Abstract | BACKGROUND: To the authors' knowledge, a comprehensive analysis of pathology outcomes after screening mammography, as it is practiced clinically in the U.S. general population, has not been performed. METHODS:
Breast Cancer Surveillance Consortium data from 1996-2001 were used to identify pathology specimens that were obtained within 1 year of screening mammograms performed on 786,846 women ages 40-89 years. The pathology results were classified as invasive carcinoma, ductal carcinoma in situ ( DCIS), or benign. The associations between overall pathology outcomes and invasive tumor size and lymph node status were analyzed by age and mammography assessment category. RESULTS: The rates of both recommending and performing a biopsy varied little with age. The 1,664,032 screening mammograms were followed by 26,748 known biopsies (1.6%) and 8815 diagnoses of breast carcinoma (0.53%). Overall, 81% of carcinomas were invasive, and 78% of those were pathologically lymph node-negative tumors, in contrast to the 66% prevalence observed in the Surveillance, Epidemiology, and End Results (SEER) data during the same period. Most invasive tumors measured between 0 mm and 10 mm (35%) or between 11 mm and 20 mm (36%) in greatest dimension, and 92% and 78% were lymph node-negative tumors, respectively: Biopsy results that were classified as malignant increased with age (P < 0.0001) and were most likely to follow Breast Imaging, Reporting, and Diagnosis System Category 5 and 4 assessments, respectively. Ductal hyperplasia (19.6%), fibroadenoma (18.5%), and other benign findings (56.1%) were the most common benign diagnoses. CONCLUSIONS: Pathologically negative lymph nodes were more prevalent in this mammographically screened population than in the overall SEER population. The prevalence of invasive carcinoma, DCIS, and benign findings presented herein establish a range of expected biopsy outcomes for women after screening mammography in the general U.S. population.
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Authors | Donald L Weaver, Robert D Rosenberg, William E Barlow, Laura Ichikawa, Patricia A Carney, Karla Kerlikowske, Diana S M Buist, Berta M Geller, Charles R Key, Susan J Maygarden, Rachel Ballard-Barbash |
Journal | Cancer
(Cancer)
Vol. 106
Issue 4
Pg. 732-42
(Feb 15 2006)
ISSN: 0008-543X [Print] United States |
PMID | 16411214
(Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)
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Copyright | Copyright 2006 American Cancer Society. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- Biopsy
- Breast Neoplasms
(diagnostic imaging, epidemiology, pathology)
- Carcinoma, Intraductal, Noninfiltrating
(diagnostic imaging, pathology)
- Female
- Humans
- Lymphatic Metastasis
- Mammography
(statistics & numerical data)
- Mass Screening
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Staging
- Prevalence
- SEER Program
(statistics & numerical data)
- United States
(epidemiology)
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