Jacky D Luiten1,2, Adri C Voogd3,4, Ernest J T Luiten2, Lucien E M Duijm5,6. 1. Faculty of Medicine and Health Sciences, Erasmus University, University Medical Centre, 's-Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands. 2. Department of Breast Surgery, Amphia Hospital, Molengracht 21, 4818CK, Breda, The Netherlands. 3. Department of Epidemiology, Faculty of Health Medicine and Life Sciences, Research Institute GROW, Maastricht University, Utrechtse Singel 40, 6229ER, Maastricht, The Netherlands. 4. Department of Research, Netherlands Comprehensive Cancer Organisation, Godebaldkwartier 419, 3511DT, Utrecht, The Netherlands. 5. Department of Radiology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532SZ, Nijmegen, The Netherlands. lemduijm@hotmail.com. 6. Dutch Reference Centre for Screening, Wijchenseweg 101, 6538SW, Nijmegen, The Netherlands. lemduijm@hotmail.com.
Abstract
PURPOSE: In a biennial screening mammography programme, we analysed the trends in incidence of screen-detected DCIS and invasive breast cancers in the era of screen-film mammography (SFM) screening, the period of the transition to full-field digital mammography (FFDM) screening and the period of FFDM screening. We also investigated a possible association between the incidence and grading of screen-detected DCIS and invasive breast cancer. METHODS: In the southern part of the Netherlands, FFDM screening gradually replaced SFM screening between May 2009 and April 2010. We included a consecutive series of 484, 422 screens obtained between July 2005 and July 2015 and divided these screens into three groups; SFM-only cohort, transition cohort and FFDM-only cohort. RESULTS: A total of 3059 referred women were diagnosed with DCIS (n = 623) or invasive breast cancer (n = 2436). The majority of DCIS were high-grade (48.2%), whereas the majority of the invasive breast cancers were low-grade (45.4%) or intermediate-grade (41.6%). The cancer detection rate (CDR) per 1000 screened women showed the same distribution by grade in both groups. The transition to FFDM was characterised by an increased overall detection rate of invasive cancers. CONCLUSIONS: Screening mammography detects mostly high-grade DCIS and low- or intermediate-grade invasive cancers. The grade distribution as well as the CDR in the years after the introduction of FFDM remained stable compared to the era of SFM screening. By diagnosing and treating high-grade DCIS, which otherwise may develop into high-grade invasive carcinoma, our findings provide new evidence for the beneficial value of screening mammography programmes.
PURPOSE: In a biennial screening mammography programme, we analysed the trends in incidence of screen-detected DCIS and invasive breast cancers in the era of screen-film mammography (SFM) screening, the period of the transition to full-field digital mammography (FFDM) screening and the period of FFDM screening. We also investigated a possible association between the incidence and grading of screen-detected DCIS and invasive breast cancer. METHODS: In the southern part of the Netherlands, FFDM screening gradually replaced SFM screening between May 2009 and April 2010. We included a consecutive series of 484, 422 screens obtained between July 2005 and July 2015 and divided these screens into three groups; SFM-only cohort, transition cohort and FFDM-only cohort. RESULTS: A total of 3059 referred women were diagnosed with DCIS (n = 623) or invasive breast cancer (n = 2436). The majority of DCIS were high-grade (48.2%), whereas the majority of the invasive breast cancers were low-grade (45.4%) or intermediate-grade (41.6%). The cancer detection rate (CDR) per 1000 screened women showed the same distribution by grade in both groups. The transition to FFDM was characterised by an increased overall detection rate of invasive cancers. CONCLUSIONS: Screening mammography detects mostly high-grade DCIS and low- or intermediate-grade invasive cancers. The grade distribution as well as the CDR in the years after the introduction of FFDM remained stable compared to the era of SFM screening. By diagnosing and treating high-grade DCIS, which otherwise may develop into high-grade invasive carcinoma, our findings provide new evidence for the beneficial value of screening mammography programmes.
Entities:
Keywords:
Breast cancer screening; Ductal carcinoma in situ; Invasive breast cancer; Tumour grade
Authors: Julius Emons; Peter A Fasching; Marius Wunderle; Felix Heindl; Jens Rieger; Florian Horn; Georg Pelzer; Andre Ritter; Thomas Weber; Marcus Radicke; Iris Polifka; David L Wachter; Evelyn Wenkel; Thilo Michel; Michael Uder; Arndt Hartmann; Gisela Anton; Matthias W Beckmann; Rüdiger Schulz-Wendtland; Sebastian M Jud Journal: Ther Adv Med Oncol Date: 2020-09-18 Impact factor: 8.168