Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, the Netherlands.
Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, the Netherlands.
Eur J Radiol. 2018 Nov;108:215-221. doi: 10.1016/j.ejrad.2018.09.026. Epub 2018 Sep 24.
Unilateral interval breast cancers show less favourable prognostic features than unilateral screen-detected cancers, but data on tumour characteristics of bilateral interval cancers in a systematically screened population are sparse. Therefore, we compared tumour characteristics of bilateral interval cancers with those of bilateral screen-detected cancers.
We included all 468,720 screening mammograms of women who underwent biennial screening mammography in the South of the Netherlands between January 2005 and January 2015. We collected breast imaging reports, biopsy results and surgical reports of all recalled women and of all women who presented with interval breast cancer. In women with synchronous bilateral breast cancer, the tumour with the highest tumour stage was defined as the index cancer. For comparison of data between both groups Fisher exact test and Chi-square test were used.
Synchronous bilateral cancer was diagnosed in 2.2% of screen-detected cancers (64/2947) and in 3.2% of interval cancers (24/753) (P = 0.1). Index tumours of bilateral screen-detected cancers and interval cancers showed similar characteristics, except for a larger proportion of T-stage 2 or worse (T2+) cancers among interval cancers (16/24 (66.7%) versus 23/58 (39.7%) (P = 0.03). Index cancers, compared to contralateral cancers, were less frequently stage T1 in both bilateral screen-detected cancers and bilateral interval cancers (35/64 (60.3%) versus 40/64 (88.9%) (P = 0.001) and 8/24 (33.3%) versus 18/24 (85.7%) (P < 0.001), respectively). In bilateral screen-detected cancers, contralateral cancers were more often stage 1a-c (P < 0.001) compared to index cancers. In bilateral index cancers, index cancers were more often of the lobular subtype (P < 0.001).
Index cancers of bilateral screen-detected cancers and bilateral interval cancers show significant differences in tumour size, whereas nodal status, receptor status and final surgical treatment are comparable. In bilateral screen-detected cancer, index cancers had a significantly higher tumour stage. In bilateral screen-detected cancer, index cancers were more often the ductal invasive subtype compared to contralateral cancers.
单侧间隔期乳腺癌的预后特征不如单侧筛查发现的癌症有利，但在系统筛查人群中，双侧间隔期乳腺癌的肿瘤特征数据很少。因此，我们比较了双侧间隔期乳腺癌和双侧筛查发现的乳腺癌的肿瘤特征。
我们纳入了 2005 年 1 月至 2015 年 1 月期间在荷兰南部接受两年一次筛查乳房 X 线摄影的 468720 名女性的所有筛查乳房 X 线摄影结果。我们收集了所有召回女性和所有出现间隔期乳腺癌女性的乳房影像报告、活检结果和手术报告。对于双侧同步性乳腺癌，肿瘤分期最高的肿瘤被定义为索引肿瘤。Fisher 确切检验和卡方检验用于比较两组数据。
双侧筛查发现的癌症中有 2.2%（64/2947）和双侧间隔期癌症中有 3.2%（24/753）诊断为双侧同步性癌症（P=0.1）。双侧筛查发现的癌症和间隔期癌症的索引肿瘤具有相似的特征，除了间隔期癌症中 T 分期为 2 期或更差（T2+）的比例较大（24/24（66.7%））与 58/58（39.7%）（P=0.03）。与对侧癌症相比，双侧筛查发现的癌症和双侧间隔期癌症的索引癌症中 T 分期为 T1 的比例较小，分别为 64/64（60.3%）与 64/64（88.9%）（P=0.001）和 24/24（33.3%）与 24/24（85.7%）（P<0.001）。在双侧筛查发现的癌症中，与索引肿瘤相比，对侧癌症的分期更常为 1a-c 期（P<0.001）。在双侧指数癌症中，指数癌症更常为小叶癌（P<0.001）。
双侧筛查发现的癌症和双侧间隔期癌症的索引癌症在肿瘤大小方面存在显著差异，而淋巴结状态、受体状态和最终手术治疗则相似。在双侧筛查发现的癌症中，索引癌症的肿瘤分期显著较高。在双侧筛查发现的癌症中，与对侧癌症相比，索引癌症更常为导管浸润性亚型。
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