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Breast Cancer Research and Treatment

, Volume 132, Issue 3, pp 871–879 | Cite as

Locally advanced breast cancers are more likely to present as Interval Cancers: results from the I-SPY 1 TRIAL (CALGB 150007/150012, ACRIN 6657, InterSPORE Trial)

  • Cheryl Lin
  • Meredith Becker Buxton
  • Dan Moore
  • Helen Krontiras
  • Lisa Carey
  • Angela DeMichele
  • Leslie Montgomery
  • Debasish Tripathy
  • Constance Lehman
  • Minetta Liu
  • Olufunmilayo Olapade
  • Christina Yau
  • Donald Berry
  • Laura J. Esserman
  • I-SPY TRIAL Investigators
Epidemiology

Abstract

Interval cancers (ICs), defined as cancers detected between regular screening mammograms, have been shown to be of higher grade, larger size, and associated with lower survival, compared with screen-detected cancers (SDCs) and comprise 17% of cancers from population-based screening programs. We sought to determine the frequency of ICs in a study of locally advanced breast cancers, the I-SPY 1 TRIAL. Screening was defined as having a mammogram with 2 years, and the proportion of ICs at 1 and 2 years was calculated for screened patients. Differences in clinical characteristics for ICs versus SDCs and screened versus non-screened cancers were assessed. For the 219 evaluable women, mean tumor size was 6.8 cm. Overall, 80% of women were over 40 and eligible for screening; however, only 31% were getting screened. Among women screened, 85% were ICs, with 68% diagnosed within 1 year of a previously normal mammogram. ICs were of higher grade (49% vs. 10%) than SDCs. Among non-screened women, 28% (43/152) were younger than the recommended screening age of 40. Of the entire cohort, 12% of cancers were mammographically occult (MO); the frequency of MO cancers did not differ between screened (11%) and non-screened (15%). ICs were common in the I-SPY 1 TRIAL suggesting the potential need for new approaches beyond traditional screening to reduce mortality in women who present with larger palpable cancers.

Keywords

Screening Neoadjuvant Interval cancer 

Notes

Acknowledgments

National Cancer Institute Specialized Program of Research Excellence in Breast Cancer, American College of Radiology Imaging Network, Cancer and Leukemia Group B, National Cancer Institute Center for Bioinformatics, The Breast Cancer Research Foundation, and Bruce and Martha Atwater are acknowledged. Grant numbers: NCI SPORE: CA58207, ACRIN: U01 CA079778 & CA080098, CALGB: CA31964 & CA33601.

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Cheryl Lin
    • 1
  • Meredith Becker Buxton
    • 1
  • Dan Moore
    • 2
  • Helen Krontiras
    • 3
  • Lisa Carey
    • 4
  • Angela DeMichele
    • 5
  • Leslie Montgomery
    • 6
  • Debasish Tripathy
    • 7
  • Constance Lehman
    • 8
  • Minetta Liu
    • 9
  • Olufunmilayo Olapade
    • 10
  • Christina Yau
    • 1
  • Donald Berry
    • 11
  • Laura J. Esserman
    • 1
  • I-SPY TRIAL Investigators
  1. 1.Carol Franc Buck Breast Cancer CenterUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Helen Diller Comprehensive Cancer CenterUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.UAB Medical Center, The Kirklin ClinicUniversity of Alabama, BirminghamBirminghamUSA
  4. 4.University of North Carolina, Chapel HillChapel HillUSA
  5. 5.Center for Clinical Epidemiology and BiostatisticsUniversity of PennsylvaniaPhiladelphiaUSA
  6. 6.Montefiore Medical GroupAlbert Einstein College of MedicineBronxUSA
  7. 7.Norris Comprehensive Cancer Center and HospitalUniversity of Southern CaliforniaLos AngelesUSA
  8. 8.Seattle Cancer Care AllianceUniversity of WashingtonSeattleUSA
  9. 9.Georgetown University HospitalWashingtonUSA
  10. 10.Department of Medicine and Human GeneticsUniversity of ChicagoChicagoUSA
  11. 11.MD Anderson Cancer CenterUniversity of TexasHoustonUSA

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