Department of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus U33, 24105, Kiel, Germany.
Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
J Cancer Res Clin Oncol. 2022 Feb;148(2):387-400. doi: 10.1007/s00432-021-03841-x. Epub 2021 Oct 27.
We explored the hypothesis that high-quality standards in diagnostic mammography can lead to an early diagnosis of breast cancers and identifies at risk populations outside screening programs. The histopathological features and distribution of the TNM classification were examined in relation to patient age in a large group of women with breast cancers participating in the Quality Assured Mamma Diagnostic (QuaMaDi) program of the state of Schleswig-Holstein.
Surgical pathological reports were studied for clinicopathological characteristics, receptor status, molecular subtype and tumor stage. The analysis was conducted by dividing the study population into three age groups: women under 50 years (pre-screening), 50-69 years (peri-screening) and over 70 years (post-screening).
7.111 biopsies and 2.887 resection specimens were included. Breast cancer was diagnosed in 4.241 (59.7%) cases, one fourth of them in women < 50 years. Elderly women (> 70 years) had more well-differentiated, estrogen receptor (ER)-positive and HER2-negative carcinomas, whereas younger women (< 50 years) tended to have more poorly differentiated, ER negative, and HER2-positive carcinomas. 47% of breast carcinoma were luminal B tumors and were most common regardless of age. 70.4% of resected specimen had pT1 stage. Nodal negative were 71.2%.
In QuaMaDi breast cancer was diagnosed at an early and potentially curable stage of the disease due to high-quality standards in diagnostic mammography. In addition, regardless of age, an increased number of prognostically unfavorable molecular subtypes were detected. Thus, QuaMaDi helps to identify at risk populations. QuaMaDi significantly improves diagnostic mammography and complements mammography screening programs.
我们探讨了这样一个假设，即高质量的诊断性乳房 X 光摄影标准可以导致乳腺癌的早期诊断，并确定筛查计划之外的高危人群。在参与石勒苏益格-荷尔斯泰因州质量保证乳房诊断（QuaMaDi）计划的大量乳腺癌女性患者中，我们研究了组织病理学特征和 TNM 分类的分布与患者年龄之间的关系。
研究了外科病理报告中的临床病理特征、受体状态、分子亚型和肿瘤分期。通过将研究人群分为三个年龄组进行分析：50 岁以下（筛查前）、50-69 岁（筛查中）和 70 岁以上（筛查后）。
共纳入 7111 例活检和 2887 例切除标本。诊断为乳腺癌 4241 例（59.7%），其中四分之一为 50 岁以下女性。老年女性（>70 岁）的分化程度较好，雌激素受体（ER）阳性和 HER2 阴性的癌较多，而年轻女性（<50 岁）的分化程度较差，ER 阴性和 HER2 阳性的癌较多。47%的乳腺癌为管腔 B 型肿瘤，无论年龄大小均最为常见。70.4%的切除标本为 pT1 期，淋巴结阴性占 71.2%。
由于诊断性乳房 X 光摄影的高质量标准，QuaMaDi 诊断的乳腺癌处于疾病早期且具有潜在的可治愈阶段。此外，无论年龄大小，均发现了更多预后不良的分子亚型。因此，QuaMaDi 有助于确定高危人群。QuaMaDi 显著提高了诊断性乳房 X 光摄影水平，并补充了乳房 X 光筛查计划。
