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Tumor Characteristics and Molecular Subtypes in Breast Cancer Screening with Digital Breast Tomosynthesis : The Malmö Breast Tomosynthesis Screening Trial

Johnson, Kristin LU ; Zackrisson, Sophia LU ; Rosso, Aldana LU ; Sartor, Hanna LU ; Saal, Lao H. LU ; Andersson, Ingvar LU and Lång, Kristina LU (2019) In Radiology 293(2). p.273-281
Abstract

Background Screening accuracy can be improved with digital breast tomosynthesis (DBT). To further evaluate DBT in screening, it is important to assess the molecular subtypes of the detected cancers. Purpose To describe tumor characteristics, including molecular subtypes, of cancers detected at DBT compared with those detected at digital mammography (DM) in breast cancer screening. Materials and Methods The Malmö Breast Tomosynthesis Screening Trial is a prospective, population-based screening trial comparing one-view DBT with two-view DM. Tumor characteristics were obtained, and invasive cancers were classified according to St Gallen as follows: luminal A-like, luminal B-like human epidermal growth factor receptor... (More)

Background Screening accuracy can be improved with digital breast tomosynthesis (DBT). To further evaluate DBT in screening, it is important to assess the molecular subtypes of the detected cancers. Purpose To describe tumor characteristics, including molecular subtypes, of cancers detected at DBT compared with those detected at digital mammography (DM) in breast cancer screening. Materials and Methods The Malmö Breast Tomosynthesis Screening Trial is a prospective, population-based screening trial comparing one-view DBT with two-view DM. Tumor characteristics were obtained, and invasive cancers were classified according to St Gallen as follows: luminal A-like, luminal B-like human epidermal growth factor receptor (HER)2-negative/HER2-positive, HER2-positive, and triple-negative cancers. Tumor characteristics were compared by mode of detection: DBT alone or DM (ie, DBT and DM or DM alone). χ2 test was used for data analysis. Results Between January 2010 and February 2015, 14 848 women were enrolled (mean age, 57 years ± 10; age range, 40-76 years). In total, 139 cancers were detected; 118 cancers were invasive and 21 were ductal carcinomas in situ. Thirty-seven additional invasive cancers (36 cancers with complete subtypes and stage) were detected at DBT alone, and 81 cancers (80 cancers with complete stage) were detected at DM. No differences were seen between DBT and DM in the distribution of tumor size 20 mm or smaller (86% [31 of 36] vs 85% [68 of 80], respectively; P = .88), node-negative status (75% [27 of 36] vs 74% [59 of 80], respectively; P = .89), or luminal A-like subtype (53% [19 of 36] vs 46% [37 of 81], respectively; P = .48). Conclusion The biologic profile of the additional cancers detected at digital breast tomosynthesis in a large prospective population-based screening trial was similar to those detected at digital mammography, and the majority were early-stage luminal A-like cancers. This indicates that digital breast tomosynthesis screening does not alter the predictive and prognostic profile of screening-detected cancers.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Radiology
volume
293
issue
2
pages
9 pages
publisher
Radiological Society of North America
external identifiers
  • pmid:31478799
  • scopus:85073580692
ISSN
1527-1315
DOI
10.1148/radiol.2019190132
language
English
LU publication?
yes
id
261d2c89-97eb-481c-83d5-e63962103e71
date added to LUP
2019-10-25 12:26:32
date last changed
2020-02-23 08:05:11
@article{261d2c89-97eb-481c-83d5-e63962103e71,
  abstract     = {<p>Background Screening accuracy can be improved with digital breast tomosynthesis (DBT). To further evaluate DBT in screening, it is important to assess the molecular subtypes of the detected cancers. Purpose To describe tumor characteristics, including molecular subtypes, of cancers detected at DBT compared with those detected at digital mammography (DM) in breast cancer screening. Materials and Methods The Malmö Breast Tomosynthesis Screening Trial is a prospective, population-based screening trial comparing one-view DBT with two-view DM. Tumor characteristics were obtained, and invasive cancers were classified according to St Gallen as follows: luminal A-like, luminal B-like human epidermal growth factor receptor (HER)2-negative/HER2-positive, HER2-positive, and triple-negative cancers. Tumor characteristics were compared by mode of detection: DBT alone or DM (ie, DBT and DM or DM alone). χ2 test was used for data analysis. Results Between January 2010 and February 2015, 14 848 women were enrolled (mean age, 57 years ± 10; age range, 40-76 years). In total, 139 cancers were detected; 118 cancers were invasive and 21 were ductal carcinomas in situ. Thirty-seven additional invasive cancers (36 cancers with complete subtypes and stage) were detected at DBT alone, and 81 cancers (80 cancers with complete stage) were detected at DM. No differences were seen between DBT and DM in the distribution of tumor size 20 mm or smaller (86% [31 of 36] vs 85% [68 of 80], respectively; P = .88), node-negative status (75% [27 of 36] vs 74% [59 of 80], respectively; P = .89), or luminal A-like subtype (53% [19 of 36] vs 46% [37 of 81], respectively; P = .48). Conclusion The biologic profile of the additional cancers detected at digital breast tomosynthesis in a large prospective population-based screening trial was similar to those detected at digital mammography, and the majority were early-stage luminal A-like cancers. This indicates that digital breast tomosynthesis screening does not alter the predictive and prognostic profile of screening-detected cancers.</p>},
  author       = {Johnson, Kristin and Zackrisson, Sophia and Rosso, Aldana and Sartor, Hanna and Saal, Lao H. and Andersson, Ingvar and Lång, Kristina},
  issn         = {1527-1315},
  language     = {eng},
  number       = {2},
  pages        = {273--281},
  publisher    = {Radiological Society of North America},
  series       = {Radiology},
  title        = {Tumor Characteristics and Molecular Subtypes in Breast Cancer Screening with Digital Breast Tomosynthesis : The Malmö Breast Tomosynthesis Screening Trial},
  url          = {http://dx.doi.org/10.1148/radiol.2019190132},
  doi          = {10.1148/radiol.2019190132},
  volume       = {293},
  year         = {2019},
}