Rationale and Objective
Mammographic screening detects most breast cancers but there are still women diagnosed
with breast cancer between annual mammograms. We aim to identify features that differentiate
screen detected breast cancers from interval breast cancer.
Materials and Methods
All screening mammograms (n = 211,517) performed 7/1/2013-6/30/2020 at our institution were reviewed. Patients
with breast cancer diagnosed within one year of screening were included and divided
into two distinct groups: screen detected cancer group and interval cancer group.
Characteristics in these groups were compared using the chi square test, fisher test,
and student's T test.
Results
A total of 1,232 patients were included (mean age 64 +/- 11). Sensitivity of screening
mammography was 92% (1,136 screen detected cancers, 96 interval cancers).
Patient age, race, and personal history of breast cancer were similar between the
groups (p > 0.05). Patients with interval cancers more often had dense breast tissue (75/96 = 78%
versus 694/1136 = 61%, p < 0.001).
Compared to screen detected cancers, interval cancers were more often primary tumor
stage two or higher (41/96 = 43% versus 139/1136 = 12%, p < 0.001) and regional lymph node stage one or higher (21/96 = 22% versus 132/1136 = 12%,
p = 0.003). Interval cancers were more often triple negative (16/77 = 21% versus [48/813 = 6%],
p < 0.001) with high Ki67 proliferation indices (28/45 = 62% versus 188/492 = 38%,
p = 0.002).
Conclusion
Mammographic screening had high sensitivity for breast cancer detection (92%). Interval
cancers were associated with dense breast tissue and had higher stage with less favorable
molecular features compared to screen detected cancers.
Key Words
Abbreviations:
DBT (Digital breast tomosynthesis), FFDM (Full field digital mammography), BI-RADS (Breast Imaging Reporting and Data Systems), ER (Estrogen receptor), PR (Progesterone receptor), HER-2 (Human epidermal growth factor receptor)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 03, 2023
Accepted:
January 5,
2023
Received in revised form:
December 28,
2022
Received:
December 2,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
