Mode of detection matters: Differences in screen-detected versus symptomatic breast cancers

INTRODUCTION We determined whether it is safe to avoid mammograms in a group of symptomatic women with a non-suspicious history and clinical examination. PATIENTS AND METHODS Symptomatic women aged 35 years or over newly referred to a rapid-diagnosis breast clinic underwent mammography on arrival in the clinic. A breast radiologist reported on the mammograms. An experienced clinician who was unaware of the mammogram findings examined patients and decided whether a mammogram was indicated or not. If not, a management plan was formulated. Mammogram findings were then provided to the clinician and any change to the original management plan as a result of mammography was recorded. RESULTS In two-thirds (67%) of 218 patients, the clinician felt a mammogram was indicated. Half (46%) of these mammograms showed an abnormality; of these abnormal mammograms, 41% were breast cancer. Among the third (n = 71) of mammograms felt not to be indicated, 3 showed abnormalities of which 2 were breast cancer. One cancer was not suspected clinically or mammographically but was diagnosed on cyto/histopathological assessment. CONCLUSIONS A significant proportion of patients attending a symptomatic breast clinic have a non-suspicious history and normal clinical findings on examination. However, even in this group avoiding mammograms risks missing clinically occult breast cancers. It would appear sensible to offer mammograms to all symptomatic women over 35 years of age.

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Early Detection of Breast Cancer through Population-Based Mammographic Screening in Asian Women: A Comparison Study between Screen-Detected and Symptomatic Breast Cancers

The Breast Journal ◽

10.1111/j.1524-4741.2009.00687.x ◽

2009 ◽

Vol 15 (2) ◽

pp. 133-139 ◽

Cited By ~ 12

Author(s):

Esther W. L. Chuwa ◽

Allen W. Y. Yeo ◽

Heng Nung Koong ◽

Chow Yin Wong ◽

Wei Sean Yong ◽

...

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Population Based ◽

Mammographic Screening ◽

Asian Women ◽

Breast Cancers ◽

Comparison Study ◽

Symptomatic Breast

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Clinically Indeterminate Breast Lesions with Normal Imaging: A Retrospective Study in a Symptomatic Breast Care Unit

Iranian Journal of Radiology ◽

10.5812/iranjradiol.103859 ◽

2020 ◽

Vol 17 (4) ◽

Author(s):

Emre Pakdemirli ◽

Mohamed Elkorety ◽

Sherif Monib

Keyword(s):

Core Biopsy ◽

Lobular Carcinoma ◽

Needle Aspiration ◽

Breast Lesions ◽

Breast Cancers ◽

Fine Needle ◽

Triple Assessment ◽

Important Pathway ◽

Needle Aspiration Cytology ◽

Symptomatic Breast

Background: Triple assessment of breast pathologies is a very important pathway to detect breast cancers earlier. Objectives: To ascertain the necessity of clinical-guided core biopsy (CGCB) or fine-needle aspiration cytology (FNAC) for investigating clinically indeterminate breast lesions with no significant imaging findings. Patients and Methods: Retrospective analysis of 72 patients who had clinical core biopsy or fine-needle cytology was carried out to investigate clinically indeterminate breast lesions with normal imaging during the period from September 2017 to September 2019. Results: Out of 72 patients, 61 clinically indeterminate breast lesions (P3) were investigated and showed that 39 lesions (63.9%) were graded as B1, 17 lesions (27.8%) were graded as B2, two lesions (3.2%) were graded as B3 showing atypia, no lesions were graded as B4, two lesions (3.2%) were graded as B5 (one [1.6%] was found to be invasive lobular carcinoma [ILC] and the other one [1.6%] was found to be metastatic colorectal cancer to the breast), while one lesion investigated by FNAC was graded as C2 (1.6%). Conclusion: CGCB or FNAC is still necessary and vital for investigating clinically indeterminate breast lesions with normal imaging.

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The incidence of missed breast cancers in a one stop symptomatic breast clinic-our experience in Southwest Wales

European Journal of Cancer ◽

10.1016/s0959-8049(18)30682-8 ◽

2018 ◽

Vol 92 ◽

pp. S152

Author(s):

S. Khawaja ◽

M.W. Lam ◽

L. Mills ◽

A. Huws ◽

D. Thomas ◽

...

Keyword(s):

Breast Cancers ◽

Breast Clinic ◽

One Stop ◽

Symptomatic Breast

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

Breast Care ◽

10.1159/000504662 ◽

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.

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Does a better grade of tumour occurring in women under hormone replacement therapy compensate for their lower probability of detection by screening mammography

Journal of Medical Screening ◽

10.1136/jms.9.2.70 ◽

2002 ◽

Vol 9 (2) ◽

pp. 70-73 ◽

Cited By ~ 13

Author(s):

J. Estève ◽

B. Séradour ◽

J. Jacquemier ◽

L. Remontet

Keyword(s):

Breast Cancer ◽

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Hormone Replacement ◽

Screening Mammography ◽

Probability Of Detection ◽

Lower Probability ◽

Lower Grade ◽

Breast Cancers ◽

Mode Of Detection

OBJECTIVE: To compare the prognostic factor of breast cancer survival between breast cancer diagnosed in subjects receiving hormone replacement therapy (HRT) before diagnosis to those without such a therapy. Subjects and methods: All breast cancers diagnosed between 1993 and 2000 within the breast cancer screening programme in Bouches du Rhône (France) were analysed for size, node status, and grade according to use, or not, of HRT. Univariate and multivariate analyses were carried out taking into account age, density of the breast, and mode of detection. RESULTS: The breast tumours diagnosed among HRT users had a lower grade whatever the mode of detection. The proportion of node positive tumours was identical in the two groups after adjustment for age. The smaller size of the tumours among HRT users is partly explained by the lower grade of these tumours Conclusion: Although tumours occurring in HRT users have a lower chance of being detected by screening, their prognostic factors, especially the grade of the tumour, are better than in non-users. More work is needed to find which part of this advantage is attributable to better surveillance of women treated with HRT

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The incidence and outcome of incidental breast lesions detected by computed tomography

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12518836439083 ◽

2010 ◽

Vol 92 (2) ◽

pp. 124-126 ◽

Cited By ~ 16

Author(s):

A Hussain ◽

A Gordon-Dixon ◽

H Almusawy ◽

P Sinha ◽

A Desai

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Breast Lesion ◽

Chest Ct ◽

Ct Scans ◽

Breast Lesions ◽

Breast Cancers ◽

The Mean ◽

The Uk ◽

Symptomatic Breast

INTRODUCTION In the UK, the majority of breast cancers are diagnosed through symptomatic breast clinics and the breast screening programmes. With increased use of computed tomography (CT) to assess various pathologies, breast lesions are picked up incidentally. The aim of this study was to investigate the incidence and outcomes of breast lesions detected incidentally on CT scans. PATIENTS AND METHODS A retrospective study was conducted to assess the incidence and outcome of incidentally found breast lesions, which were detected on chest CT scans that were conducted for other pathologies during the period from February 2007 to October 2008. RESULTS A total of 432 chest CT scans were performed over 18 months. Thirty-three (7.63%) patients were found to have an incidental breast lesion. The mean age was 73 years (range, 50–86 years). Of these, 17 (52%) were benign, eight (24%) were primary breast cancer and the remaining eight (24%) had no definite pathology. The detection rate of breast cancer was 1.85%. CONCLUSIONS CT is emerging as an important contributor to the detection of occult breast lesions. Radiological awareness of incidental breast lesions is important so that appropriate referral to a specialised breast unit is made.

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