title: Growth rate of invasive ductal carcinomas from a screened 50-74-year-old population.
abstract: Objective As breast cancer growth rate is associated with menopause, most screening programmes target mainly women aged 50-74. We studied the association between age at diagnosis and growth rate in this screening-specific age range. Methods We used data from breast cancer patients diagnosed in the screening programme in Nijmegen, the Netherlands. The data were restricted to the screening rounds when analogue mammography was used in both the screening and clinical setting. Growth rate expressed as tumour volume doubling time was based on increasing tumour size in longitudinal series of mammograms. Estimates were based on (a) tumours showing at least two measurable shadows, (b) tumours showing a shadow at detection only (left censored), and (c) tumours showing no growth (right-censored observation). All 293 tumours were consecutively diagnosed invasive ductal breast cancers in participants of the Nijmegen screening programme in the period 2000-2007. Results Depending on the assumptions made on tumour margins and mammographic density, the relation of volume doubling time with age non-significantly varies from a decrease of 3.3% to an increase of 1.4% for each year increase in age at diagnosis (all P-values ≥ 0.18). Applying left censoring on indistinct tumours, the geometric mean volume doubling time was 191 days (95% confidence interval 158-230). Conclusion We found no significant change in growth rate with age in women diagnosed with invasive ductal breast cancer in the screening age range 50-74. This outcome does not support differential screening intervals by age based solely on breast cancer growth rate for this particular group.
authors.affiliation: 1 Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Johannes Dm
authors.initials: JD
authors.lastname: Otten
authors.affiliation: 2 Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Guido
authors.initials: G
authors.lastname: van Schoor
authors.affiliation: 1 Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Petronella Gm
authors.initials: PG
authors.lastname: Peer
authors.affiliation: 3 Dutch Reference Centre for Screening, Nijmegen, The Netherlands.|4 Department of Radiology, Biomechcanical Engineering & Physics, Academic Medical Centre Amsterdam, The Netherlands.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: den Heeten
authors.affiliation: 5 Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Roland
authors.initials: R
authors.lastname: Holland
authors.affiliation: 1 Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.|3 Dutch Reference Centre for Screening, Nijmegen, The Netherlands.
authors.forename: Mireille Jm
authors.initials: MJ
authors.lastname: Broeders
authors.affiliation: 1 Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: André Lm
authors.initials: AL
authors.lastname: Verbeek
mesh_terms: D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009426:Netherlands
keywords: Breast cancer; age specific; growth rate; mammography; screening; tumour doubling time