Short interval.

One of the first questions you ask a patient referred for a breast cancer consultation is whether it was detected on routine screening mammogram or self-detected. Why do we care? Because just like receptor status or Oncotype score, the presentation can be extremely helpful in honing in on a woman’s risk of recurrence. In this huge prospective Canadian screening cohort study of nearly 70K women, 911 breast cancers diagnoses were made within the screening program. At a median follow-up of 7 years, those that were clinically diagnosed during a 24-month interval after a normal mammogram (n=206) carried significantly more risk of breast cancer death (HR 3.55). This is likely related to the interval cases more heavily representing high-grade (OR 6.33) and estrogen receptor-negative (OR 2.88) tumors. TBL: Breast cancers that emerge during the interval between routine mammograms should be taken seriously. | Niraula, JAMA Netw Open 2020