Breast cancer: age-specific growth rates and screening strategies.

Moskowitz, Myron

doi:10.1148/radiology.161.1.3532183

Cited by 137 publications

(31 citation statements)

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“…In agreement with the literature survival was significantly reduced with increasing age, tumour size, grade of anaplasia and number of positive lymph nodes (13, 14, 19,[23][24][25][26]. A long patient's delay was associated with larger turnours, more positive lymph nodes, and reduced survival.…”

Section: Discussionsupporting

confidence: 87%

“…The reason for the shorter delay of younger patients in seeking medical advice could be a tendency of younger women to have a more rapid progression of the disease (26,27) or a higher awareness of breast disorders. The reduction of patient's delay during the period of patient accrual can probably be ascribed to the increased public attention to breast cancer that occurred after the introduction of the nation-wide breast cancer programme in 1977.…”

Section: Discussionmentioning

confidence: 99%

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Patient's and Doctor's Delay in Primary Breast Cancer: Prognostic implications

et al. 1994

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Patient's and Doctor's Delay in Primary Breast Cancer: Prognostic implications

et al. 1994

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“…For the current study, we used a subset of postmenopausal women with invasive breast cancer (n = 286) who had a screening mammogram available 4 or more years before the cancer diagnosis. This reduced the possibility of an occult tumor being present at the time of the density measurement on the study mammogram (13). When multiple mammograms were available for the study period, the mammogram closest to and at least 4 years before the date of cancer diagnosis was used for density estimation for the study.…”

Section: Methodsmentioning

confidence: 99%

Association of Mammographic Density with the Pathology of Subsequent Breast Cancer among Postmenopausal Women

Ghosh

Brandt²,

Sellers

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Limited studies have examined the associations between mammographic density and subsequent breast tumor characteristics. Methods: Eligible women were part of a case-control study of postmenopausal breast cancer, were 40 years or older and had a routine mammogram 4 years or more before their diagnosis. Mammographic density (percent density, dense area, and nondense area) was estimated using a computer-assisted thresholding program. At the time of cancer diagnosis, cases were classified as asymptomatic or symptomatic based on medical record review and breast imaging workup. Pathologic review was done blinded to the density status. Linear regression models and tests for trend examined the association between pathologic characteristics of the breast tumor and the components of density for all participants, and stratified by symptom status at diagnosis. Results: Of the 286 eligible cases, 77% were 60 years or older and mean percent density was 29.5% (SD, 14.6%).

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“…These cancers surface among negative screenees before the next scheduled examination would have taken place. Of all breast cancers in a screened population about 20-35% are diagnosed within 2 years after the last screening examination (Verbeek, 1985;Tabar et al, 1987;Moskowitz, 1986;de Waard et al, 1984; Lundgren, 1979). The survival of patients with interval cancers turned out to be just as bad as the survival of patients diagnosed outside screening programmes (Holmberg et al, 1986;Shapiro et al, 1982).…”

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confidence: 99%

The occurrence of interval cancers in the Nijmegen screening programme

Peeters

Verbeek²,

Hendriks³

et al. 1989

Br J Cancer

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Summary Since January 1975 a population-based screening programme for the early detection of breast cancer has been carried out in the city of Nijmegen. During five interscreening periods of 2 years each a total of 158 so-called interval cancers were diagnosed. Careful revision of all screening and diagnostic mammograms was executed. Of all interval cancers 26% were 'missed' at the previous screening examination (due to technical or observer error), 16% were radiographically occult at the time of diagnosis and 58% were 'true' interval cancers. Interval cancers were regarded as 'true' when an obvious lesion was observed on the diagnostic mammogram while no suspect signs were seen on the previous screening mammogram. The prevalence of 'missed' cancers did not decline in the course of the screening programme. Radiographically occult tumours were localised, mostly in Wolfe's P2/DY breast parenchyma (83%), 33% were lobular invasive and 25% ductal non-invasive. 'True' interval cancer cases (58%) showed the same overall survival as control breast cancer patients, diagnosed in a non-screening situation. Shortening the screening interval would reduce interval cancer rates and probably further decrease breast cancer mortality in a screened population. However, from the present series of interval cancers 63% would not have been prevented by an annual screening examination. As regards women under age 50 annual screening would still leave 66% of all interval cancers in this age group undetected. Probably more benefit will be gained by searching for new imaging techniques to reduce numbers of 'missed' cancers and to detect lobular invasive and ductal non-invasive cancers in dense breast parenchyma.Within any screening programme for the early detection of breast cancer, women are diagnosed as having so-called interval cancer. These cancers surface among negative screenees before the next scheduled examination would have taken place. Of all breast cancers in a screened population about 20-35% are diagnosed within 2 years after the last screening examination (Verbeek, 1985;Tabar et al., 1987;Moskowitz, 1986;de Waard et al., 1984;Lundgren, 1979). The survival of patients with interval cancers turned out to be just as bad as the survival of patients diagnosed outside screening programmes (Holmberg et al., 1986;Shapiro et al., 1982). This finding would seem to suggest that shortening the screening interval to, say, one year might further decrease breast cancer mortality in a population offered a screening programme. The aim of the present study was to search for more evidence validating such recommendations. It was evaluated whether the number of 'missed' cancers decreased during the 12-year observation period. Interval cancers were compared with breast cancers, detected at one of the five screening rounds, in terms of such radiological and prognostic aspects as Wolfe classification, mammographical tumour size, age at the previous examination, quetelet index, oestrogen receptor positivity and axillary lymph node involvement. To eva...

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Breast cancer: age-specific growth rates and screening strategies.

Cited by 137 publications

References 0 publications

Patient's and Doctor's Delay in Primary Breast Cancer: Prognostic implications

Patient's and Doctor's Delay in Primary Breast Cancer: Prognostic implications

Association of Mammographic Density with the Pathology of Subsequent Breast Cancer among Postmenopausal Women

The occurrence of interval cancers in the Nijmegen screening programme

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