Abstract
This study estimated the sensitivity and specificity of self-reported breast cancer and their associations with patient factors and pathologic findings using data from the Breast Cancer Surveillance Consortium. We included 24,631 women with and 463,804 women without a prior diagnosis of breast cancer who completed a questionnaire (including breast cancer history) at participating US mammography facilities between 1996 and 2006. We determined “true” cancer status using cancer registries and pathology databases. Multivariable logistic regression models were used to examine associations with patient factors and pathologic findings. Sensitivity of self-reported breast cancer was higher for women with invasive cancer (96.9%) than for those with ductal carcinoma in situ (DCIS) (90.2%). Specificity was high overall (99.7%) but much lower for women with a history of lobular carcinoma in situ (LCIS) (65.0%). In multivariable models, women reporting older ages, a nonwhite race/ethnicity, or less education had lower sensitivities and specificities. Sensitivity was reduced when there was evidence of prior DCIS, especially when this diagnosis had been made more than 2 years before questionnaire completion. Women reporting a family history of breast cancer had higher sensitivity. Evidence of prior LCIS was associated with lower specificity. The accuracy of self-reported breast cancer depends on the respondent’s characteristics and prior diagnoses. Accuracy is lower among nonwhite women and women reporting less education. There appears to be uncertainty surrounding breast findings such as DCIS and LCIS. These results have important implications for research relying on self-report and for patient communication and care.
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Acknowledgments
We thank the participating BCSC mammography facilities, radiologists, and women for the data they have provided for this study. A list of the BCSC investigators and procedures for requesting BCSC data for research purposes are provided at http://breastscreening.cancer.gov/.
Financial support
This research was supported by a National Cancer Institute-funded Breast Cancer Surveillance Consortium cooperative agreement (U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040). The collection of cancer incidence data used in this study was supported in part by several state public health departments and cancer registries throughout the United States. For a full description of these sources, please see http://breastscreening.cancer.gov/work/acknowledgement.html.
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Abraham, L., Geller, B.M., Yankaskas, B.C. et al. Accuracy of self-reported breast cancer among women undergoing mammography. Breast Cancer Res Treat 118, 583–592 (2009). https://doi.org/10.1007/s10549-009-0375-4
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DOI: https://doi.org/10.1007/s10549-009-0375-4