Causes and consequences of delayed diagnosis in breast cancer screening with a focus on mammographic features and tumour characteristics

被引:0
|
作者
van der Veer, Eline L. [1 ]
Lameijer, Joost [2 ]
Coolen, Angela M. P. [1 ]
Bluekens, Adriana M. J. [1 ]
Nederend, Joost [3 ]
Gielens, Maaike [3 ]
Voogd, Adri [4 ]
Duijm, Lucien [5 ]
机构
[1] Elisabeth TweeSteden Hosp, Dept Neurol, Hilvarenbeekse Weg 60, NL-5022 GC Tilburg, Netherlands
[2] Christchurch Hosp, 2 Riccarton Ave, Christchurch 8011, New Zealand
[3] Catharina Hosp, Michelangelolaan 2, NL-5623 EJ Eindhoven, Netherlands
[4] Maastricht Univ, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands
[5] Canisius Wilhelmina Hosp, Weg Door Jonkerbos 100, NL-6532 SZ Nijmegen, Netherlands
关键词
Diagnostic delay; Breast cancer; Screening programme; Tumour characteristics; RISK;
D O I
10.1016/j.ejrad.2023.111048
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To study the prevalence, causes and consequences of delayed breast cancer diagnosis in the screening population. Methods: This retrospective study was performed in women who underwent biennial screening mammography between January 1, 2009 and June 30, 2019. Patients were divided into 3 groups; screen-detected breast cancer (SDC) without a diagnostic delay, a primary diagnostic delay (i.e. missed cancer at previous screening round) and a delay in diagnostic work-up after recall. Women with a true interval cancer (IC; i.e. not visible on prior examinations) were excluded. Outcome parameters included mammographic and tumour characteristics, lymph node status and surgical treatment. Results: In our sample of 4491 women with breast cancer (4292 SDC and 199 'missed' IC), respectively, a total of 1112 women experienced a diagnostic delay of >= 4 months. Compared to women without a diagnostic delay (n = 2720), the 176 women with a delay in diagnostic work-up showed overall similar mammographic abnormalities (P = 0.052). These groups show similar distributions in invasive tumours, tumour stage and lymph node status (P = 0.25, P = 0.95 and P = 0.93, respectively). Women with a primary diagnostic delay (n = 936) showed less calcifications (P < 0.001), and more masses with calcifications and architectural distortions on mammography (P = 0.01 and P = 0.04, respectively). Moreover, this group comprised larger tumours (P < 0.001) and lymph node metastases (P < 0.001), and more often underwent mastectomy (P < 0.001). Conclusions: A primary diagnostic delay in breast cancer diagnosis results in less favourable tumour characteristics and relatively more mastectomies compared to no delay in breast cancer diagnosis and a delay in diagnostic work-up after recall.
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页数:9
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