Influence of mammographic parenchymal pattern in screening-detected and interval invasive breast cancers on pathologic features, mammographic features, and patient survival.
OBJECTIVE
The aim of our study was to assess the effect of mammographic parenchymal pattern on patient survival, mammographic features, and pathologic features of breast cancer in a screened population.


METHODS
We classified the parenchymal pattern (according to BI-RADS) of 759 screened women who presented with a screening-detected (n = 455) or interval (n = 304) invasive breast cancer. Pathologic details (tumor size, histologic grade, lymph node stage, vascular invasion, and histologic type) and mammographic appearances were recorded. Breast cancer-specific survival was ascertained, with a median follow-up of 9.0 years.


RESULTS
An excess of interval cancers was seen in women with dense breasts (p < 0.0001). Screening-detected (but not interval) tumors were significantly smaller in fatty breasts (p = 0.014). Tumor grade, lymph node stage, vascular invasion, and histologic type did not vary significantly with mammographic parenchymal pattern in screening-detected or interval cancers. Screening-detected cancers in fatty breasts were more likely to appear as indistinct (p = 0.003) or spiculated (p = 0.002) masses in contrast to cancers in dense breasts, which more commonly appeared as architectural distortions (p < 0.0001). No significant breast cancer-specific survival difference was seen by mammographic parenchymal pattern for screening-detected cancers (p = 0.75), interval cancers (p = 0.82), or both groups combined (p = 0.12).


CONCLUSIONS
The prognosis of screened women presenting with breast cancer is unrelated to dense mammographic parenchymal pattern despite an excess of interval cancers and larger screening-detected tumors in this group. These data support the mammographic screening of women with dense parenchymal patterns.
Porter
Gareth J R
GJ
Nottingham Breast Institute, City Hospital, Hucknall Rd., Nottingham, England, NG5 1PB. gareth.porter@phnt.swest.nhs.uk
Evans
Andrew J
AJ
Cornford
Eleanor J
EJ
Burrell
Helen C
HC
James
Jonathan J
JJ
Lee
Andrew H S
AH
Chakrabarti
Jayeta
J
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013534:Survival; D015996:Survival Rate