Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States: A report from the Breast Cancer Surveillance Consortium

Kimberly H. Allison, Linn A. Abraham, Donald L. Weaver, Anna N A Tosteson, Heidi Nelson, Tracy Onega, Berta M. Geller, Karla Kerlikowske, Patricia (Patty) Carney, Laura E. Ichikawa, Diana S M Buist, Joann G. Elmore

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background Current data on the pathologic diagnoses of breast biopsy after mammography can inform patients, clinicians, and researchers about important population trends. Methods Breast Cancer Surveillance Consortium data on 4,020,140 mammograms between 1996 and 2008 were linked to 76,567 pathology specimens. Trends in diagnoses in biopsies by time and risk factors (patient age, breast density, and family history of breast cancer) were examined for screening and diagnostic mammography (performed for a breast symptom or short-interval follow-up). Results Of the total mammograms, 88.5% were screening and 11.5% diagnostic; 1.2% of screening and 6.8% of diagnostic mammograms were followed by biopsies. The frequency of biopsies over time was stable after screening mammograms, but increased after diagnostic mammograms. For biopsies obtained after screening, frequencies of invasive carcinoma increased over time for women ages 40-49 and 60-69, Ductal carcinoma in situ (DCIS) increased for those ages 40-69, whereas benign diagnoses decreased for all ages. No trends in pathology diagnoses were found following diagnostic mammograms. Dense breast tissue was associated with high-risk lesions and DCIS relative to nondense breast tissue. Family history of breast cancer was associated with DCIS and invasive cancer. Conclusion Although the frequency of breast biopsy after screening mammography has not changed over time, the percentages of biopsies with DCIS and invasive cancer diagnoses have increased. Among biopsies following mammography, women with dense breasts or family history of breast cancer were more likely to have high-risk lesions or invasive cancer. These findings are relevant to breast cancer screening and diagnostic practices.

Original languageEnglish (US)
Pages (from-to)1369-1378
Number of pages10
JournalCancer
Volume121
Issue number9
DOIs
StatePublished - May 1 2015

Fingerprint

Mammography
Breast
Pathology
Breast Neoplasms
Biopsy
Carcinoma, Intraductal, Noninfiltrating
Neoplasms
Early Detection of Cancer
Research Personnel
Carcinoma
Population

Keywords

  • atypia
  • breast biopsy
  • breast cancer diagnosis
  • breast pathology
  • ductal carcinoma in situ
  • false positive
  • mammography

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States : A report from the Breast Cancer Surveillance Consortium. / Allison, Kimberly H.; Abraham, Linn A.; Weaver, Donald L.; Tosteson, Anna N A; Nelson, Heidi; Onega, Tracy; Geller, Berta M.; Kerlikowske, Karla; Carney, Patricia (Patty); Ichikawa, Laura E.; Buist, Diana S M; Elmore, Joann G.

In: Cancer, Vol. 121, No. 9, 01.05.2015, p. 1369-1378.

Research output: Contribution to journalArticle

Allison, KH, Abraham, LA, Weaver, DL, Tosteson, ANA, Nelson, H, Onega, T, Geller, BM, Kerlikowske, K, Carney, PP, Ichikawa, LE, Buist, DSM & Elmore, JG 2015, 'Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States: A report from the Breast Cancer Surveillance Consortium', Cancer, vol. 121, no. 9, pp. 1369-1378. https://doi.org/10.1002/cncr.29199
Allison, Kimberly H. ; Abraham, Linn A. ; Weaver, Donald L. ; Tosteson, Anna N A ; Nelson, Heidi ; Onega, Tracy ; Geller, Berta M. ; Kerlikowske, Karla ; Carney, Patricia (Patty) ; Ichikawa, Laura E. ; Buist, Diana S M ; Elmore, Joann G. / Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States : A report from the Breast Cancer Surveillance Consortium. In: Cancer. 2015 ; Vol. 121, No. 9. pp. 1369-1378.
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abstract = "Background Current data on the pathologic diagnoses of breast biopsy after mammography can inform patients, clinicians, and researchers about important population trends. Methods Breast Cancer Surveillance Consortium data on 4,020,140 mammograms between 1996 and 2008 were linked to 76,567 pathology specimens. Trends in diagnoses in biopsies by time and risk factors (patient age, breast density, and family history of breast cancer) were examined for screening and diagnostic mammography (performed for a breast symptom or short-interval follow-up). Results Of the total mammograms, 88.5{\%} were screening and 11.5{\%} diagnostic; 1.2{\%} of screening and 6.8{\%} of diagnostic mammograms were followed by biopsies. The frequency of biopsies over time was stable after screening mammograms, but increased after diagnostic mammograms. For biopsies obtained after screening, frequencies of invasive carcinoma increased over time for women ages 40-49 and 60-69, Ductal carcinoma in situ (DCIS) increased for those ages 40-69, whereas benign diagnoses decreased for all ages. No trends in pathology diagnoses were found following diagnostic mammograms. Dense breast tissue was associated with high-risk lesions and DCIS relative to nondense breast tissue. Family history of breast cancer was associated with DCIS and invasive cancer. Conclusion Although the frequency of breast biopsy after screening mammography has not changed over time, the percentages of biopsies with DCIS and invasive cancer diagnoses have increased. Among biopsies following mammography, women with dense breasts or family history of breast cancer were more likely to have high-risk lesions or invasive cancer. These findings are relevant to breast cancer screening and diagnostic practices.",
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T1 - Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States

T2 - A report from the Breast Cancer Surveillance Consortium

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AU - Abraham, Linn A.

AU - Weaver, Donald L.

AU - Tosteson, Anna N A

AU - Nelson, Heidi

AU - Onega, Tracy

AU - Geller, Berta M.

AU - Kerlikowske, Karla

AU - Carney, Patricia (Patty)

AU - Ichikawa, Laura E.

AU - Buist, Diana S M

AU - Elmore, Joann G.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background Current data on the pathologic diagnoses of breast biopsy after mammography can inform patients, clinicians, and researchers about important population trends. Methods Breast Cancer Surveillance Consortium data on 4,020,140 mammograms between 1996 and 2008 were linked to 76,567 pathology specimens. Trends in diagnoses in biopsies by time and risk factors (patient age, breast density, and family history of breast cancer) were examined for screening and diagnostic mammography (performed for a breast symptom or short-interval follow-up). Results Of the total mammograms, 88.5% were screening and 11.5% diagnostic; 1.2% of screening and 6.8% of diagnostic mammograms were followed by biopsies. The frequency of biopsies over time was stable after screening mammograms, but increased after diagnostic mammograms. For biopsies obtained after screening, frequencies of invasive carcinoma increased over time for women ages 40-49 and 60-69, Ductal carcinoma in situ (DCIS) increased for those ages 40-69, whereas benign diagnoses decreased for all ages. No trends in pathology diagnoses were found following diagnostic mammograms. Dense breast tissue was associated with high-risk lesions and DCIS relative to nondense breast tissue. Family history of breast cancer was associated with DCIS and invasive cancer. Conclusion Although the frequency of breast biopsy after screening mammography has not changed over time, the percentages of biopsies with DCIS and invasive cancer diagnoses have increased. Among biopsies following mammography, women with dense breasts or family history of breast cancer were more likely to have high-risk lesions or invasive cancer. These findings are relevant to breast cancer screening and diagnostic practices.

AB - Background Current data on the pathologic diagnoses of breast biopsy after mammography can inform patients, clinicians, and researchers about important population trends. Methods Breast Cancer Surveillance Consortium data on 4,020,140 mammograms between 1996 and 2008 were linked to 76,567 pathology specimens. Trends in diagnoses in biopsies by time and risk factors (patient age, breast density, and family history of breast cancer) were examined for screening and diagnostic mammography (performed for a breast symptom or short-interval follow-up). Results Of the total mammograms, 88.5% were screening and 11.5% diagnostic; 1.2% of screening and 6.8% of diagnostic mammograms were followed by biopsies. The frequency of biopsies over time was stable after screening mammograms, but increased after diagnostic mammograms. For biopsies obtained after screening, frequencies of invasive carcinoma increased over time for women ages 40-49 and 60-69, Ductal carcinoma in situ (DCIS) increased for those ages 40-69, whereas benign diagnoses decreased for all ages. No trends in pathology diagnoses were found following diagnostic mammograms. Dense breast tissue was associated with high-risk lesions and DCIS relative to nondense breast tissue. Family history of breast cancer was associated with DCIS and invasive cancer. Conclusion Although the frequency of breast biopsy after screening mammography has not changed over time, the percentages of biopsies with DCIS and invasive cancer diagnoses have increased. Among biopsies following mammography, women with dense breasts or family history of breast cancer were more likely to have high-risk lesions or invasive cancer. These findings are relevant to breast cancer screening and diagnostic practices.

KW - atypia

KW - breast biopsy

KW - breast cancer diagnosis

KW - breast pathology

KW - ductal carcinoma in situ

KW - false positive

KW - mammography

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