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However, the evidence to support this hypothesis is limited. We compared the risk of death from any cause for women with true, minimal signs, and missed invasive screen-detected (SDC) and interval breast cancers (IC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This nation-wide study included 1022 SDC and 788 IC diagnosed through BreastScreen Norway during 2005\u20132016. Cancers were classified as true, minimal signs, or missed by five breast radiologists in a consensus-based informed review of prior screening and diagnostic images. We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of death from any cause associated with true, minimal signs, and missed breast cancers, adjusting for age at diagnosis, histopathologic tumour diameter and grade, and subtype. Separate models were created for SDC and IC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among SDC, 463 (44%) were classified as true and 242 (23%) as missed; among IC, 325 (39%) were classified as true and 235 (32%) missed. Missed SDC were associated with a similar risk of death as true SDC (HR = 1.20, 95% CI (0.49, 2.46)). Similar results were observed for missed versus true IC (HR = 1.31, 95% CI (0.77, 2.23)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We did not observe a statistical difference in the risk of death for women diagnosed with true or missed SDC or IC; however, the number of cases reviewed and follow-up time limited the precision of our estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Points<\/jats:title><jats:p><jats:italic>\u2022 An informed radiological review classified screen-detected and interval cancers as true, minimal signs, or missed based on prior screening and diagnostic mammograms.<\/jats:italic><\/jats:p><jats:p><jats:italic>\u2022 It has been hypothesised that true cancers, not visible on the prior screening examination, may be more aggressive than missed cancers.<\/jats:italic><\/jats:p><jats:p><jats:italic>\u2022 We did not observe a statistical difference in the risk of death from any cause for women with missed versus true screen-detected or interval breast cancers.<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1007\/s00330-020-07340-4","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T05:06:34Z","timestamp":1605157594000},"page":"2677-2686","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Survival among women diagnosed with screen-detected or interval breast cancer classified as true, minimal signs, or missed through an informed radiological review"],"prefix":"10.1007","volume":"31","author":[{"given":"Kaitlyn M.","family":"Tsuruda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tone","family":"Hovda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Bhargava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marit B.","family":"Veier\u00f8d","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0178-8939","authenticated-orcid":false,"given":"Solveig","family":"Hofvind","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"7340_CR1","volume-title":"European guidelines for quality assurance in breast cancer screening and diagnosis","author":"N Perry","year":"2006","unstructured":"Perry N, Broeders M, de Wolf C, T\u00f6rnberg S, Holland R, von Karsa L (2006) European guidelines for quality assurance in breast cancer screening and diagnosis, 4th edn. 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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors has significant statistical expertise (Marit B. Veier\u00f8d).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was not required for this study because the Cancer Registry Regulations waive the requirement for informed consent for surveillance and quality assurance projects based on data collected as a part of invitation to and\/or participation in BreastScreen Norway.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was not required because this was a quality assurance project. Approval was obtained from the Oslo University Hospital data protection official for research (PVO 2016-4696).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Some study subjects may have been previously reported in other studies using population-based breast cancer data from the Cancer Registry of Norway.The study sample from the submitted manuscript partially overlaps with a study submitted in March 2020 to European Radiology by Hovda T, Tsuruda KM, Hoff SR et al (2020) Radiological review of prior screening mammograms of screen-detected breast cancer. Eur Radiol.. The article by Hovda et al focuses on the mammographic features of true, missed, and minimal signs screen-detected breast cancer.This article focuses on the survival associated with true, missed, and minimal signs breast cancer, both screen-detected and interval breast cancer, and does not discuss the mammographic features associated with these classifications.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"value":"<i>\u2022<\/i> retrospective<i>\u2022<\/i> observational<i>\u2022<\/i> multicentre study","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}