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Mammographic features associated with interval breast cancers in screening programs.

Norman F Boyd, Ella Huszti, Olga Melnichouk

    Breast Cancer Research : BCR
    |October 28, 2014
    PubMed
    Summary

    Younger age and mammographic density characteristics independently predict interval breast cancers. Tailoring screening based on baseline mammograms may reduce interval cancer detection in women.

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    Area of Science:

    • Radiology
    • Oncology
    • Breast Cancer Screening

    Background:

    • Percent mammographic density (PMD) is a known risk factor for interval breast cancer.
    • Factors like younger age, pre-menopausal status, lower BMI, and hormone therapy are associated with both PMD and interval breast cancer risk.

    Purpose of the Study:

    • To investigate if age, BMI, menopausal status, and hormone therapy influence interval vs. screen-detected breast cancer risk independently or via PMD.
    • To examine the association of tumor size with PMD and dense/non-dense areas in both screen-detected and interval breast cancers.

    Main Methods:

    • Utilized data from three case-control studies nested within screened populations.
    • Defined interval breast cancer as invasive cancer detected within 12 months of a negative mammogram.

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  • Employed computer-assisted analysis of baseline mammograms to measure dense area, non-dense area, and PMD.

    • Main Results:

    • Younger age, greater dense area, and smaller non-dense area were significantly associated with interval breast cancer.
    • Interval cancers exhibited a larger maximum tumor diameter compared to screen-detected cancers, irrespective of mammographic measures.

    Conclusions:

    • Baseline mammographic characteristics (dense and non-dense areas) and age are independent predictors of interval breast cancer risk.
    • Reduced cancer detection in dense tissue and potentially faster growth in non-dense areas may contribute to interval cancers.
    • Personalizing screening based on individual mammographic features at baseline could potentially decrease interval cancer incidence.