Detection methods predict differences in biology and survival in breast cancer patients

• Main Authors: Redondo Maximino, Funez Rafael, Medina-Cano Francisco, Rodrigo Isabel, Acebal Mercedes, Tellez Teresa, Roldan M Jose, Hortas M Luisa, Bellinvia Ana, Pereda Teresa, Domingo Laia, Morales-Suarez Varela María, Sala Maria, Rueda Antonio
• Format: Article
• Language: English
• Published: BMC 2012-12-01
• Series: BMC Cancer
• Subjects: Breast cancer; Detection methods; Proliferation; Apoptosis; Survival
• Online Access: http://www.biomedcentral.com/1471-2407/12/604

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to measure the biological characteristics involved in tumorigenesis and the progression of breast cancer in symptomatic and screen-detected carcinomas to identify possible differences.</p> <p>Methods</p> <p>For this purpose, we evaluated clinical-pathological parameters and proliferative and apoptotic activities in a series of 130 symptomatic and 161 screen-detected tumors.</p> <p>Results</p> <p>After adjustment for the smaller size of the screen-detected carcinomas compared with symptomatic cancers, those detected in the screening program presented longer disease-free survival (RR = 0.43, CI = 0.19-0.96) and had high estrogen and progesterone receptor concentrations more often than did symptomatic cancers (OR = 3.38, CI = 1.72-6.63 and OR = 3.44, CI = 1.94-6.10, respectively). Furthermore, the expression of bcl-2, a marker of good prognosis in breast cancer, was higher and HER2/neu expression was lower in screen-detected cancers than in symptomatic cancers (OR = 1.77, CI = 1.01-3.23 and OR = 0.64, CI = 0.40-0.98, respectively). However, when comparing prevalent <it>vs</it> incident screen-detected carcinomas, prevalent tumors were larger (OR = 2.84, CI = 1.05-7.69), were less likely to be HER2/neu positive (OR = 0.22, CI = 0.08-0.61) and presented lower Ki67 expression (OR = 0.36, CI = 0.17-0.77). In addition, incident tumors presented a shorter survival time than did prevalent ones (RR = 4.88, CI = 1.12-21.19).</p> <p>Conclusions</p> <p>Incident carcinomas include a variety of screen-detected carcinomas that exhibit differences in biology and prognosis relative to prevalent carcinomas. The detection method is important and should be taken into account when making therapy decisions.</p>