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.

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.

scholarly journals The Biological and Clinical Significance of Glutaminase in Luminal Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3963
Author(s):  
Brendah K. Masisi ◽  
Rokaya El Ansari ◽  
Lutfi Alfarsi ◽  
Madeleine L. Craze ◽  
Natasha Jewa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Outcome ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Glutamine Metabolism ◽  
Gene Copy ◽  
Luminal Breast Cancer ◽  
Potential Biomarker

The glutamine metabolism has a key role in the regulation of uncontrolled tumour growth. This study aimed to evaluate the expression and prognostic significance of glutaminase in luminal breast cancer (BC). The glutaminase isoforms (GLS/GLS2) were assessed at genomic/transcriptomic levels, using METABRIC (n = 1398) and GeneMiner datasets (n = 4712), and protein using immunohistochemistry in well-characterised cohorts of Oestrogen receptor-positive/HER2-negative BC patients: ductal carcinoma in situ (DCIS; n = 206) and invasive breast cancer (IBC; n = 717). Glutaminase expression was associated with clinicopathological features, patient outcome and glutamine-metabolism-related genes. In DCIS, GLS alone and GLS+/GLS2- expression were risk factors for shorter local recurrence-free interval (p < 0.0001 and p = 0.001, respectively) and remained prognostic factors independent of tumour size, grade and comedo necrosis (p = 0.0008 and p = 0.003, respectively). In IBC, GLS gene copy number gain with high mRNA expression was associated with poor patient outcome (p = 0.011), whereas high GLS2 protein was predictive of a longer disease-free survival (p = 0.006). Glutaminase plays a role in the biological function of luminal BC, particularly GLS in the early non-invasive stage, which could be used as a potential biomarker to predict disease progression and a target for inhibition. Further validation is required to confirm these observations, and functional assessments are needed to explore their specific roles.

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.

Uncommon Breast Malignancies: Presentation Pattern, Prognostic Issue and Treatment Outcome in an Italian Single Institution Experience

2013 ◽  
Vol 99 (1) ◽  
pp. 39-44
Author(s):  
Claudia Maria Regina Bareggi ◽  
Dario Consonni ◽  
Barbara Galassi ◽  
Donatella Gambini ◽  
Elisa Locatelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Outcome ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Medullary Carcinoma ◽  
Mucinous Carcinoma ◽  
Lymph Node Involvement ◽  
Tubular Carcinoma ◽  
Breast Malignancies

Aims and background Often neglected by large clinical trials, patients with uncommon breast malignancies have been rarely analyzed in large series. Patients and methods Of 2,052 patients diagnosed with breast cancer and followed in our Institution from January 1985 to December 2009, we retrospectively collected data on those with uncommon histotypes, with the aim of investigating their presentation characteristics and treatment outcome. Results Rare histotypes were identified in 146 patients (7.1% of our total breast cancer population), being classified as follows: tubular carcinoma in 75 (51.4%), mucinous carcinoma in 36 (24.7%), medullary carcinoma in 25 (17.1%) and papillary carcinoma in 10 patients (6.8%). Whereas age at diagnosis was not significantly different among the diverse diagnostic groups, patients with medullary and papillary subtypes had a higher rate of lymph node involvement, similar to that of invasive ductal carcinoma. Early stage diagnosis was frequent, except for medullary carcinoma. Overall, in comparison with our invasive ductal carcinoma patients, those with rare histotypes showed a significantly lower risk of recurrence, with a hazard ratio of 0.28 (95% CI, 0.12–0.62; P = 0.002). Conclusions According to our analysis, patients with uncommon breast malignancies are often diagnosed at an early stage, resulting in a good prognosis with standard treatment.

scholarly journals Tumour Size at Detection According to Different Measures of Mammographic Breast Density

2009 ◽  
Vol 16 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Carolyn Nickson ◽  
Anne M Kavanagh
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Tumour Size ◽  
Mammographic Screening ◽  
Cancer Prognosis ◽  
Mammographic Breast Density ◽  
Interval Cancers ◽  
Dense Area ◽  
Screening Strategies ◽  
Continuous Measures

Objectives Breast cancer prognosis is better for smaller tumours. Women with high breast density are at higher risk of breast cancer and have larger screen-detected and interval cancers in mammographic screening programmes. We assess which continuous measures of breast density are the strongest predictors of breast tumour size at detection and therefore the best measures to identify women who might benefit from more intensive mammographic screening or alternative screening strategies. Setting and methods We compared the association between breast density and tumour size for 1007 screen-detected and 341 interval cancers diagnosed in an Australian mammographic screening programme between 1994 and 1996, for three semi-automated continuous measures of breast density: per cent density, dense area and dense area adjusted for non-dense area. Results After adjustment for age, hormone therapy use, family history of breast cancer and mode of detection (screen-detected or interval cancers), all measures of breast density shared a similar positive and significant association with tumour size. For example, tumours increased in size with dense area from an estimated mean 2.2 mm larger in the second quintile (β = 2.2; 95% Cl 0.4–3.9, P < 0.001) to mean 6.6 mm larger in the highest decile of dense area (β = 6.6; 95% Cl 4.4–8.9, P < 0.001), when compared with first quintile of breast density. Conclusions Of the breast density measures assessed, either dense area or per cent density are suitable measures for identifying women who might benefit from more intensive mammographic screening or alternative screening strategies.

scholarly journals The prognostic significance of wild-type isocitrate dehydrogenase 2 (IDH2) in breast cancer

2019 ◽  
Vol 179 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Abrar I. Aljohani ◽  
Michael S. Toss ◽  
Sasagu Kurozumi ◽  
Chitra Joseph ◽  
Mohammed A. Aleskandarany ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Protein Expression ◽  
Isocitrate Dehydrogenase ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Prognostic Significance ◽  
Wild Type ◽  
Hormonal Receptor ◽  
Isocitrate Dehydrogenase 2 ◽  
Receptor Negativity

Abstract Background Lymphovascular invasion (LVI) is a prerequisite step in breast cancer (BC) metastasis. We have previously identified wild-type isocitrate dehydrogenase 2 (IDH2) as a key putative driver of LVI. Thus, we explored the prognostic significance of IDH2 at transcriptome and protein expression levels in pre-invasive and invasive disease. Methods Utlising tissue microarrays from a large well annotated BC cohort including ductal carcinoma in situ and invasive breast cancer (IBC), IDH2 was assessed at the transcriptomic and proteomic level. The associations between clinicopathological factors including LVI status, prognosis and the expression of IDH2 were evaluated. Results In pure DCIS and IBC, high IDH2 protein expression was associated with features of aggressiveness including high nuclear grade, larger size, comedo necrosis and hormonal receptor negativity and LVI, higher grade, larger tumour size, high NPI, HER2 positivity, and hormonal receptor negativity, respectively. High expression of IDH2 either in mRNA or in protein levels was associated with poor patient’s outcome in both DCIS and IBC. Multivariate analysis revealed that IDH2 protein expression was an independent risk factor for shorter BC specific-survival. Conclusion Further functional studies to decipher the role of IDH2 and its mechanism of action as a driver of BC progression and LVI are warranted.

Young patients with breast cancer (< 35 years): Single-institution study of 194 patients from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11013-e11013
Author(s):  
B. K Mohanti ◽  
Vinod Raina ◽  
Ajay Gogia ◽  
S. V. S Deo ◽  
N. K Shukla
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Positive Family History ◽  
Young Patients ◽  
Radical Mastectomy ◽  
Histopathological Analysis ◽  
Duration Of Symptoms ◽  
Young Breast Cancer

e11013 Background: Breast cancer in young women ( < 35 years) is uncommon and accounts for 1-2 % of all breast cancer in the West .There is paucity of data on young breast cancer from India. The aim of our study was to assess clinical and pathological parameters and outcome in young breast cancer patients. Methods: Annually we register approximately 350 new cases of breast cancer of whom young patients constitute a small fraction. This analysis was carried out in 194 patients with aged 35 years or less, who were registered in our clinic between 2000-2009, this constituted about 5.5 % of all new cases. Patients records were analysed from computer database using ICD code (C-50) Results: The median age was 31 years (range 21-35). The median duration of symptoms was 11.8 months (range 0.5-40). Breast lump was the commonest (93%) presenting symptom (left >right side). Ninety percent of patients were married and median age at first child birth was 23 years. Positive family history was elicited in 8 patients, and 3 patients presented with synchronous malignancy. The TNM (7th edition) stage distribution was stage I was 3 %, stage II- 20%, stage III- 55%, and stage IV- 22%. The median clinical tumour size was 5.9 cm. Modified Radical mastectomy was the commonest surgical procedure and this was done in 81 % of cases. The histopathological analysis showed 94% had infiltrating ductal carcinoma. Sixty percent of tumours were high grade and 56% had pathological node positive disease. ER/PR status and Her2 Neu status was available in 65% and 50% respectively. Out of these patients ER and her2neu positivity was 40% and 37% respectively. Triple negative breast cancer (TNBC) constituted 31%. A combination of anthracyclines and taxanes were used in the vast majority of patients and herceptin was used only in 5 %. With a median follow up of 30 months, three years event free (EFS) and overall survival (OS) was 50% and 60%. Higher Nodal stage, tumour size (>5 c.m ), negative ER/PR status and visceral metastasis at baseline predicted poor outcome. Conclusions: Young women constituted 5.5% cases with higher proportion of triple negativity, this is higher than the western population reflecting younger age of our population of breast cancer in general with a resultant poorer outcome.

A Study of the Clinical Features and the Treatment of Breast Cancer in 374 Patients in Iran

2003 ◽  
Vol 89 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Morteza Salsali ◽  
Dehghan Tazejani ◽  
Amir Javadi ◽  
Babak Mahmud ◽  
Hamid-Reza Sali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Features ◽  
Hospital Admissions ◽  
Ductal Carcinoma ◽  
Radical Mastectomy ◽  
Entire Series ◽  
The Mean ◽  
Second Year ◽  
Metastatic Involvement ◽  
Exact Size

For evaluation of clinical features and state of the art in the treatment of breast cancer in Iran, we studied 347 consecutive patients among 1123 hospital admissions (in 14 hospitals in three cities) who had undergone surgery for a mass in their breasts during a 2-year period, 1991 to 1992. Thirty-nine additional patients with breast cancer had been treated in the second year of the study, an increment of 8.9%. The relative frequency of positive biopsies for breast cancer was 31% for the entire series. In Teheran, Babol and Yazd, it was 35%, 24.2% and 18.1%, respectively. The mean age for the entire series was 48 ± 1 years. The mean age for patients from Yazd was 51 ± 9, which was higher than the mean age (41.5 ± 16) of patients from Babol. The pathologic diameter was >2.1 cm (pT2 and pT3) in 59.36% of the tumors. In 15.56% of the patients, the exact size of the tumor was not available. In 83.45% of the patients, the tumors were reported as infiltrating ductal carcinoma. Of 173 patients in whom regional nodes had been histologically examined, 80% had metastatic involvement (stage II disease). Modified radical mastectomy had been used more than radical mastectomy in this series, but the choice of the operation was not related to the size of tumor.

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