than in DCIS, whereas fatty acids were more abundant in DCIS than in IDC. The classification of specimens in the subtype and grade validation sets showed 100% and 78.6% agreement with the histopathological diagnosis, respectively. Our work shows the rapid classification of breast cancer utilizing AFAI-MSI. This work suggests that this method could be developed to provide surgeons with nearly real-time information to guide surgical resections.
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Affiliation(s)
- Xinxin Mao
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jiuming He
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Tiegang Li
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Zhaohui Lu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian Sun
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yunxiao Meng
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zeper Abliz
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Jie Chen
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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