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Pathologic findings from the Breast Cancer Surveillance Consortium†
Population-based outcomes in women undergoing biopsy after screening mammography
Article first published online: 12 JAN 2006
Copyright © 2006 American Cancer Society
Volume 106, Issue 4, pages 732–742, 15 February 2006
How to Cite
Weaver, D. L., Rosenberg, R. D., Barlow, W. E., Ichikawa, L., Carney, P. A., Kerlikowske, K., Buist, D. S. M., Geller, B. M., Key, C. R., Maygarden, S. J. and Ballard-Barbash, R. (2006), Pathologic findings from the Breast Cancer Surveillance Consortium. Cancer, 106: 732–742. doi: 10.1002/cncr.21652
The views expressed in this article are solely those of the authors and do not necessarily represent the official views of the NCI or the federal government.
- Issue published online: 3 FEB 2006
- Article first published online: 12 JAN 2006
- Manuscript Accepted: 1 SEP 2005
- Manuscript Revised: 1 AUG 2005
- Manuscript Received: 18 MAY 2005
- National Cancer Institute (NCI) as part of the NCI Breast Cancer Surveillance Consortium. Grant Numbers: UO1-CA70013, U01-CA86076, U01-CA63731, U01-CA86082, U01-CA63740, U01-CA69976, U01-CA70040
- breast neoplasms;
To the authors' knowledge, a comprehensive analysis of pathology outcomes after screening mammography, as it is practiced clinically in the U.S. general population, has not been performed.
Breast Cancer Surveillance Consortium data from 1996–2001 were used to identify pathology specimens that were obtained within 1 year of screening mammograms performed on 786,846 women ages 40–89 years. The pathology results were classified as invasive carcinoma, ductal carcinoma in situ (DCIS), or benign. The associations between overall pathology outcomes and invasive tumor size and lymph node status were analyzed by age and mammography assessment category.
The rates of both recommending and performing a biopsy varied little with age. The 1,664,032 screening mammograms were followed by 26,748 known biopsies (1.6%) and 8815 diagnoses of breast carcinoma (0.53%). Overall, 81% of carcinomas were invasive, and 78% of those were pathologically lymph node-negative tumors, in contrast to the 66% prevalence observed in the Surveillance, Epidemiology, and End Results (SEER) data during the same period. Most invasive tumors measured between 0 mm and 10 mm (35%) or between 11 mm and 20 mm (36%) in greatest dimension, and 92% and 78% were lymph node-negative tumors, respectively: Biopsy results that were classified as malignant increased with age (P < 0.0001) and were most likely to follow Breast Imaging, Reporting, and Diagnosis System Category 5 and 4 assessments, respectively. Ductal hyperplasia (19.6%), fibroadenoma (18.5%), and other benign findings (56.1%) were the most common benign diagnoses.
Pathologically negative lymph nodes were more prevalent in this mammographically screened population than in the overall SEER population. The prevalence of invasive carcinoma, DCIS, and benign findings presented herein establish a range of expected biopsy outcomes for women after screening mammography in the general U.S. population. Cancer 2006. © 2006 American Cancer Society.