Reviewing Interval Cancers: Time Well Spent?

Gower-Thomas, K; Fielder, H.; Branston, Lucy; Greening, Sarah; Beer, Helen; Rogers, Cerilan

doi:10.1053/crad.2001.0882

Cited by 17 publications

(6 citation statements)

References 6 publications

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“…It is possible that some breast cancers diagnosed in our screened population were detectable (but missed) at screening and thus were misclassified as interval cancers. It has been estimated that up to 35% of interval cancers may be misclassified for these reasons [47][48][49][50]. However, we were not able to review mammographic films to estimate this in our population.…”

Section: Discussionmentioning

confidence: 96%

Complementary approaches to assessing risk factors for interval breast cancer

Lowery

Byers

Hokanson

et al. 2010

Cancer Causes Control

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Incidence of interval cancer increases with age, breast density, hormone use, and family history. Attempts to reduce occurrence of these cancers through more sensitive and/or intensive screening should focus on these subgroups. The disproportionate number of interval cancers associated with young age and dense breasts suggests these cancers result from both rapid growth and difficulties in detection.

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Section: Discussionmentioning

confidence: 96%

Complementary approaches to assessing risk factors for interval breast cancer

Lowery

Byers

Hokanson

et al. 2010

Cancer Causes Control

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“…In addition, because interval-cancer status was determined by self-report, misclassification of cancer type was possible. Up to 30% of interval cancers are thought to be present at screening but missed because of technological or reader error [39, 44]. We could not review mammography reports to validate the radiological classification of cancers nor the screening date.…”

Section: Discussionmentioning

confidence: 99%

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

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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.

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“…13 Some earlier studies have shown that the retrospective review design strongly influences the number of interval cancers that are classified as missed. [14][15][16] A recent Norwegian study showed that the percentage of interval cancers classified as missed ranged from about 1% to 35% according to review design. 17 This strengthened our decision not to separate the interval cancers into true and missed categories.…”

Section: Discussionmentioning

confidence: 99%

Improved survival rate for women with interval breast cancer – results from the breast cancer screening programme in Malmö, Sweden 1976–1999

et al. 2007

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Objective Breast cancers detected between screening examinations can influence the sensitivity of a screening programme. Studies of the prognosis of these so-called interval breast cancers show diverging results. We investigated the course of interval breast cancer over time in the Malmö Mammographic Screening Trial (MMST) 1976-86 and the Malmö Mammographic Service Screening Programme (MMSSP) 1990-99. Material and methods Stage distribution and survival of interval cancers in MMSSP were compared with screen-detected and non-attender cancer cases in MMSSP, with interval cancers in MMST and with breast cancer cases in a non-screened population five years before the start of MMSSP (pre-screening cancer cases). Results In MMSSP 1990-99, the interval cancers did not differ in stage distribution or survival compared with cancer cases in non-attenders, while screen-detected cancer cases had more favourable stage distribution and rate of survival than had the interval cancer cases. The MMST interval cancer cases, 1976-1986, had more favourable stage distribution but higher overall case fatality rate, relative risks (RR) 1.78 (1.00-3.20), and breast cancer case fatality rate, RR 2.05 (1.05-4.00), compared with the more recent MMSSP interval cancer cases. No significant difference in five-year survival was seen in the MMSSP interval cancer cases compared with pre-screening cancer cases not exposed to screening. Conclusion In this urban population invited to mammographic screening, the survival rate for women with interval cancer has improved over a period of 20 years. Further studies are needed to assess what factors might explain changes in the course of interval breast cancer.

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Reviewing Interval Cancers: Time Well Spent?

Cited by 17 publications

References 6 publications

Complementary approaches to assessing risk factors for interval breast cancer

Complementary approaches to assessing risk factors for interval breast cancer

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

Improved survival rate for women with interval breast cancer – results from the breast cancer screening programme in Malmö, Sweden 1976–1999

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