Locally advanced breast cancers are more likely to present as interval cancers: Results from the I-SPY 1 TRIAL (CALGB 150007/150012, acrin 6657, interSPORE trial)

Cheryl Lin, Meredith Becker Buxton, Dan Moore, Helen Krontiras, Lisa Carey, Angela De Michele, Leslie Montgomery, Debasish Tripathy, Constance Lehman, Minetta Liu, Olufunmilayo Olapade, Christina Yau, Donald Berry, Laura J. Esserman

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Interval cancers (ICs), defined as cancers detected between regular screening mammograms, have been shown to be of higher grade, larger size, and associated with lower survival, compared with screen-detected cancers (SDCs) and comprise 17% of cancers from population-based screening programs. We sought to determine the frequency of ICs in a study of locally advanced breast cancers, the I-SPY 1 TRIAL. Screening was defined as having a mammogram with 2 years, and the proportion of ICs at 1 and 2 years was calculated for screened patients. Differences in clinical characteristics for ICs versus SDCs and screened versus non-screened cancers were assessed. For the 219 evaluable women, mean tumor size was 6.8 cm. Overall, 80% of women were over 40 and eligible for screening; however, only 31% were getting screened. Among women screened, 85% were ICs, with 68% diagnosed within 1 year of a previously normal mammogram. ICs were of higher grade (49% vs. 10%) than SDCs. Among non-screened women, 28% (43/152) were younger than the recommended screening age of 40. Of the entire cohort, 12% of cancers were mammographically occult (MO); the frequency of MO cancers did not differ between screened (11%) and non-screened (15%). ICs were common in the I-SPY 1 TRIAL suggesting the potential need for new approaches beyond traditional screening to reduce mortality in women who present with larger palpable cancers.

Original languageEnglish (US)
Pages (from-to)871-879
Number of pages9
JournalBreast Cancer Research and Treatment
Volume132
Issue number3
DOIs
StatePublished - Apr 2012

Keywords

  • Interval cancer
  • Neoadjuvant
  • Screening

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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