title: Type and Extent of Surgery for Screen-Detected and Interval Cancers at Blinded Versus Nonblinded Double-Reading in a Population-Based Screening Mammography Program.
abstract: This study aimed to compare the type and extent of surgery in patients with screen-detected and interval cancers after blinded or nonblinded double-reading of screening mammograms.
  
  
  
  The study investigated a consecutive series of screens double-read in either a blinded (n = 44,491) or nonblinded (n = 42,996) fashion between 2009 and 2011. During a 2 year follow-up period, the radiology reports, surgical correspondence, and pathology reports of all the screen-detected and interval cancers were collected.
  
  
  
  Screen-detected breast cancer was diagnosed for 325 women at blinded and 284 women at nonblinded double-reading. The majority of the women were treated by breast-conserving surgery (BCS) at both reading strategies (78.2 vs. 81.7 %; p = 0.51). Larger total resection volumes were observed at BCS for ductal carcinoma in situ (DCIS) treatment for patients after blinded double-reading (p = 0.005). The proportions of positive resection margins after BCS were comparable for patients with DCIS (p = 0.81) or invasive screen-detected cancers (p = 0.38) for the two reading strategies. A total of 158 interval cancers were diagnosed. The proportions of patients treated with BCS were comparable for the two reading strategies (p = 0.42). The total resection volume (p = 0.13) and the proportion of positive resection margins after BCS (p = 0.32) for invasive interval cancer were comparable for the two cohorts. The BCS rate was higher for women after nonblinded double-reading (p = 0.04).
  
  
  
  Blinded and nonblinded double-reading yielded comparable surgical treatments for women with screen-detected or interval breast cancer except for larger total resection volumes at BCS for screen-detected DCIS and a higher BCS rate for interval cancers at nonblinded double-reading.
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands. royweber@gmail.com.
authors.forename: Roy J P
authors.initials: RJ
authors.lastname: Weber
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Rob M G
authors.initials: RM
authors.lastname: van Bommel
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Wikke
authors.initials: W
authors.lastname: Setz-Pels
authors.affiliation: Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Eindhoven, The Netherlands.|Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Adri C
authors.initials: AC
authors.lastname: Voogd
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Elisabeth G
authors.initials: EG
authors.lastname: Klompenhouwer
authors.affiliation: Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Eindhoven, The Netherlands.
authors.forename: Marieke W
authors.initials: MW
authors.lastname: Louwman
authors.affiliation: Department of Surgery, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Luc J A
authors.initials: LJ
authors.lastname: Strobbe
authors.affiliation: Department of Internal Medicine, Division of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Vivianne C G
authors.initials: VC
authors.lastname: Tjan-Heijnen
authors.affiliation: Department of Radiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.|Dutch Reference Centre for Screening, Nijmegen, The Netherlands.
authors.forename: Lucien E M
authors.initials: LE
authors.lastname: Duijm
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000601:surgery*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography / Q000379:methods*; D000072662:Margins of Excision; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands; D016037:Single-Blind Method