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1 Department of Pathology, The Gade Institute; 2 Department of Radiology; 3 Centre for Clinical Research, Haukeland University Hospital; 4 Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway; 5 Cancer Registry of Norway, Oslo, Norway; and 6 Program in Cancer Genetics, Departments of Oncology and Human Genetics and Medicine, McGill University, Montreal, Quebec, Canada
Requests for reprints: Lars A. Akslen, Vascular Biology Program (Folkman Lab), Karp Family Research Labs 12.125, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115-5737. Phone: 617-919-2426; Fax: 617-739-5891. E-mail: lars.akslen{at}childrens.harvard.edu
Interval breast cancer reduce the effectiveness of mammography screening programs. We studied 95 interval cancers, diagnosed during 1996 to 2001 as part of the population-based Norwegian Breast Cancer Screening Program. These cases were matched on size (±2.0 mm) to 95 screen-detected breast cancers, and the tumors were compared by immunohistochemical methods using tissue microarrays. Patients with interval cancers were more likely to be younger [odds ratio (OR), 4.7; P = 0.0001], to have dense breasts (OR, 3.4; P = 0.004), and to have estrogen receptornegative tumors (OR, 2.6, P = 0.01), and p53 expression was more frequent (OR, 4.0; P = 0.001). Notably, interval cancers were more likely to have a basal epithelial phenotype, in that expression of cytokeratin 5/6 (OR, 2.3; P = 0.04) and P-cadherin (OR, 2.5; P = 0.04) was more frequent in interval cases than in size-matched, screen-detected tumors. In a logistic regression model, p53 expression, age, and breast density were independent predictors of interval cancers. Our data suggest that breast cancers with a basal epithelial phenotype are more likely than nonbasal breast cancers to present between regular mammograms.
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