Introduction
Material and methods
Patients
Method of detection
Histopathological characteristics
Laboratory methods
Statistical analysis
Results
Method of tumor detection and clinicopathological features
All age groups | Ages 50 to 69 years | |||||
---|---|---|---|---|---|---|
Factor | Screening, n(%)a (n= 408) | Outside screening, n(%) (n= 1,476) | Pvalue | Screening, n(%) (n= 347) | Outside screening, n(%) (n= 502) | Pvalue |
Primary tumor diameter (mm) | < 0.001 | < 0.001 | ||||
≤ 10 | 158 (39) | 207 (14) | 143 (41) | 82 (16) | ||
11 to 20 | 179 (44) | 576 (39) | 147 (42) | 204 (41) | ||
21 to 50 | 55 (13) | 581 (39) | 42 (12) | 183 (36) | ||
> 50 | 2 (0) | 66 (4) | 1 (0) | 21 (4) | ||
N.A. | 14 (3) | 46 (3) | 14 (4) | 12 (2) | ||
Nodal status | < 0.001 | < 0.001 | ||||
Negative | 317 (77) | 862 (58) | 273 (79) | 321 (64) | ||
Positive | 85 (21) | 552 (37) | 69 (20) | 178 (35) | ||
N.A. | 6 (1) | 62 (4) | 5 (1) | 3 (0) | ||
Histological type | 0.04 | 0.02 | ||||
Ductal | 287 (70) | 1,104 (75) | 243 (70) | 365 (73) | ||
Lobular | 65 (16) | 232 (16) | 55 (16) | 95 (19) | ||
Special type | 56 (14) | 139 (9) | 49 (14) | 41 (8) | ||
N.A. | 0 | 1 (0) | 0 | 1 (0) | ||
Histological grade | < 0.001 | < 0.001 | ||||
1 | 129 (32) | 241 (16) | 111 (32) | 85 (17) | ||
2 | 147 (36) | 515 (35) | 123 (35) | 172 (34) | ||
3 | 55 (13) | 326 (22) | 43 (12) | 115 (23) | ||
N.A. | 77 (19) | 394 (27) | 70 (20) | 130 (26) | ||
ER content | 0.038 | 0.002 | ||||
Negative | 40 (10) | 232 (16) | 31 (9) | 94 (19) | ||
Positive | 204 (50) | 802 (54) | 172 (50) | 260 (52) | ||
N.A. | 164 (40) | 442 (30) | 144 (41) | 148 (29) | ||
PR content | 0.094 | < 0.001 | ||||
Negative | 79 (19) | 392 (27) | 64 (18) | 171 (34) | ||
Positive | 161 (39) | 620 (42) | 132 (38) | 173 (34) | ||
N.A. | 168 (41) | 464 (31) | 151 (44) | 158 (31) | ||
HER2 | ||||||
Amplification | 0.09 | 0.19 | ||||
Negative | 217 (53) | 852 (58) | 176 (51) | 293 (58) | ||
Positive | 37 (9) | 202 (14) | 32 (9) | 72 (14) | ||
N.A. | 154 (38) | 422 (29) | 139 (40) | 137 (27) | ||
Expression | 0.25 | 0.33 | ||||
Negative | 218 (53) | 889 (60) | 179 (52) | 299 (60) | ||
Positive | 39 (10) | 198 (13) | 33 (10) | 69 (14) | ||
N.A. | 151 (37) | 389 (26) | 135 (39) | 134 (27) | ||
Ki-67 | 0.08 | 0.07 | ||||
Negative | 155 (38) | 615 (42) | 133 (38) | 209 (42) | ||
Positive | 73 (18) | 379 (26) | 54 (16) | 121 (24) | ||
N.A. | 180 (44) | 482 (33) | 160 (46) | 172 (34) | ||
p53 | 0.63 | 0.21 | ||||
Negative | 171 (42) | 786 (53) | 145 (42) | 254 (51) | ||
Positive | 38 (9) | 192 (13) | 31 (9) | 73 (15) | ||
N.A. | 199 (49) | 498 (34) | 171 (49) | 175 (35) | ||
Adjuvant systemic therapy | < 0.001 | < 0.001 | ||||
Not given | 314 (77) | 827 (56) | 271 (78) | 297 (59) | ||
Given | 89 (22) | 609 (41) | 72 (21) | 197 (39) | ||
N.A. | 5 (1) | 40 (3) | 4 (1) | 8 (2) |
Method of detection and breast cancer survival
Screening | Outside screening | |||||
---|---|---|---|---|---|---|
Primary tumor diameter (mm) | At risk (n) | 15-year survival (%) | At risk (n) | 15-year survival (%) | Pvalue | RR |
All age groups | ||||||
≤ 10 | 132 | 92.1 | 116 | 83.9 | 0.0296 | 2.04 |
11 to 20 | 133 | 84 | 297 | 74.5 | 0.0066 | 1.75 |
21 to 50 | 37 | 76.6 | 214 | 56.5 | 0.0088 | 2.08 |
> 50 | N.A. | N.A. | 19 | 34.1 | N.A. | N.A. |
Ages 50 to 69 years | ||||||
≤ 10 | 122 | 92.1 | 54 | 83.1 | 0.0343 | 2.25 |
11 to 20 | 110 | 81.5 | 123 | 74.6 | 0.0764 | 1.52 |
21 to 50 | 30 | 77.7 | 89 | 59.4 | 0.0325 | 1.02 |
> 50 | N.A. | N.A. | 5 | 35.7 | N.A. | N.A. |
Node-negative ages 50 to 69 years | ||||||
≤ 10 | 114 | 93.7 | 48 | 84 | 0.021 | 2.66 |
11 to 20 | 84 | 87 | 89 | 79.3 | 0.0534 | 1.85 |
21 to 50 | 19 | 90.7 | 58 | 70.9 | 0.0769 | 2.79 |
> 50 | N.A. | N.A. | 2 | 50 | N.A. | N.A. |
Influence of screening on outcome according to nodal status
Influence of age at diagnosis on outcome
Screening | Outside screening | |||||||
---|---|---|---|---|---|---|---|---|
Survival (%) | Survival (%) | |||||||
Age at diagnosis (years) | Patients ( n ) | 5 years | 10 years | 15 years | Patients ( n ) | 5 years | 10 years | 15 years |
Node-negative and node-positive | ||||||||
≤ 39 | 2 | N.A. | N.A. | N.A. | 118 | 81.4 | 63.5 | 57.3 |
40 to 49 | 47 | 100 | 93.5 | 93.5 | 362 | 85.6 | 75.8 | 71.3 |
50 to 59 | 254 | 94.1 | 89.6 | 86.3 | 230 | 84.2 | 77.1 | 71.5 |
60 to 69 | 93 | 97.8 | 92.1 | 84.9 | 272 | 83.3 | 71.2 | 65.8 |
≥ 70 | 12 | N.A. | N.A. | N.A. | 494 | 80.4 | 69.1 | 60.8 |
Node-negative | ||||||||
≤ 39 | 1 | N.A. | N.A. | N.A. | 64 | 92.2 | 81.2 | 76.3 |
40 to 49 | 34 | 100 | 97.1 | 97.1 | 195 | 92.8 | 85.6 | 82.5 |
50 to 59 | 190 | 98.4 | 95.2 | 92.4 | 150 | 92 | 86.5 | 82.3 |
60 to 69 | 83 | 98.9 | 92.5 | 87.2 | 171 | 86.1 | 79.1 | 72.1 |
≥ 70 | 9 | N.A. | N.A. | N.A. | 282 | 88.6 | 78 | 70.7 |
Node-positive | ||||||||
≤ 39 | 1 | N.A. | N.A. | N.A. | 54 | 72.2 | 46.3 | 38.6 |
40 to 49 | 12 | 100 | 91.7 | 91.7 | 165 | 76.9 | 64 | 57.8 |
50 to 59 | 61 | 83.4 | 75 | 69.9 | 79 | 69.5 | 59.2 | 50.9 |
60 to 69 | 8 | 100 | 100 | 71.4 | 99 | 78.4 | 58.4 | 55.6 |
≥ 70 | 3 | N.A. | N.A. | N.A. | 155 | 66 | 55.5 | 45.4 |
Multivariate survival analyses
Variable | HR (95% CI) | Pvalue |
---|---|---|
Detection outside screening | 1.69 (1.06 to 2.70) | 0.028 |
Tumor size (per cm) | 1.02 (1.01 to 1.03) | < 0.001 |
Positive lymph nodes (n/metastatic node) | 1.31 (1.10 to 1.17) | < 0.001 |
Histological grade (grade II vs grade III vs grade I) | 2.54 (1.52 to 4.25) | < 0.001 |
PR (negative vs positive) | 1.23 (0.92 to 1.64) | 0.154 |
HER2 amplification (positive vs negative) | 1.45 (1.06 to 1.97) | 0.019 |
Age at diagnosis (years) | ||
≤ 39a | 1.00 | |
40 to 49 | 0.62 (0.28 to 1.00) | 0.051 |
50 to 59 | 0.82 (0.50 to 1.34) | 0.437 |
60 to 69 | 0.92 (0.57 to 1.49) | 0.733 |
≥ 70 | 1.13 (0.70 to 1.83) | 0.605 |