Breast cancer biology varies by method of detection and may contribute to overdiagnosis

Background Recently, it has been suggested that screening mammography may result in some degree of overdiagnosis (ie, detection of breast cancers that would never become clinically important within the lifespan of the patient). The extent and biology of these overdiagnosed cancers, however, is not w...

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Bibliographic Details
Published in:Surgery 2016-08, Vol.160 (2), p.454-462
Main Authors: Hayse, Brandon, BSc, Hooley, Regina J., MD, Killelea, Brigid K., MD, MPH, Horowitz, Nina R., MD, Chagpar, Anees B., MD, MSc, MPH, MA, MBA, Lannin, Donald R., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Breast Neoplasms - diagnosis
Carcinoma - diagnosis
Diagnostic Self Evaluation
Early Detection of Cancer
Female
Humans
Logistic Models
Magnetic Resonance Imaging
Mammography
Mass Screening
Medical Overuse
Middle Aged
Neoplasm Grading
Physical Examination
Retrospective Studies
Surgery
Ultrasonography
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Summary:Background Recently, it has been suggested that screening mammography may result in some degree of overdiagnosis (ie, detection of breast cancers that would never become clinically important within the lifespan of the patient). The extent and biology of these overdiagnosed cancers, however, is not well understood, and the effect of newer screening modalities on overdiagnosis is unknown. Methods We performed a retrospective review of a prospectively collected database of breast cancers diagnosed at the Yale Breast Center from 2004–2014. The mode of initial presentation was categorized into 5 groups: screening mammogram, screening magnetic resonance imaging, screening ultrasonography, self-detected masses, and physician-detected masses. Results Compared with cancers presenting with masses, cancers detected by image-based screening were more likely to present with ductal carcinoma-in-situ or T1 cancers ( P  
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2016.03.031