Tumor characteristics in screen-detected and symptomatic breast cancers
Tumor characteristics in screen-detected and symptomatic breast cancers
复制标题
DOI：
10.1007/s12253-008-9010-7
复制
发表时间：
2008-06-01
影响因子：
2.8
通讯作者：
Kahan, Zsuzsanna
中科院分区：
文献类型：
--
作者：
Palka, Istvan;Kelemen, Gyoengyi;Kahan, Zsuzsanna
早期乳腺癌的自然进程已经改变，由于乳房X线检查的引入。本研究的目的是在乳腺X线摄影筛查的时代，对筛查发现的和有症状的可手术乳腺癌进行前瞻性分析。研究了569例浸润性乳腺癌的检测模式（筛查、症状性或间歇性癌症）、乳腺X线摄影图像类型和其他特征（浸润性肿瘤大小、组织学肿瘤类型、分级、淋巴结、激素受体和HER 2状态以及淋巴血管浸润的存在）。筛查发现的癌症更常见于I级、< 10 mm大小和淋巴结阴性（分别为p< 0.001）。症状性/间歇性癌症明显更常见于3级，大小> 20 mm（p< 0.001），并表现出淋巴管浸润（p= 0.001）。肿瘤的筛查检测有利于保乳手术、前哨淋巴结活检和避免化疗（p< 0.001）。与乳房X线片上的铸型型钙化相关的癌症通常为导管型（p= 0.043），2 - 3级，雌激素受体和孕激素受体阴性和HER 2阳性（p< 0.001）。与其他癌症相比，间隔期癌症在年轻时发生率更高，并且在乳房X线摄影中仍然是隐匿性的。乳腺X线筛查发现的癌症表现出更有利的预后特征，并且需要比症状性或间歇性癌症更少的广泛治疗。乳腺癌的X线表现反映了其生物学行为，在优化治疗时应考虑到这一点。
The natural course of early breast cancer has changed as a result of the introduction of mammographic screening. The present aim was a prospective analysis of screen-detected and symptomatic operable breast cancers in the era of mammographic service screening. The mode of detection (screen-detected, symptomatic or interval cancer), the type of mammographic image and other characteristics (the invasive tumor size, histological tumor type, grade, nodal, hormone receptor and HER2 status and the presence of lymphovascular invasion) of 569 invasive breast cancers were studied. Screen-detected cancers were significantly more frequently of grade I, < 10 mm of size and node-negative (p< 0.001, respectively). Symptomatic/interval cancers were significantly more frequently of grade 3, > 20 mm of size (p< 0.001), and exhibited lymphovascular invasion (p= 0.001). Screening-detection of the tumor favored breast-conserving surgery, sentinel lymph node biopsy and the avoidance of chemotherapy (p< 0.001). Cancers associated with casting-type calcifications on the mammogram were typically of ductal type (p= 0.043), of grade 2 -3, estrogen receptor and progesterone receptor-negative and HER2-positive (p< 0.001). Interval cancers occurred significantly more often at a younger age and remained mammographically occult as compared with other cancers. Mammographic screen-detected cancers demonstrate more favorable prognostic features, and need less extensive treatment than symptomatic or interval cancers. The mammographic appearance of the tumor reflects its biological behavior, and this should be considered in the management optimization.