Interval cancers and cancers in non-attenders in the Ostergötland Mammographic Screening Programme. Duration between screening and diagnosis, S-phase fraction and distant recurrence.
The study was based on a population mammographic screening programme for women aged 40-74 years. Metastatic potential was analysed in 843 invasive breast cancers with regard to mode of detection and a number of prognostic factors. There was a higher metastatic capacity in clinically detected cases, but multivariate analyses showed that neither the mode of detection (hazard rate ratio of distant recurrence RR = 1.39, 95% CI 0.78-2.46 interval cancers and RR = 1.6, 95% CI 0.76-3.36 non-attenders) nor the duration between screening and diagnosis for true interval cancers (RR = 0.47, 95% CI 0.16-1.35 in tumours detected later than one year after screening) were independent prognostic factors. A correlation was found between metastatic potential and the SPF (RR = 2.94, 95% CI 1.57-5.50 in tumours with a high SPF), the oestrogen receptor status and the tumour stage. In conclusion, interval cancers intrinsically are not different from other breast cancers with equivalent characteristics; the duration between screening and diagnosis in interval cancers was not clearly correlated to the prognosis, but the S-phase fraction was a powerful predictor of prognosis.
Vitak
B
B
Mammography Screening Clinic, University Hospital, Linköping, Sweden.
Stål
O
O
Månson
J C
JC
Thomas
B A
BA
Arnesson
L G
LG
Ekelund
L
L
Måre
K
K
Nordenskjöld
B
B
Källström
A C
AC
Bång
H
H
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis / Q000473:pathology*; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D016196:S Phase; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors