Comparison between screen-detected and symptomatic breast cancers according to molecular subtypes

Jiyoung Kim, Sekyung Lee, Sooyoun Bae, Min Young Choi, Jeonghui Lee, Seung Pil Jung, Sangmin Kim, Jun Ho Choe, Jung Han Kim, Jee Soo Kim, Jeong Eon Lee, Seok Jin Nam, Jung Hyun Yang

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

Breast cancer screening programs make it possible to detect early cancer, thus reducing breast cancer mortality. We studied the clinicopathologic characteristics and prognosis of screen-detected invasive breast cancer compared with symptomatic breast cancer. And we compared the result according to molecular subtypes (luminal A, luminal B, Her2, and triple negative), with the goal of identifying the role of screening in each subtypes. From January 2002 to June 2008, 3,141 patients who underwent surgery for the treatment of invasive ductal carcinoma at Samsung Medical Center were included. Among them, 1,025 patients were screen-detected, and 2,116 patients who were screened over 2 years or never were symptomatic. We retrospectively reviewed the clinical and pathologic data. Screen-detected breast cancer was associated with older age, smaller tumor size, more hormone-receptor positive, less lymph node involvement, earlier stage, and reduced mortality compared with symptomatic breast cancer (P < 0.001). According to the molecular subtype, luminal A was most common (63.6%) and showed the most obvious survival benefit in screen-detected tumors in comparison with symptomatic tumors (5-year OS: 99.7 vs. 96.5%, 5-year DFS: 96.4 vs. 90.7%). Screen detection was independently associated with improved overall and disease-free survival outcomes after adjustment for covariates (HR 0.32, P = 0.035; HR 0.58, P = 0.020, respectively) only in the luminal A subtype. Differences in pathological features such as tumor size, nodal status, grade, and age at diagnosis with different molecular subtype distributions may explain the survival advantage of patients with screen-detected breast cancer. Screening programs seem to have a different efficacy depending on the molecular subtype of the breast cancer, especially in the luminal A subtype, for which screen detection acts as an independent prognostic factor itself.

Original languageEnglish
Pages (from-to)527-540
Number of pages14
JournalBreast Cancer Research and Treatment
Volume131
Issue number2
DOIs
Publication statusPublished - 2012 Jan
Externally publishedYes

Keywords

  • Breast cancer
  • Molecular subtype
  • Prognosis
  • Screen-detected

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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