title: Human epidermal growth factor receptor 2 status and interval breast cancer in a population-based cancer registry study.
abstract: OBJECTIVE
  To determine whether human epidermal growth factor receptor 2 (HER2) -positive status is associated with risk of breast cancer diagnosis in the interval between mammographic screening, we estimated the distribution of features of aggressive tumor behavior in a general population with newly diagnosed breast cancer and known screening status.
  
  
  METHODS
  We evaluated all invasive breast cancers (N = 641) that were systematically collected by the Parma Province Cancer Registry and diagnosed in women age 50 to 69 years from 2004 to 2007. From this population, 292 screen-detected cancers and 48 interval cases with negative screening mammograms on expert rereading (true interval cancers) were selected for study purposes. Unconditional logistic regression adjusted for age and tumor size was used to determine whether interval cancers were associated with selected clinicobiologic characteristics.
  
  
  RESULTS
  Tumors with a high histologic grade (odds ratio [OR], 1.8; 95% CI, 1.2 to 3.8), high proliferative rate (OR, 2.4; 95% CI, 1.2 to 4.5), negative estrogen receptor status (OR, 1.6; 95% CI, 1.1 to 3.1), or HER2-positive status (OR, 3.4; 95% CI, 1.7 to 7.1) were more likely to be diagnosed in the interval between screening. Women age less than 60 years with HER2-positive breast cancer were four times more likely to be diagnosed in the interval between screening compared with only a two-fold increased risk for older women.
  
  
  CONCLUSIONS
  This population-based cancer registry study demonstrated that HER2-positive tumors account for a substantial proportion of mammographic screening failure. The distribution of biologic characteristics in screen-detected cancers differs from that observed in interval cancers and may account in part for the more aggressive behavior of interval-detected cases.
authors.affiliation: Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy. antoninomusolino@hotmail.com
authors.forename: Antonino
authors.initials: A
authors.lastname: Musolino
authors.forename: Maria
authors.initials: M
authors.lastname: Michiara
authors.forename: Giovanni Maria
authors.initials: GM
authors.lastname: Conti
authors.forename: Daniela
authors.initials: D
authors.lastname: Boggiani
authors.forename: Marella
authors.initials: M
authors.lastname: Zatelli
authors.forename: Dario
authors.initials: D
authors.lastname: Palleschi
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Bella
authors.forename: Paolo
authors.initials: P
authors.lastname: Sgargi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Di Blasio
authors.forename: Andrea
authors.initials: A
authors.lastname: Ardizzoni
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000201:enzymology* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*; D012042:Registries
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases