Table 4.
Biopsy yield (95% CI) of benign findings, ductal carcinoma in situ (DCIS) and invasive breast cancer per 100 biopsies following a screening mammogram, by age at screen and comorbidity (adjusted for age, comorbidity score and Breast Cancer Surveillance Consortium registry)
| Age and comorbidity groups | All biopsies (N=9479) | p-trend* | Fine needle aspiration‡ N=659) | p-trend* | Core biopsy (N=5477) | p-trend* | Surgical biopsy (N=3343) | p-trend* |
|---|---|---|---|---|---|---|---|---|
| All Biopsies | ||||||||
| Benign† | 55.2 (52.1, 58.4) | 79.2 (67.3, 87.1) | 57.9 (53.7, 62.1) | 47.1 (41.8, 52.4) | ||||
| DCIS | 9.9 (8.2, 12.1) | NA | 9.8 (7.6, 12.7) | 11.8 (8.8, 15.8) | ||||
| Invasive | 34.8 (31.8, 37.9) | 20.8 (12.9, 32.7) | 32.2 (28.4, 36.3) | 41.1 (36.0, 46.5) | ||||
| Benign † | ||||||||
| Age at screen, years | ||||||||
| 66–74 | 58.8 (56.0, 61.5) | < 0.001 | 83.8 (73.9, 89.9) | 0.01 | 61.3 (57.7, 64.8) | <0.001 | 50.0 (45.3, 54.7) | 0.01 |
| 75–84 | 51.3 (48.1, 54.6) | 73.7 (60.5, 82.9) | 54.6 (50.2, 58.8) | 43.4 (38.2, 48.7) | ||||
| 85–94 | 43.8 (37.1, 50.7) | 68.4 (43.4, 86.1) | 44.5 (35.6, 53.7) | 40.2 (29.5, 51.8) | ||||
| Charlson Comorbidity Score (CCS) | ||||||||
| 0 | 54.7 (52.0, 57.4) | 0.61 | 80.0 (70.2, 86.6) | 0.83 | 56.8 (53.2, 60.3) | 0.28 | 47.2 (42.7, 51.7) | 0.77 |
| 1 | 57.0 (53.1, 60.9) | 76.3 (60.5, 86.7) | 61.5 (56.4, 66.4) | 46.8 (40.3, 53.4) | ||||
| 2+ | 55.5 (49.9, 61.1) | 80.0 (57.0, 93.0) | 59.4 (52.0, 66.4) | 46.2 (37.1, 55.6) | ||||
| Age 66–74 | ||||||||
| CCS=0 | 58.4 (56.0, 60.7) | 0.49 | 84.7 (77.2, 89.7) | 0.94 | 60.4 (57.2, 63.4) | 0.67 | 50.0 (45.9, 54.1) | 0.30 |
| CCS=1 | 61.0 (57.6, 64.3) | 80.4 (67.2, 88.8) | 64.7 (60.4, 68.9) | 51.4 (45.4, 57.3) | ||||
| CCS=2+ | 56.7 (51.9, 61.5) | 84.1 (59.7, 95.0) | 61.7 (55.4, 67.6) | 45.9 (38.1, 53.9) | ||||
| Age 75–84 | ||||||||
| CCS=0 | 50.6 (47.8, 53.4) | 0.08 | 74.0 (62.3, 82.2) | 0.50 | 53.1 (49.4, 56.8) | 0.19 | 43.9 (39.4, 48.5) | 0.51 |
| CCS=1 | 52.4 (48.5, 56.3) | 70.7 (53.7, 82.7) | 58.5 (53.3, 63.6) | 40.2 (34.1, 46.7) | ||||
| CCS=2+ | 55.8 (50.1, 61.4) | 79.3 (60.6, 90.4) | 58.3 (50.6, 65.6) | 47.2 (37.8, 56.8) | ||||
| Age 85–94 | ||||||||
| CCS=0 | 43.6 (38.1, 49.2) | 0.81 | 70.3 (49.7, 84.4) | 0.34 | 43.8 (36.4, 51.4) | 0.92 | 39.6 (30.8, 49.1) | 0.74 |
| CCS=1 | 45.1 (36.2, 54.4) | 70.7 (34.8, 91.5) | 47.7 (35.9, 59.7) | 41.3 (27.3, 56.7) | ||||
| CCS=2+ | 41.8 (29.6, 55.1) | 43.4 (6.6, 88.4) | 42.8 (27.3, 59.8) | 43.6 (23.7, 65.5) | ||||
| DCIS | ||||||||
| Age at screen, years | ||||||||
| 66–74 | 9.9 (8.4, 11.8) | 0.97 | NA | NA | 9.9 (7.9, 12.4) | 0.79 | 11.7 (9.0, 15.2) | 0.91 |
| 75–84 | 10.0 (8.3, 12.2) | NA | 9.6 (7.4, 12.5) | 12.0 (9.0, 16.0) | ||||
| 85–94 | 10.0 (6.7, 14.9) | NA | 10.4 (6.1, 17.6) | 11.5 (6.4, 20.6) | ||||
| CCS | ||||||||
| 0 | 10.2 (8.6, 12.0) | 0.86 | NA | NA | 10.2 (8.2, 12.7) | 0.41 | 11.9 (9.2, 15.2) | 0.55 |
| 1 | 9.3 (7.2, 11.9) | NA | 8.7 (6.3, 12.1) | 11.2 (7.7, 16.3) | ||||
| 2+ | 10.0 (7.1, 14.0) | NA | 9.0 (5.7, 14.4) | 12.9 (7.9, 20.7) | ||||
| Age 66–74 | ||||||||
| CCS=0 | 9.9 (8.5, 11.5) | 0.33 | NA | NA | 10.0 (8.2, 12.1) | 0.81 | 11.7 (9.3, 14.7) | 0.23 |
| CCS=1 | 9.5 (7.7, 11.8) | NA | 9.5 (7.2, 12.5) | 10.7 (7.5, 15.0) | ||||
| CCS=2+ | 11.3 (8.6, 14.8) | NA | 9.6 (6.4, 14.0) | 14.8 (9.9, 21.5) | ||||
| Age 75–84 | ||||||||
| CCS=0 | 10.6 (8.9, 12.4) | 0.11 | NA | NA | 10.5 (8.4, 13.0) | 0.36 | 12.0 (9.3, 15.4) | 0.38 |
| CCS=1 | 9.0 (7.0, 11.5) | NA | 7.2 (5.0, 10.3) | 12.9 (9.1, 17.9) | ||||
| CCS=2+ | 7.7 (5.1, 11.3) | NA | 8.3 (4.9, 13.6) | 9.2 (4.9, 16.6) | ||||
| Age 85–94 | ||||||||
| CCS=0 | 10.4 (7.5, 14.2) | 0.81 | NA | NA | 10.6 (6.8, 16.3) | 0.71 | 12.3 (7.6, 19.4) | 0.53 |
| CCS=1 | 8.2 (4.4, 14.7) | NA | 10.1 (4.8, 20.0) | 6.5 (2.1, 18.4) | ||||
| CCS=2+ | 11.4 (5.5, 22.3) | NA | 8.6 (2.8, 23.7) | 17.0 (6.3, 38.0) | ||||
| Invasive | ||||||||
| Age at screen, years | ||||||||
| 66–74 | 31.3 (28.8, 34.0) | <0.001 | 16.2 (10.1, 26.1) | 0.01 | 28.8 (25.6, 32.2) | <0.001 | 38.4 (33.9, 43.1) | 0.01 |
| 75–84 | 38.6 (35.4, 41.8) | 26.3 (17.1, 39.5) | 35.7 (31.7, 40.0) | 44.5 (39.2, 49.9) | ||||
| 85–94 | 45.9 (39.2, 52.8) | 31.6 (13.9, 56.6) | 44.8 (36.0, 54.0) | 47.8 (36.9, 59.0) | ||||
| CCS | ||||||||
| 0 | 35.1 (32.5, 37.8) | 0.70 | 20.0 (13.4, 29.8) | 0.83 | 33.0 (29.6, 36.5) | 0.55 | 40.9 (36.5, 45.5) | 0.92 |
| 1 | 33.8 (30.1, 37.6) | 23.7 (13.3, 39.5) | 29.8 (25.3, 34.7) | 42.0 (35.6, 48.6) | ||||
| 2+ | 34.5 (29.3, 40.0) | 20.0 (7.0, 43.0) | 31.7 (25.2, 38.8) | 40.7 (32.0, 50.1) | ||||
| Age 66–74 | ||||||||
| CCS=0 | 31.7 (29.6, 34.0) | 0.91 | 15.3 (10.3, 22.8) | 0.94 | 29.6 (26.8, 32.6) | 0.78 | 38.4 (34.5, 42.4) | 0.85 |
| CCS=1 | 29.5 (26.5, 32.7) | 19.6 (11.2, 32.8) | 25.7 (22.1, 29.8) | 38.1 (32.5, 44.0) | ||||
| CCS=2+ | 32.0 (27.7, 36.6) | 15.9 (5.0, 40.3) | 28.9 (23.5, 34.8) | 39.1 (31.7, 47.1) | ||||
| Age 75–84 | ||||||||
| CCS=0 | 38.8 (36.1, 41.6) | 0.44 | 26.0 (17.8, 37.7) | 0.50 | 36.4 (32.8, 40.1) | 0.44 | 43.9 (39.4, 48.6) | 0.94 |
| CCS=1 | 38.5 (34.8, 42.4) | 29.3 (17.3, 46.3) | 34.3 (29.5, 39.4) | 46.6 (40.2, 53.1) | ||||
| CCS=2+ | 36.5 (31.2, 42.2) | 20.7 (9.6, 39.4) | 33.4 (26.6, 41.0) | 43.6 (34.3, 53.3) | ||||
| Age 85–94 | ||||||||
| CCS=0 | 45.7 (40.2, 51.3) | 0.93 | 29.7 (15.6, 50.3) | 0.34 | 45.2 (37.8, 52.9) | 0.73 | 47.4 (38.4, 56.6) | 0.44 |
| CCS=1 | 46.6 (37.7, 55.8) | 29.3 (8.5, 65.2) | 42.1 (30.8, 54.3) | 52.5 (37.4, 67.1) | ||||
| CCS=2+ | 46.3 (33.8, 59.3) | 56.6 (11.6, 93.4) | 48.4 (32.3, 65.0) | 38.5 (20.5, 60.1) |
*
The p-values testing for trend across age group and across comorbidity score are based on models that do not include an interaction between age and comorbidity. The p-values testing for trend across comorbidity within each age group are based on models with an interaction between age group and comorbidity group.
†
Includes high-risk benign and other benign findings.
‡
Results for DCIS and invasive breast cancer have been combined for fine needle aspiration due to small cell sizes.
CCS: Charlson Comorbidity Score, CI: Confidence Interval, DCIS: Ductal Carcinoma in Situ.