A case-case analysis of women with breast cancer: predictors of interval vs screen-detected cancer - PubMed (original) (raw)

A case-case analysis of women with breast cancer: predictors of interval vs screen-detected cancer

Nickolas Dreher et al. Breast Cancer Res Treat. 2022 Feb.

Abstract

Purpose: The Breast Cancer Surveillance Consortium (BCSC) model is a widely used risk model that predicts 5- and 10-year risk of developing invasive breast cancer for healthy women aged 35-74 years. Women with high BCSC risk may also be at elevated risk to develop interval cancers, which present symptomatically in the year following a normal screening mammogram. We examined the association between high BCSC risk (defined as the top 2.5% by age) and breast cancers presenting as interval cancers.

Methods: We conducted a case-case analysis among women with breast cancer in which we compared the mode of detection and tumor characteristics of patients in the top 2.5% BCSC risk by age with age-matched (1:2) patients in the lower 97.5% risk. We constructed logistic regression models to estimate the odds ratio (OR) of presenting with interval cancers, and poor prognosis tumor features, between women from the top 2.5% and bottom 97.5% of BCSC risk.

Results: Our analysis included 113 breast cancer patients in the top 2.5% of risk for their age and 226 breast cancer patients in the lower 97.5% of risk. High-risk patients were more likely to have presented with an interval cancer within one year of a normal screening, OR 6.62 (95% CI 3.28-13.4, p < 0.001). These interval cancers were also more likely to be larger, node positive, and higher stage than the screen-detected cancers.

Conclusion: Breast cancer patients in the top 2.5% of BCSC risk for their age were more likely to present with interval cancers. The BCSC model could be used to identify healthy women who may benefit from intensified screening.

Keywords: Breast cancer; Breast density; Interval cancer; Screening; Supplemental screening.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Conflict of interest statement

Conflicts of Interest: The authors declare no potential conflicts of interest.

Figures

Figure 1:

Figure 1:

Selection of the study group from women seen at the UCSF Breast Care Center from 2013–2017. Top 2.5% threshold determined from distributions of BCSC 5-year risk estimates.

References

    1. Kirsh VA, Chiarelli AM, Edwards SA, O’Malley FP, Shumak RS, Yaffe MJ, Boyd NF (2011) Tumor characteristics associated with mammographic detection of breast cancer in the Ontario breast screening program. J Natl Cancer Inst 103:942–950. 10.1093/jnci/djr138 -DOI -PubMed
    1. Holm J, Humphreys K, Li J, Ploner A, Cheddad A, Eriksson M, Törnberg S, Hall P, Czene K (2015) Risk Factors and Tumor Characteristics of Interval Cancers by Mammographic Density. J Clin Oncol. 10.1200/JCO.2014.58.9986 -DOI -PubMed
    1. Henderson LM, Miglioretti DL, Kerlikowske K, Wernli KJ, Sprague BL, Lehman CD (2015) Breast Cancer Characteristics Associated with Digital Versus Film-Screen Mammography for Screen-Detected and Interval Cancers. AJR Am J Roentgenol 205:676–684. 10.2214/AJR.14.13904 -DOI -PMC -PubMed
    1. PAM50 and risk of recurrence scores for interval breast cancers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984721/. Accessed 18 Sep 2019 -PMC -PubMed
    1. Tice JA, Miglioretti DL, Li C-S, Vachon CM, Gard CC, Kerlikowske K (2015) Breast Density and Benign Breast Disease: Risk Assessment to Identify Women at High Risk of Breast Cancer. J Clin Oncol 33:3137–3143. 10.1200/JCO.2015.60.8869 -DOI -PMC -PubMed

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