Cumulative risk of breast cancer screening outcomes according to the presence of previous benign breast disease and family history of breast cancer: supporting personalised screening

Br J Cancer. 2017 May 23;116(11):1480-1485. doi: 10.1038/bjc.2017.107. Epub 2017 Apr 20.

Abstract

Background: Our aim was to assess the cumulative risk of false-positive screening results, screen-detected cancer, and interval breast cancer in mammography screening among women with and without a previous benign breast disease and a family history of breast cancer.

Methods: The cohort included 42 928 women first screened at the age of 50-51 years at three areas of the Spanish Screening Programme (Girona, and two areas in Barcelona) between 1996 and 2011, and followed up until December 2012. We used discrete-time survival models to estimate the cumulative risk of each screening outcome over 10 biennial screening exams.

Results: The cumulative risk of false-positive results, screen-detected breast cancer, and interval cancer was 36.6, 5.3, and 1.4 for women with a previous benign breast disease, 24.1, 6.8, and 1.6% for women with a family history of breast cancer, 37.9, 9.0, and 3.2%; for women with both a previous benign breast disease and a family history, and 23.1, 3.2, and 0.9% for women without either of these antecedents, respectively.

Conclusions: Women with a benign breast disease or a family history of breast cancer had an increased cumulative risk of favourable and unfavourable screening outcomes than women without these characteristics. A family history of breast cancer did not increase the cumulative risk of false-positive results. Identifying different risk profiles among screening participants provides useful information to stratify women according to their individualised risk when personalised screening strategies are discussed.

MeSH terms

  • Aged
  • Breast Diseases / epidemiology
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / genetics
  • Early Detection of Cancer / statistics & numerical data*
  • False Positive Reactions
  • Female
  • Humans
  • Mammography
  • Middle Aged
  • Risk Factors
  • Spain / epidemiology