Higher Detection Rates of Biologically Aggressive Breast Cancers in Mammography Screening than in the Biennial Interval

Anna Prange; Beate Bokhof; Philipp Polzer; Joke Tio; Isabel Radke; Oliver Heidinger; Walter Heindel; Stefanie Weigel

doi:10.1055/a-0657-3970

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2019; 191(02): 130-136
DOI: 10.1055/a-0657-3970

Breast

Higher Detection Rates of Biologically Aggressive Breast Cancers in Mammography Screening than in the Biennial Interval

Article in several languages: English | deutsch

Anna Prange

¹Institute of Clinical Radiology and Reference Center for Mammography Muenster, University of Muenster and University Hospital Muenster, Germany

,

Beate Bokhof

¹Institute of Clinical Radiology and Reference Center for Mammography Muenster, University of Muenster and University Hospital Muenster, Germany

,

Philipp Polzer

¹Institute of Clinical Radiology and Reference Center for Mammography Muenster, University of Muenster and University Hospital Muenster, Germany

,

Joke Tio

²Department of Gynecology and Obstetrics, University of Muenster and University Hospital Muenster, Germany

,

Isabel Radke

²Department of Gynecology and Obstetrics, University of Muenster and University Hospital Muenster, Germany

,

Oliver Heidinger

³Cancer Registry of North Rhine-Westphalia, Bochum, Germany

,

Walter Heindel

¹Institute of Clinical Radiology and Reference Center for Mammography Muenster, University of Muenster and University Hospital Muenster, Germany

,

Stefanie Weigel

¹Institute of Clinical Radiology and Reference Center for Mammography Muenster, University of Muenster and University Hospital Muenster, Germany

› Author Affiliations

Abstract

Purpose Assessment of age group-dependent detection rates of invasive breast cancers among participants in mammography screening including the interval, classified into immunohistochemical subtypes indicating the intrinsic tumor aggressiveness.

Materials und Methods The target population comprises women aged 50 – 69 years. All invasive breast cancers diagnosed in one screening (sc) unit during the implementation phase 1/2006 – 12/2010 or identified by the cancer registry during the biennial interval (iv) were categorized based on hormonal-receptor status (HR) and Her2-expression (Her2) into the following subtypes: a) HR+ Her2-, b) HR+ Her2 +, c) HR– Her2 + or d) HR– Her2– (triple-negative); Her2 + and triple-negative types were defined as aggressive. The calculated detection rates (DR, ‰) were based on 53 375 sc-examinations and for the interval on 52 887 sc-negative examinations.

Results The DRs of all subtypes were higher in screening versus the interval: (a) 4.95 ‰ (n = 264) vs. 1.00 ‰ (n = 53); b) 0.92 ‰ (n = 49) vs. 0.25 ‰ (n = 13); c) 0.36 ‰ (n = 19) vs. 0.06 ‰ (n = 3); d) 0.39 ‰ (n = 21) vs. 0.19 ‰ (n = 10). 77.4 ‰ (89/115) of all aggressive breast cancers including the following 2-year interval were diagnosed by screening. The sum of the DR of aggressive cancers was 1.67 ‰ in screening and 0.49 ‰ in the interval; the corresponding DRs for women aged 60 – 69 years [sc: 2.24 ‰ (51/22 814), iv: 0.58 ‰ (13/22 536)] were higher than among women aged 50 – 59 years [sc: 1.24 ‰ (38/30 561), iv: 0.43 ‰ (13/30 351)].

Conclusion Screening has the potential for earlier diagnosis of aggressive tumor types as its detection rate is about three-fold higher compared to the interval. Within the target group, participants aged 60 – 69 years are at risk based on absolute numbers. They show a nearly two-fold higher detection rate of Her2-positive or triple-negative tumors compared to the age group 50 – 59 years.

Key Points

Her2-positive and triple-negative detection rates are higher in screening than in the interval.
77 % of aggressive subtypes are diagnosed by screening, 23 % during the 2-year interval.
The detection rate is highest among women aged 60 – 69 years in screening.

Citation Format

Prange A, Bokhof B, Polzer P et al. Higher Detection Rates of Biologically Aggressive Breast Cancers in Mammography Screening than in the Biennial Interval. Fortschr Röntgenstr 2019; 191: 130 – 136

Key words

breast cancer - mammography screening - interval breast cancer - tumor subtypes - cancer characteristics

Full Text

References

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