Rationale and Objectives
To explore radiological aspects of interval breast cancer in a population-based screening
program.
Materials and Methods
We performed a consensus-based informed review of mammograms from diagnosis and prior
screening from women diagnosed with interval cancer 2004-2016 in BreastScreen Norway.
Cases were classified as true (no findings on prior screening mammograms), occult
(no findings at screening or diagnosis), minimal signs (minor/non-specific findings)
and missed (obvious findings). We analyzed mammographic findings, density, time since
prior screening, and histopathological characteristics between the classification
groups.
Results
The study included 1010 interval cancer cases. Mean age at diagnosis was 61 years
(SD = 6), mean time between screening and diagnosis 14 months (SD = 7). A total of
48% (479/1010) were classified as true or occult, 28% (285/1010) as minimal signs
and 24% (246/1010) as missed. We observed no differences in mammographic density between
the groups, except from a higher percentage of dense breasts in women with occult
cancer. Among cancers classified as missed, about 1/3 were masses and 1/3 asymmetries
at prior screening. True interval cancers were diagnosed later in the screening interval
than the other classification categories. No differences in histopathological characteristics
were observed between true, minimal signs and missed cases.
Conclusion
In an informed review, 24% of the interval cancers were classified as missed based
on visibility and mammographic findings on prior screening mammograms. Three out of
four true interval cancers were diagnosed in the second year of the screening interval.
We observed no statistical differences in histopathological characteristics between
true and missed interval cancers.
Key Words
Abbreviations:
BI-RADS (Breast Imaging Reporting and Data System), CI (Confidence interval), DBT (Digital breast tomosynthesis), DM (Standard Digital mammography), IQR (Interquartile range), NST (Invasive carcinoma no special type), PACS (Picture archiving and communication system), SD (Standard deviation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 26, 2021
Accepted:
March 23,
2021
Received in revised form:
March 22,
2021
Received:
November 10,
2020
Identification
Copyright
© 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
