Risk factors for interval breast cancer: insights from a decade of a mammography screening program

Purpose Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk fact...

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Published in:	Breast cancer research and treatment Vol. 211; no. 1; pp. 23 - 33
Main Authors:	Subelack, Jonas, Morant, Rudolf, Blum, Marcel, Eichenberger, Alena, Geissler, Alexander, Ehlig, David
Format:	Journal Article
Language:	English
Published:	New York Springer US 01.05.2025 Springer Nature B.V
Subjects:	Adult Aged Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - diagnostic imaging Breast Neoplasms - epidemiology Breast Neoplasms - mortality Breast Neoplasms - pathology Early Detection of Cancer - methods Early Detection of Cancer - statistics & numerical data Female Humans Incidence Mammography Mammography - methods Mass Screening Medicine Medicine & Public Health Middle Aged Oncology Public health Registries Retrospective Studies Risk Factors Survival Switzerland - epidemiology Tumors Switzerland Interval cancer Interval carcinoma Mammography screening program Breast cancer Interval breast cancer Risk factors
ISSN:	0167-6806, 1573-7217, 1573-7217
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Abstract	Purpose Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data. Methods In this retrospective cohort study, we merged data from the Swiss MSP “donna” with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses. Results We identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC ( p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages ( p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative ( p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55–59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant ( p < 0.05) risk factors for IBC diagnoses. Conclusions Women with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics).
AbstractList	Purpose Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data. Methods In this retrospective cohort study, we merged data from the Swiss MSP “donna” with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses. Results We identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC ( p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages ( p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative ( p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55–59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant ( p < 0.05) risk factors for IBC diagnoses. Conclusions Women with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics). PurposeBreast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data.MethodsIn this retrospective cohort study, we merged data from the Swiss MSP “donna” with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses.ResultsWe identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC (p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages (p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative (p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55–59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant (p < 0.05) risk factors for IBC diagnoses.ConclusionsWomen with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics). Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data.PURPOSEBreast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data.In this retrospective cohort study, we merged data from the Swiss MSP "donna" with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses.METHODSIn this retrospective cohort study, we merged data from the Swiss MSP "donna" with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses.We identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC (p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages (p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative (p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55-59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant (p < 0.05) risk factors for IBC diagnoses.RESULTSWe identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC (p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages (p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative (p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55-59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant (p < 0.05) risk factors for IBC diagnoses.Women with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics).CONCLUSIONSWomen with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics). Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data. In this retrospective cohort study, we merged data from the Swiss MSP "donna" with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses. We identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC (p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages (p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative (p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55-59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant (p < 0.05) risk factors for IBC diagnoses. Women with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics).
Author	Ehlig, David Morant, Rudolf Subelack, Jonas Blum, Marcel Eichenberger, Alena Geissler, Alexander
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Keywords	Interval cancer Interval carcinoma Mammography screening program Breast cancer Interval breast cancer Risk factors
Language	English
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PublicationTitle	Breast cancer research and treatment
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Snippet	Purpose Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival.... Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval... PurposeBreast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival....
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SubjectTerms	Adult Aged Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - diagnostic imaging Breast Neoplasms - epidemiology Breast Neoplasms - mortality Breast Neoplasms - pathology Early Detection of Cancer - methods Early Detection of Cancer - statistics & numerical data Female Humans Incidence Mammography Mammography - methods Mass Screening Medicine Medicine & Public Health Middle Aged Oncology Public health Registries Retrospective Studies Risk Factors Survival Switzerland - epidemiology Tumors
Title	Risk factors for interval breast cancer: insights from a decade of a mammography screening program
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