title: Influence of mammographic parenchymal pattern in screening-detected and interval invasive breast cancers on pathologic features, mammographic features, and patient survival.
abstract: 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.
authors.affiliation: Nottingham Breast Institute, City Hospital, Hucknall Rd., Nottingham, England, NG5 1PB. gareth.porter@phnt.swest.nhs.uk
authors.forename: Gareth J R
authors.initials: GJ
authors.lastname: Porter
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Evans
authors.forename: Eleanor J
authors.initials: EJ
authors.lastname: Cornford
authors.forename: Helen C
authors.initials: HC
authors.lastname: Burrell
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: James
authors.forename: Andrew H S
authors.initials: AH
authors.lastname: Lee
authors.forename: Jayeta
authors.initials: J
authors.lastname: Chakrabarti
mesh_terms: 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