scholarly journals Microcalcifications Detected as an Abnormality on Screening Mammography: Outcomes and Followup over a Five-Year Period

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Melissa Craft ◽  
Anne M. Bicknell ◽  
Georges J. Hazan ◽  
Karen M. Flegg
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Breast Screening ◽  
Malignant Disease ◽  
Screening Program ◽  
Screening Mammography ◽  
Initial Assessment ◽  
Outcome Group ◽  
Low Rate

Objectives. This study reviewed the outcome of women attending a breast screening program recalled for assessment of microcalcifications and examined the incidence of a breast carcinoma detected during the following five years in any of the women who were given a benign diagnosis at assessment.Method. A retrospective study consisted of 235 clients attending an Australian BreastScreen program in 2003, who were recalled for investigation of microcalcifications detected on screening mammography. Records for the following five years were available for 168 women in the benign outcome group including those who did not require biopsy at initial assessment.Results. Malignant disease was detected in 26.0% (n=146) of the women who underwent biopsy. None of the women in the benign outcome group, with available five-year follow-up records, developed a subsequent breast cancer, arising from the calcifications initially recalled in 2003.Conclusions. This study highlights the effectiveness of an Australian screening program in diagnosing malignancy in women with screen detected microcalcification. This has been achieved by correctly determining 38% (n=235) of the women as benign without the need for biopsy or early recall. A low rate of open surgical biopsies was performed with no cancer diagnoses missed at the time of initial assessment.

scholarly journals The Incidence of Brain Metastases Among Patients with Metastatic Breast Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Markus Kuksis ◽  
Yizhuo Gao ◽  
William Tran ◽  
Christianne Hoey ◽  
Alex Kiss ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Metastatic Breast Cancer ◽  
Brain Metastases ◽  
Triple Negative ◽  
Screening Program ◽  
Meta Analysis ◽  
Metastatic Breast ◽  
Breast Cancer Brain Metastasis

Abstract Background Patients with metastatic breast cancer (MBC) are living longer, but development of brain metastases often limits their survival. We conducted a systematic review and meta-analysis to determine the incidence of brain metastases in this patient population. Methods Articles published from January 2000 to January 2020 were compiled from four databases using search terms related to: breast cancer, brain metastasis, and incidence. The overall and per patient-year incidence of brain metastases were extracted from studies including patients with HER2+, triple negative, and hormone receptor (HR)+/HER2- MBC; pooled overall estimates for incidence were calculated using random effects models. Results 937 articles were compiled, and 25 were included in the meta-analysis. Incidence of brain metastases in patients with HER2+ MBC, triple negative MBC, and HR+/HER2- MBC was reported in 17, 6, and 4 studies, respectively. The pooled cumulative incidence of brain metastases was 31% for the HER2+ subgroup (median follow-up: 30.7 months, IQR: 24.0 – 34.0), 32% for the triple negative subgroup (median follow-up: 32.8 months, IQR: 18.5 – 40.6), and 15% among patients with HR+/HER2- MBC (median follow-up: 33.0 months, IQR: 31.9 – 36.2). The corresponding incidences per patient-year were 0.13 (95% CI: 0.10 – 0.16) for the HER2+ subgroup, 0.13 (95%CI: 0.09 – 0.20) for the triple negative subgroup, and only 0.05 (95%CI: 0.03 – 0.08) for patients with HR+/HER2- MBC. Conclusion There is high incidence of brain metastases among patients with HER2+ and triple negative MBC. The utility of a brain metastases screening program warrants investigation in these populations.

Breast cancer overdiagnosis in stop-screen trials: More uncertainty than previously reported

2020 ◽  
pp. 096914132095078
Author(s):  
Stuart G Baker ◽  
Philip C Prorok
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Confidence Interval ◽  
Breast Cancer Screening ◽  
Confidence Intervals ◽  
Latent Class ◽  
Screening Program ◽  
Screen Interval ◽  
Binomial Confidence Interval

Objective According to the Independent UK Panel on Breast Cancer Screening, the most reliable estimates of overdiagnosis for breast cancer screening come from stop-screen trials Canada 1, Canada 2, and Malmo. The screen-interval overdiagnosis fraction is the fraction of cancers in a screening program that are overdiagnosed. We used the cumulative incidence method to estimate screen-interval overdiagnosis fraction. Our goal was to derive confidence intervals for estimated screen-interval overdiagnosis fraction and adjust for refusers in these trials. Methods We first show that the UK Panel’s use of a 95% binomial confidence interval for estimated screen-interval overdiagnosis fraction was incorrect. We then derive a correct 95% binomial-Poisson confidence interval. We also use the method of latent-class instrumental variables to adjust for refusers. Results For the Canada 1 trial, the estimated screen-interval overdiagnosis fraction was 0.23 with a 95% binomial confidence interval of (0.18, 0.27) and a 95% binomial-Poisson confidence interval of (0.04, 0.41). For the Canada 2 trial, the estimated screen-interval overdiagnosis fraction was 0.16 with a 95% binomial confidence interval of (0.12, 0.19) and a 95% binomial-Poisson confidence interval of (−0.01, 0.32). For the Malmo trial, the estimated screen-interval overdiagnosis fraction was 0.19 with a 95% binomial confidence interval of (0.15, 0.22). Adjusting for refusers, the estimated screen-interval overdiagnosis fraction was 0.26 with a 95% binomial-Poisson confidence interval of (0.03, 0.50). Conclusion The correct 95% binomial-Poisson confidence interval s for the estimated screen-interval overdiagnosis fraction based on the Canada 1, Canada 2, and Malmo stop-screen trials are much wider than the previously reported incorrect 95% binomial confidence intervals. The 95% binomial-Poisson confidence intervals widen as follow-up time increases, an unappreciated downside of longer follow-up in stop-screen trials.

Clinical response to primary Letrozole therapy in women over 70 years with early breast cancer: A retrospective study with a 5 year follow up

2012 ◽  
Vol 38 (5) ◽  
pp. 433 ◽  
Author(s):  
Tasadooq Hussain ◽  
Vijay Agarwal ◽  
Veerabhadram Garimella ◽  
Selvi Rhadhakrishna ◽  
John Fox ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Clinical Response ◽  
Early Breast Cancer

Coorscreen: A Low-Cost, on-Site Mammography Screening Program

1996 ◽  
Vol 10 (5) ◽  
pp. 364-370 ◽  
Author(s):  
Mary Greenwood ◽  
Joanne Henritze
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Malignant Disease ◽  
Screening Program ◽  
Low Cost ◽  
Cost Savings ◽  
Participation Rate ◽  
Program Cost ◽  
Mammography Screening Program ◽  
Screening And Prevention

Setting. Coors Brewing Company is a self-insured corporation of 10,600 employees located in Golden, Colorado. Management has long believed in the value of a healthy workforce and has instituted ongoing health and wellness programming since 1981. Program design. Coorscreen was started in September 1985 to create an ongoing awareness of breast cancer screening and prevention for all female employees, spouses, and retirees and to lower the health care costs for the company through early detection of breast cancer. Program impact. From 1985 through 1993, 12,210 mammograms were completed on 3729 employees, spouses, and retirees. The participation rate was 83%. Forty-seven malignant conditions were confirmed during the first 8 years. Pathology reports confirmed 43 early detections (10 employees) and four late detections (two employees). The 10 cases of malignant disease detected early among employees cost an average of $12,388 in terms of direct medical costs, short-term disability, temporary replacement, and ongoing benefits. The two cases detected late among employees cost an average of $143,398. Among spouses, cases of malignant disease detected late have cost an average of $69,230 more than cases detected early. On the basis of early detection for 10 employees and 26 spouses, the total savings are estimated to be $3,110,000. Discussion. The Coorscreen program cost savings for the first 8 years were $3,110,080 because of the lower cost of early versus late detection. Total screening and procedural costs to the company have equaled $668,690. Thus the company has realized a total cost savings of $2,441,190.

scholarly journals Is Follow up of Patients after Surgery for Breast Cancer Worthwhile?

1985 ◽  
Vol 78 (11) ◽  
pp. 920-921 ◽  
Author(s):  
M C Ormiston ◽  
A G Timoney ◽  
A R Qureshi
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Recurrent Disease ◽  
X Rays ◽  
Routine Examination ◽  
Curative Surgery ◽  
Recurrent Cancer ◽  
Distant Spread ◽  
Asymptomatic Disease

The effectiveness of routine outpatient follow up in detecting recurrent disease after ‘curative’ surgery for breast cancer has been evaluated in a retrospective study of 148 patients. In all, 32 patients developed recurrent cancer. In 3 cases, asymptomatic disease was discovered by routine X-rays. In 25 cases, the patient noticed local disease or complained of symptoms due to distant spread, and over half of these returned to the clinic before the next routine appointment. In only 4 cases was routine examination by a doctor solely responsible for the discovery of recurrent disease. It is concluded that routine follow up made little contribution to the welfare of these patients.

Buckle Up for Breast Cancer—Deaths from Breast Cancer Can Be Analyzed in the Same Way as Deaths in Automobile Accidents

2010 ◽  
Vol 06 ◽  
pp. 36
Author(s):  
Matthew L Webb ◽  
Blake Cady ◽  
James S Michaelson ◽  
◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Limited Data ◽  
Women Studies ◽  
Large Hospital ◽  
Regular Screening ◽  
The Us ◽  
Screening Mammograms

Background:Randomized population mammographic screening trials demonstrated a statistically significant mortality reduction in screened women. Studies in Sweden and The Netherlands show that screening is the main reason that the death rate has decreased in the general population, but ony limited data are available to assess this in the US. In a previous report, 75% of breast cancer deaths occurred in the small proportion of unscreened women. This conclusion needs confirmation.Methods:In a large hospital consortium, 6,997 invasive breast cancer diagnoses occurred between 1990 and 1999. Among all subsequent deaths through 2007, breast cancer deaths in Massachusetts women were documented by review of hospital and outpatient records. Regular screening was defined as two or more screening mammograms at intervals of two years or less in asymptomatic women.Results:After 12.5 (range: eight to 17) years of median follow-up, 461 deaths from breast cancer were confirmed. Seventy-two deaths (15.6%) resulted from non-palpable screen-detected cancers, 44 deaths (9.6%) resulted from palpable interval cancers, and a total of 116 deaths (25.2%) occurred in regularly screened women. Three hundred and twenty-two deaths (69.9%) occurred in women who had never had screening mammography, and 23 deaths (5%) occurred after one or more previous mammograms, none within two years of diagnosis. Thus, 345 breast cancer deaths (74.8%) occurred in women who were not regularly screened.Conclusion:The most effective method of avoiding death from breast cancer is for women to participate in regular screening mammography.

The Egyptian National Breast Screening Program: Priorities, challenges, and results of the pilot phase

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1523-1523
Author(s):  
D. S. Salem ◽  
R. Kamal ◽  
N. H. Said ◽  
I. Adel ◽  
S. Talaat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Screening ◽  
Screening Program ◽  
University Hospital ◽  
World Health ◽  
Cancer Awareness ◽  
Full Field ◽  
Full Field Digital Mammography ◽  
Mobile Mammography ◽  
National Breast

1523 Background: According to the World Health Organization,the number of breast cancercases in developing countries will increase dramatically by the year 2050. Egypt is likely to see an increase in this disease burden unless effective programs for early detection and control are implemented. Many women, especially those who are medically underserved, still do not understand the importance of regular mammograms, or how and where to get one. Methods: Four mobile mammography vans were launched in October 2007, to screen women over 45 years old in the underserved areas of Cairo. Each van was equipped with a full field digital mammography (FFDM) machine, dedicated computer system linked to the National Breast Screening Center via video SAT & ADSL, sphygmomanometer, blood glucose measuring kit, and spring scale and meter to measure weight and height. Based on positive findings, patients were directed to Cairo University Hospital to receive appropriate treatment. Mobile units continued to operate through October, 2008. Results: From October 2007 through October 2008, 11,414 women were screened for breast cancer, hypertension, diabetes, and obesity. Two hundred forty four (2.13%) women were radiologically positive for cancer; of these, only 112 (45.9%) women agreed to be recalled for assessment; of these, 49.1% were confirmed to be true positive with BI-RADS 4,5 (61% cases were mass, with 27.9 % 1–2 cm in size; 16.4% cases were microcalcifications alone; multicentricity in 6.6 %; bilaterality in 2.5% of cases). 36.6% were false positive, and 14.2% are under further investigation. Conclusions: Although Cairo is the most developed city in Egypt, there is lack of breast cancer awareness, especially in the underserved areas. Breast cancer is now a priority for the Ministry of Health, with four more vans and 10 fixed FFDM units to be implemented during the next year. A 5-year plan has been established to cover all 29 Egyptian Governorates. No significant financial relationships to disclose.

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