Age-speciﬁc differences in tumour characteristics between screen-detected and non-screen-detected breast cancers in women aged 40–74 at diagnosis in Sweden from 2008 to 2017

Q: What is the study objective regarding breast cancer detection?

The study analyzes differences between screen-detected and non-screen-detected invasive breast cancers by tumour characteristics and age at diagnosis within Sweden’s nationwide mammography screening program.

Q: What tumour characteristics were associated with lower likelihood of screen detection?

Likelihood decreased with larger tumour size, lymph node metastases, higher histological grade, distant metastasis, and showed specific odds ratios for hormone receptor status and Ki-67 expression.

Sep 21, 2026

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Objective: Analyze differences between screen-detected and non-screen-detected invasive breast cancers by tumour characteristics and age at diagnosis within Sweden’s nationwide population-based mammography screening program. Methods: Retrieve data from the National Quality Register for Breast Cancer (2008–2017) and use logistic regression to estimate screen-detection likelihood by tumour characteristics and age group. Results: Among 51,429 invasive cancers, detection likelihood declined with larger tumour size, nodal metastases, higher histological grade, and distant metastasis, with significant tumour-characteristic by age interactions. Conclusions: Screen-detected cancers show more favourable characteristics than non-screen-detected cancers after adjustment, with the 40–49 group deviating most.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Objective

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Introduction

Age-speciﬁc differences in tumour characteristics between screen-detected and non-screen-detected breast cancersin women aged 40–74 at diagnosis in Sweden from 2008 to 2017 Håkan Jonsson 1,2 , Anne Andersson 1, Zheng Mao 1 , and Lennarth Nyström2 J Med Screen 2024, Vol. 31(4) 248–257 © The Author(s) 2024 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/09691413241237616](DOI: 10.1177/09691413241237616)[ ](DOI: 10.1177/09691413241237616)[journals.sagepub.com/home/msc](journals.sagepub.com/home/msc) Abstract Objective: To analyze differences between screen-detected and non-screen-detected invasive breast cancers by tumour characteristics and age at diagnosis in the nationwide population-based mammography screening program in Sweden. Methods: Data were retrieved from the National Quality Register for Breast Cancer for 2008–2017. Logistic regression analysis was used to estimate the likelihood for a tumour to be screen-detected by tumour characteristics and age group at diagnosis. Results: In total there were 51,429 invasive breast cancers in the target age group for mammography screening of 40–74 years. Likelihood of screen detection decreased with larger tumour size, lymph node metastases, higher histological grade and distant metastasis. Odds ratios (ORs) for negative oestrogen (ER) and progesterone (PgR) were 0.41 and 0.57; for positive HER2, 0.62; for Ki-67 high versus low, 0.49. Molecular sub-types had OR of 0.56, 0.40 and 0.28, respectively, for luminal B-like, HER2-positive and triple negative versus luminal A-like. Adjusting for tumour size (T), lymph node status (N), age, year and county at diagnosis slightly elevated the ORs. Statistically signiﬁcant interactions between tumour characteristics and age were found (p<0.05) except for ER and PgR. The age group 40–49 deviated most from the other age groups. Conclusions: Our study demonstrates that screen-detected invasive breast cancers had more favourable tumour characteristics than non-screen-detected after adjusting for age, year and county of diagnosis, and even after adjusting for T and N. The trend towards favourable tumour characteristics was less pronounced in the 40–49 age group compared to the other age groups, except for ER and PgR. Keywords Breast cancer, screening program, mammography, tumour characteristics, detection mode Date received: 26 October 2023; accepted: 16 February 2024 Introduction Breast cancer is the most common malignancy among women worldwide. According to the National Cancer and Cause of Death Register in Sweden in 2021, 8619 women were diagnosed with breast cancer and 1326 women died with breast cancer as the underlying cause of death.1 Overviews and meta-analysis of the randomized controlled trials on mammography screening have shown that breast cancer screening with mammography can reduce the mortality from breast cancer for women aged 50–69 by 20–25% .2,3 Similar or even larger effects have been seen in evaluations of the screening service programs in Europe and New Zealand.4–6 Similar effects have also been found in cohort studies of the 40–49 and 70–74 year age groups in the screening program in Sweden.7,8 The European Commission Initiative on Breast Cancer has recently evaluated all studies on the effect of inviting women to breast cancer screening and strongly recommended biannual screening of women 50–69 years, conditionally recommended biannual/triannual 1 Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden 2Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden Corresponding author: Håkan Jonsson, Department of Epidemiology and Global Health, Umeå University, 90187 Umeå, Sweden. Email: [hakan.jonsson@umu.se](hakan.jonsson@umu.se) screening of women 70–74 years, and conditionally recommended biannual screening of women 45–49 years.9 In 1986, the Nationa

FAQs

What is the study objective regarding breast cancer detection?

The study analyzes differences between screen-detected and non-screen-detected invasive breast cancers by tumour characteristics and age at diagnosis within Sweden’s nationwide mammography screening program.

How were the data and statistical approach designed?

Data were retrieved from the National Quality Register for Breast Cancer for 2008–2017, and logistic regression estimated the likelihood of a tumour being screen-detected based on tumour characteristics and age group.

What tumour characteristics were associated with lower likelihood of screen detection?

Likelihood decreased with larger tumour size, lymph node metastases, higher histological grade, distant metastasis, and showed specific odds ratios for hormone receptor status and Ki-67 expression.

Sep 21, 2026

Upload by Skyler