为了评估乳腺癌在人群中如何被发现（发现方式[MOD]），确定不同MOD的相对频率，并描述与MOD相关的患者和肿瘤特征。我们使用罗切斯特流行病学计划，在明尼苏达州的9个郡区中识别了年龄在40岁至75岁之间，在2017年5月9日至2019年5月9日期间首次被诊断为乳腺癌的妇女（n=500）。我们进行了一项回顾性医疗记录审查，以确定MOD的相对频率，评估筛查乳腺摄影与所有其他MOD之间在乳腺密度和癌症特征方面的差异。进行了多元逻辑回归，以检查乳腺密度和疾病阶段对MOD的可能性。在我们的人群基础队列中，500个乳腺癌中有162个（32.4％）是通过除筛查乳腺摄影以外的MOD检测到的，包括124个（24.8％）自我检测的癌症。与乳腺摄影检测到的妇女相比，除筛查乳腺摄影以外的MOD的患者更频繁地年龄低于50岁（P = .004），且肿瘤级别更高（ P=.007），阳性淋巴结数量更多（P <.001），并且肿瘤大小更大（ P <.001）。与乳腺摄影检测到的妇女相比，除筛查乳腺摄影以外的MOD的患者更可能患有密集型乳腺（比值比，1.87; 95％置信区间，1.20到2.92; P=.006），并且在诊断时处于晚期癌症（比值比，3.58; 95％置信区间，2.29到5.58; P <.001）。该人群中三分之一的乳腺癌是通过除筛查乳腺摄影以外的MOD检测到的。密集型乳腺和晚期癌症的女性更有可能采用非乳腺摄影的MOD。版权所有© 2022 Mayo Foundation for Medical Education and Research。由Elsevier Inc.出版。保留所有权利。

To evaluate how breast cancers come to clinical attention (mode of detection [MOD]) in a population-based cohort, determine the relative frequency of different MODs, and characterize patient and tumor characteristics associated with MOD.We used the Rochester Epidemiology Project to identify women ages 40 to 75 years with a first-time diagnosis of breast cancer from May 9, 2017, to May 9, 2019 (n=500) in a 9-county region in Minnesota. We conducted a retrospective medical record review to ascertain the relative frequency of MODs, evaluating differences between screening mammography vs all other MODs by breast density and cancer characteristics. Multiple logistic regression was conducted to examine the likelihood of MOD for breast density and stage of disease.In our population-based cohort, 162 of 500 breast cancers (32.4%) were detected by MODs other than screening mammography, including 124 (24.8%) self-detected cancers. Compared with women with mammography-detected cancers, those with MODs other than screening mammography were more frequently younger than 50 years of age (P=.004) and had higher-grade tumors (P=.007), higher number of positive lymph nodes (P<.001), and larger tumor size (P<.001). Relative to women with mammography-detected cancers, those with MODs other than screening mammography were more likely to have dense breasts (odds ratio, 1.87; 95% CI, 1.20 to 2.92; P=.006) and advanced cancer at diagnosis (odds ratio, 3.58; 95% CI, 2.29 to 5.58; P<.001).One-third of all breast cancers in this population were detected by MODs other than screening mammography. Increased likelihood of nonmammographic MODs was observed among women with dense breasts and advanced cancer.Copyright © 2022 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.