Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

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

Maximino Redondo1*, Rafael Funez2, Francisco Medina-Cano3, Isabel Rodrigo2, Mercedes Acebal4, Teresa Tellez1, M Jose Roldan1, M Luisa Hortas1, Ana Bellinvia5, Teresa Pereda2, Laia Domingo6, María Morales-Suarez Varela7, Maria Sala6 and Antonio Rueda8

Author Affiliations

1 Research Unit, Hospital Costa del Sol, University of Málaga, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carretera de Cádiz Km 187, 29600, Marbella, Málaga, Spain

2 Department of Pathology, Hospital Costa del Sol, 29600, Marbella, Málaga, Spain

3 Department of Surgery, Hospital Costa del Sol, 29600, Marbella, Málaga, Spain

4 Department of Radiology, Hospital Clinico Universitario Virgen de la Victoria, Campus Universitario Teatinos, 29010, Málaga, Spain

5 Department of Radiology, Hospital Costa del Sol, 29600, Marbella, Málaga, Spain

6 Epidemiology and Evaluation Department. IMIM Hospital del Mar, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC). Parc de Salut Mar, Universitat Autònoma de Barcelona, Catalonia, Spain

7 Unit of Public Health and Environmental Care, Department of Preventive Medicine, CIBER ESP, University of Valencia, Valencia, Spain

8 Department of Medical Oncology, Hospital Costa del Sol, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 29600, Marbella, Málaga, Spain

For all author emails, please log on.

BMC Cancer 2012, 12:604  doi:10.1186/1471-2407-12-604

Published: 17 December 2012

Abstract

Background

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.

Methods

For this purpose, we evaluated clinical-pathological parameters and proliferative and apoptotic activities in a series of 130 symptomatic and 161 screen-detected tumors.

Results

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 vs 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).

Conclusions

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.

Keywords:
Breast cancer; Detection methods; Proliferation; Apoptosis; Survival