Detection method and breast carcinoma histology.
BACKGROUND
The association between method of detection and breast carcinoma histopathology has not been assessed adequately in a population-based setting.


METHODS
Among women who were included in a population-based, case-control study of breast cancer, patients who were newly diagnosed with invasive breast carcinoma were identified from Wisconsin's statewide tumor registry. Only women age > or = 50 years were analyzed, because screening by mammography was not recommended before age 50 years at the time of the study. The breast tumors among these women (n = 2341 tumors) included the following histopathologies: lobular carcinoma (n = 206 tumors); ductal carcinoma, not otherwise specified (n = 1920 tumors); papillary carcinoma (n = 15 tumors); medullary carcinoma (n = 36 tumors); mucinous adenocarcinoma (n = 56 tumors); tubular adenocarcinoma (n = 41 tumors); invasive comedocarcinoma (n = 24 tumors); scirrhous adenocarcinoma (n = 15 tumors); and mixed ductal/lobular carcinoma (n = 28 tumors).


RESULTS
Overall, women reported that 41% of tumors were detected by mammography, 48% of tumors were self detected, and 11% of tumors were detected by clinical breast examination (CBE). Detection by mammography was significantly more likely for women who had tubular carcinoma (83%; P < 0.001) and invasive comedocarcinoma (67%; P = 0.23) compared with women who had ductal carcinoma (40%). Mammography was significantly less likely to detect medullary carcinoma (17%) than ductal carcinoma (40%; P = 0.01). Lobular carcinoma was the only histopathology that, compared with ductal carcinoma, was detected significantly more often by CBE than by self detection. Mammography detected lobular carcinoma (42%) as frequently as ductal carcinoma (40%). However, the use of postmenopausal hormones may have modified these detection patterns: Among current users, mammography discovered a greater percentage of ductal carcinomas (51%) and fewer lobular carcinomas (36%) than nonusers.


CONCLUSIONS
Among women age > or = 50 years, breast cancer detection by mammography, self detection, and CBE varied according to tumor histopathology.
Newcomer
Laura M
LM
Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Newcomb
Polly A
PA
Trentham-Dietz
Amy
A
Storer
Barry E
BE
Yasui
Yutaka
Y
Daling
Janet R
JR
Potter
John D
JD
D000230:Adenocarcinoma / Q000175:diagnosis; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis; D002293:Adenocarcinoma, Scirrhous / Q000175:diagnosis; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis; D018275:Carcinoma, Lobular / Q000175:diagnosis; D002291:Carcinoma, Papillary / Q000175:diagnosis; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D016353:Self-Examination / Q000379:methods* / Q000592:standards; D014922:Wisconsin / Q000453:epidemiology