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ABSTRACT: Breast Cancers Found by Screening: Earlier Detection,
Lower Malignant Potential or Both?
A population-based study was performed to compare the
characteristics of clinically detected breast cancers and cancers
detected by the Dutch screening program.
To determine whether
differences are most likely to be explained by earlier diagnosis
or by the detection of biologically different cancers in the
screening program, comparisons were stratified according to tumor
size.
Data were obtained from the population-based Eindhoven Cancer
Registry. During the period 1996-1999, 568 screen-detected and 630
clinically detected invasive breast cancers were available for
analysis. Compared with patients with clinically detected breast
cancer, women with screen-detected breast cancer had smaller
tumors (P < 0.0001), were more likely to have negative lymph nodes
(P < 0.0001), tumors with a positive estrogen (P = 0.007) or
progesterone (P = 0.019) receptor status and a lower mitotic activity
index (P = 0.009).
In the group with cancers .1.0 cm the
screen-detected were more likely to have negative estrogen receptors
(P = 0.027). The group with screen-detected tumors 1.1-2.0 cm across
were more likely to have positive estrogen and progesterone receptors
(P = 0.005 and P = 0.044, respectively) and tended to have a lower
mitotic activity index (P = 0.078).
No significant differences were
found between screen-detected and clinically detected breast cancers
of 2.1-3.0 cm across.
After adjustments for tumor size, most of the
differences between clinically detected and screen-detected breast
cancers disappeared, suggesting that screen-detected breast cancers
represent tumors in an earlier phase of their development, not a
biologically different class.
[09/30/2002; Breast Cancer Research and Treatment]
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