The identification of false negatives in a population of interval cancers: a method for audit of screening mammography

The Breast ◽  
1995 ◽  
Vol 4 (3) ◽  
pp. 183-188 ◽  
Author(s):  
W. Simpson ◽  
F. Neilson ◽  
J.R. Young
Keyword(s):  
Screening Mammography ◽  
Interval Cancers ◽  
False Negatives

scholarly journals Mammographic features and histopathological findings of interval breast cancers

2008 ◽  
Vol 49 (9) ◽  
pp. 975-981 ◽  
Author(s):  
S. Hofvind ◽  
B. Geller ◽  
P. Skaane
Keyword(s):  
Screening Program ◽  
Lymph Node Involvement ◽  
Screening Mammography ◽  
Tumor Characteristics ◽  
Breast Cancers ◽  
Interval Cancers ◽  
True Negative ◽  
Node Involvement ◽  
Screening Mammograms ◽  
Baseline Screening

Background: Interval cancers are considered a shortcoming in screening mammography due to less favorable prognostic tumor characteristics compared to screening-detected cancers and consequently a lower chance of survival from the disease. Purpose: To describe the mammographic features and prognostic histopathological tumor characteristics of interval breast cancers. Material and Methods: A total of 231 interval breast cancer cases diagnosed in prevalently screened women aged 50–69 years old were examined. Thirty-five percent of the cases were retrospectively classified as missed cancers, 23% as minimal sign, and 42% as true negative (including occult cancers) in a definitive classification performed by six experienced breast radiologists. The retrospective classification described the mammographic features of the baseline screening mammograms in missed and minimal-sign interval cancers, while histopathological reports were used to describe the tumor characteristics in all the subgroups of interval cancers. Results: Fifty percent of the missed and minimal-sign interval cancers combined presented poorly defined mass or asymmetric density, and 26% calcifications with or without associated density or mass at baseline screening. Twenty-seven percent of invasive tumors were <15 mm for missed and 47% for true interval cancers ( P<0.001). Lymph node involvement was more common in missed (49%) compared with the true cases (33%, P<0.05). Conclusion: Missed interval cancers have less prognostically favorable histopathological tumor characteristics compared with true interval cancers. Improving the radiologist's perception and interpretation by establishing systematic collection of features and implementation of organized reviews may decrease the number of interval cancers in a screening program.

Measuring the burden of interval cancers in long-standing screening mammography programmes

2015 ◽  
Vol 22 (2) ◽  
pp. 83-92
Author(s):  
Sune Bangsbøll Andersen ◽  
Sven Törnberg ◽  
Sini Kilpeläinen ◽  
Elsebeth Lynge ◽  
Sisse Helle Njor ◽  
...  
Keyword(s):  
Screening Mammography ◽  
Interval Cancers

scholarly journals The Mode of Detection Is Not Associated with Quality of Life in Women with Breast Cancer

Breast Care ◽  
2019 ◽  
Vol 15 (5) ◽  
pp. 498-505
Author(s):  
Bettina Braun ◽  
Marc-André Kurosinski ◽  
Laura Khil ◽  
Joke Tio ◽  
Barbara Krause-Bergmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Tumor Stage ◽  
Screening Mammography ◽  
Influential Factors ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Screening Programs ◽  
Mode Of Detection

Introduction: Apart from saving lives, mammography screening programs (MSP) are expected to reduce negative side effects of treatment by detecting cancer earlier, when it is more responsive to less aggressive treatment. This study compared quality of life (QoL) among women with breast cancers that were detected either by screening mammography, as interval cancers, or clinically among women not participating in the MSP. Methods: Retrospective study of first-ever invasive breast cancers detected among MSP-eligible women aged 50–69 years between 2006 and 2012 in Münster, Germany. EORTC QLQ-C30 and -BR23 questionnaires were mailed to 1,399 cases still alive in 2015 (response rate 64.1%). Results: Women’s responses were obtained on average 6.1 years after diagnosis. Mean crude and age-adjusted scores for overall QoL, breast and body image (BBI), and five functional scales (FS) were comparable between groups of detection mode. Clearly lower adjusted means for most scores were observed in women with interval cancers, if time since diagnosis was less than 5 years. Cases younger than 60 years showed lower values for some FS, particularly among interval and screen-detected cases. Discussion/Conclusion: In summary, cases with breast cancer showed health-related score values that were similar to the general population of the same age. There was also no indication that mode of detection markedly influenced these scores. However, after adjusting for tumor stage and other influential factors, screening participants appeared more susceptible to score declines after a diagnosis of cancer than non-participants.

Classifying interval cancers as false negatives or newly occurring in fecal immunochemical testing

2021 ◽  
pp. 096914132098683
Author(s):  
Wen-Feng Hsu ◽  
Chen-Yang Hsu ◽  
Amy Ming-Fang Yen ◽  
Sam Li-Sheng Chen ◽  
Sherry Yueh-Hsia Chiu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Incidence Rate ◽  
Screening Program ◽  
False Negative ◽  
Interval Cancer ◽  
Fecal Immunochemical Test ◽  
Colorectal Cancers ◽  
Interval Cancers ◽  
False Negatives ◽  
Immunochemical Test

Objective To classify interval colorectal cancers as false negatives or newly occurring cases in a biennial Fecal immunochemical test (FIT) screening program and by various interscreening intervals. Setting Data from the Taiwanese biennial colorectal cancer screening program involving FIT from 2004 to 2014 were used to estimate the incidence rate of asymptomatic colorectal cancer and the rate of its subsequent progression to clinical mode. Methods The sensitivity of detecting asymptomatic colorectal cancers excluding newly developed colorectal cancers was compared to the conventional estimate of sensitivity, the complementary FIT interval cancer rate as a percentage of the expected incidence rate ((1-I/E)%). The relative contribution of newly developed or false-negative cases to FIT interval colorectal cancers was estimated by age and interscreening intervals. Results The Taiwanese biennial fecal immunochemical test screening program had a conventional sensitivity estimate of 70.2%. After newly developed colorectal cancers were separated from FIT interval cancers, the ability to detect asymptomatic colorectal cancers increased to 75.5%. FIT interval colorectal cancers from the biennial program mainly resulted from newly developed colorectal cancers (68.8%). The corresponding figures decreased to 61.1% for the annual program but increased to 74.7% for the triennial program. The preponderance of newly developed colorectal cancers among FIT interval cancers was more prominent in screenees aged 50–59  than in those aged 60–69. Conclusions Newly developed colorectal cancers showed a predominance among the FIT interval colorectal cancers in particular in the younger population screened. It is desirable to identify high-risk individuals to offer them a short interscreening interval or advanced detection methods to reduce their odds of developing interval cancer.

scholarly journals Breast Density and Risk of Interval Cancers: The Effect of Annual Versus Biennial Screening Mammography Policies in Canada

2021 ◽  
pp. 084653712110279
Author(s):  
Jean Morag Seely ◽  
Susan Elizabeth Peddle ◽  
Huiming Yang ◽  
Anna M. Chiarelli ◽  
Megan McCallum ◽  
...  
Keyword(s):  
Screening Program ◽  
Breast Cancer Mortality ◽  
Interval Cancer ◽  
Screening Mammography ◽  
Dense Breast ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Screening Programs ◽  
Dense Breasts ◽  
Cancer Rates

Regular screening mammography reduces breast cancer mortality. However, in women with dense breasts, the performance of screening mammography is reduced, which is reflected in higher interval cancer rates (ICR). In Canada, population-based screening mammography programs generally screen women biennially; however, some provinces and territories offer annual mammography for women with dense breast tissue routinely and/or on recommendation of the radiologist. This study compared the ICRs in those breast screening programs with a policy of annual vs. those with biennial screening for women with dense breasts. Among 148,575 women with dense breasts screened between 2008 to 2010, there were 288 invasive interval breast cancers; screening programs with policies offering annual screening for women with dense breasts had fewer interval cancers 63/70,814 (ICR 0.89/1000, 95% CI: 0.67-1.11) compared with those with policies of usual biennial screening 225/77,761 (ICR 1.45 /1000 (annualized), 95% CI: 1.19-1.72) i.e. 63% higher (p = 0.0016). In screening programs where radiologists’ screening recommendations were able to be analyzed, a total of 76,103 women were screened, with 87 interval cancers; the ICR was lower for recommended annual (65/69,650, ICR 0.93/1000, 95% CI: 0.71, 1.16) versus recommended biennial screening (22/6,453, ICR 1.70/1000 (annualized), 95%CI: 0.70, 2.71)(p = 0.0605). Screening program policies of annual as compared with biennial screening in women with dense breasts had the greatest impact on reducing interval cancer rates. We review our results in the context of current dense breast notification in Canada.

Tumour characteristics of bilateral screen-detected cancers and bilateral interval cancers in women participating at biennial screening mammography

2018 ◽  
Vol 108 ◽  
pp. 215-221
Author(s):  
Rob van Bommel ◽  
Joost R.C. Lameijer ◽  
Adri C. Voogd ◽  
Joost Nederend ◽  
Marieke W.J. Louwman ◽  
...  
Keyword(s):  
Screening Mammography ◽  
Interval Cancers ◽  
Tumour Characteristics

Type and Extent of Surgery for Screen-Detected and Interval Cancers at Blinded Versus Nonblinded Double-Reading in a Population-Based Screening Mammography Program

2016 ◽  
Vol 23 (12) ◽  
pp. 3822-3830 ◽  
Author(s):  
Roy J. P. Weber ◽  
Rob M. G. van Bommel ◽  
Wikke Setz-Pels ◽  
Adri C. Voogd ◽  
Elisabeth G. Klompenhouwer ◽  
...  
Keyword(s):  
Population Based ◽  
Screening Mammography ◽  
Interval Cancers ◽  
Double Reading ◽  
Extent Of Surgery

The impact of screening mammography in women age 40-49 as a function of tumor biology.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 113-113
Author(s):  
John C. Ruckdeschel ◽  
William V. Rees ◽  
Brett T Parkinson ◽  
Thomas Belnap ◽  
Braden D. Rowley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Large Scale ◽  
Triple Negative ◽  
Tumor Biology ◽  
Screening Mammography ◽  
Her2 Status ◽  
Screening Mammogram ◽  
Interval Cancers ◽  
Her2 Positive ◽  
The Impact

113 Background: Mammographic screening for women 40-49 years of age remains controversial based on results from earlier large scale, controlled mammography trials. Methods: From 2002-2006, 871 women aged 40-49 were diagnosed with breast cancer at Intermountain. The charts of all patients without a record of a screening mammogram at Intermountain (n= 436) were reviewed to confirm that they had not had a screening mammogram in the prior two years at any facility (Interval Cancers) and their survival was compared to 435 women who had their cancer diagnosed on a screening exam (Screen Detected). All patients were followed for at least 5 years via the tumor registry. Results: Stage distribution for Screen Detected/Interval cancers was 25.3/6.4% stage 0, 36.8/24.8% stage I, 24.6/35.6% stage II, 6.9/20.4% stage III and 0.5/3.4% stage IV. Overall, 67 patients (7.7%) did not have complete staging data. Overall survival was significantly better (p<.0001) for 40-49 year old women with Screen Detected compared to those with Interval cancers. 702 (79.6%) had ER/PR status recorded (83.5% ER/PR positive). Women with DCIS or LCIS did not have tissue sent for markers. 679 patients (76.9%) had HER2 status recorded (78.8% HER2 neg). Of the patients with both HER2 and ER/PR status recorded 10.4% were “triple negative.” Survival following screening mammography was significantly enhanced for women who were ER/PR positive (p<0.0001), HER2 negative (p=0.0065), or HER2 positive (p=0.0013). Survival was not improved by screening mammography for women who were ER/PR negative (p=0.3818) or for women who were triple negative (p=0.416). Conclusions: A minority of women age 40-49 who develop breast cancer (13%) have biologic features suggestive of aggressive disease and, after 5 years of follow up, they are not benefitted by screening mammography. The remaining 87% are clearly benefitted by screening mammography. Our results suggest that the discrepancies noted in the screening mammography trials in 40-49 year old women may have resulted from population variations in the proportion of women with unfavorable biology. Based in part on these results, we continue to recommend regular screening in the 40-49 year old cohort.

Characteristics and prognosis of interval cancers after biennial screen-film or full-field digital screening mammography

2016 ◽  
Vol 158 (3) ◽  
pp. 471-483 ◽  
Author(s):  
Roy J. P. Weber ◽  
Rob M. G. van Bommel ◽  
Marieke W. Louwman ◽  
Joost Nederend ◽  
Adri C. Voogd ◽  
...  
Keyword(s):  
Screening Mammography ◽  
Interval Cancers ◽  
Full Field

scholarly journals Screening for breast cancer in 2018— what should we be doing today?

2018 ◽  
Vol 25 ◽  
pp. 115 ◽  
Author(s):  
J.M. Seely ◽  
T. Alhassan
Keyword(s):  
Breast Cancer ◽  
Breast Biopsy ◽  
Breast Cancer Mortality ◽  
Digital Breast Tomosynthesis ◽  
Screening Mammography ◽  
False Positives ◽  
Breast Cancers ◽  
False Negatives ◽  
Dense Breast Tissue ◽  
Additional Imaging

Although screening mammography has delivered many benefits since its introduction in Canada in 1988, questions about perceived harms warrant an up-to-date review. To help oncologists and physicians provide optimal patient recommendations, the literature was reviewed to find the latest guidelines for screening mammography, including benefits and perceived harms of overdiagnosis, false positives, false negatives, and technologic advances.For women 40–74 years of age who actually participate in screening every 1–2 years, breast cancer mortality is reduced by 40%. With appropriate corrections, overdiagnosis accounts for 10% or fewer breast cancers. False positives occur in about 10% of screened women, 80% of which are resolved with additional imaging, and 10%, with breast biopsy. An important limitation of screening is the false negatives (15%–20%). The technologic advances of digital breast tomosynthesis, breast ultrasonography, and magnetic resonance imaging counter the false negatives of screening mammography, particularly in women with dense breast tissue.

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