The mammography screening detection of ductal carcinoma in situ and invasive breast cancer according to women’s characteristics: is it the same?
- 113 Downloads
Detection of ductal carcinoma in situ (DCIS) has increased with the mammography dissemination. Given the potential role of DCIS as a precursor of invasive breast cancer (IBC), we aimed to assess whether women’s characteristics have a different effect on the DCIS compared to IBC detection rate.
This study included 3,609,569 screening mammograms performed from 2002 to 2015 in our organized breast cancer screening program, which actively invites women 50–69 years of age. The association between women’s characteristics and the DCIS detection rate, the IBC detection rate and the odds ratio of DCIS among screen-detected cancers was assessed by logistic regression and generalized estimating equations with independent correlation matrix and sandwich estimator.
A total of 4173 DCIS and 15,136 IBC were screen-detected. Increasing women’s age, current hormone replacement therapy use and higher body mass index were less associated with the DCIS than with IBC detection rates (p value for the odds of DCIS among screen-detected cancers of, respectively, < 0.0001, 0.0244 and < 0.0001). In contrast, having a previous breast aspiration or biopsy and increasing breast density were more strongly associated with DCIS than with IBC detection rates (p value of, respectively, 0.0050 and < 0.0001).
The results suggest that some women’s characteristics could be playing a role in the initiation and other in the progression from in situ to invasive breast cancer. These characteristics can also affect the screening sensitivity, and this effect may differ depending on whether screen-detected cases were DCIS or IBC.
KeywordsBreast cancer Mammography Screening Detection rate Ductal carcinoma in situ
Body mass index
Cancer detection rate
Ductal carcinoma in situ
Generalized estimating equations
Hormone replacement therapy
Invasive breast cancer
International Classification of Diseases, 9th edition
International Classification of Diseases, 10th edition
Programme québécois de dépistage du cancer du sein (Quebec Breast Cancer Screening Program)
This study was financially supported by the Direction générale de cancérologie of the Quebec Ministry of Health and Social Services.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All women included in this analysis signed a consent form agreeing to participate in the PQDCS, which includes transmission of their data to central database for analysis.
- 3.Allred DC (2010) Ductal carcinoma in situ: terminology, classification, and natural history. J Natl Cancer Inst Monogr 41:134–138Google Scholar
- 8.Ma H, Henderson KD, Sullivan-Halley J, Duan L, Marshall SF, Ursin G et al (2010) Pregnancy-related factors and the risk of breast carcinoma in situ and invasive breast cancer among postmenopausal women in the California Teachers Study cohort. Breast Cancer Res 12(3):R35PubMedPubMedCentralGoogle Scholar
- 9.Mullooly M, Khodr ZG, Dallal CM, Nyante SJ, Sherman ME, Falk R et al (2017) Epidemiologic risk factors for in situ and invasive breast cancers among postmenopausal women in the National Institutes of Health-AARP Diet and Health Study. Am J Epidemiol 186(12):1329–1340PubMedPubMedCentralGoogle Scholar
- 13.Théberge I, Major D, Langlois A, Brisson J (2003) [Validation de stratégies pour obtenir le taux de détection du cancer, la valeur prédictive positive, la proportion des cancers in situ, la proportion des cancers infiltrants de petite taille et la proportion des cancers infiltrants sans envahissement ganglionnaire dans le cadre des données fournies par le Programme québécois de dépistage du cancer du sein (PQDCS)] [In French]. Institut national de santé publique du Québec. https://www.inspq.qc.ca/publications/201. Accessed 9 Oct 2018
- 14.Pelletier E, Major D, Brisson J (2005) [Développement d’algorithmes permettant d’identifier les interventions et les délais liés à l’investigation diagnostique suite à une mammographie de dépistage anormale - Programme québécois de dépistage du cancer du sein (PQDCS)] [In French]. Institut national de santé publique du Québec. https://www.inspq.qc.ca/publications/417. Accessed 9 Oct 2018
- 17.Canadian Partnership Against Cancer (2017) Breast cancer screening in Canada: monitoring and evaluation of quality indicators—results report, January 2011 to December 2012. Toronto, Canadian Partnership Against CancerGoogle Scholar
- 18.Australian Insitute of Health and Welfare (2017) BreastScreen Australia monitoring report 2014–2015. Cancer series no. 106. Cat. No. CAN 105. AIHW, CanberraGoogle Scholar
- 26.Trentham-Dietz A, Newcomb PA, Storer BE, Remington PL (2000) Risk factors for carcinoma in situ of the breast. Cancer Epidemiol Biomark Prev 9(7):697–703Google Scholar
- 27.Longnecker MP, Bernstein L, Paganini-Hill A, Enger SM, Ross RK (1996) Risk factors for in situ breast cancer. Cancer Epidemiol Biomark Prev 5(12):961–965Google Scholar
- 34.Nazari SS, Mukherjee P (2018) An overview of mammographic density and its association with breast cancer. Breast Cancer Tokyo Jpn25(3):259–267Google Scholar
- 37.Kavanagh AM, Cawson J, Byrnes GB, Giles GG, Marr G, Tong B et al (2005) Hormone replacement therapy, percent mammographic density, and sensitivity of mammography. Cancer Epidemiol Biomark Prev 14(5):1060–1064Google Scholar
- 41.Santen RJ, Yue W, Heitjan DF (2012) Modeling of the growth kinetics of occult breast tumors: role in interpretation of studies of prevention and menopausal hormone therapy. Cancer Epidemiol Biomark Prev 21(7):1038–1048Google Scholar
- 43.O’Grady S, Morgan MP (2018) Microcalcifications in breast cancer: from pathophysiology to diagnosis and prognosis. Biochim Biophys Acta 1869(2):310–320Google Scholar