A comparative study of risk factors and prognostic features between symptomatic and screen detected breast cancer

Burke, J.P.; Power, C.; Gorey, T.F.; Flanagan, F.; Kerin, M.J.; Kell, M.R.

doi:10.1016/j.ejso.2007.03.025

« Previous Next »European Journal of Surgical Oncology
Volume 34, Issue 2 , Pages 149-153, February 2008

A comparative study of risk factors and prognostic features between symptomatic and screen detected breast cancer

J.P. Burke
- Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
C. Power
- Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
T.F. Gorey
- Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
- Eccles Breast Screening Unit, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
F. Flanagan
- Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
- Eccles Breast Screening Unit, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
M.J. Kerin
- Eccles Breast Screening Unit, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
- Clinical Science Institute, University College Hospital, Galway, Ireland
M.R. Kell
- Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
- Eccles Breast Screening Unit, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
- Corresponding author. Eccles Breast Screening Unit, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland. Tel.: +353 1 882 6200; fax: +353 1 882 6225.

Accepted 27 March 2007.

Abstract

Aims

To compare prognostic factors in screen detected breast cancer (SDBC) and symptomatically presenting breast cancer (SBC).

Methods

Data were examined on 100 SDBC and 100 SBC. Multiple clinical patient factors were assessed including histopathological features. Using the Gail model each patient's risk of developing breast cancer was calculated and these data were examined for differences between groups.

Results

There was no difference in the mean age of patient presentation or in the risk of breast cancer development between groups (2.2% vs. 2.2%, SDBC vs. SBC, actuarial risk of cancer at 5 years). SDBC patients had a significantly lower grade (1.95 vs. 2.44, SDBC vs. SBC, P<0.05), a smaller size of tumour (15.4mm vs. 29.3mm, SDBC vs. SBC, P<0.05) and a higher rate of oestrogen (94% vs. 81%, P<0.05) and progesterone (75% vs. 52%, P<0.05) receptor positivity. When compared using the Nottingham Prognostic Index, SDBC was associated with a better prognosis (r=−0.444, P<0.001).

Conclusions

Though both groups have similar demographics and risk, SDBC patients appear to have more favourable prognostic features. This has implications for the application of systemic therapy in breast cancer and supports the observation that SDBC is a more indolent form of disease.

Keywords: Breast, Neoplasm, Screening mammography, Prognosis, Risk factors, Comparative study

Abbreviations: SDBC, screen detected breast cancer, SBC, symptomatic breast cancer, WLE, wide local excision, LN, lymph node, ER, oestrogen receptor, PR, progesterone receptor, LVI, lymphovascular invasion, NPI, Nottingham Prognostic Index, RR, relative risk, CI, confidence interval