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- Title
Risk Factors and Mortality Among Women With Interval Breast Cancer vs Screen-Detected Breast Cancer.
- Authors
Song, Huiyeon; Tran, Thi Xuan Mai; Kim, Soyeoun; Park, Boyoung
- Abstract
Key Points: Question: What are the established risk factors for women with interval breast cancer (IBC) vs screen-detected breast cancer (SBC), and how might they be associated with mortality outcomes? Findings: In this cohort study of 18 194 Korean women who underwent mammographic breast cancer screening, breast density, obesity, and hormone replacement therapy use were associated with IBC compared with SBC. Overall mortality of IBC was comparable with that of SBC. Meaning: These findings suggest that breast density is associated with IBC; additional research is warranted to determine whether a shortened screening period and new screening strategies are needed for women with risk factors for IBC. This cohort study of Korean women uses mammographic breast cancer screening data to assess the risk factors for interval breast cancer vs screen-detected breast cancer and investigates the associated mortality outcomes. Importance: The risk factors for interval breast cancer (IBC) compared with those for screen-detected breast cancer (SBC) and their association with mortality outcomes have not yet been evaluated among Korean women. Objective: To evaluate risk factors associated with IBC and survival among Korean women with IBC compared with those with SBC. Design, Setting, and Participants: This retrospective cohort study used data from the Korean National Health Insurance Service Database. Women who participated in a national mammographic breast cancer screening program between January 1, 2009, and December 31, 2012, were included. Mortality outcomes were calculated from the date of breast cancer diagnosis to the date of death or December 31, 2020. Data were analyzed from March 1 to June 30, 2023. Exposure: Breast cancer diagnosed within 6 to 24 months after a negative screening result (ie, IBC) or within 6 months after a positive screening result (ie, SBC). Main Outcomes and Measures: Risk factors and survival rates for IBC and SBC. Results: This study included 8702 women with IBC (mean [SD] age, 53.3 [8.6] years) and 9492 women with SBC (mean [SD] age, 54.1 [9.0] years). Compared with SBC, the probability of IBC decreased as mammographic density increased. Lower body mass index, menopausal status, hormone replacement therapy (HRT) use, and lack of family history of breast cancer were associated with a higher likelihood of IBC. When stratified by detection time, younger age at breast cancer diagnosis and family history of breast cancer were associated with an increased likelihood of IBC diagnosed at 6 to 12 months but a decreased likelihood of IBC diagnosed at 12 to 24 months. Overall mortality of IBC was comparable with SBC, but total mortality and cancer-related mortality of IBC diagnosed between 6 and 12 months was higher than that of SBC. Conclusions and Relevance: The findings of this cohort study suggest that breast density, obesity, and HRT use were associated with IBC compared with SBC. These findings also suggest that higher supplemental breast ultrasound use among Korean women, especially those with dense breasts, could be attributed to a lower incidence of IBC among women with dense breasts compared with women with SBC, due to greater detection. Finally, overall mortality of IBC was comparable with that of SBC.
- Subjects
SOUTH Korea; BREAST cancer prognosis; BREAST tumor diagnosis; BREAST tumor risk factors; BREAST tumor prevention; BREAST ultrasound; MORTALITY risk factors; RISK assessment; RESEARCH funding; BODY mass index; T-test (Statistics); BREAST tumors; EARLY detection of cancer; MENOPAUSE; MULTIPLE regression analysis; RETROSPECTIVE studies; DESCRIPTIVE statistics; FAMILY history (Medicine); CHI-squared test; LONGITUDINAL method; ODDS ratio; MAMMOGRAMS; HORMONE therapy; WOMEN'S health; SURVIVAL analysis (Biometry); COMPARATIVE studies; DATA analysis software; CONFIDENCE intervals; PROPORTIONAL hazards models
- Publication
JAMA Network Open, 2024, Vol 7, Issue 5, pe2411927
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.11927