Aggressiveness of ‘true’ interval invasive ductal carcinomas of the breast in postmenopausal women

Vegt, Bert van der; Wesseling, Jelle; Pijnappel, Ruud M.; Dorrius, Monique D.; Heeten, Gerard J. den; Roos, Marnix A.J. de; Bock, Geertruida H. de

doi:10.1038/modpathol.2009.188

Cited by 14 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ER and PR positivity was more frequent in screen-detected than in clinically detected cancers, as observed in other studies (Sihto et al, 2008;Dawson et all (Joensuu et al, 2004). In agreement with previous series (Domingo et al, 2010;Van der Vegt et al, 2010;Rayson et al, 2011), we found the highest percentage of triple-negative tumors among true interval cancers, with substantial differences when compared with both screen-detected and symptom-detected cancers.…”

Section: Discussionsupporting

confidence: 93%

“…Nonetheless, most of the studies considered all interval cancers together, which may have attenuated the worse outcome in the true interval cancer subgroup. Studies revealed that true interval cancers (Vitak et al, 1997;Van der Vegt et al, 2010;Rayson et al, 2011) showed a trend toward decreased relapse-free and overall survival when compared with cancers detected by other means. However, only Vitak et al (1997) compared true interval with both screen-detected Kaplan-Meier curves comparing disease-free rates by detection mode and phenotypes.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Aggressiveness features and outcomes of true interval cancers

Domingo

Blanch²,

Servitja³

et al. 2013

European Journal of Cancer Prevention

View full text Add to dashboard Cite

The question of whether screen detection confers an additional survival benefit in breast cancer is unclear and subject to several biases. Our aim was to examine the role of the diagnostic method (screen-detected, symptom-detected, and true interval cancers) and the clinical-pathological features in relapse-free survival and overall survival in breast cancer patients. We included 228 invasive breast cancers diagnosed in Barcelona from 1996 to 2008 among women aged 50-69 years. Ninety-seven patients were screen detected within the screening, 34 truly arose between 2-year screening mammograms (true interval cancers), and 97 were symptom detected outside the screening. The clinical-pathological features at diagnosis were compared. The overall and disease-free survival probabilities were computed using the Kaplan-Meier method. Cox proportional hazard models were applied, with adjustment by clinical-pathological variables. At diagnosis, symptom-detected and true interval cancers were in more advanced stages and were less differentiated. The highest proportion of triple-negative cancers was detected among true interval cancers (P=0.002). At 5 years of follow-up, the disease-free survival rates for screen-detected, true interval, and symptom-detected cancers were 87.5% (95% confidence interval, 80.5-95.2%), 64.1% (46.4-88.5%), and 79.4% (71.0-88.8%), respectively, and the overall survival rates were 94.5% (89.3-99.9%), 65.5% (47.1-91.2%), and 85.6% (78.3-93.6%), respectively. True interval cancers had the highest hazard ratio for relapse prediction (1.89; 0.67-5.31) and a hazard ratio of death of 5.55 (1.61-19.15) after adjustment for tumor-node-metastasis stage and phenotype. Clinically detected tumors, especially true interval cancers, more frequently showed biological features related to worse prognosis and were associated with poorer survival even after adjustment for clinical-pathological characteristics.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 96%

Aggressiveness features and outcomes of true interval cancers

Domingo

Blanch²,

Servitja³

et al. 2013

European Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…They are also more likely to be ER−/PR− tumors, conferring non-response to endocrine therapy and poor prognosis [1, 8, 10, 12, 14, 29, 30]. Our data confirmed a greater tendency for interval cancers to be ER−/PR− though only among women aged 50 and older.…”

Section: Discussionsupporting

confidence: 73%

Differential expression of prognostic biomarkers between interval and screen-detected breast cancers: does age or family history matter?

Lowery

Byers

Kittelson

et al. 2011

Breast Cancer Res Treat

View full text Add to dashboard Cite

The aim of this study was to compare tumor expression of prognostic biomarkers between interval breast cancers and screen-detected breast cancers overall, and according to age at diagnosis and familial risk. Tissue micro-arrays were constructed from 98 breast cancers (47 interval and 51 screen-detected) diagnosed in women in the Cancer Genetics Network. Arrays were immuno-stained to compare protein expression of six biomarkers including estrogen and progesterone receptor (ER/PR), Her2/neu, EGFR, cytokeratin 5/6, and Ki67. Fisher’s Exact test was used to compare expression between interval and screen-detected cancers. Interval cancers were larger (P = 0.04), higher stage (P < 0.001), and more likely to have lobular histology (P = 0.01) than screen-detected cancers. Overall, interval cancers more often over-expressed EGFR (P = 0.01) and were somewhat more likely to be ER− (55% vs. 43%, P = 0.3), and triple negative (ER−/PR−/Her2−) (21 vs. 12%, P = 0.26). A greater difference in the proportion of interval versus screen-detected tumors that were ER− (53 vs. 35%; P = 0.29), PR− (35 vs. 21%; P = 0.25) and EGFR+ (17 vs. 0%; P = 0.02) was evident among women over 50. There was a trend toward differential expression among women with familial risk for PR− (P = 0.005) and triple negative status (P = 0.02). This study provides new data indicating that EGFR may be important in the etiology of interval cancer and be a possible therapeutic target. Our data also suggest that biological differences between interval and screen-detected cancers are more defined in older women. Future studies to confirm this finding and to elucidate novel markers for characterizing interval cancers may be more beneficial to this subgroup.

show abstract

“…However, one of the study limitations is the lack of information on whether the symptom-detected tumors in the study cohort represented cancers detected in the interval between screening examinations or tumors that were missed during screening mammography or were self-detected in an unscreened population of women. Whether these categories of symptom-detected tumors differ biologically is not clear although associations with increased aggressiveness have been reported for `true' interval cancers (54). An additional limitation is the lack of information on the type of mammography screening that patients in the ESBCR received.…”

Section: Discussionmentioning

confidence: 99%

Copy Number Imbalances between Screen- and Symptom-Detected Breast Cancers and Impact on Disease-Free Survival

Brewster¹,

Thompson²,

Şahin³

et al. 2011

Cancer Prevention Research

View full text Add to dashboard Cite

Background Screening mammography results in the increased detection of indolent tumors. We hypothesized that screen and symptom-detected tumors would show genotypic differences as copy number imbalances (CNIs) that in part explain differences in the clinical behavior between screen and symptom-detected breast tumors. Methods We evaluated 850 women aged ≥ 40 diagnosed with stage I–II breast cancer at the MD Anderson Cancer Center between 1985 to 2000 with information available on method of tumor detection (screen versus symptoms). CNIs in screen and symptom-detected tumors were identified using high-density molecular inversion probe arrays. Cox proportional modeling was used to estimate the effect of method of tumor detection on disease-free survival after adjusting for age, stage and the CNIs. Results The majority of tumors were symptom-detected (n=603) compared to screen-detected (n=247). Copy number gains in chromosomes 2p, 3q, 8q, 11p and 20q were associated with method of breast cancer detection (p<0.00001). We estimated that 32% and 63% of the survival advantage of screen-detection was accounted for by age, stage, nuclear grade and Ki67 in women aged 50–70 and aged 40–87, respectively. In each age category, an additional 20% of the survival advantage was accounted for by CNIs associated with method of detection. Conclusion Specific CNIs differ between screen and symptom-detected tumors and explain part of the survival advantage associated with screen-detected tumors. Measurement of tumor genotype has the potential to improve discrimination between indolent and aggressive screen-detected tumors and aid patient and physician decision making about use of surgical and adjuvant treatments.

show abstract

Aggressiveness of ‘true’ interval invasive ductal carcinomas of the breast in postmenopausal women

Cited by 14 publications

References 27 publications

Aggressiveness features and outcomes of true interval cancers

Aggressiveness features and outcomes of true interval cancers

Differential expression of prognostic biomarkers between interval and screen-detected breast cancers: does age or family history matter?

Copy Number Imbalances between Screen- and Symptom-Detected Breast Cancers and Impact on Disease-Free Survival

Contact Info

Product

Resources

About