间隔乳腺癌与检测到的乳腺癌的乳腺癌：回顾性队列研究
Interval Breast Cancers Versus Screen Detected Breast Cancers: A Retrospective Cohort Study
影响因子:3.90000
分区:医学2区 / 核医学2区
发表日期:2023 Sep
作者:
Emily B Ambinder, Emerson Lee, Derek L Nguyen, Anna J Gong, Orli J Haken, Kala Visvanathan
摘要
乳房X线检查检测大多数乳腺癌，但在每年乳房X线照片之间仍有诊断出患有乳腺癌的女性。我们旨在确定将检测到的屏幕癌与间隔乳腺癌区分开的特征。对我们机构进行了7/1/2013-6/30/2020进行的所有筛查乳房X线照片（n = 211,517）。包括在筛查一年内诊断出的乳腺癌患者，并分为两组：检测到的筛查癌组和间隔癌组。使用Chi Square测试，Fisher测试和学生的T检验比较了这些组中的特征。总共包括1,232例患者（平均64 /-11岁）。筛查乳房X线摄影的敏感性为92％（1,136个检测到癌症，间隔96个癌症）。两组之间的患者年龄，种族和乳腺癌的个人病史相似（p> 0.05）。间隔癌症患者经常患有密集的乳房组织（75/96 = 78％对694/1136 = 61％，p <0.001）。与检测到的筛查癌症相比，间隔癌症通常是第二期或更高的原发性肿瘤（41/96 = 43％对139/1136 = 12％，p <0.001）和区域淋巴结一级或更高（21/96 = 21/96 = 22％= 22％对132/1136 = 12％，P = 0.003）。间隔癌的三重阴性（16/77 = 21％对[48/813 = 6％]，p <0.001），Ki67较高的扩散指数（28/45 = 62％与188/492 = 38％，p = 0.002）。摄像学筛查对乳腺癌的敏感性高（92％）。与检测到的癌症相比，间隔癌与密集的乳房组织相关，并且具有较高的分子特征。
Abstract
Mammographic screening detects most breast cancers but there are still women diagnosed with breast cancer between annual mammograms. We aim to identify features that differentiate screen detected breast cancers from interval breast cancer.All screening mammograms (n = 211,517) performed 7/1/2013-6/30/2020 at our institution were reviewed. Patients with breast cancer diagnosed within one year of screening were included and divided into two distinct groups: screen detected cancer group and interval cancer group. Characteristics in these groups were compared using the chi square test, fisher test, and student's T test.A total of 1,232 patients were included (mean age 64 +/- 11). Sensitivity of screening mammography was 92% (1,136 screen detected cancers, 96 interval cancers). Patient age, race, and personal history of breast cancer were similar between the groups (p > 0.05). Patients with interval cancers more often had dense breast tissue (75/96 = 78% versus 694/1136 = 61%, p < 0.001). Compared to screen detected cancers, interval cancers were more often primary tumor stage two or higher (41/96 = 43% versus 139/1136 = 12%, p < 0.001) and regional lymph node stage one or higher (21/96 = 22% versus 132/1136 = 12%, p = 0.003). Interval cancers were more often triple negative (16/77 = 21% versus [48/813 = 6%], p < 0.001) with high Ki67 proliferation indices (28/45 = 62% versus 188/492 = 38%, p = 0.002).Mammographic screening had high sensitivity for breast cancer detection (92%). Interval cancers were associated with dense breast tissue and had higher stage with less favorable molecular features compared to screen detected cancers.