José Bento Maria, Gonçalves Guilherme, Aguiar Ana, Antunes Luis, Veloso Vitor, Rodrigues Vítor
Institute of Biomedical Sciences Abel Salazar, University of Porto, and Epidemiology Unit, Portuguese Oncology Institute, Porto, Portugal
Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal.
J Med Screen. 2014 Jun;21(2):104-9. doi: 10.1177/0969141314534406. Epub 2014 May 6.
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--2007.
Breast Cancer Screening Programme of the north region of Portugal.
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.
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 ± 5.8 years and 58.4 ± 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.
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.
评估2000 - 2007年参加有组织乳腺筛查项目的女性中，筛查发现（SD）和间隔期（IC）乳腺癌的临床病理差异。
葡萄牙北部地区乳腺癌筛查项目。
利用筛查项目和基于人群的北部地区癌症登记处的数据，确定SD和IC。从癌症登记处以及临床和病理报告中获取筛查史、年龄、诊断日期、肿瘤大小、组织学类型和分级、淋巴结状态、肿瘤分期、生物标志物和治疗等信息。通过无条件逻辑回归估计检测方式与这些临床病理特征之间的关联。
在50 - 69岁女性中，共确定442例SD和112例IC。与SD相比，IC患者年龄更小（分别为60.0±5.8岁和58.4±6.0岁），肿瘤更大（肿瘤大小>20mm：60.2%对25.1%），小叶癌更多（6.3%对16.1%），分化程度更高（3级：17.7%对38.9%），有更多的淋巴结转移、更晚期，雌激素受体（ER）阴性（12.9%对29.0%）、孕激素阴性且HER2阳性。多变量分析后，与SD相比，IC更可能肿瘤大于20mm、为小叶癌、3级且ER阴性。
我们的结果与其他研究一致。IC的生物学行为比SD更具侵袭性。我们的研究结果未显示出任何需要改变筛查程序的意外模式，但建议持续识别和表征IC。
