Effect of Screening Mammography on the Surgery of Breast Cancer in Finland: A Population-Based Analysis during the Years 1985–2004

2006 ◽  
Vol 72 (2) ◽  
pp. 167-171
Author(s):  
Hannu Paajanen ◽  
Lea Kyhälä ◽  
Riitta Varjo ◽  
Sirkku Rantala
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Diagnostic Procedures ◽  
Geographic Area ◽  
Population Based ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Better Than

A nationwide mammographic screening of women aged 50 to 59 years commenced in Finland in January 1987. We studied the effect of screening on surgical diagnosis, treatment, and survival of breast cancer in one geographic area in Finland. We reviewed the medical records, survival data from Finnish Cancer Registry, and screening data from the Finnish Mammogrphic Working Group of 1,049 women who underwent surgery for breast cancer in our hospital between the years 1985 and 2004. Altogether, 35 parameters including diagnostic procedures, operative data, and staging were recorded. The results of tumors detected by mammographic screening (n = 156) and interval cancers (n = 148) were compared with the tumors detected outside of screening (n = 745). The incidence of breast cancer increased from 35 to 72 cases per 100,000 inhabitants, and the percentage of nonpalpable cancers increased from 12 to 33. Approximately 30 women per 100,000 inhabitants were annually referred from mass screening for surgical biopsies, in 60 per cent of which cancer was detected. Breast lump was still a first sign of cancer in 60 per cent of patients. The mammographic screening detected 20 per cent of new breast cancers. The cancers detected by screening were smaller, found at an earlier stage, and their 10-year-survival was better (90% vs 70%) than those detected by other means (P = 0.003). Overall mortality of interval cancers was worse (27%) than screening cancers (6%, P < 0.0001). Mammographic screening detects up to 20 per cent of new breast cancers in a well-defined population area. The prognosis of screening cancers is better than the cancers found outside of screening.

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.

Improved survival rate for women with interval breast cancer – results from the breast cancer screening programme in Malmö, Sweden 1976–1999

2007 ◽  
Vol 14 (3) ◽  
pp. 138-143 ◽  
Author(s):  
Sophia Zackrisson ◽  
Lars Janzon ◽  
Jonas Manjer ◽  
Ingvar Andersson
Keyword(s):  
Breast Cancer ◽  
Case Fatality Rate ◽  
Screening Programme ◽  
Interval Cancer ◽  
Case Fatality ◽  
Mammographic Screening ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Stage Distribution ◽  
Interval Breast Cancer

Objective: Breast cancers detected between screening examinations can influence the sensitivity of a screening programme. Studies of the prognosis of these so-called interval breast cancers show diverging results. We investigated the course of interval breast cancer over time in the Malmö Mammographic Screening Trial (MMST) 1976–86 and the Malmö Mammographic Service Screening Programme (MMSSP) 1990–99. Material and methods: Stage distribution and survival of interval cancers in MMSSP were compared with screen-detected and non-attender cancer cases in MMSSP, with interval cancers in MMST and with breast cancer cases in a non-screened population five years before the start of MMSSP (pre-screening cancer cases). Results: In MMSSP 1990–99, the interval cancers did not differ in stage distribution or survival compared with cancer cases in non-attenders, while screen-detected cancer cases had more favourable stage distribution and rate of survival than had the interval cancer cases. The MMST interval cancer cases, 1976–1986, had more favourable stage distribution but higher overall case fatality rate, relative risks (RR) 1.78 (1.00–3.20), and breast cancer case fatality rate, RR 2.05 (1.05–4.00), compared with the more recent MMSSP interval cancer cases. No significant difference in five-year survival was seen in the MMSSP interval cancer cases compared with pre-screening cancer cases not exposed to screening. Conclusion: In this urban population invited to mammographic screening, the survival rate for women with interval cancer has improved over a period of 20 years. Further studies are needed to assess what factors might explain changes in the course of interval breast cancer.

Human Epidermal Growth Factor Receptor 2 Status and Interval Breast Cancer in a Population-Based Cancer Registry Study

2012 ◽  
Vol 30 (19) ◽  
pp. 2362-2368 ◽  
Author(s):  
Antonino Musolino ◽  
Maria Michiara ◽  
Giovanni Maria Conti ◽  
Daniela Boggiani ◽  
Marella Zatelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Cancer Registry ◽  
Growth Factor Receptor ◽  
Population Based ◽  
Mammographic Screening ◽  
Registry Study ◽  
Interval Cancers ◽  
Her2 Positive ◽  
Epidermal Growth

Purpose To determine whether human epidermal growth factor receptor 2 (HER2) –positive status is associated with risk of breast cancer diagnosis in the interval between mammographic screening, we estimated the distribution of features of aggressive tumor behavior in a general population with newly diagnosed breast cancer and known screening status. Patients and Methods We evaluated all invasive breast cancers (N = 641) that were systematically collected by the Parma Province Cancer Registry and diagnosed in women age 50 to 69 years from 2004 to 2007. From this population, 292 screen-detected cancers and 48 interval cases with negative screening mammograms on expert rereading (true interval cancers) were selected for study purposes. Unconditional logistic regression adjusted for age and tumor size was used to determine whether interval cancers were associated with selected clinicobiologic characteristics. Results Tumors with a high histologic grade (odds ratio [OR], 1.8; 95% CI, 1.2 to 3.8), high proliferative rate (OR, 2.4; 95% CI, 1.2 to 4.5), negative estrogen receptor status (OR, 1.6; 95% CI, 1.1 to 3.1), or HER2-positive status (OR, 3.4; 95% CI, 1.7 to 7.1) were more likely to be diagnosed in the interval between screening. Women age less than 60 years with HER2-positive breast cancer were four times more likely to be diagnosed in the interval between screening compared with only a two-fold increased risk for older women. Conclusion This population-based cancer registry study demonstrated that HER2-positive tumors account for a substantial proportion of mammographic screening failure. The distribution of biologic characteristics in screen-detected cancers differs from that observed in interval cancers and may account in part for the more aggressive behavior of interval-detected cases.

Self-exam is the most common method of breast cancer identification

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1543-1543 ◽  
Author(s):  
A. Rosenberg ◽  
L. Burke ◽  
P. Vos ◽  
D. Liles
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Private Insurance ◽  
College Education ◽  
Diagnostic Procedures ◽  
Screening Mammography ◽  
Breast Cancers ◽  
Exact Methods ◽  
Tumor Identification ◽  
Self Examination

1543 Background: Breast cancer survival is improved by early diagnosis. The role of self-exam as an adjunct to screening mammography has been questioned as some studies suggest that self-examinations lead to unnecessary diagnostic procedures without improving survival. Methods: Patients who had been diagnosed with breast cancer and who were attending a university-based cancer clinic were interviewed, using a structured questionnaire, to determine the way in which their breast cancers were first identified. Inference was conducted using exact methods (Clopper-Pearson intervals for proportions and Fisher’s test for odds ratios). Results: Breast cancers were first identified by mammogram in 16% of women, by provider in 9%, by the spouse in 2%. Seventy-five percent (95% CI=61% to 85%) of patients first identified their tumors by self exam. Self-identifiers occurred in all demographic groups. These women included those with all types of insurance: private insurance (68%), Medicare (60%), Medicaid (100%), or no insurance (85%); all levels of education: 77% with college education and 75% with high school; all income levels: for example, among 79% with annual incomes of <$10K and 73% with incomes >$50K; and among both black (91%) and white (66%) women. Of the women who reported both regular mammograms and regular self-examination (N=35), 77% (95% CI=60 to 90%) were self-identifiers. However, cancers found by mammography were more likely to be Stage I than were those identified by self-examination (odds ratio=3.9, 95% CI .9 to 17.5, p=.047). Conclusions: Most breast cancers (75%) were found by self-examination, even among women who had regular mammography. We did not find any demographic factor that predicted mammography as the primary method of tumor identification. These findings suggest that self-examination remains an important method of breast cancer identification. No significant financial relationships to disclose.

scholarly journals Left–right breast asymmetry and risk of screen-detected and interval cancers in a large population-based screening population

2020 ◽  
Vol 93 (1112) ◽  
pp. 20200154
Author(s):  
Sue M Hudson ◽  
Louise S Wilkinson ◽  
Bianca L De Stavola ◽  
Isabel dos-Santos-Silva
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Cancer Diagnosis ◽  
Linear Trend ◽  
Conditional Logistic Regression ◽  
Large Population ◽  
Interval Cancer ◽  
Population Based ◽  
Breast Cancers ◽  
Interval Cancers

Objectives: To assess the associations between automated volumetric estimates of mammographic asymmetry and breast cancers detected at the same (“contemporaneous”) screen, at subsequent screens, or in between (interval cancers). Methods: Automated measurements from mammographic images (N = 79,731) were used to estimate absolute asymmetry in breast volume (BV) and dense volume (DV) in a large ethnically diverse population of attendees of a UK breast screening programme. Logistic regression models were fitted to assess asymmetry associations with the odds of a breast cancer detected at contemporaneous screen (767 cases), adjusted for relevant confounders. Nested case–control investigations were designed to examine associations between asymmetry and the odds of: (a) interval cancer (numbers of cases/age-matched controls: 153/646) and (b) subsequent screen-detected cancer (345/1438), via conditional logistic regression. Results: DV, but not BV, asymmetry was positively associated with the odds of contemporaneous breast cancer (P-for-linear-trend (Pt) = 0.018). This association was stronger for first (prevalent) screens (Pt = 0.012). Both DV and BV asymmetry were positively associated with the odds of an interval cancer diagnosis (Pt = 0.060 and 0.030, respectively). Neither BV nor DV asymmetry were associated with the odds of having a subsequent screen-detected cancer. Conclusions: Increased DV asymmetry was associated with the risk of a breast cancer diagnosis at a contemporaneous screen or as an interval cancer. BV asymmetry was positively associated with the risk of an interval cancer diagnosis. Advances in knowledge: The findings suggest that DV and BV asymmetry may provide additional signals for detecting contemporaneous cancers and assessing the likelihood of interval cancers in population-based screening programmes.

scholarly journals Still Controversial: Early Detection and Screening for Breast Cancer in Brazil, 1950–2010s

2019 ◽  
Vol 64 (1) ◽  
pp. 52-70
Author(s):  
Luiz Antonio da Silva Teixeira ◽  
Luiz Alves Araújo Neto
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Health Care ◽  
Western Europe ◽  
Population Based ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Formative Period ◽  
Public Health Approach ◽  
Public Health Agencies

Mammographic screening for breast cancer is a widely used public health approach, but is constantly a subject of controversy. Medical and historical research on this topic has been mainly conducted in Western Europe and North America. In Brazil, screening mammography has been an open topic of discussion and a challenge for health care and public health since the 1970s. Effectively, Brazilian public health agencies never implemented a nationwide population-based screening programme for breast cancer, despite the pressures of many specific groups such as advocacy associations and the implementation of local programmes. This article examines the complex process of incorporating mammography as a diagnostic tool and the debates towards implementing screening programmes in Brazil. We argue that debates about screening for breast malignancies, especially those conducted in the late twentieth and early twenty-first centuries, took place in a context of change and uncertainty in the Brazilian health field. These discussions were strongly affected both by tensions between the public and the private health care sectors during the formative period of a new Brazilian health system, and by the growing role of civil society actors. Our study investigates these tensions and their consequences. We use several medical sources that discussed the topic in Brazil, mainly specialised leading oncology journals published between 1950 and 2017, medical congress reports for the same period, books and theses, institutional documents and oral testimonies of health professionals, patients and associations collected in the framework of the ‘The History of Cancer’ project from the Oswaldo Cruz Foundation and Brazilian National Cancer Institute.

scholarly journals Comparison of survival in non-metastatic inflammatory and other T4 breast cancers: a SEER population-based analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dechuang Jiao ◽  
Jingyang Zhang ◽  
Jiujun Zhu ◽  
Xuhui Guo ◽  
Yue Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Model ◽  
Survival Rates ◽  
Tumor Grade ◽  
Population Based ◽  
Rank Test ◽  
Breast Cancers ◽  
Significant Independent Predictor ◽  
Cancer Specific Survival ◽  
7Th Edition

Abstract Background Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored. Methods Surveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type. Results Out of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004). Conclusions Patients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.

scholarly journals Likelihood of early detection of breast cancer in relation to false-positive risk in life-time mammographic screening: population-based cohort study

2013 ◽  
Vol 24 (10) ◽  
pp. 2501-2506 ◽  
Author(s):  
J.D.M. Otten ◽  
J. Fracheboud ◽  
G.J. den Heeten ◽  
S.J. Otto ◽  
R. Holland ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Early Detection ◽  
False Positive ◽  
Life Time ◽  
Population Based ◽  
Mammographic Screening ◽  
Screening Population
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