Interval breast cancer: is it a different type of breast cancer?

Raja, M. A.; Hubbard, A. L.; Salman, A.

doi:10.1054/brst.2000.0217

Cited by 20 publications

(16 citation statements)

References 43 publications

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“…It is possible that some breast cancers diagnosed in our screened population were detectable (but missed) at screening and thus were misclassified as interval cancers. It has been estimated that up to 35% of interval cancers may be misclassified for these reasons [47][48][49][50]. However, we were not able to review mammographic films to estimate this in our population.…”

Section: Discussionmentioning

confidence: 96%

“…Interval cancers tend to be larger at diagnosis and of higher grade and stage than are cancers detected at screening, suggesting that they may be biologically different from screen-detected cancers and potentially more aggressive [1][2][3][4][5][6][7][8]. Insomuch as these cancers represent a sizeable proportion of breast cancers among screened women and that they may represent a more virulent form of cancer, it is important to understand This work was performed at The University of Colorado Denver.…”

Section: Introductionmentioning

confidence: 99%

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Complementary approaches to assessing risk factors for interval breast cancer

Lowery

Byers

Hokanson

et al. 2010

Cancer Causes Control

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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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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Complementary approaches to assessing risk factors for interval breast cancer

Lowery

Byers

Hokanson

et al. 2010

Cancer Causes Control

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“…4 Over the years many studies have been conducted on the differences between intervaland screen-detected carcinomas. [5][6][7][8][9][10][11][12][13][14][15][16] Comparison of these studies is difficult, because of the great heterogeneity in screening group, screening interval and study design. Therefore, in this analysis a very homogeneous group of postmenopausal women is studied.…”

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confidence: 99%

Aggressiveness of ‘true’ interval invasive ductal carcinomas of the breast in postmenopausal women

et al. 2010

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There is debate whether interval carcinomas differ from screen-detected tumours biologically. In this study, clinico-pathological parameters and the expression of well-validated biological markers were compared between 'true' interval carcinomas and screen-detected/missed carcinomas hypothesising that 'true' interval carcinomas show a more aggressive biological behaviour. The study group consisted of 92 consecutive postmenopausal women attending the breast screening programme and presenting with an invasive ductal carcinoma. All screening mammograms were re-reviewed. Sixteen patients had a 'true' interval carcinoma. Seven carcinomas were missed at screening, but detected on re-reviewing of the screening mammogram. Radiological characteristics were assessed from diagnostic mammograms. Data on patient-and tumour characteristics and follow-up data were recorded from hospital records. Median follow-up was 61 months. Immunohistochemistry for ER, PR, Her2/neu and p53 was performed on TMA sections. Univariate and multivariate logistic regression analyses were performed. In univariate analysis, 'true' interval carcinomas were significantly larger (odd ratios (OR) 7.2, 95% CI 1.8-28.1) and less frequently ER (OR 0.3, 95% CI 0.1-0.9) and PR (OR 0.3, 95% CI 0.1-1.0) positive. In multivariate analysis, 'true' interval carcinoma was independently associated with larger tumours (OR 7.0,. A trend toward ER negativity was found (OR 0.3, 95% CI 0.1-1.1). 'True' interval carcinomas showed a trend toward a decreased relapse-free survival (HR 1.7 95% CI 0.9-3.1). Although 'true' interval carcinomas were significantly larger than screen-detected/missed interval carcinomas, it remains challenging to observe parameters that determine this difference between 'true' interval carcinomas and screen-detected lesions.

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“…14,27 In this study, IC were significantly larger than SD, in agreement with the findings from other studies. 10,12,[28][29][30] Lobular histological type was more frequent among IC than SD breast cancers. This has also been observed in some studies, 5,14,22,31 but others have found no difference in the histology type between IC and SD.…”

Section: Discussionmentioning

confidence: 99%

“…Radiological review of last screening/assessment imaging and diagnostic mammography of the IC was not performed; this may be considered a limitation. However, although some authors have used a radiological category to distinguish between true interval and missed interval breast cancers, 28,[38][39][40][41] others have not considered this assessment essential, and some have even thought it to be misleading. 11 Mammographic density has been considered a risk factor for IC, 23,26 but in this study the retrospective analysis of the mammographic pattern was not performed.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological differences between interval and screen-detected breast cancers diagnosed within a screening programme in Northern Portugal

et al. 2014

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Objective: To evaluate clinicopathological differences between screen-detected (SD) and interval (IC) breast cancers diagnosed in women enrolled in an organized breast screening programme in [2000][2001][2002][2003][2004][2005][2006][2007]. Setting: Breast Cancer Screening Programme of the north region of Portugal. Methods: Using data from the screening programme and from the population-based North Region Cancer Registry, SD and IC were identified. Information on screening history, age, date of diagnosis, tumour size, histological type and grade, lymph node status, tumour stage, biomarkers, and treatment was obtained from the cancer registry and from clinical and pathological reports. Association between mode of detection and these clinicopathological characteristics was estimated by unconditional logistic regression. Results: A total of 442 SD and 112 IC were identified in women aged 50-69. Compared with SD, IC were diagnosed in younger women (60.0 AE 5.8 years and 58.4 AE 6.0 years, respectively), were larger (tumour size >20 mm: 60.2% versus 25.1%), lobular (6.3% versus 16.1%), with a higher differentiation grade (grade 3: 17.7% versus 38.9%), had more lymph node metastases, more advanced stage, and oestrogen receptor (ER) negative (12.9% versus 29.0%) and progesterone negative, and HER2 positive. After multivariable analysis, compared with SD, IC were more likely to be larger than 20 mm, lobular, of grade 3 and negative for ER. Conclusion: Our results are consistent with other studies. IC's have a more aggressive biology than SDs. Our findings did not show any unexpected pattern requiring changes to our screening procedures, but continuous identification and characterization of IC is advisable.

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Interval breast cancer: is it a different type of breast cancer?

Cited by 20 publications

References 43 publications

Complementary approaches to assessing risk factors for interval breast cancer

Complementary approaches to assessing risk factors for interval breast cancer

Aggressiveness of ‘true’ interval invasive ductal carcinomas of the breast in postmenopausal women

Clinicopathological differences between interval and screen-detected breast cancers diagnosed within a screening programme in Northern Portugal

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