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Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study

INTRODUCTION: The aims of this study were to determine trends in the incidence of advanced breast cancer at screening mammography and the potential of screening to reduce it. METHODS: We included a consecutive series of 351,009 screening mammograms of 85,274 women aged 50-75 years, who underwent bie...

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Autores principales: Nederend, Joost, Duijm, Lucien EM, Voogd, Adri C, Groenewoud, Johanna H, Jansen, Frits H, Louwman, Marieke WJ
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496125/
https://www.ncbi.nlm.nih.gov/pubmed/22230363
http://dx.doi.org/10.1186/bcr3091
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author Nederend, Joost
Duijm, Lucien EM
Voogd, Adri C
Groenewoud, Johanna H
Jansen, Frits H
Louwman, Marieke WJ
author_facet Nederend, Joost
Duijm, Lucien EM
Voogd, Adri C
Groenewoud, Johanna H
Jansen, Frits H
Louwman, Marieke WJ
author_sort Nederend, Joost
collection PubMed
description INTRODUCTION: The aims of this study were to determine trends in the incidence of advanced breast cancer at screening mammography and the potential of screening to reduce it. METHODS: We included a consecutive series of 351,009 screening mammograms of 85,274 women aged 50-75 years, who underwent biennial screening at a Dutch breast screening region in the period 1997-2008. Two screening radiologists reviewed the screening mammograms of all advanced screen detected and advanced interval cancers and determined whether the advanced cancer (tumor > 20 mm and/or lymph node positive tumor) had been visible at a previous screen. Interval cancers were breast cancers diagnosed in women after a negative screening examination (defined as no recommendation for referral) and before any subsequent screen. Patient and tumor characteristics were compared between women with advanced cancer and women with non-advanced cancer, including ductal carcinoma in situ. RESULTS: A total of 1,771 screen detected cancers and 669 interval cancers were diagnosed in 2,440 women. Rates of advanced cancer remained stable over the 12-year period; the incidence of advanced screen-detected cancers fluctuated between 1.5 - 1.9 per 1,000 screened women (mean 1.6 per 1,000) and of advanced interval cancers between 0.8 - 1.6 per 1,000 screened women (mean 1.2 per 1,000). Of the 570 advanced screen-detected cancers, 106 (18.6%) were detected at initial screening; 265 (46.5%) cancers detected at subsequent screening had been radiologically occult at the previous screening mammogram, 88 (15.4%) had shown a minimal sign, and 111 (19.5%) had been missed. Corresponding figures for advanced interval cancers were 50.9% (216/424), 24.3% (103/424) and 25.1% (105/424), respectively. At multivariate analysis, women with a ≥ 30 months interval between the latest two screens had an increased risk of screen-detected advanced breast cancer (OR 1.63, 95%CI: 1.07-2.48) and hormone replacement therapy increased the risk of advanced disease among interval cancers (OR 3.04, 95%CI: 1.22-7.53). CONCLUSION: We observed no decline in the risk of advanced breast cancer during 12 years of biennial screening mammography. The majority of these cancers could not have been prevented through earlier detection at screening.
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spelling pubmed-34961252012-11-14 Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study Nederend, Joost Duijm, Lucien EM Voogd, Adri C Groenewoud, Johanna H Jansen, Frits H Louwman, Marieke WJ Breast Cancer Res Research Article INTRODUCTION: The aims of this study were to determine trends in the incidence of advanced breast cancer at screening mammography and the potential of screening to reduce it. METHODS: We included a consecutive series of 351,009 screening mammograms of 85,274 women aged 50-75 years, who underwent biennial screening at a Dutch breast screening region in the period 1997-2008. Two screening radiologists reviewed the screening mammograms of all advanced screen detected and advanced interval cancers and determined whether the advanced cancer (tumor > 20 mm and/or lymph node positive tumor) had been visible at a previous screen. Interval cancers were breast cancers diagnosed in women after a negative screening examination (defined as no recommendation for referral) and before any subsequent screen. Patient and tumor characteristics were compared between women with advanced cancer and women with non-advanced cancer, including ductal carcinoma in situ. RESULTS: A total of 1,771 screen detected cancers and 669 interval cancers were diagnosed in 2,440 women. Rates of advanced cancer remained stable over the 12-year period; the incidence of advanced screen-detected cancers fluctuated between 1.5 - 1.9 per 1,000 screened women (mean 1.6 per 1,000) and of advanced interval cancers between 0.8 - 1.6 per 1,000 screened women (mean 1.2 per 1,000). Of the 570 advanced screen-detected cancers, 106 (18.6%) were detected at initial screening; 265 (46.5%) cancers detected at subsequent screening had been radiologically occult at the previous screening mammogram, 88 (15.4%) had shown a minimal sign, and 111 (19.5%) had been missed. Corresponding figures for advanced interval cancers were 50.9% (216/424), 24.3% (103/424) and 25.1% (105/424), respectively. At multivariate analysis, women with a ≥ 30 months interval between the latest two screens had an increased risk of screen-detected advanced breast cancer (OR 1.63, 95%CI: 1.07-2.48) and hormone replacement therapy increased the risk of advanced disease among interval cancers (OR 3.04, 95%CI: 1.22-7.53). CONCLUSION: We observed no decline in the risk of advanced breast cancer during 12 years of biennial screening mammography. The majority of these cancers could not have been prevented through earlier detection at screening. BioMed Central 2012 2012-01-09 /pmc/articles/PMC3496125/ /pubmed/22230363 http://dx.doi.org/10.1186/bcr3091 Text en Copyright ©2012 Nederend et al. ; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Nederend, Joost
Duijm, Lucien EM
Voogd, Adri C
Groenewoud, Johanna H
Jansen, Frits H
Louwman, Marieke WJ
Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study
title Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study
title_full Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study
title_fullStr Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study
title_full_unstemmed Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study
title_short Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study
title_sort trends in incidence and detection of advanced breast cancer at biennial screening mammography in the netherlands: a population based study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496125/
https://www.ncbi.nlm.nih.gov/pubmed/22230363
http://dx.doi.org/10.1186/bcr3091
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