title: Locally advanced breast cancers are more likely to present as Interval Cancers: results from the I-SPY 1 TRIAL (CALGB 150007/150012, ACRIN 6657, InterSPORE Trial).
abstract: Interval cancers (ICs), defined as cancers detected between regular screening mammograms, have been shown to be of higher grade, larger size, and associated with lower survival, compared with screen-detected cancers (SDCs) and comprise 17% of cancers from population-based screening programs. We sought to determine the frequency of ICs in a study of locally advanced breast cancers, the I-SPY 1 TRIAL. Screening was defined as having a mammogram with 2 years, and the proportion of ICs at 1 and 2 years was calculated for screened patients. Differences in clinical characteristics for ICs versus SDCs and screened versus non-screened cancers were assessed. For the 219 evaluable women, mean tumor size was 6.8 cm. Overall, 80% of women were over 40 and eligible for screening; however, only 31% were getting screened. Among women screened, 85% were ICs, with 68% diagnosed within 1 year of a previously normal mammogram. ICs were of higher grade (49% vs. 10%) than SDCs. Among non-screened women, 28% (43/152) were younger than the recommended screening age of 40. Of the entire cohort, 12% of cancers were mammographically occult (MO); the frequency of MO cancers did not differ between screened (11%) and non-screened (15%). ICs were common in the I-SPY 1 TRIAL suggesting the potential need for new approaches beyond traditional screening to reduce mortality in women who present with larger palpable cancers.
authors.affiliation: Carol Franc Buck Breast Cancer Center, University of California, San Francisco, 1600 Divisadero Street, 2nd Floor, Box 1710, San Francisco, CA 94115, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Lin
authors.forename: Meredith Becker
authors.initials: MB
authors.lastname: Buxton
authors.forename: Dan
authors.initials: D
authors.lastname: Moore
authors.forename: Helen
authors.initials: H
authors.lastname: Krontiras
authors.forename: Lisa
authors.initials: L
authors.lastname: Carey
authors.forename: Angela
authors.initials: A
authors.lastname: DeMichele
authors.forename: Leslie
authors.initials: L
authors.lastname: Montgomery
authors.forename: Debasish
authors.initials: D
authors.lastname: Tripathy
authors.forename: Constance
authors.initials: C
authors.lastname: Lehman
authors.forename: Minetta
authors.initials: M
authors.lastname: Liu
authors.forename: Olufunmilayo
authors.initials: O
authors.lastname: Olapade
authors.forename: Christina
authors.initials: C
authors.lastname: Yau
authors.forename: Donald
authors.initials: D
authors.lastname: Berry
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Esserman
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002986:Clinical Trials as Topic; D057210:Delayed Diagnosis; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D060787:Neoplasm Grading; D047368:Tumor Burden