Influence of Mammographic Parenchymal Pattern in Screening-Detected and Interval Invasive Breast Cancers on Pathologic Features, Mammographic Features, and Patient Survival

Porter, G; Evans, Andrew; Cornford, Eleanor; Burrell, H.C.; James, Jonathan; Lee, Andrew H.S.; Chakrabarti, Jayeta

doi:10.2214/ajr.05.1950

Cited by 103 publications

(79 citation statements)

References 30 publications

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“…Similar results were found among screening-detected, invasive, and small tumors. Our results are in line with Porter et al who reported a higher proportion of spiculated masses among women with fat involuted breasts, as well as a higher proportion of architectural distortions among women with dense breasts (18).…”

Section: Discussionsupporting

confidence: 93%

Do mammographic tumor features in breast cancer relate to breast density and invasiveness, tumor size, and axillary lymph node involvement?

et al. 2015

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Background Breast density and mammographic tumor features of breast cancer may carry prognostic information. The potential benefit of using the combined information obtained from breast density, mammographic tumor features, and pathological tumor characteristics has not been extensively studied. Purpose To investigate how mammographic tumor features relate to breast density and pathological tumor characteristics. Material and Methods This retrospective study was carried out within the Malmö Diet and Cancer Study: a population-based cohort study recruiting 17,035 women during 1991–1996. A total of 826 incident breast cancers were identified during follow-up. Mammography images were collected and analyzed according to breast density and tumor features at diagnosis. Pathological data were retrieved from medical reports. Mammographic tumor features in relation to invasiveness, tumor size, and axillary lymph node involvement were analyzed using logistic regression yielding odds ratios (OR) with 95% confidence intervals (CI) and adjusted for age at diagnosis, mode of detection, and breast density. Results Tumors presenting as an ill-defined mass or calcifications were more common in dense breasts than tumors presenting as a distinct mass or with spiculated appearance. Invasive cancer was more common in tumors with spiculated appearance than tumors presenting as a distinct mass (adjusted OR, 5.68 [1.81–17.84]). Among invasive tumors, an ill-defined mass was more often large (>20 mm) compared with a distinct mass, (adjusted OR, 3.16 [1.80–5.55]). Conclusion Tumors presenting as an ill-defined mass or calcifications were more common in dense breasts. Spiculated appearance was related to invasiveness, and ill-defined mass to larger tumor size, regardless of mode of detection and breast density. The potential role of mammographic tumor features in clinical decision-making warrants further investigation.

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Section: Discussionsupporting

confidence: 93%

Do mammographic tumor features in breast cancer relate to breast density and invasiveness, tumor size, and axillary lymph node involvement?

et al. 2015

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“…Including only deaths from BC gave a case fatality rate ratio of 0.53 ). An earlier study indicated a slightly worse BC-specific survival for BI-RADS category 2 cancers than for category 1, 3, and 4 cancers (Porter et al, 2007).…”

Section: Discussionmentioning

confidence: 89%

Breast density and outcome of mammography screening: a cohort study

et al. 2009

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The purpose of this study was to investigate the effect of breast density on breast cancer (BC) mortality in a mammography screening programme. The cohort included 48 052 women participating in mammography screening in Copenhagen, Denmark, where biennial screening is offered to women aged 50 -69 years. We collected information for the years 1991 -2001 on screening outcome, incident BCs (screen-, interval-, and later detected), and BC deaths. Breast density was dichotomised into fatty (F) and mixed/dense (M/D) breasts. Screening sensitivity was measured as the odds ratio of interval versus screen-detected cancer for dense versus F breasts. Poisson regression was used to estimate the ratios for BC incidence, case fatality, and mortality between women with M/D and F breasts. For women with M/D breasts, the odds ratio of an interval cancer was 1.62 (95% confidence interval, CI, 1.14 -2.30), and the age-adjusted rate ratios were 2.45 (95% CI 2.14 -2.81) for BC incidence, 0.60 (95% CI 0.43 -0.84) for case fatality, and 1.78 (95% CI 1.17 -2.72) for BC mortality. The study shows that BC in women with M/D breasts is more frequent, but on average less severe, than in women with F breasts. British Journal of Cancer (2009) Breast density is a measure of the composition of the breast tissue. Breasts with low density have a high proportion of fatty (F) tissue, whereas breasts with high density have a high proportion of epithelial and connective tissue. Mammography has a lower sensitivity in women with mixed/dense (M/D) breasts than in women with F breasts (Mandelson et al, 2000, Ciatto et al, 2004Chiarelli et al, 2006), and women with M/D breasts have a higher incidence of breast cancer (BC) than women with F breasts (McCormack and dos Santos Silva, 2006;Boyd et al, 2007). We therefore examined whether breast density affects the outcome of mammography screening using data from the organised mammography screening programme in Copenhagen, Denmark, earlier shown to reduce BC mortality in targeted women by 25% and in participating women by 37% (Olsen et al, 2005).We tested the following hypotheses: compared with women with F breasts, (1) the sensitivity of mammography is lower in women with M/D breasts, and (2) women with M/D breasts have a higher BC incidence. Our results were well in accordance with those of earlier studies. We further tested whether: (3) because of the lower sensitivity the case fatality rate of BC patients with M/D breasts will be higher than that of patients with F breasts, and (4) screened women with M/D breasts will experience a higher BC mortality than screened women with F breasts. This study is the first to report on the effect of breast density on BC mortality in screened women.

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“…Only a few studies have examined mammographic density in relation to breast tumor characteristics, and most of these studies assessed mammographic density of the contralateral breast at the time of cancer diagnosis (7)(8)(9)(10). These illustrated positive associations between mammographic density and tumor size, lymphatic invasion, later stage, and lymph node status but were inconsistent on associations with tumor grade and estrogen receptor status of the tumor.…”

Section: Introductionmentioning

confidence: 99%

Association of Mammographic Density with the Pathology of Subsequent Breast Cancer among Postmenopausal Women

Ghosh

Brandt²,

Sellers

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Limited studies have examined the associations between mammographic density and subsequent breast tumor characteristics. Methods: Eligible women were part of a case-control study of postmenopausal breast cancer, were 40 years or older and had a routine mammogram 4 years or more before their diagnosis. Mammographic density (percent density, dense area, and nondense area) was estimated using a computer-assisted thresholding program. At the time of cancer diagnosis, cases were classified as asymptomatic or symptomatic based on medical record review and breast imaging workup. Pathologic review was done blinded to the density status. Linear regression models and tests for trend examined the association between pathologic characteristics of the breast tumor and the components of density for all participants, and stratified by symptom status at diagnosis. Results: Of the 286 eligible cases, 77% were 60 years or older and mean percent density was 29.5% (SD, 14.6%).

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Influence of Mammographic Parenchymal Pattern in Screening-Detected and Interval Invasive Breast Cancers on Pathologic Features, Mammographic Features, and Patient Survival

Cited by 103 publications

References 30 publications

Do mammographic tumor features in breast cancer relate to breast density and invasiveness, tumor size, and axillary lymph node involvement?

Do mammographic tumor features in breast cancer relate to breast density and invasiveness, tumor size, and axillary lymph node involvement?

Breast density and outcome of mammography screening: a cohort study

Association of Mammographic Density with the Pathology of Subsequent Breast Cancer among Postmenopausal Women

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