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Type and Extent of Surgery for Screen-Detected and Interval Cancers at Blinded Versus Nonblinded Double-Reading in a Population-Based Screening Mammography Program

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to compare the type and extent of surgery in patients with screen-detected and interval cancers after blinded or nonblinded double-reading of screening mammograms.

Methods

The study investigated a consecutive series of screens double-read in either a blinded (n = 44,491) or nonblinded (n = 42,996) fashion between 2009 and 2011. During a 2 year follow-up period, the radiology reports, surgical correspondence, and pathology reports of all the screen-detected and interval cancers were collected.

Results

Screen-detected breast cancer was diagnosed for 325 women at blinded and 284 women at nonblinded double-reading. The majority of the women were treated by breast-conserving surgery (BCS) at both reading strategies (78.2 vs. 81.7 %; p = 0.51). Larger total resection volumes were observed at BCS for ductal carcinoma in situ (DCIS) treatment for patients after blinded double-reading (p = 0.005). The proportions of positive resection margins after BCS were comparable for patients with DCIS (p = 0.81) or invasive screen-detected cancers (p = 0.38) for the two reading strategies. A total of 158 interval cancers were diagnosed. The proportions of patients treated with BCS were comparable for the two reading strategies (p = 0.42). The total resection volume (p = 0.13) and the proportion of positive resection margins after BCS (p = 0.32) for invasive interval cancer were comparable for the two cohorts. The BCS rate was higher for women after nonblinded double-reading (p = 0.04).

Conclusions

Blinded and nonblinded double-reading yielded comparable surgical treatments for women with screen-detected or interval breast cancer except for larger total resection volumes at BCS for screen-detected DCIS and a higher BCS rate for interval cancers at nonblinded double-reading.

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Author information

Authors and Affiliations

  1. Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands

    Roy J. P. Weber MD, Rob M. G. van Bommel MD, Wikke Setz-Pels MD, PhD & Elisabeth G. Klompenhouwer MD

  2. Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Eindhoven, The Netherlands

    Adri C. Voogd PhD & Marieke W. Louwman PhD

  3. Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

    Adri C. Voogd PhD

  4. Department of Surgery, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands

    Luc J. A. Strobbe MD, PhD

  5. Department of Internal Medicine, Division of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands

    Vivianne C. G. Tjan-Heijnen MD, PhD

  6. Department of Radiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands

    Lucien E. M. Duijm MD, PhD

  7. Dutch Reference Centre for Screening, Nijmegen, The Netherlands

    Lucien E. M. Duijm MD, PhD

Authors
  1. Roy J. P. Weber MD
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  2. Rob M. G. van Bommel MD
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Correspondence to Roy J. P. Weber MD.

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Weber, R.J.P., van Bommel, R.M.G., Setz-Pels, W. et al. Type and Extent of Surgery for Screen-Detected and Interval Cancers at Blinded Versus Nonblinded Double-Reading in a Population-Based Screening Mammography Program. Ann Surg Oncol 23, 3822–3830 (2016). https://doi.org/10.1245/s10434-016-5295-z

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  • DOI: https://doi.org/10.1245/s10434-016-5295-z

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