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Annual or biennial mammography screening for women at a higher risk with a family history of breast cancer: prognostic indicators of screen-detected cancers in New South Wales, Australia

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Abstract

Objective

This study examined whether offering annual mammography screening for women with the risk factor of a family history of breast cancer resulted in more favorable prognostic indicators of diagnosed cancers than the usual approach of biennial screening.

Methods

The study involved women aged 50–69 years with a family history of breast cancer, defined as having ≥1 first-degree relative diagnosed with breast cancer, who were diagnosed with a screen-detected invasive breast cancer between 1998 and 2004 in BreastScreen New South Wales (n = 590). The women were grouped according to whether they screened in an area offering annual screening to women with a family history, or were offered the standard biennial screening. The odds of having favorable tumor size, grade, and nodal status prognosis were compared between these screening groups using logistic regression. A comparison group of women without a family history, all offered biennial screening, was also evaluated based on the same area groupings to examine whether any differences were due to the area, rather than the screening interval policy.

Results

Women with a family history who were offered annual screening at BreastScreen NSW were significantly more likely than those who were offered biennial screening to be diagnosed with a tumor ≤20 mm in size (adjusted odds ratio (AOR) = 1.91, 95% CI: 1.21–3.02), and to have a node-negative tumor (AOR = 1.61, 95% CI: 1.03–2.50). There were also significantly higher odds of being diagnosed with tumors ≤15 mm (p < 0.001) and ≤10 mm in size (p = 0.011) in women offered annual screening. There was no significant difference in the odds of a Grade 1 tumor being detected (AOR = 1.26, 95% CI: 0.87–1.81), although the direction of the effect was consistent with that seen for size and nodal status. No significant differences were found in the comparison group of women without a family history.

Conclusions

Offering annual screening for women aged 50–69 years with a family history of breast cancer significantly increased the odds of being diagnosed with a smaller, node-negative tumors. Further investigation is required to assess whether the improved prognostic indicators translate into significantly better mortality outcomes for women with a family history offered annually screening.

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References

  1. Duffy SW, Tabar L, Chen HH et al (2002) The impact of organized mammography service screening on breast carcinoma mortality in seven Swedish counties. Cancer 95:458–469. doi:10.1002/cncr.10765

    Article  PubMed  Google Scholar 

  2. Taylor R, Morrell S, Estoesta J, Brassil A (2004) Mammography screening and breast cancer mortality in New South Wales, Australia. Cancer Causes Control 15:543–550. doi:10.1023/B:CACO.0000036153.95908.f2

    Article  PubMed  Google Scholar 

  3. Breast Cancer Screening (2002) In: Vainio H, Bianchini F (eds) IARC handbooks of cancer prevention, vol 7. IARC Press, Lyon, France

  4. Kerlikowske K, Carney PA, Geller B et al (2000) Performance of screening mammography among women with and without a first-degree relative with breast cancer. Ann Intern Med 133:855–863

    PubMed  CAS  Google Scholar 

  5. Lalloo F, Boggis CRM, Evans DGR, Shenton A, Threlfall AG, Howell A (1998) Screening by mammography, women with a family history of breast cancer. Eur J Cancer 34(6):937–940. doi:10.1016/S0959-8049(98)00005-7

    Article  PubMed  CAS  Google Scholar 

  6. Kollias J, Sibbering DM, Blamey RW et al (1998) Screening women aged less than 50 years with a family history of breast cancer. Eur J Cancer 34(6):878–883. doi:10.1016/S0959-8049(97)00365-1

    Article  PubMed  CAS  Google Scholar 

  7. Dumitrescu RG, Cotarla I (2005) Understanding breast cancer risk—where do we stand in 2005? J Cell Mol Med 9(1):208–221. doi:10.1111/j.1582-4934.2005.tb00350.x

    Article  PubMed  CAS  Google Scholar 

  8. Collaborative Group on Hormonal Factors in Breast Cancer (2001) Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet 358:1389–1399. doi:10.1016/S0140-6736(01)06524-2

    Article  Google Scholar 

  9. Australian Institute of Health and Welfare (2007) BreastScreen Australia monitoring report, 2003–2004. AIHW cat. no. CAN 31,. AIHW, Canberra

  10. Breast Tumours (1997) In: Sobin LH, Wittekind Ch (eds) UICC TNM classification of malignant tumours, 5th edn. Wiley-Liss, New York, pp 123–130

  11. Goldhirsch A, Glick JH, Gelber RD, Coates AS, Thürlimann B, Senn H-J, Panel Members (2005) Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005. Ann Oncol 16:1569–1583. doi:10.1093/annonc/mdi326

    Article  PubMed  CAS  Google Scholar 

  12. Boyages J, Taylor R, Chua B et al (2006) A risk index for early node-negative breast cancer. Br J Surg 93:564–571. doi:10.1002/bjs.5207

    Article  PubMed  CAS  Google Scholar 

  13. National Breast and Ovarian Cancer Centre (2005) NBOCC position statements: sentinel node biopsy in breast cancer. http://www.nbcc.org.au/media/Sentinel_node_biopsy.html#. Accessed 27 Oct 2008

  14. Lai MS, Yen MF, Kuo HS, Koong SL, Chen TH, Duffy SW (1998) Efficacy of breast-cancer screening for female relatives of breast-cancer-index cases: Taiwan multicentre cancer screening (TAMCAS). Int J Cancer 78:21–26. doi:10.1002/(SICI)1097-0215(19980925)78:1<21::AID-IJC5>3.0.CO;2-Z

    Article  PubMed  CAS  Google Scholar 

  15. Tabar L, Fagerberg G, Chen H, Duffy SW, Smart C, Smith RA (1995) Efficacy of breast cancer screening by age. Cancer 75:2507–2517. doi:10.1002/1097-0142(19950515)75:10<2507::AID-CNCR2820751017>3.0.CO;2-H

    Article  PubMed  CAS  Google Scholar 

  16. Nixon RM, Pharoah P, Tabar L et al (2000) Mammographic screening in women with a family history of breast cancer: some results from the Swedish two-county trial. Rev Epidemiol Sante Publique 48(4):325–331

    PubMed  CAS  Google Scholar 

  17. Myles JP, Nixon RM, Duffy SW et al (2003) Bayesian evaluation of breast cancer screening using data from two studies. Stat Med 22:1661–1674. doi:10.1002/sim.1365

    Article  PubMed  Google Scholar 

  18. Halapy EE, Chiarelli AM, Klar N, Knight J (2004) Breast screening outcomes in women with and without a family history of breast and/or ovarian cancer. J Med Screen 11:32–38. doi:10.1258/096914104772950736

    Article  PubMed  CAS  Google Scholar 

  19. The Breast Screening Frequency Trial Group (2002) The frequency of breast cancer screening: results from the UKCCCR Randomised Trial. Eur J Cancer 38:1458–1464. doi:10.1016/S0959-8049(01)00397-5

    Article  Google Scholar 

  20. White E, Miglioretti DL, Yankaskas BC et al (2004) Biennial versus annual mammography and the risk of late-stage breast cancer. J Natl Cancer Inst 96(24):1832–1839

    Article  PubMed  Google Scholar 

  21. Goel A, Littenberg B, Burack RC (2007) The association between the pre-diagnosis mammography screening interval and advanced breast cancer. Breast Cancer Res Treat 102:339–345. doi:10.1007/s10549-006-9334-5

    Article  PubMed  Google Scholar 

  22. Wai ES, D’yachkova Y, Olivotto IA et al (2005) Comparison of 1- and 2-year screening intervals for women undergoing screening mammography. Br J Cancer 92:961–966. doi:10.1038/sj.bjc.6602393

    Article  PubMed  CAS  Google Scholar 

  23. National Breast Cancer Centre (2006) Advice about familial aspects of breast cancer and epithelial ovarian cancer: a guide for health professionals. http://www.nbcc.org.au/bestpractice/resources/BOG182_adviceaboutfamiliala.pdf. Accessed 27 Oct 2008

  24. National Breast Cancer Centre (2002) Do you have breast cancer in your family? http://www.nbcc.org.au/resources/documents/CYF_familyhistory.pdf. Accessed 27 Oct 2008

  25. Gail MH, Brinton LA, Byar DP et al (1989) Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 81:1879–1886. doi:10.1093/jnci/81.24.1879

    Article  PubMed  CAS  Google Scholar 

  26. Kent F, Hoskins KF, Zwaagstra A, Ranz M (2006) Validation of a tool for identifying women at high risk for hereditary breast cancer in population-based screening. Cancer 107(8):1769–1776. doi:10.1002/cncr.22202

    Article  Google Scholar 

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Acknowledgements

Deborah Randall was employed by the NSW Department of Health under the NSW Biostatistical Officer Training Program. The authors would like to thank Ms. Jane Estoesta, Mr. Kojo Odoom and Ms. Connie Ho for their assistance in extracting the BSNSW Register data for analysis and providing guidance in the use of the Register data.

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Authors and Affiliations

  1. NSW Dept of Health, North Sydney, NSW, Australia

    Deborah Randall

  2. School of Public Health, University of Sydney, Sydney, Australia

    Stephen Morrell

  3. Cancer Institute NSW, Level 1, Biomedical Building, Australian Technology Park, Eveleigh, NSW 2015, Australia

    Stephen Morrell & Wai Tak Hung

  4. School of Population Health, University of Queensland, Brisbane, Australia

    Richard Taylor

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  1. Deborah Randall
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  2. Stephen Morrell
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Correspondence to Stephen Morrell.

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Randall, D., Morrell, S., Taylor, R. et al. Annual or biennial mammography screening for women at a higher risk with a family history of breast cancer: prognostic indicators of screen-detected cancers in New South Wales, Australia. Cancer Causes Control 20, 559–566 (2009). https://doi.org/10.1007/s10552-008-9264-0

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  • DOI: https://doi.org/10.1007/s10552-008-9264-0

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