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PeerJ. 2018 Apr 26;6:e4567. doi: 10.7717/peerj.4567. eCollection 2018.

Comparison of pathological characteristics between self-detected and screen-detected invasive breast cancers in Chinese women: a retrospective study.

Zhang Q#1, Ding L#2,3, Liang X2,3, Wang Y2,3, Jiao J1, Lu W2,3, Guo X1.

Author information

1
Department of Breast Pathology and Lab, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
2
Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China.
3
Collaborative Innovation Center of Chronic Disease Prevention and Control, Tianjin Medical University, Tianjin, China.
#
Contributed equally

Abstract

Background:

In China, there is insufficient evidence to support that screening programs can detect breast cancer earlier and improve outcomes compared with patient self-reporting. Therefore, we compared the pathological characteristics at diagnosis between self-detected and screen-detected cases of invasive breast cancer at our institution and determined whether these characteristics were different after the program's introduction (vs. prior to).

Methods:

Three databases were selected (breast cancer diagnosed in 1995-2000, 2010, and 2015), which provided a total of 3,014 female patients with invasive breast cancer. The cases were divided into self-detected and screen-detected groups. The pathological characteristics were compared between the two groups and multiple imputation and complete randomized imputation were used to deal with missing data.

Results:

Compared with patient self-reporting, screening was associated with the following factors: a higher percentage of stage T1 tumors (75.0% vs 17.1%, P = 0.109 in 1995-2000; 66.7% vs 40.4%, P < 0.001 in 2010; 67.8% vs 35.7%, P < 0.001 in 2015); a higher percentage of tumors with stage N0 lymph node status (67.3% vs. 48.4%, P = 0.007 in 2010); and a higher percentage of histologic grade I tumors (22.9% vs 13.9%, P = 0.017 in 2010).

Conclusion:

Screen-detected breast cancer was associated with a greater number of favorable pathological characteristics. However, although screening had a beneficial role in early detection in China, we found fewer patients were detected by screening in this study compared with those in Western and Asian developed countries.

KEYWORDS:

Breast cancer; Chinese; Pathological characteristics; Screen-detected; Self-detected

Conflict of interest statement

The authors declare that they have no competing interests.

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