Screen detected breast cancer in an Asian population: pathological findings of the Singapore breast screening project.

We document the pathological characteristics of 135 cancers detected in 132 predominantly Chinese women in the Singapore breast screening project. Thirty-four (25%) screen detected tumours were in situ ductal cancers; 98 (73%) invasive, while three (2%) women with malignant fine needle aspirate smears refused further treatment. The median size of in situ cancers was 10 mm; the majority (56%) demonstrated a comedo pattern. Of the invasive tumours which had a median size of 15 mm, three (3%) were microinvasive, 75 (77%) infiltrative ductal, three (3%) invasive lobular, and the remaining 17 (17%) special types or others. Histologic grading revealed 23 (24%) grade I, 52 (53%) grade II, 19 (19%) grade III and four (4%) ungraded cases. Sixty-three (65%) of the invasive cancers were node negative, while 64% of all screen detected malignancies were Stages 0 (in situ) or I. From the pathological perspective, problems of borderline lesions, microinvasion, grade assessment and histological subtyping have to be addressed.

[1]  P. Rosen.  Rosen's Breast Pathology , 2001 .

[2]  I. Ellis,et al.  Pathological prognostic factors in breast cancer. , 1999, Critical reviews in oncology/hematology.

[3]  P. Tan,et al.  Results of intermediate measures of a population‐based, randomized trial of mammographic screening prevalence and detection of breast carcinoma among Asian women: the Singapore Breast Screening Project , 1998, Cancer.

[4]  P. Tan,et al.  Results of intermediate measures from a population‐based, randomized trial of mammographic screening prevalence and detection of breast carcinoma among asian women , 1998 .

[5]  K. Soo,et al.  Risk factors for breast carcinoma in Singaporean Chinese women , 1997, Cancer.

[6]  N. Day,et al.  A comparison of the performance and impact of breast cancer screening programmes in East Anglia, U.K. and Bouches du Rhône, France. , 1997, European journal of cancer.

[7]  I. Ellis,et al.  Atypical ductal hyperplasia, ductal carcinoma in situ and in situ atypical apocrine proliferations of the breast , 1996 .

[8]  F. Knox,et al.  A comparison of axillary node status between cancers detected at the prevalence and first incidence breast screening rounds. , 1996, British Journal of Cancer.

[9]  M. R. Shetty.  The new era in breast cancer. , 1996, Archives of surgery.

[10]  J. G. Schuler,et al.  The new era in breast cancer. Invasion, size, and nodal involvement dramatically decreasing as a result of mammographic screening. , 1996, Archives of surgery.

[11]  S. Duffy,et al.  Breast cancer in Singapore: trends in incidence 1968-1992. , 1996, International journal of epidemiology.

[12]  R. Hutter,et al.  Predictors of recurrence for patients with small (one centimeter or less) localized breast cancer (T 1 a,b NO MO) , 1995 .

[13]  I. Ellis,et al.  Prognostic factors in primary breast carcinoma. , 1995, Journal of clinical pathology.

[14]  N. Weidner.  The Difficult Diagnosis in Surgical Pathology , 1995 .

[15]  I. Jatoi,et al.  Mammographically detected ductal carcinoma in situ: are we overdiagnosing breast cancer? , 1995, Surgery.

[16]  M. J. van de Vijver,et al.  Ductal carcinoma in situ: a proposal for a new classification. , 1994, Seminars in diagnostic pathology.

[17]  S Shapiro,et al.  Report of the International Workshop on Screening for Breast Cancer. , 1993, Journal of the National Cancer Institute.

[18]  A. Patchefsky,et al.  Subclinical ductal carcinoma in situ of the breast: Treatment by local excision and surveillance alone , 1992, Cancer.

[19]  L. Tabár,et al.  The Swedish two-county trial of mammographic screening for breast cancer: recent results on mortality and tumor characteristics. , 1992, Pathologie-biologie.

[20]  R. Blamey,et al.  Pathological prognostic factors in breast cancer. II. Histological type. Relationship with survival in a large study with long‐term follow‐up , 1992, Histopathology.

[21]  Max H. Myers,et al.  Manual for Staging of Cancer , 1992 .

[22]  K. Chia,et al.  Cervical cancer: trends in incidence and mortality in Singapore 1968 to 1987. , 1992, Annals of the Academy of Medicine, Singapore.

[23]  A. Huggins,et al.  Comparative pathology of breast cancer in a randomised trial of screening. , 1991, British Journal of Cancer.

[24]  M. Lagios.  Duct carcinoma in situ. Pathology and treatment. , 1990, The Surgical clinics of North America.

[25]  I. Ellis,et al.  Pathology and breast screening , 1990, Histopathology.

[26]  N. Day,et al.  Breast cancer screening programmes: the development of a monitoring and evaluation system. , 1989, British Journal of Cancer.

[27]  David L. Page,et al.  Diagnostic Histopathology of the Breast , 1988 .

[28]  S. Feig,et al.  Decreased breast cancer mortality through mammographic screening: results of clinical trials. , 1988, Radiology.

[29]  S. Schnitt,et al.  Ductal carcinoma in situ (intraductal carcinoma) of the breast. , 1988, The New England journal of medicine.

[30]  L. Tabár,et al.  REDUCTION IN MORTALITY FROM BREAST CANCER AFTER MASS SCREENING WITH MAMMOGRAPHY Randomised Trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare , 1985, The Lancet.

[31]  W. Dupont,et al.  Intraductal carcinoma of the breast: Follow‐up after biopsy only , 1982, Cancer.

[32]  S. Shapiro,et al.  Evidence on screening for breast cancer from a randomized trial , 1977, Cancer.

[33]  J. Johnson,et al.  In situ ductal carcinoma of the breast. , 1962, JAMA.

[34]  I. Ellis,et al.  Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. , 2002, Histopathology.

[35]  P. Tan,et al.  Male breast cancer: A retrospective study with immunohistochemical analysis of hormone receptor expression , 1997, Pathology.

[36]  J. King,et al.  A Practical Approach To Breast Ductal Carcinoma In Situ And Tumors With An Extensive Intraductal Component* , 1994, Pathology.

[37]  U. Chetty,et al.  Noninvasive ductal carcinoma of the breast: the relevance of histologic categorization. , 1993, Human pathology.

[38]  M. Lagios,et al.  Impact of mammographic screening on the size and the relative frequency of invasion in breast cancers seen in a community hospital from 1975-1988. , 1992, Pathology.

[39]  Fatteneh Ed. Tavassoli,et al.  Pathology of The Breast , 1992 .

[40]  S. Feig,et al.  Nonpalpable in situ ductal carcinoma of the breast. Predictors of multicentricity and microinvasion and implications for treatment. , 1989, Archives of surgery.

[41]  S. Schnitt,et al.  Evaluation of breast biopsy specimens in patients considered for treatment by conservative surgery and radiation therapy for early breast cancer. , 1988, Pathology annual.

[42]  T. T. Alagaratnam,et al.  Limitations of mammography in Chinese females. , 1985, Clinical radiology.

[43]  Gunnar Eklund,et al.  Randomised Trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare , 1985 .

[44]  D. Lowe,et al.  Recent advances in histopathology , 1978 .