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Tumor size distribution of invasive breast cancers and the sensitivity of screening methods in the Canadian National Breast Screening Study


1 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada
2 Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, Ontario M5B 2K3, Canada
3 Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S 3G8, Canada

Correspondence Address:
Sharareh Taghipour,
Department of Mechanical and Industrial Engineering, Ryerson University, Eric Palin Hall, Room 338A, 87 Gerrard Street East, Toronto, Ontario M5B 2K3
Canada
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Source of Support: None, Conflict of Interest: None

Introduction: This study set out to explore if breast cancers of different sizes are detected with varying sensitivity. In addition, we attempt to determine the effect of tumor size on screening detectability. Subjects and Methods: Data arising from the Canadian National Breast Screening Study (CNBSS) was used to perform all analyses. The CNBSS consists of two randomized controlled trials, which includes data on detection methods, age, and allocation groups. We stratified tumor size by 5 mm; age into 40-49 and 50-59 years age groups; and cancer detection or presentation methods into mammography only, physical breast examination only, both mammography and physical breast examination, interval cancers, and incident cancers. Results: This study revealed that a difference in tumor size exists for age (smaller tumor sizes are found in older women) and breast cancer detection or presentation modes. More specifically, breast cancers detected by mammography screening are statistically smaller than those detected by physical breast examination or those presenting as incident or interval cancers. This study also found that tumor size affects screening detectability for women in their 50's but not in their forties. That is, a statistically significant difference between mammography screening alone and physical examination alone was observed for women between the ages of 50-59 for tumor sizes up to 20 mm, including prevalent cases, and up to 15 mm when prevalent cases were excluded. Conclusion: The results of this study suggest that smaller breast cancers are more likely to be detected among women in their 50s.


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    -  Shaevitch D
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    -  Miller AB
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