TY - JOUR
T1 - Locally advanced breast cancers are more likely to present as interval cancers
T2 - Results from the I-SPY 1 TRIAL (CALGB 150007/150012, acrin 6657, interSPORE trial)
AU - Lin, Cheryl
AU - Buxton, Meredith Becker
AU - Moore, Dan
AU - Krontiras, Helen
AU - Carey, Lisa
AU - De Michele, Angela
AU - Montgomery, Leslie
AU - Tripathy, Debasish
AU - Lehman, Constance
AU - Liu, Minetta
AU - Olapade, Olufunmilayo
AU - Yau, Christina
AU - Berry, Donald
AU - Esserman, Laura J.
N1 - Funding Information:
Acknowledgments National Cancer Institute Specialized Program of Research Excellence in Breast Cancer, American College of Radiology Imaging Network, Cancer and Leukemia Group B, National Cancer Institute Center for Bioinformatics, The Breast Cancer Research Foundation, and Bruce and Martha Atwater are acknowledged. Grant numbers: NCI SPORE: CA58207, ACRIN: U01 CA079778 & CA080098, CALGB: CA31964 & CA33601.
PY - 2012/4
Y1 - 2012/4
N2 - 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.
AB - 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.
KW - Interval cancer
KW - Neoadjuvant
KW - Screening
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U2 - 10.1007/s10549-011-1670-4
DO - 10.1007/s10549-011-1670-4
M3 - Article
C2 - 21796368
AN - SCOPUS:84865188320
SN - 0167-6806
VL - 132
SP - 871
EP - 879
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 3
ER -