Accuracy and Outcomes of Screening Mammography in Women with a Personal History of Early-stage Breast Cancer

Overview

Journal JAMA

Publisher American Medical Association

Specialty General Medicine

Date 2011 Feb 24

PMID 21343578

Citations 55

Authors

Nehmat Houssami

Linn A Abraham

Diana L Miglioretti

Edward A Sickles

Karla Kerlikowske

Diana S M Buist

Berta M Geller

Hyman B Muss

Les Irwig

Affiliations

Soon will be listed here.

Abstract

Context: Women with a personal history of breast cancer (PHBC) are at risk of developing another breast cancer and are recommended for screening mammography. Few high-quality data exist on screening performance in PHBC women.

Objective: To examine the accuracy and outcomes of mammography screening in PHBC women relative to screening of similar women without PHBC.

Design And Setting: Cohort of PHBC women, mammogram matched to non-PHBC women, screened through facilities (1996-2007) affiliated with the Breast Cancer Surveillance Consortium.

Participants: There were 58,870 screening mammograms in 19,078 women with a history of early-stage (in situ or stage I-II invasive) breast cancer and 58,870 matched (breast density, age group, mammography year, and registry) screening mammograms in 55,315 non-PHBC women.

Main Outcome Measures: Mammography accuracy based on final assessment, cancer detection rate, interval cancer rate, and stage at diagnosis.

Results: Within 1 year after screening, 655 cancers were observed in PHBC women (499 invasive, 156 in situ) and 342 cancers (285 invasive, 57 in situ) in non-PHBC women. Screening accuracy and outcomes in PHBC relative to non-PHBC women were cancer rates of 10.5 per 1000 screens (95% CI, 9.7-11.3) vs 5.8 per 1000 screens (95% CI, 5.2-6.4), cancer detection rate of 6.8 per 1000 screens (95% CI, 6.2-7.5) vs 4.4 per 1000 screens (95% CI, 3.9-5.0), interval cancer rate of 3.6 per 1000 screens (95% CI, 3.2-4.1) vs 1.4 per 1000 screens (95% CI, 1.1-1.7), sensitivity 65.4% (95% CI, 61.5%-69.0%) vs 76.5% (95% CI, 71.7%-80.7%), specificity 98.3% (95% CI, 98.2%-98.4%) vs 99.0% (95% CI, 98.9%-99.1%), abnormal mammogram results in 2.3% (95% CI, 2.2%-2.5%) vs 1.4% (95% CI, 1.3%-1.5%) (all comparisons P < .001). Screening sensitivity in PHBC women was higher for detection of in situ cancer (78.7%; 95% CI, 71.4%-84.5%) than invasive cancer (61.1%; 95% CI, 56.6%-65.4%), P < .001; lower in the initial 5 years (60.2%; 95% CI, 54.7%-65.5%) than after 5 years from first cancer (70.8%; 95% CI, 65.4%-75.6%), P = .006; and was similar for detection of ipsilateral cancer (66.3%; 95% CI, 60.3%-71.8%) and contralateral cancer (66.1%; 95% CI, 60.9%-70.9%), P = .96. Screen-detected and interval cancers in women with and without PHBC were predominantly early stage.

Conclusion: Mammography screening in PHBC women detects early-stage second breast cancers but has lower sensitivity and higher interval cancer rate, despite more evaluation and higher underlying cancer rate, relative to that in non-PHBC women.

Citing Articles

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References

Dershaw D, McCormick B, Osborne M . Detection of local recurrence after conservative therapy for breast carcinoma. Cancer. 1992; 70(2):493-6. DOI: 10.1002/1097-0142(19920715)70:2<493::aid-cncr2820700219>3.0.co;2-3. View

Fowble B, Solin L, Schultz D, Rubenstein J, Goodman R . Breast recurrence following conservative surgery and radiation: patterns of failure, prognosis, and pathologic findings from mastectomy specimens with implications for treatment. Int J Radiat Oncol Biol Phys. 1990; 19(4):833-42. DOI: 10.1016/0360-3016(90)90002-2. View

Lu W, Jansen L, Post W, Bonnema J, Van de Velde J, de Bock G . Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer: a meta-analysis. Breast Cancer Res Treat. 2008; 114(3):403-12. DOI: 10.1007/s10549-008-0023-4. View

Punglia R, Hassett M . Using lifetime risk estimates to recommend magnetic resonance imaging screening for breast cancer survivors. J Clin Oncol. 2010; 28(27):4108-10. PMC: 2953968. DOI: 10.1200/JCO.2010.30.0350. View

Montgomery D, Krupa K, Cooke T . Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature. Br J Cancer. 2007; 97(12):1632-41. PMC: 2360278. DOI: 10.1038/sj.bjc.6604065. View

Sickles E, Miglioretti D, Ballard-Barbash R, Geller B, Leung J, Rosenberg R . Performance benchmarks for diagnostic mammography. Radiology. 2005; 235(3):775-90. DOI: 10.1148/radiol.2353040738. View

Carlson R, Allred D, Anderson B, Burstein H, Carter W, Edge S . Breast cancer. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2009; 7(2):122-92. DOI: 10.6004/jnccn.2009.0012. View

Houssami N, Ciatto S . Mammographic surveillance in women with a personal history of breast cancer: how accurate? How effective?. Breast. 2010; 19(6):439-45. DOI: 10.1016/j.breast.2010.05.010. View

Lu W, Schaapveld M, Jansen L, Bagherzadegan E, Sahinovic M, Baas P . The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer. Eur J Cancer. 2009; 45(17):3000-7. DOI: 10.1016/j.ejca.2009.08.007. View

10.

Ciatto S, Miccinesi G, Zappa M, Marco Z, Guido M . Prognostic impact of the early detection of metachronous contralateral breast cancer. Eur J Cancer. 2004; 40(10):1496-501. DOI: 10.1016/j.ejca.2004.03.010. View

11.

Lash T, Fox M, Buist D, Wei F, Field T, Frost F . Mammography surveillance and mortality in older breast cancer survivors. J Clin Oncol. 2007; 25(21):3001-6. DOI: 10.1200/JCO.2006.09.9572. View

12.

Hayes D . Clinical practice. Follow-up of patients with early breast cancer. N Engl J Med. 2007; 356(24):2505-13. DOI: 10.1056/NEJMcp067260. View

13.

Khatcheressian J, Wolff A, Smith T, Grunfeld E, Muss H, Vogel V . American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol. 2006; 24(31):5091-7. DOI: 10.1200/JCO.2006.08.8575. View

14.

Schwartz G, Veronesi U, Clough K, Dixon J, Fentiman I, Heywang-Kobrunner S . Consensus conference on breast conservation. J Am Coll Surg. 2006; 203(2):198-207. DOI: 10.1016/j.jamcollsurg.2006.04.009. View

15.

Rosenberg R, Yankaskas B, Abraham L, Sickles E, Lehman C, Geller B . Performance benchmarks for screening mammography. Radiology. 2006; 241(1):55-66. DOI: 10.1148/radiol.2411051504. View

16.

Temple L, Wang E, McLeod R . Preventive health care, 1999 update: 3. Follow-up after breast cancer. Canadian Task Force on Preventive Health Care. CMAJ. 1999; 161(8):1001-8. PMC: 1230673. View

17.

Grunfeld E, Noorani H, McGahan L, Paszat L, Coyle D, Van Walraven C . Surveillance mammography after treatment of primary breast cancer: a systematic review. Breast. 2004; 11(3):228-35. DOI: 10.1054/brst.2001.0404. View

18.

Berg W, Blume J, Cormack J, Mendelson E, Lehrer D, Bohm-Velez M . Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA. 2008; 299(18):2151-63. PMC: 2718688. DOI: 10.1001/jama.299.18.2151. View

19.

Houssami N, Ciatto S, Martinelli F, Bonardi R, Duffy S . Early detection of second breast cancers improves prognosis in breast cancer survivors. Ann Oncol. 2009; 20(9):1505-1510. DOI: 10.1093/annonc/mdp037. View

20.

Stomper P, Recht A, BERENBERG A, Jochelson M, Harris J . Mammographic detection of recurrent cancer in the irradiated breast. AJR Am J Roentgenol. 1987; 148(1):39-43. DOI: 10.2214/ajr.148.1.39. View