Pathologic findings from the Breast Cancer Surveillance Consortium - Population-based outcomes in women undergoing biopsy after screening mammography

被引:101
作者
Weaver, DL
Rosenberg, RD
Barlow, WE
Ichikawa, L
Carney, PA
Kerlikowske, K
Buist, DSM
Geller, BM
Key, CR
Maygarden, SJ
Ballard-Barbash, R
机构
[1] Univ Vermont, Coll Med, Dept Pathol, Burlington, VT 05405 USA
[2] Univ Vermont, Dept Hlth Promot Res, Burlington, VT 05405 USA
[3] Univ New Mexico, Dept Radiol, Hlth Sci Ctr, Albuquerque, NM 87131 USA
[4] Canc Res & Biostat, Seattle, WA USA
[5] Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA USA
[6] Dartmouth Coll Sch Med, Dept Community & Family Med, Hanover, NH USA
[7] Dept Vet Affairs, Gen Internal Med Sect, San Francisco, CA USA
[8] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
[9] Univ Vermont, Vermont Canc Ctr, Burlington, VT 05405 USA
[10] Univ New Mexico, Dept Pathol, Albuquerque, NM 87131 USA
[11] Univ New Mexico, New Mexico Tumor Registry, Albuquerque, NM 87131 USA
[12] Univ N Carolina, Dept Pathol, Chapel Hill, NC USA
关键词
breast neoplasms; mammography; biopsy; pathology; population;
D O I
10.1002/cncr.21652
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 mammo-grams per-formed 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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收藏
页码:732 / 742
页数:11
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