Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
JAMA Netw Open. 2024 May 1;7(5):e2411927. doi: 10.1001/jamanetworkopen.2024.11927.
The risk factors for interval breast cancer (IBC) compared with those for screen-detected breast cancer (SBC) and their association with mortality outcomes have not yet been evaluated among Korean women.
To evaluate risk factors associated with IBC and survival among Korean women with IBC compared with those with SBC.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from the Korean National Health Insurance Service Database. Women who participated in a national mammographic breast cancer screening program between January 1, 2009, and December 31, 2012, were included. Mortality outcomes were calculated from the date of breast cancer diagnosis to the date of death or December 31, 2020. Data were analyzed from March 1 to June 30, 2023.
Breast cancer diagnosed within 6 to 24 months after a negative screening result (ie, IBC) or within 6 months after a positive screening result (ie, SBC).
Risk factors and survival rates for IBC and SBC.
This study included 8702 women with IBC (mean [SD] age, 53.3 [8.6] years) and 9492 women with SBC (mean [SD] age, 54.1 [9.0] years). Compared with SBC, the probability of IBC decreased as mammographic density increased. Lower body mass index, menopausal status, hormone replacement therapy (HRT) use, and lack of family history of breast cancer were associated with a higher likelihood of IBC. When stratified by detection time, younger age at breast cancer diagnosis and family history of breast cancer were associated with an increased likelihood of IBC diagnosed at 6 to 12 months but a decreased likelihood of IBC diagnosed at 12 to 24 months. Overall mortality of IBC was comparable with SBC, but total mortality and cancer-related mortality of IBC diagnosed between 6 and 12 months was higher than that of SBC.
The findings of this cohort study suggest that breast density, obesity, and HRT use were associated with IBC compared with SBC. These findings also suggest that higher supplemental breast ultrasound use among Korean women, especially those with dense breasts, could be attributed to a lower incidence of IBC among women with dense breasts compared with women with SBC, due to greater detection. Finally, overall mortality of IBC was comparable with that of SBC.
与筛查发现的乳腺癌（SBC）相比，韩国女性的间隔期乳腺癌（IBC）的风险因素及其与死亡率结局的关系尚未得到评估。
评估韩国女性中 IBC 相关的风险因素以及与 SBC 相比的 IBC 患者的生存情况。
设计、设置和参与者：这是一项回顾性队列研究，使用了韩国国民健康保险服务数据库的数据。该研究纳入了 2009 年 1 月 1 日至 2012 年 12 月 31 日期间参加全国乳腺 X 线筛查项目的女性。死亡率结局是从乳腺癌诊断日期到死亡日期或 2020 年 12 月 31 日计算的。数据分析于 2023 年 3 月 1 日至 6 月 30 日进行。
在阴性筛查结果后 6 至 24 个月内（即 IBC）或在阳性筛查结果后 6 个月内（即 SBC）诊断出的乳腺癌。
IBC 和 SBC 的风险因素和生存率。
这项研究纳入了 8702 名 IBC 女性（平均[标准差]年龄 53.3[8.6]岁）和 9492 名 SBC 女性（平均[标准差]年龄 54.1[9.0]岁）。与 SBC 相比，随着乳腺密度的增加，IBC 的发生概率降低。较低的体重指数、绝经状态、激素替代疗法（HRT）的使用以及缺乏乳腺癌家族史与更高的 IBC 发生概率相关。按发现时间分层，IBC 诊断时的年龄较小和乳腺癌家族史与 6 至 12 个月内诊断的 IBC 发生概率增加相关，但与 12 至 24 个月内诊断的 IBC 发生概率降低相关。IBC 的总死亡率与 SBC 相当，但 6 至 12 个月内诊断的 IBC 的总死亡率和癌症相关死亡率高于 SBC。
这项队列研究的结果表明，与 SBC 相比，乳腺密度、肥胖和 HRT 的使用与 IBC 相关。这些发现还表明，由于致密乳腺女性中 IBC 的检出率较高，韩国女性中乳腺超声检查的补充使用增加，可能导致致密乳腺女性中 IBC 的发生率低于 SBC。最后，IBC 的总死亡率与 SBC 相当。
