Department of Radiology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ Nijmegen, the Netherlands.
Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW Nijmegen, the Netherlands; Radboud University Medical Center, Department for Health Evidence, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands.
Eur J Radiol. 2022 Sep;154:110391. doi: 10.1016/j.ejrad.2022.110391. Epub 2022 Jun 3.
We determined the incidence and effects of different screening intervals prior to a true positive recall on the tumour characteristics of screen-detected cancers (SDC) and interval cancers (ICs) at biennial screening mammography.
A consecutive series of 553020 subsequent screens was included, obtained in a Dutch screening region between January 2009 and July 2019. During 2-year follow-up, we obtained data on radiological procedures, pathology and surgical interventions of all recalled women.
A total of 13,221 women were recalled (2.4% recall rate), yielding 3662 women with a SDC (6.6 SDCs per 1000 screen). Of these, 3477 (94.9%) had attended their two most recent screens as scheduled (i.e., 2-year screening interval), whereas the interval between the two most recent screens was four years or at least six years in respectively 132 (3.6%) and 53 (1.4%) women. There was a trend of higher cancer detection rates in case of longer screening intervals. The proportions of DCIS versus invasive cancer, as well as tumour histology, tumour size, axillary lymph node status, B&R grading, hormone receptor status and type of surgical treatment (breast conserving surgery or mastectomy) were comparable for women with a 2-year or 4-year interval between their two latest screens. SDCs in women with at least six years between their two latest screens were more frequently estrogen receptor negative or triple negative and were more frequently treated by mastectomy. All tumour characteristics mentioned above were less favourable for ICs than SDCs.
A vast majority of women with a SDC had a 2-year screening interval between their two latest screens. A screening interval of at least six years had a slight negative influence on the tumour characteristics and treatment of SDCs.
我们在每两年进行一次筛查的乳腺钼靶筛查中，确定真正阳性召回前不同筛查间隔对筛查发现的癌症（SDC）和间期癌（IC）的肿瘤特征的发生率和影响。
本研究纳入了 2009 年 1 月至 2019 年 7 月在荷兰一个筛查区域进行的连续 553020 次后续筛查。在 2 年的随访期间，我们获得了所有召回女性的放射学程序、病理学和手术干预的数据。
共有 13221 名女性被召回（召回率为 2.4%），其中 3662 名女性患有 SDC（每 1000 次筛查中有 6.6 例 SDC）。其中，3477 名女性（94.9%）按计划参加了最近两次筛查（即 2 年筛查间隔），而最近两次筛查之间的间隔分别为 4 年或至少 6 年，分别有 132 名（3.6%）和 53 名（1.4%）女性。筛查间隔越长，癌症检出率越高。在最近两次筛查之间间隔 4 年的女性中，DCIS 与浸润性癌的比例以及肿瘤组织学、肿瘤大小、腋窝淋巴结状态、B&R 分级、激素受体状态和手术治疗类型（保乳手术或乳房切除术）与最近两次筛查之间间隔 2 年的女性相似。在最近两次筛查之间间隔至少 6 年的女性中，SDC 雌激素受体阴性或三阴性的比例更高，更常接受乳房切除术治疗。与 SDC 相比，上述所有肿瘤特征在 IC 中都不太有利。
大多数患有 SDC 的女性最近两次筛查之间的筛查间隔为 2 年。至少 6 年的筛查间隔对 SDC 的肿瘤特征和治疗有轻微的负面影响。
