Abstract P1-02-02: Is ultrasound screening justified for non-palpable breast cancer in asymptomatic Chinese women: A real-world study based on long-term survival of consecutive cohort (2001-2017)

Background: Ultrasound (US) is an effective initial screening test for breast cancer both in Caucasian and Chinese women [PMID: 26712110, 26715161, and 25668012]. The real-world modality of breast cancer screening in the China is hospital-based screening among asymptomatic self-referred women. In our previous study, we showed that US and mammography (MG) detected non-palpable breast cancer (NPBC) had similar long-term survival and that US detected more invasive NPBC with positive lymph node [2016 SABCS P5-02-05, PMID: 27689334]. This study was to investigate whether these findings would be still true with more NPBC cases included and longer follow-up in the consecutive hospital cohort. Methods: From 2001 to 2017, 5,264 asymptomatic women with positive (BI-RADS 4 and 5) initial screening US underwent biopsies in PUMC Hospital, and 914 US-NPBC in 883 women were diagnosed. Meanwhile, women without dense breasts (defined as BI-RADS category C and D) also received screening MG after physical examination and US. There were 1,159 patients with positive (BI-RADS 4 and 5) MG and normal US (BI-RADS 1, 2 and 3) underwent MG-guided biopsies and 216 MG-NPBC were diagnosed in 214 women. The clinicopathological characteristics and 10-year disease-free survival (DFS) and overall survival (OS) were reviewed and compared between the US-NPBC and MG-NPBC. Prognostic factors of NPBC were identified by univariate and multivariate Cox analysis. Result: Compared to MG, US could detect more invasive (81.2% vs 48.6%, p Conclusion: Overall, US could detect more invasive NPBC patients with positive lymph node and advanced stage compared to MG, and screen invasive NPBC at similar TNM stage and subtype distribution as MG. US-NPBC patients received more breast conserving surgery and chemotherapy, and could achieve comparable 10-year DFS and OS as MG-detected NPBC. Hence US is justified in the real-world as the initial imaging modality in hospital-based screening Chinese women. Citation Format: Yao R, Pan B, Xu Y, Zhou Y, Zhu Q, Zhang J, Wu H, Mao F, Lin Y, Shen S, Sun Q. Is ultrasound screening justified for non-palpable breast cancer in asymptomatic Chinese women: A real-world study based on long-term survival of consecutive cohort (2001-2017) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-02.