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Mammographic and clinical characteristics of different phenotypes of screen-detected and interval breast cancers in a nationwide screening program

  • Epidemiology
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Abstract

In the context of a population-based screening program, we aimed to evaluate the major mammographic features and clinicopathological characteristics of breast tumors at diagnosis and the associations between them, focusing on tumors with the worst prognosis. We analyzed cancers diagnosed in a cohort of 645,764 women aged 45–69 years participating in seven population-based screening programs in Spain, between January 1, 2000 and December 31, 2006 and followed up until June 2009. We included all interval cancers and a sample of screen-detected cancers, whether invasive or in situ. We compared tumor-related information and breast density for different phenotypes (Triple-negative (TN), HER2+, Luminal B and Luminal A) in screen-detected and interval cancers. We used Chi-square or Fisher’s exact test to compare major mammographic features of invasive versus in situ tumors, of screen-detected versus interval cancers, and of different types of interval cancers. We included 2582 tumors (1570 screen-detected and 1012 interval cancers). There were significant differences in the distribution of most clinicopathological variables between screen-detected and interval cancers. Invasive TN interval tumors were more common than other phenotypes in breasts with low mammographic density; three-quarters of these tumors presented as masses without associated calcifications. HER2+ tumors were more common in denser breasts and were associated with calcifications and multifocality. Architectural distortion was more common in Luminal A and Luminal B tumors. Certain radiologic findings are associated with pre-invasive lesions; these differ among invasive tumor phenotypes. We corroborate that TN and HER2+ cancers have distinctive appearances also in the context of population-based screening programs. This information can be useful for establishing protocols for diagnostic strategies in screening units.

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Acknowledgments

This work was supported by Instituto de Salud Carlos III-FEDER (PI 09/01153, PI09/02385, PI09/01340).

Author information

Authors and Affiliations

  1. Clinical Epidemiology and Cancer Screening, UDIAT-DC, Corporació Sanitària Parc Taulí, Sabadell, Catalonia, Spain

    Marisa Baré & Núria Torà

  2. Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Barcelona (UAB), Bellaterra, Barcelona, Spain

    Marisa Baré, Xavier Castells & Maria Sala

  3. Research Network on Health Services in Chronic Diseases (REDISSEC), Sabadell, Spain

    Marisa Baré, Núria Torà, Xavier Castells & Maria Sala

  4. General Directorate Public Health and Centre for Public Health Research (CSISP), FISABIO, Valencia, Spain

    Dolores Salas & Josefa Ibáñez

  5. Breast Imaging, Department of Radiology, UDIAT-DC, Parc Taulí Sabadell, Sabadell, Spain

    Melchor Sentís

  6. Department of Radiology, Hospital de Santa Caterina, Salt, Girona, Spain

    Joana Ferrer

  7. Galician Breast Cancer Screening Programme, Directorate for Innovation and Management of Public Health, Santiago de Compostela, Spain

    Raquel Zubizarreta

  8. Osakidetza Breast Cancer Screening Programme, Basque Country Health Service, Bilbao, Spain

    Garbiñe Sarriugarte

  9. General Directorate of Health Care Programmes, Canary Islands Health Service, Las Palmas de Gran Canaria, Spain

    Teresa Barata

  10. Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain

    Laia Domingo, Xavier Castells & Maria Sala

Authors
  1. Marisa Baré
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  2. Núria Torà
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  3. Dolores Salas
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  4. Melchor Sentís
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  5. Joana Ferrer
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  6. Josefa Ibáñez
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  7. Raquel Zubizarreta
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  8. Garbiñe Sarriugarte
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  9. Teresa Barata
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  10. Laia Domingo
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  11. Xavier Castells
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  12. Maria Sala
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Corresponding author

Correspondence to Marisa Baré.

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The authors declare that they have no conflict of interest.

Additional information

On behalf of INCA Study Group. The members of INCA Study Group are given in Appendix.

Appendix: INCA study group

Appendix: INCA study group

The authors acknowledge the dedication and support of the entire Interval Cancer (INCA) Study Group. The members of the Interval Cancer (INCA) Study Group are (alphabetical order): IMIM (Hospital del Mar Medical Research Institute), Barcelona: Jordi Blanch, Xavier Castells, Mercè Comas, Laia Domingo, Francesc Macià, Juan Martínez, Ana Rodríguez-Arana, Marta Román, Anabel Romero, Maria Sala. General Directorate Public Health and Centre for Public Health Research (CSISP), FISABIO, Valencia: Carmen Alberich, María Casals, Josefa Ibáñez, Amparo Lluch, Inmaculada Martínez, Josefa Miranda, Javier Morales, Dolores Salas, Ana Torrella. Galician Breast Cancer Screening Programme, Xunta de Galicia: Raquel Almazán, Miguel Conde, Montserrat Corujo, Ana Belén Fernández, Joaquín Mosquera, Alicia Sarandeses, Manuel Vázquez, Raquel Zubizarreta. General Directorate of Health Care Programmes. Canary Islands Health Service: Teresa Barata, Isabel Díez de la Lastra, Juana María Reyes. Basque Country Breast Cancer Screening Programme, Osakidetza: Arantza Otegi, Garbiñe Sarriugarte. Corporació Sanitària Parc Taulí, Sabadell: Marisa Baré, Núria Torà. Hospital Santa Caterina, Girona: Joana Ferrer, Francesc Castanyer, Gemma Renart. Epidemiology Unit and Girona Cancer Registry; and University of Girona: Rafael Marcos-Gragera, Montserrat Puig-Vives. Biomedical Research Institut of Lleida (IRBLLEIDA): Carles Forné, Montserrat Martínez-Alonso, Albert Roso, Montse Rué, Ester Vilaprinyó . Universitat Rovira i Virgili, Tarragona: Misericordia Carles, Aleix Gregori, María José Pérez, Roger Pla.

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Baré, M., Torà, N., Salas, D. et al. Mammographic and clinical characteristics of different phenotypes of screen-detected and interval breast cancers in a nationwide screening program. Breast Cancer Res Treat 154, 403–415 (2015). https://doi.org/10.1007/s10549-015-3623-9

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  • DOI: https://doi.org/10.1007/s10549-015-3623-9

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