Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Radiax, Seattle, WA, USA.
Breast Cancer Res Treat. 2024 Jan;203(2):215-224. doi: 10.1007/s10549-023-07092-x. Epub 2023 Oct 25.
The impact of opportunistic screening mammography in the United States is difficult to quantify, partially due to lack of inclusion regarding method of detection (MOD) in national registries. This study sought to determine the feasibility of MOD collection in a multicenter community registry and to compare outcomes and characteristics of breast cancer based on MOD.
We conducted a retrospective study of breast cancer patients from a multicenter tumor registry in Missouri from January 2004 - December 2018. Registry data were extracted by certified tumor registrars and included MOD, clinicopathologic information, and treatment. MOD was assigned as screen-detected or clinically detected. Data were analyzed at the patient level. Chi-squared tests were used for categorical variable comparison and Mann-Whitney-U test was used for numerical variable comparison.
5351 women (median age, 63 years; interquartile range, 53-73 years) were included. Screen-detected cancers were smaller than clinically detected cancers (median size 12 mm vs. 25 mm; P < .001) and more likely node-negative (81% vs. 54%; P < .001), lower grade (P < .001), and lower stage (P < .001). Screen-detected cancers were more likely treated with lumpectomy vs. mastectomy (73% vs. 41%; P < .001) and less likely to require chemotherapy (24% vs. 52%; P < .001). Overall survival for patients with invasive breast cancer was higher for screen-detected cancers (89% vs. 74%, P < .0001).
MOD can be routinely collected and linked to breast cancer outcomes through tumor registries, with demonstration of significant differences in outcome and characteristics of breast cancers based on MOD. Routine inclusion of MOD in US tumor registries would help quantify the impact of opportunistic screening mammography in the US.
美国机会性筛查乳房 X 光检查的影响难以量化，部分原因是国家登记处缺乏关于检测方法（MOD）的纳入。本研究旨在确定在多中心社区登记处收集 MOD 的可行性，并根据 MOD 比较乳腺癌的结局和特征。
我们对密苏里州一个多中心肿瘤登记处的乳腺癌患者进行了回顾性研究，时间为 2004 年 1 月至 2018 年 12 月。登记处数据由认证的肿瘤登记员提取，包括 MOD、临床病理信息和治疗。MOD 被分配为筛查检出或临床检出。数据在患者水平上进行分析。使用卡方检验进行分类变量比较，使用曼-惠特尼 U 检验进行数值变量比较。
共纳入 5351 名女性（中位年龄 63 岁，四分位距 53-73 岁）。筛查检出的癌症比临床检出的癌症小（中位大小 12mm 比 25mm；P<0.001），且淋巴结阴性的可能性更高（81%比 54%；P<0.001），分级较低（P<0.001），分期较低（P<0.001）。筛查检出的癌症更可能接受保乳手术而不是乳房切除术（73%比 41%；P<0.001），不太可能需要化疗（24%比 52%；P<0.001）。浸润性乳腺癌患者的总体生存率，筛查检出的癌症更高（89%比 74%，P<0.0001）。
通过肿瘤登记处可以常规收集 MOD 并将其与乳腺癌结局相关联，结果显示 MOD 显著影响乳腺癌的结局和特征。美国肿瘤登记处常规纳入 MOD 将有助于量化美国机会性筛查乳房 X 光检查的影响。
