Trends in frequency and outcome of high-risk breast lesions at core needle biopsy in women recalled at biennial screening mammography, a multiinstitutional study.

Autor: Luiten JD; Department of Surgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.; School for Oncology and Developmental Biology, Faculty of Health Medicine and Life Sciences, Research Institute GROW, Maastricht University, Maastricht, The Netherlands., Korte B; Department of Radiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands., Voogd AC; Department of Epidemiology, Faculty of Health Medicine and Life Sciences, Research Institute GROW, Maastricht University, Maastricht, The Netherlands.; Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands., Vreuls W; Department of Pathology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands., Luiten EJT; Department of Surgical Oncology, Amphia Hospital, Breda, The Netherlands., Strobbe LJ; Department of Surgical Oncology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands., Rutten MJCM; Department of Radiology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Plaisier ML; Department of Radiology, Maxima Medical Centre, Veldhoven, The Netherlands., Lohle PN; Department of Radiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands., Hooijen MJH; Department of Radiology, St Anna Hospital, Geldrop, The Netherlands., Tjan-Heijnen VCG; School for Oncology and Developmental Biology, Faculty of Health Medicine and Life Sciences, Research Institute GROW, Maastricht University, Maastricht, The Netherlands.; Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Center, Maastricht, The Netherlands., Duijm LEM; Department of Radiology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.; Dutch Expert Centre for Screening, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2019 Nov 15; Vol. 145 (10), pp. 2720-2727. Date of Electronic Publication: 2019 May 02.
DOI: 10.1002/ijc.32353
Abstrakt: Between January 1, 2011, and December 31, 2016, we studied the incidence, management and outcome of high-risk breast lesions in a consecutive series of 376,519 screens of women who received biennial screening mammography. During the 6-year period covered by the study, the proportion of women who underwent core needle biopsy (CNB) after recall remained fairly stable, ranging from 39.2% to 48.1% (mean: 44.2%, 5,212/11,783), whereas the proportion of high-risk lesions at CNB (i.e., flat epithelial atypia, atypical ductal hyperplasia, lobular carcinoma in situ and papillary lesions) gradually increased from 3.2% (25/775) in 2011 to 9.5% (86/901) in 2016 (p < 0.001). The mean proportion of high-risk lesions at CNB that were subsequently treated with diagnostic surgical excision was 51.4% (169/329) and varied between 41.0% and 64.3% through the years, but the excision rate for high-risk lesions per 1,000 screens and per 100 recalls increased from 0.25 (2011) to 0.70 (2016; p < 0.001) and from 0.81 (2011) to 2.50 (2016; p < 0.001), respectively. The proportion of all diagnostic surgical excisions showing in situ or invasive breast cancer was 29.0% (49/169) and varied from 22.2% (8/36) in 2014 to 38.5% (5/13) in 2011. In conclusion, the proportion of high-risk lesions at CNB tripled in a 6-year period, with a concomitant increased excision rate for these lesions. As the proportion of surgical excisions showing in situ or invasive breast cancer did not increase, a rising number of screened women underwent invasive surgical excision with benign outcome.
(© 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)
Databáze: MEDLINE
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