Interval breast cancer rates and tumor characteristics in the prospective population-based Malmö breast tomosynthesis screening trial

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Abstract

Background: Interval cancer rates can be used to evaluate whether screening with digital breast tomosynthesis (DBT) contributes to a screening benefit. Purpose: To compare interval cancer rates and tumor characteristics in DBT screening to those in a contemporary population screened with digital mammography (DM). Materials and Methods: The prospective population-based Malmö Breast Tomosynthesis Screening Trial (MBTST) was designed to compare one-view DBT to two-view DM in breast cancer detection. The interval cancer rates and cancer characteristics in the MBTST were compared with an age-matched contemporary control group, screened with two-view DM at the same center. Conditional logistic regression was used for data analysis. Results: There were 14 848 women who were screened with DBT and DM in the MBTST between January 2010 and February 2015. The trial women were matched with two women of the same age and screening occasion at DM screening during the same period. Matches for 13 369 trial women (mean age, 56 years ± 10 [standard deviation]) were found with 26 738 women in the control group (mean age, 56 years ± 10). The interval cancer rate in the MBTST was 1.6 per 1000 screened women (21 of 13 369; 95% CI: 1.0, 2.4) compared with 2.8 per 1000 screened women in the control group (76 of 26 738 [95% CI: 2.2, 3.6]; conditional odds ratio, 0.6 [95% CI: 0.3, 0.9]; P = .02). The invasive interval cancers in the MBTST and in the control group showed in general high Ki-67 (63% [12 of 19] and 75% [54 of 72]), and low proportions of luminal A–like subtype (26% [five of 19] and 17% [12 of 72]), respectively. Conclusion: The reduced interval cancer rate after screening with digital breast tomosynthesis compared with a contemporary age-matched control group screened with digital mammography might translate into screening benefits. Interval cancers in the trial generally had nonfavorable characteristics.

Original languageEnglish
Pages (from-to)559-567
Number of pages9
JournalRadiology
Volume299
Issue number3
DOIs
Publication statusPublished - 2021 Jun

Bibliographical note

Funding Information:
and speaker fees from Siemens Healthcare. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. D.M.I. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: disclosed consultancy from Hologic; payment for lectures from CME Science; royalties from Elsevier; payment for development of educational presentations from CME Science. Other relationships: disclosed no relevant relationships. A.A. disclosed no relevant relationships. I.A. disclosed no relevant relationships. S.Z. Activities related to the present article: disclosed grant from the Swedish Cancer Society. Activities not related to the present article: disclosed payment for lectures from Siemens Healthcare. Other relationships: disclosed patent issues by the U.S. Patent Authority.

Funding Information:
Disclosures of Conflicts of Interest: K.J. Activities related to the present article: disclosed an ALF government grant; disclosed travel support from the John and Augusta Persson fund. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. K.L. Activities related to the present article: disclosed travel grant

Publisher Copyright:
© RSNA, 2021.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Subject classification (UKÄ)

  • Cancer and Oncology
  • Radiology, Nuclear Medicine and Medical Imaging

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