Using Mammographic Density to Improve Breast Cancer Screening Outcomes
Identifieur interne : 008940 ( Main/Exploration ); précédent : 008939; suivant : 008941Using Mammographic Density to Improve Breast Cancer Screening Outcomes
Auteurs : Anne M. Kavanagh [Australie] ; Graham B. Byrnes [France] ; Carolyn Nickson [Australie] ; Jennifer N. Cawson [Australie] ; Graham G. Giles [Australie] ; John L. Hopper [Australie] ; Dorota M. Gertig [Australie] ; Dallas R. English [Australie]Source :
- Cancer epidemiology, biomarkers & prevention [ 1055-9965 ] ; 2008.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
It is possible that the performance of mammographic screening would be improved if it is targeted at women at higher risk of breast cancer or who are more likely to have their cancer missed at screening, through more intensive screening or alternative screening modalities. We conducted a case-control study within a population-based Australian mammographic screening program (1,706 invasive breast cancers and 5,637 randomly selected controls). We used logistic regression to examine the effects of breast density, age, and hormone therapy use, all known to influence both breast cancer risk and the sensitivity of mammographic screening, on the risk of small (≤15 mm) and large (>15 mm) screen-detected and interval breast cancers. The risk of small screen-detected cancers was not associated with density, but the risk of large screen-detected cancers was nearly 3-fold for the second quintile and approximately 4-fold for the four highest density categories (third and fourth quintiles and the two highest deciles) compared with the lowest quintile. The risk of interval cancers increased monotonically across the density categories [highest decile odds ratio (OR), 4.65; 95% confidence interval (95% CI), 2.96-7.31]. The risk of small and large screen-detected cancers, but not interval cancers, increased with age. After adjusting for age and density, hormone therapy use was associated with a moderately elevated risk of interval cancers (OR, 1.43; 95% CI, 1.12-1.81). The effectiveness of the screening program could be improved if density were to be used to identify women most likely to have poor screening outcomes. There would be little additional benefit in targeting screening based on age and hormone therapy use.
Affiliations:
- Australie, France
- Auvergne-Rhône-Alpes, Rhône-Alpes, Victoria (État)
- Lyon, Melbourne
- Université de Melbourne
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Le document en format XML
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Hopper</name><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Centre for MEGA Epidemiology, Melbourne School of Population Health, University of Melbourne</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Melbourne</settlement></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Gertig, Dorota M" sort="Gertig, Dorota M" uniqKey="Gertig D" first="Dorota M." last="Gertig">Dorota M. Gertig</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Victorian Cervical Cytology Registry</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>7 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="English, Dallas R" sort="English, Dallas R" uniqKey="English D" first="Dallas R." last="English">Dallas R. English</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Cancer Epidemiology Centre, Cancer Council of Victoria</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Centre for MEGA Epidemiology, Melbourne School of Population Health, University of Melbourne</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Melbourne</settlement></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author></analytic><series><title level="j" type="main">Cancer epidemiology, biomarkers & prevention</title><title level="j" type="abbreviated">Cancer epidemiol. biomark. prev.</title><idno type="ISSN">1055-9965</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Cancer epidemiology, biomarkers & prevention</title><title level="j" type="abbreviated">Cancer epidemiol. biomark. prev.</title><idno type="ISSN">1055-9965</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Breast cancer</term><term>Cancerology</term><term>Density</term><term>Evolution</term><term>Improvement</term><term>Malignant tumor</term><term>Mammary gland</term><term>Mammography</term><term>Medical screening</term><term>Prognosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Mammographie</term><term>Densité</term><term>Amélioration</term><term>Cancer du sein</term><term>Glande mammaire</term><term>Dépistage</term><term>Tumeur maligne</term><term>Pronostic</term><term>Evolution</term><term>Cancérologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">It is possible that the performance of mammographic screening would be improved if it is targeted at women at higher risk of breast cancer or who are more likely to have their cancer missed at screening, through more intensive screening or alternative screening modalities. We conducted a case-control study within a population-based Australian mammographic screening program (1,706 invasive breast cancers and 5,637 randomly selected controls). We used logistic regression to examine the effects of breast density, age, and hormone therapy use, all known to influence both breast cancer risk and the sensitivity of mammographic screening, on the risk of small (≤15 mm) and large (>15 mm) screen-detected and interval breast cancers. The risk of small screen-detected cancers was not associated with density, but the risk of large screen-detected cancers was nearly 3-fold for the second quintile and approximately 4-fold for the four highest density categories (third and fourth quintiles and the two highest deciles) compared with the lowest quintile. The risk of interval cancers increased monotonically across the density categories [highest decile odds ratio (OR), 4.65; 95% confidence interval (95% CI), 2.96-7.31]. The risk of small and large screen-detected cancers, but not interval cancers, increased with age. After adjusting for age and density, hormone therapy use was associated with a moderately elevated risk of interval cancers (OR, 1.43; 95% CI, 1.12-1.81). The effectiveness of the screening program could be improved if density were to be used to identify women most likely to have poor screening outcomes. There would be little additional benefit in targeting screening based on age and hormone therapy use.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Rhône-Alpes</li><li>Victoria (État)</li></region><settlement><li>Lyon</li><li>Melbourne</li></settlement><orgName><li>Université de Melbourne</li></orgName></list><tree><country name="Australie"><region name="Victoria (État)"><name sortKey="Kavanagh, Anne M" sort="Kavanagh, Anne M" uniqKey="Kavanagh A" first="Anne M." last="Kavanagh">Anne M. Kavanagh</name></region><name sortKey="Cawson, Jennifer N" sort="Cawson, Jennifer N" uniqKey="Cawson J" first="Jennifer N." last="Cawson">Jennifer N. Cawson</name><name sortKey="English, Dallas R" sort="English, Dallas R" uniqKey="English D" first="Dallas R." last="English">Dallas R. English</name><name sortKey="English, Dallas R" sort="English, Dallas R" uniqKey="English D" first="Dallas R." last="English">Dallas R. English</name><name sortKey="Gertig, Dorota M" sort="Gertig, Dorota M" uniqKey="Gertig D" first="Dorota M." last="Gertig">Dorota M. Gertig</name><name sortKey="Giles, Graham G" sort="Giles, Graham G" uniqKey="Giles G" first="Graham G." last="Giles">Graham G. Giles</name><name sortKey="Hopper, John L" sort="Hopper, John L" uniqKey="Hopper J" first="John L." last="Hopper">John L. Hopper</name><name sortKey="Nickson, Carolyn" sort="Nickson, Carolyn" uniqKey="Nickson C" first="Carolyn" last="Nickson">Carolyn Nickson</name></country><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Byrnes, Graham B" sort="Byrnes, Graham B" uniqKey="Byrnes G" first="Graham B." last="Byrnes">Graham B. Byrnes</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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