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Complementary approaches to assessing risk factors for interval breast cancer

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Abstract

Objective

To examine risk factors for interval breast cancer among women screened in a population-based mammography program.

Methods

Risk for interval cancer was assessed in terms of both the incidence per 10,000 negative screens and the proportion of all breast cancers diagnosed among screened women. Interval (N = 557) and screen-detected cancers (N = 1,545) were identified among 208,667 women receiving mammography in Colorado (1994–2001). Logistic regression was used to assess independent effects of multiple factors.

Results

Overall risk of interval cancer was 29.5/10,000 women screened. Incidence was higher in women >50 years (OR: 2.28, 1.86–2.80), with family history (OR: 2.23, 1.85–2.70), with dense breasts (OR: 3.84, 2.76–5.35), and using hormones (OR: 1.54, 1.20–1.97). Hispanics had lower incidence than Whites (OR: 0.52, 0.34–0.81). Interval cancers represented 26% of all cancers diagnosed. This proportion was higher in women <50 (OR: 1.41, 1.09–1.82) and in women with dense breasts (OR: 2.95, 1.94–4.48).

Conclusions

Incidence of interval cancer increases with age, breast density, hormone use, and family history. Attempts to reduce occurrence of these cancers through more sensitive and/or intensive screening should focus on these subgroups. The disproportionate number of interval cancers associated with young age and dense breasts suggests these cancers result from both rapid growth and difficulties in detection.

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Acknowledgments

We would like to acknowledge the Colorado Mammography Project (NCI grant # 5U01 CA63736-10) and the project staff for providing access to these data for this analysis. This work was supported in part by an Endowed Chair through the University of Colorado Comprehensive Cancer Center and a grant from the Colorado Department of Public Health and Environment.

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Authors and Affiliations

  1. Colorado School of Public Health, University of Colorado, Denver, CO, USA

    Jan T. Lowery, Tim Byers, John E. Hokanson, John Kittelson & Betsy Risendal

  2. Department of Pathology, State University of New York at Stony Brook, Stony Brook, NY, USA

    Meenakshi Singh

  3. Department of Pathology, Stony Brook University Medical Center, Stony Brook, NY, USA

    Meenakshi Singh

  4. Diversified Radiology of Colorado, Denver, CO, USA

    John Lewin

  5. Kaiser Permanente, Denver, CO, USA

    Judy Mouchawar

  6. Department of Epidemiology, Colorado School of Public Health, AMC Building 500, MS F-538, 13001 E. 17th Place, Aurora, CO, 80045-0508, USA

    Jan T. Lowery

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  1. Jan T. Lowery
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Corresponding author

Correspondence to Jan T. Lowery.

Additional information

This work was performed at The University of Colorado Denver.

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Lowery, J.T., Byers, T., Hokanson, J.E. et al. Complementary approaches to assessing risk factors for interval breast cancer. Cancer Causes Control 22, 23–31 (2011). https://doi.org/10.1007/s10552-010-9663-x

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  • DOI: https://doi.org/10.1007/s10552-010-9663-x

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