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Breast cancer outcomes based on method of detection in community-based breast cancer registry

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Abstract

Purpose

The impact of opportunistic screening mammography in the United States is difficult to quantify, partially due to lack of inclusion regarding method of detection (MOD) in national registries. This study sought to determine the feasibility of MOD collection in a multicenter community registry and to compare outcomes and characteristics of breast cancer based on MOD.

Methods

We conducted a retrospective study of breast cancer patients from a multicenter tumor registry in Missouri from January 2004 - December 2018. Registry data were extracted by certified tumor registrars and included MOD, clinicopathologic information, and treatment. MOD was assigned as screen-detected or clinically detected. Data were analyzed at the patient level. Chi-squared tests were used for categorical variable comparison and Mann-Whitney-U test was used for numerical variable comparison.

Results

5351 women (median age, 63 years; interquartile range, 53–73 years) were included. Screen-detected cancers were smaller than clinically detected cancers (median size 12 mm vs. 25 mm; P < .001) and more likely node-negative (81% vs. 54%; P < .001), lower grade (P < .001), and lower stage (P < .001). Screen-detected cancers were more likely treated with lumpectomy vs. mastectomy (73% vs. 41%; P < .001) and less likely to require chemotherapy (24% vs. 52%; P < .001). Overall survival for patients with invasive breast cancer was higher for screen-detected cancers (89% vs. 74%, P < .0001).

Conclusion

MOD can be routinely collected and linked to breast cancer outcomes through tumor registries, with demonstration of significant differences in outcome and characteristics of breast cancers based on MOD. Routine inclusion of MOD in US tumor registries would help quantify the impact of opportunistic screening mammography in the US.

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Data Availability

The datasets analysed during the current study are not publicly available due to their linkage to personal health information but are available from the corresponding author on reasonable request.

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Funding

This work is supported by a grant from the Saint Louis University Research Institute and resources from the AHEAD Institute.

Author information

Authors and Affiliations

  1. Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

    Debbie Lee Bennett & Christina Michelle Doherty

  2. Radiax, Seattle, WA, USA

    Andrea Marie Winter

  3. SSM Health, St. Louis, MO, USA

    Laura Billadello, Mary Catherine Lowdermilk & Sydney Laster

  4. Department of Radiology, University of Michigan, Ann Arbor, MI, USA

    Sakina Kazmi

  5. Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA

    Noor Al-Hammadi & Anna Hardy

  6. Department of Radiology, Saint Louis University School of Medicine, St. Louis, USA

    Anna Hardy

  7. Department of Radiology, Harvard Medical School, Boston, MA, USA

    Daniel B. Kopans

  8. Department of Radiology, NYU Langone Health, NYU School of Medicine, New York, NY, USA

    Linda Moy

Authors
  1. Debbie Lee Bennett
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Debbie Bennett, Andrea Winter, Laura Billadello, Mary Catherine Lowdermilk, Christina Marie Doherty, Sakina Kazmi, and Sydney Laster. Statistical analysis was performed by Noor Al-Hammadi. The first draft of the manuscript was written by Debbie Bennett and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Debbie Lee Bennett.

Ethics declarations

Competing interests

Linda Moy MD, reported grant support (Siemens Research Grant, Gordon and Betty Moore Foundation, Mary Kay Foundation and Google), personal fees (Lunit Insight, Inc., Advisory Board, ICAD, Guerbet Inc), meeting and travel expenses (British Society of Breast Radiology, European Society of Breast Imaging), board membership (International Society for Magnetic Resonance in Medicine and Society of Breast Imaging, and salary support (Radiological Society of North America). The remainder of the authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This is an observational study. The Saint Louis University Institutional Review Board has confirmed that no ethical approval is required.

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Bennett, D.L., Winter, A.M., Billadello, L. et al. Breast cancer outcomes based on method of detection in community-based breast cancer registry. Breast Cancer Res Treat 203, 215–224 (2024). https://doi.org/10.1007/s10549-023-07092-x

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  • DOI: https://doi.org/10.1007/s10549-023-07092-x

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