Breast cancer outcomes based on method of detection in community-based breast cancer registry

Purpose: The impact of opportunistic screening mammography in the United States is difficult to quantify, partially due to lack of inclusion regarding method of detection (MOD) in national registries. This study sought to determine the feasibility of MOD collection in a multicenter community registry and to compare outcomes and characteristics of breast cancer based on MOD. Methods: We conducted a retrospective study of breast cancer patients from a multicenter tumor registry in Missouri from January 2004 - December 2018. Registry data were extracted by certified tumor registrars and included MOD, clinicopathologic information, and treatment. MOD was assigned as screen-detected or clinically detected. Data were analyzed at the patient level. Chi-squared tests were used for categorical variable comparison and Mann-Whitney-U test was used for numerical variable comparison. Results: 5351 women (median age, 63 years; interquartile range, 53–73 years) were included. Screen-detected cancers were smaller than clinically detected cancers (median size 12 mm vs. 25 mm; P <.001) and more likely node-negative (81% vs. 54%; P <.001), lower grade (P <.001), and lower stage (P <.001). Screen-detected cancers were more likely treated with lumpectomy vs. mastectomy (73% vs. 41%; P <.001) and less likely to require chemotherapy (24% vs. 52%; P <.001). Overall survival for patients with invasive breast cancer was higher for screen-detected cancers (89% vs. 74%, P <.0001). Conclusion: MOD can be routinely collected and linked to breast cancer outcomes through tumor registries, with demonstration of significant differences in outcome and characteristics of breast cancers based on MOD. Routine inclusion of MOD in US tumor registries would help quantify the impact of opportunistic screening mammography in the US.