Explaining the difference in prognosis between screen-detected and 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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Screening and Early Diagnosis of Breast Cancer: Assessment of Knowledge and Practical Abilities of Final Year Nursing and Midwifery Students in Health Schools of Ouagadougou

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2017.2.3.47 ◽

2017 ◽

Vol 2 (3) ◽

pp. 47

Author(s):

Nayi Zongo ◽

Sanon/Lompo Marthe Sandrine ◽

Bambara H. Aboubacar ◽

Soma Chantal ◽

Bambara Augustin Tozoula ◽

...

Keyword(s):

Breast Cancer ◽

Early Diagnosis ◽

Clinical Signs ◽

Study Data ◽

P Value ◽

Screening Methods ◽

Breast Cancers ◽

Chi Square ◽

Cross Sectional ◽

The Difference

The Objective was to assess the knowledge and practical abilities of final year nursing and midwifery students in health schools of Ouagadougou relating to screening and early diagnosis of breast cancer. This is a cross-sectional, prospective and descriptive observational study conducted from 1st November 2014 to 31st January 2015. A sample of 403 students was used for this study. Data were collected using an individual questionaire and were typed on Epi data and then analyzed on SPSS software. Chi-square tests were used to compare the different proportions. The difference is considered to be significant if p value < 0.05. Three hundred and ninety nine students filled the questionnaire, i.e. a rate of non-respondents of 1%. All students were aware of the existence of breast cancer. The media (47.8%) was the main source of information. The level of knowledge of students was satisfactory with frequencies of 83.9% for risk factors; 91.6% for clinical signs; 83.4 % for screening methods and 88.1% for therapeutic terms of breast cancers. However, focus should be put on the teaching of cancerology and the supervision of students during internship, must be reinforced. These results attest that the level of students in the knowledge and practical abilities concerning screening and early diagnosis of breast cancer is satisfactory.

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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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Deep inspiration breath hold (DIBH) with electromagnetic surface transponder confirmation of chest wall (CW) position during radiation for left breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.26_suppl.126 ◽

2014 ◽

Vol 32 (26_suppl) ◽

pp. 126-126

Author(s):

Madeera Kathpal ◽

Kelly Sun ◽

Cynthia Malmer ◽

Stephanie Ninneman ◽

Stacie Wendt ◽

...

Keyword(s):

Free Breathing ◽

Left Breast ◽

Breath Hold ◽

Breast Cancers ◽

Deep Inspiration Breath Hold ◽

Heart Dose ◽

Real Time Tracking ◽

The Mean ◽

The Difference ◽

Ischemic Events

126 Background: DIBH during radiation of left breast cancers reduces heart dose, potentially reducing late cardiac ischemic events, but requires a treatment CW position significantly different from a free-breathing (FB) position. We sought to improve the accuracy of radiation therapy during DIBH by using electromagnetic surface transponders to track the position of the CW during treatment. We examined the benefit of this technique in reducing dose to the heart and consistently reproducing the DIBH position. We also evaluated the difference between FB and DIBH CW position and compared CW movement within the plateau of each DIBH to within beam-on time. Methods: 15 patients participated in this IRB-approved study. Patients were planned and treated using DIBH. We fused treatment-position FB CT scans to DIBH scans to compare mean heart (MH) and left anterior descending coronary artery (LAD) dose. We used surface transponder tracking reports to determine CW motion at the time of daily port films, during FB, the plateau of each DIBH, and beam-on time. We summed anterior and superior motion using the Pythagorean Theorem and report our results in this combined axis. Paired t-test was used to compare heart dose with vs. without DIBH and CW motion during plateau DIBH vs. beam-on. Results: DIBH significantly reduced MH and LAD dose vs. FB plans (MH 1.26 ± 0.51 Gy v 2.84 ± 1.55 Gy, p < 0.01), (LAD 5.49 ± 4.02 Gy v 18.15 ± 8.78 Gy, p < 0.01). DIBH CW position was a mean of 13.9 ± 5.3 mm anterior and superior to FB position. The mean difference in CW position at the time of daily port film vs. beam-on was -1.0 ± 2.5 mm. Plateau DIBH CW motion was 2.8 ± 2.3 mm, significantly increased from CW motion during beam-on (1.1 ± 1.2 mm, p < 0.01). Treatment was paused in 23% of fractions to adjust for suboptimal breath hold or CW position. Conclusions: DIBH reduced the MH and LAD dose by at least 50%. Real-time tracking with electromagnetic transponders allowed us to limit treatment to the most stable portion of the DIBH plateau, significantly reducing intra-fraction motion. Electromagnetic confirmation of CW position allowed verification of breath-hold reproducibility.

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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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