Improved survival rate for women with interval breast cancer – results from the breast cancer screening programme in Malmö, Sweden 1976–1999

2007 ◽  
Vol 14 (3) ◽  
pp. 138-143 ◽  
Author(s):  
Sophia Zackrisson ◽  
Lars Janzon ◽  
Jonas Manjer ◽  
Ingvar Andersson
Keyword(s):  
Breast Cancer ◽  
Case Fatality Rate ◽  
Screening Programme ◽  
Interval Cancer ◽  
Case Fatality ◽  
Mammographic Screening ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Stage Distribution ◽  
Interval Breast Cancer

Objective: Breast cancers detected between screening examinations can influence the sensitivity of a screening programme. Studies of the prognosis of these so-called interval breast cancers show diverging results. We investigated the course of interval breast cancer over time in the Malmö Mammographic Screening Trial (MMST) 1976–86 and the Malmö Mammographic Service Screening Programme (MMSSP) 1990–99. Material and methods: Stage distribution and survival of interval cancers in MMSSP were compared with screen-detected and non-attender cancer cases in MMSSP, with interval cancers in MMST and with breast cancer cases in a non-screened population five years before the start of MMSSP (pre-screening cancer cases). Results: In MMSSP 1990–99, the interval cancers did not differ in stage distribution or survival compared with cancer cases in non-attenders, while screen-detected cancer cases had more favourable stage distribution and rate of survival than had the interval cancer cases. The MMST interval cancer cases, 1976–1986, had more favourable stage distribution but higher overall case fatality rate, relative risks (RR) 1.78 (1.00–3.20), and breast cancer case fatality rate, RR 2.05 (1.05–4.00), compared with the more recent MMSSP interval cancer cases. No significant difference in five-year survival was seen in the MMSSP interval cancer cases compared with pre-screening cancer cases not exposed to screening. Conclusion: In this urban population invited to mammographic screening, the survival rate for women with interval cancer has improved over a period of 20 years. Further studies are needed to assess what factors might explain changes in the course of interval breast cancer.

A blind review and an informed review of interval breast cancer cases in the Limburg screening programme, the Netherlands

2000 ◽  
Vol 7 (1) ◽  
pp. 19-23 ◽  
Author(s):  
J.M. de Rijke ◽  
L.J. Schouten ◽  
J.L. Schreutelkamp ◽  
I. Jochem ◽  
A.L.M. Verbeek
Keyword(s):  
Breast Cancer ◽  
The Netherlands ◽  
Screening Programme ◽  
Interval Cancer ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Blind Review ◽  
Screening Practice ◽  
Cancer Screening Programme ◽  
Screening Mammograms

Objective To investigate the proportion of interval breast cancers that could have been detected at the previous screening examination, and to gain more insight into the characteristics of these tumours. Setting Breast cancer screening programme in mid- and southern Limburg, the Netherlands. Method Firstly, previous screening mammograms of 92 interval cancer cases were blindly reread by the radiologists from two different units as part of their daily screening workload. Secondly, a separate informed review was conducted, in which all of the cases (except for two) were subclassified into four categories: screening error; minimal signs; radiologically occult both at previous screening and at diagnosis; or radiologically occult at previous screening. Trends in recall rates and false and true positive rates were calculated to study potential changes during and after the blind review. Results In the blind review, 15% of the interval cancers were detected in both rereadings and 21% in one rereading. In the informed review, 25% were classified as a screening error and 24% as minimal signs present; 74% of the cases classified as a screening error had been recalled at least once in the blind review. Recall rates and false positive rates in daily screening practice increased significantly during and after the study period. Conclusions About one third of the interval cancers could have been detected in the previous screening round. In order to diminish the number of avoidable interval cancers, review and classification of interval cancers is an important tool for continuing the education of screening radiologists. Therefore, further development of review training procedures is necessary.

scholarly journals Characteristics of Screen-Detected Breast Cancer of Turkish Bahcesehir (Istanbul) Screening Project

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 9s-9s
Author(s):  
Neslihan Cabıoğlu ◽  
Sibel Ozkan-Gurdal ◽  
Arda Kayhan ◽  
Ayse Nilufer Ozaydın ◽  
Cennet Şahin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Research Funding ◽  
Conflicts Of Interest ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Multivariable Logistic Regression Analysis ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Ki 67 ◽  
Screening Programs

Purpose The Turkish Bahcesehir Breast Cancer Screening Project is a 10-year organized population-based screening program carried out in one of the largest counties of Istanbul, Turkey. The aim of the current study was to examine the biologic features of screen-detected and interval breast cancers for the first 9-year study period. Methods Between January 2009 and January 2018, 26,040 mammographies were performed with 2-year intervals for 8,408 women age 40 to 69 years. Clinicopathologic and biologic tumor characteristics—estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2-neu, and protein encoded by the MKI67 gene (Ki-67) —were analyzed for those patients who were diagnosed with breast cancer. Interval cancer was defined as symptomatic cancer diagnosed within 24 months of a negative screening. Ki-67 level > 20% was considered a high score. Results Median age was 52.5 years, and 37% were younger than age 50 years. Of 8,408 women, 113 breast cancers (1.3%) were detected. There were 14 ductal carcinoma in situ (12.4%) and 99 invasive cancers (87.6%). The majority of patients with invasive cancer had stage 1 (49.1%) or stage 2 (31.8%) disease. The majority of patients underwent breast-conserving therapy (83%) with sentinel lymph node biopsy alone (74.1%). Interval cancers (n = 11) were more likely to have multifocality or multicentricity ( P = .002) and high Ki-67 score ( P = .05). Furthermore, diagnosis with interval cancer was associated with more advanced disease, including stage II to IV disease and axillary positivity, and patients were more likely to have nonluminal cancers or tumors with lymphovascular invasion. However, these associations did not reach statistical significance. Multivariable logistic regression analysis identified multifocality or multicentricity as the only significant factor to be associated with interval cancers (odds ratio, 5.94; 95% CI, 1.4 to 25.4; P = .016). Conclusion Our findings suggest that the majority of screen-detected breast cancers exhibit either luminal A or B subtype with low Ki-67 scores and unifocal tumors. However, interval cancers were more likely to have aggressive biology and multicentricity that was less likely to be detected by mammographic screening programs and that required more aggressive surgical and systemic therapies. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Neslihan Cabioğlu Research Funding: Roche (Inst) Travel, Accommodations, Expenses: Genomic Health Sibel Ozkan-Gurdal Research Funding: Roche (Inst) Arda Kayhan Research Funding: Roche (Inst) Ayse Nilufer Ozaydin Research Funding: Roche (Inst) Cennet Şahin Research Funding: Roche (Inst) Beyza Ozcinar Research Funding: Roche (Inst) Erkin Aribal Employment: Nutricia – Danone and TRPharm (I) Leadership: Nutricia – Danone and TRPharm (I) Stock or Other Ownership: Roche (I) Honoraria: GE Healthcare, Fuji, Roche Travel, Accommodations, Expenses: Bayer Vahit Ozmen Honoraria: Pfizer, Roche Research Funding: Roche (Inst), Genekor, Roche Travel, Accommodations, Expenses: Pfizer

Breast cancer detection among Irish BRCA1 and BRCA2 mutation carriers.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12038-e12038 ◽  
Author(s):  
Elaine Walsh ◽  
Michael P. Farrell ◽  
Fergal Gallagher ◽  
Roisin Clarke ◽  
Carmel Nolan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brca Mutation ◽  
Brca2 Mutation ◽  
Interval Cancer ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Brca1 And Brca2 ◽  
Clinical Breast Exam ◽  
Mutation Carriers ◽  
Clinical Breast

e12038 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical breast exam, mammography and MRI have sensitivities approaching 100%. Even with intensive screening BRCA mutation carriers can present with self-detected interval cancers. We investigate screening practices and presentation among a cohort of Irish BRCA1/2 mutation carriers. Methods: Females with breast cancer belonging to kindreds now known to harbour BRCA1/2 mutations were retrospectively identified. Records were reviewed for BRCA mutation, demographics, breast cancer diagnosis, stage, histology and screening. We assessed screening modalities and whether breast cancers were diagnosed at screening or as interval cancers. Results: 53 cases of breast cancer were diagnosed from 1968-2010 among 53 Irish hereditary breast ovarian cancer kindreds. BRCA mutation status was unknown at time of diagnosis but subsequently confirmed. Detection method was identified in 50% of patients: 84% by clinical breast exam (CBE), 4% mammography, 4% MRI and 8% by a combination of CBE and mammography. Fifteen women (28%) developed second breast cancer; 9(60%) were undergoing screening, 2 were not and 27% were unknown. 22% were detected by CBE alone; 34% mammography; 22% a combination of mammography and CBE and 22% by MRI. In 41%, histology changed between first and second diagnosis. Two women developed a third breast cancer. In one, her second was an interval cancer despite being in a screening programme. Her third was radiologically detected. Conclusions: In this cohort of Irish BRCA1/2 mutation carriers almost 25% of second breast cancers were not detected by screening. 4% of cases were phenocopies and in 41% histology changed between first and second diagnosis. [Table: see text]

scholarly journals Left–right breast asymmetry and risk of screen-detected and interval cancers in a large population-based screening population

2020 ◽  
Vol 93 (1112) ◽  
pp. 20200154
Author(s):  
Sue M Hudson ◽  
Louise S Wilkinson ◽  
Bianca L De Stavola ◽  
Isabel dos-Santos-Silva
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Cancer Diagnosis ◽  
Linear Trend ◽  
Conditional Logistic Regression ◽  
Large Population ◽  
Interval Cancer ◽  
Population Based ◽  
Breast Cancers ◽  
Interval Cancers

Objectives: To assess the associations between automated volumetric estimates of mammographic asymmetry and breast cancers detected at the same (“contemporaneous”) screen, at subsequent screens, or in between (interval cancers). Methods: Automated measurements from mammographic images (N = 79,731) were used to estimate absolute asymmetry in breast volume (BV) and dense volume (DV) in a large ethnically diverse population of attendees of a UK breast screening programme. Logistic regression models were fitted to assess asymmetry associations with the odds of a breast cancer detected at contemporaneous screen (767 cases), adjusted for relevant confounders. Nested case–control investigations were designed to examine associations between asymmetry and the odds of: (a) interval cancer (numbers of cases/age-matched controls: 153/646) and (b) subsequent screen-detected cancer (345/1438), via conditional logistic regression. Results: DV, but not BV, asymmetry was positively associated with the odds of contemporaneous breast cancer (P-for-linear-trend (Pt) = 0.018). This association was stronger for first (prevalent) screens (Pt = 0.012). Both DV and BV asymmetry were positively associated with the odds of an interval cancer diagnosis (Pt = 0.060 and 0.030, respectively). Neither BV nor DV asymmetry were associated with the odds of having a subsequent screen-detected cancer. Conclusions: Increased DV asymmetry was associated with the risk of a breast cancer diagnosis at a contemporaneous screen or as an interval cancer. BV asymmetry was positively associated with the risk of an interval cancer diagnosis. Advances in knowledge: The findings suggest that DV and BV asymmetry may provide additional signals for detecting contemporaneous cancers and assessing the likelihood of interval cancers in population-based screening programmes.

Effect of Screening Mammography on the Surgery of Breast Cancer in Finland: A Population-Based Analysis during the Years 1985–2004

2006 ◽  
Vol 72 (2) ◽  
pp. 167-171
Author(s):  
Hannu Paajanen ◽  
Lea Kyhälä ◽  
Riitta Varjo ◽  
Sirkku Rantala
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Diagnostic Procedures ◽  
Geographic Area ◽  
Population Based ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Better Than

A nationwide mammographic screening of women aged 50 to 59 years commenced in Finland in January 1987. We studied the effect of screening on surgical diagnosis, treatment, and survival of breast cancer in one geographic area in Finland. We reviewed the medical records, survival data from Finnish Cancer Registry, and screening data from the Finnish Mammogrphic Working Group of 1,049 women who underwent surgery for breast cancer in our hospital between the years 1985 and 2004. Altogether, 35 parameters including diagnostic procedures, operative data, and staging were recorded. The results of tumors detected by mammographic screening (n = 156) and interval cancers (n = 148) were compared with the tumors detected outside of screening (n = 745). The incidence of breast cancer increased from 35 to 72 cases per 100,000 inhabitants, and the percentage of nonpalpable cancers increased from 12 to 33. Approximately 30 women per 100,000 inhabitants were annually referred from mass screening for surgical biopsies, in 60 per cent of which cancer was detected. Breast lump was still a first sign of cancer in 60 per cent of patients. The mammographic screening detected 20 per cent of new breast cancers. The cancers detected by screening were smaller, found at an earlier stage, and their 10-year-survival was better (90% vs 70%) than those detected by other means (P = 0.003). Overall mortality of interval cancers was worse (27%) than screening cancers (6%, P < 0.0001). Mammographic screening detects up to 20 per cent of new breast cancers in a well-defined population area. The prognosis of screening cancers is better than the cancers found outside of screening.

Breast cancer detection among Irish BRCA1 and BRCA2 mutation carriers.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 59-59
Author(s):  
Elaine Walsh ◽  
Michael P. Farrell ◽  
Fergal Gallagher ◽  
Roisin Clarke ◽  
Carmel Nolan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brca Mutation ◽  
Brca2 Mutation ◽  
Interval Cancer ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Brca1 And Brca2 ◽  
Clinical Breast Exam ◽  
Mutation Carriers ◽  
Clinical Breast

59 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical breast exam, mammography and MRI have sensitivities approaching 100%. Even with intensive screening BRCA mutation carriers can present with self-detected interval cancers. We investigate screening practices and presentation among a cohort of Irish BRCA1/2 mutation carriers. Methods: Females with breast cancer belonging to kindreds now known to harbour BRCA1/2 mutations were retrospectively identified. Records were reviewed for BRCA mutation, demographics, breast cancer diagnosis, stage, histology and screening. We assessed screening modalities and whether breast cancers were diagnosed at screening or as interval cancers. Results: 53 cases of breast cancer were diagnosed from 1968-2010 among 53 Irish hereditary breast ovarian cancer kindreds. BRCA mutation status was unknown at time of diagnosis but subsequently confirmed. Detection method was identified in 50% of patients: 84% by clinical breast exam (CBE), 4% mammography, 4% MRI and 8% by a combination of CBE and mammography. Fifteen women (28%) developed second breast cancer; 9(60%) were undergoing screening, 2 were not and 27% were unknown. 22% were detected by CBE alone; 34% mammography; 22% a combination of mammography and CBE and 22% by MRI. In 41%, histology changed between first and second diagnosis. Two women developed a third breast cancer. In one, her second was an interval cancer despite being in a screening programme. Her third was radiologically detected. Conclusions: In this cohort of Irish BRCA1/2 mutation carriers almost 25% of second breast cancers were not detected by screening. 4% of cases were phenocopies and in 41% histology changed between first and second diagnosis. [Table: see text]

Comparing Interval Breast Cancer Rates in Norway and North Carolina: Results and Challenges

2009 ◽  
Vol 16 (3) ◽  
pp. 131-139 ◽  
Author(s):  
Solveig Hofvind ◽  
Bonnie C Yankaskas ◽  
Jean-Luc Bulliard ◽  
Carrie N Klabunde ◽  
Jacques Fracheboud
Keyword(s):  
Breast Cancer ◽  
North Carolina ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Interval Cancer ◽  
Lymph Node Involvement ◽  
Interval Cancers ◽  
Interval Breast Cancer ◽  
Second Year ◽  
Cancer Rates

Objective To compare interval breast cancer rates (ICR) between a biennial organized screening programme in Norway and annual opportunistic screening in North Carolina (NC) for different conceptualizations of interval cancer. Setting Two regions with different screening practices and performance. Methods 620,145 subsequent screens (1996–2002) performed in women aged 50–69 and 1280 interval cancers were analysed. Various definitions and quantification methods for interval cancers were compared. Results ICR for one year follow-up were lower in Norway compared with NC both when the rate was based on all screens (0.54 versus 1.29 per 1000 screens), negative final assessments (0.54 versus 1.29 per 1000 screens), and negative screening assessments (0.53 versus 1.28 per 1000 screens). The rate of ductal carcinoma in situ was significantly lower in Norway than in NC for cases diagnosed in both the first and second year after screening. The distributions of histopathological tumour size and lymph node involvement in invasive cases did not differ between the two regions for interval cancers diagnosed during the first year after screening. In contrast, in the second year after screening, tumour characteristics remained stable in Norway but became prognostically more favorable in NC. Conclusion Even when applying a common set of definitions of interval cancer, the ICR was lower in Norway than in NC. Different definitions of interval cancer did not influence the ICR within Norway or NC. Organization of screening and screening performance might be major contributors to the differences in ICR between Norway and NC.

Interval Breast Cancers in the NHS Breast Screening Programme: Does the Current Definition Exclude Too Many?

1997 ◽  
Vol 4 (3) ◽  
pp. 169-173 ◽  
Author(s):  
A M Faux ◽  
D C Richardson ◽  
G M Lawrence ◽  
M E Wheaton ◽  
M G Wallisconsultant
Keyword(s):  
Breast Screening ◽  
Interval Cancer ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Exclusion Criteria ◽  
National Statistics ◽  
Screening Unit ◽  
Cancer Rates ◽  
Definition Of ◽  
The Impact

Objectives— To examine the impact of the definition of interval breast cancers on interval cancer rates arising from the prevalent (first) screening round. Design— Interval breast cancers arising from the prevalent (first) screening round at the Warwickshire, Solihull and Coventry Breast Screening Unit (17 April 1989 to 31 March 1992) were identified by comparison of data held at the unit with records at the West Midlands Cancer Intelligence Unit. Exclusion criteria used in National statistics were applied to this sample to quantify their impact on achieved interval cancer rates. The round lengths experienced by individual women at the unit were determined from the prevalent and incident invitation dates for 155 women with incident (re-screen) breast cancers detected in the second round. Setting— Warwickshire, Solihull and Coventry Breast Screening Unit. Subects—59 017 women screened between 17 April 1989 and 31 March 1992 with a negative screening result and 155 women with incident screen detected cancers. Results— A total of 278 interval cancers were identified, giving an overall rate from the prevalent screening round of 47.1/10 000 women screened. Of these, 213 met the criteria used in the definition of interval cancers for National statistics and were termed “core” interval cancers. The overall “core” interval rate was 36.1/10 000 women screened, similar to interval cancer rates found in the north west of United Kingdom. Thus applying commonly used exclusion criteria produced a 23.4% reduction in the apparent interval cancer rate, with the largest decrease resulting from the exclusion of cancers arising at 36 months or more from the last screen. Conclusions— The exclusion criteria used in the definition of interval cancers have a significant impact on observed interval cancer rates. Of particular concern is the exclusion in the current National definitions of cancers arising at 36 months or more from the last screen, which may mask a problem with significant implications for the success of the NHSBSP.

scholarly journals Lower attendance rates in immigrant versus non-immigrant women in the Norwegian Breast Cancer Screening Programme

2017 ◽  
Vol 25 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Sameer Bhargava ◽  
Kaitlyn Tsuruda ◽  
Kåre Moen ◽  
Ida Bukholm ◽  
Solveig Hofvind
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Immigrant Women ◽  
Population Based ◽  
Mammographic Screening ◽  
Attendance Rates ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme

Objective The Norwegian Breast Cancer Screening Programme invites women aged 50–69 to biennial mammographic screening. Although 84% of invited women have attended at least once, attendance rates vary across the country. We investigated attendance rates among various immigrant groups compared with non-immigrants in the programme. Methods There were 4,053,691 invitations sent to 885,979 women between 1996 and 2015. Using individual level population-based data from the Cancer Registry and Statistics Norway, we examined percent attendance and calculated incidence rate ratios, comparing immigrants with non-immigrants, using Poisson regression, following women's first invitation to the programme and for ever having attended. Results Immigrant women had lower attendance rates than the rest of the population, both following the first invitation (53.1% versus 76.1%) and for ever having attended (66.9% versus 86.4%). Differences in attendance rates between non-immigrant and immigrant women were less pronounced, but still present, when adjusted for sociodemographic factors. We also identified differences in attendance between immigrant groups. Attendance increased with duration of residency in Norway. A subgroup analysis of migrants' daughters showed that 70.0% attended following the first invitation, while 82.3% had ever attended. Conclusions Immigrant women had lower breast cancer screening attendance rates. The rationale for immigrant women's non-attendance needs to be explored through further studies targeting women from various birth countries and regions.

Sign in / Sign up

Export Citation Format

Share Document