Clinicopathological characteristics and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014).

Abstract

PURPOSE:

The mainstay modality of breast cancer screening in China is the hospital-based opportunistic screening among asymptomatic self-referred women. There is little data about the ultrasound (US) detected non-palpable breast cancer (NPBC) in Chinese population.

METHODS:

We analyzed 699 consecutive NPBC from 1.8-2.3 million asymptomatic women from 2001 to 2014, including 572 US-detected NPBC from 3,786 US-positive women and 127 mammography (MG) detected NPBC from 788 MG-positive women. The clinicopathological features, disease-free survival (DFS) and overall survival (OS) were compared between the US- and MG-detected NPBC. Prognostic factors of NPBC were identified.

RESULTS:

Compared to MG, US could detect more invasive NPBC (83.6% vs 54.3%, p<0.001), lymph node positive NPBC (19.1% vs 10.2%, p=0.018), lower grade (24.8% vs 16.5%, p<0.001), multifocal (19.2% vs 6.3%, p<0.001), PR positive (71.4% vs 66.9%, p=0.041), Her2 negative (74.3% vs 54.3%, p<0.001), Ki67 high (defined as >14%, 46.3% vs 37.0%, p=0.031) cancers and more NPBC who received chemotherapy (40.7% vs 21.3%, p<0.001). There was no significant difference in 10-year DFS and OS between US-detected vs MG-detected NPBC, DCIS and invasive NPBC. For all NPBC and the US-detected NPBC, the common DFS-predictors included pT, pN, p53 and bilateral cancers.

CONCLUSION:

US could detect more invasive, node-positive, multifocal NPBC in hospital-based asymptomatic Chinese female, who could achieve comparable 10-year DFS and OS as MG-detected NPBC. US would not delay early detection of NPBC with improved cost-effectiveness, thus could serve as the feasible initial imaging modality in hospital-based opportunistic screening among Chinese women.

• Authors: Bo Pan, Ru Yao, Qing-Li Zhu, Chang-Jun Wang, Shan-Shan You, Jing Zhang, Qian-Qian Xu, Feng Cai, Jie Shi, Yi-Dong Zhou, Feng Mao, Yan Lin, Jing-Hong Guan, Song-Jie Shen, Zhi-Yong Liang, Yu-Xin Jiang, Qiang Sun
• Journal: Oncotarget (Oncotarget) Vol. 7 Issue 47 Pg. 76840-76851 (Nov 22 2016) ISSN: 1949-2553 [Electronic] United States
• PMID: 27689334 (Publication Type: Journal Article)

Topics

• Adult
• Breast Neoplasms (diagnostic imaging, pathology)
• China
• Early Detection of Cancer (methods)
• Female
• Humans
• Mammography
• Mass Screening
• Middle Aged
• Neoplasm Grading
• Neoplasm Staging
• Prognosis
• Sensitivity and Specificity
• Survival Analysis
• Ultrasonography, Mammary (methods)