Breast Cancer Diagnostic Methods: Screen-Detected and Clinical Cases. An Italian Survey of Women's Experiences

2007 ◽  
Vol 93 (5) ◽  
pp. 452-460 ◽  
Author(s):  
Paolo Giorgi Rossi ◽  
Laura Camilloni ◽  
Paola Mantellini ◽  
Vincenzo Barile ◽  
Piero Borgia ◽  
...  

Aims and Background The real practice of breast cancer diagnosis and treatment is often very different from guideline recommendations. Screening programs should minimize deviations from “best practice”. The aim of the study was to compare cases detected by screening programs with cases that were not part of the public screening program, analyzing the diagnostic pathways from the first suspected breast problem to therapeutic intervention for breast cancer. Methods We interviewed a random sample of 268 women aged 49–70 years in three Italian regions (Lazio, Tuscany, Basilicata) who were treated for breast cancer, stratified by screening participation. Results In the nonscreened group, 48% of women were symptomatic and 50% were diagnosed by preventive tests. The proportion of women treated within 30 days of diagnosis was significantly lower in the screened group, 21.3% vs 35.8% (P = 0.0003). The mean number of tests (mammography, ultrasonography, cytology and histology) performed in the screened group was significantly higher than in the nonscreened group, 3.7 vs 2.8 (P = 0.001). The percentage of women treated without a preoperative histological or cytological diagnosis was lower in the screened group than in the nonscreened group, 14% vs 25% (P = 0.024). Conclusion Participation in screening programs seems to lead to more appropriate disease management even for breast cancer cases treated at the same hospital.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jesper Bo Nielsen ◽  
Gabriele Berg-Beckhoff ◽  
Anja Leppin

Abstract Background Screening programs for colorectal cancer (CRC) exist in many countries, and with varying participation rates. The present study aimed at identifying socio-demographic factors for accepting a cost-free screening offer for CRC in Denmark, and to study if more people would accept the screening offer if the present fecal test was replaced by a blood test. Methods We used a cross-sectional survey design based on a representative group of 6807 Danish citizens aged 50–80 years returning a fully answered web-based questionnaire with socio-demographic data added from national registries. Data were analyzed in STATA and based on bivariate analyses followed by regression models. Results Danes in general have a high level of lifetime participation (+ 80%) in the national CRC screening program. The results of the stepwise logistic regression model to predict CRC screening participation demonstrated that female gender, higher age, higher income, and moderate alcohol intake were positively associated with screening participation, whereas a negative association was observed for higher educational attainment, obesity, being a smoker, and higher willingness to take health risks. Of the 1026 respondents not accepting the screening offer, 61% were willing to reconsider their initial negative response if the fecal sampling procedure were replaced by blood sampling. Conclusion The CRC screening program intends to include the entire population within a certain at-risk age group. However, individual factors (e.g. sex, age obesity, smoking, risk aversity) appear to significantly affect willingness to participate in the screening program. From a preventive perspective, our findings indicate the need for a more targeted approach trying to reach these groups.


2011 ◽  
pp. 143-147
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.


2017 ◽  
Vol 3 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Olalekan Olasehinde ◽  
Carla Boutin-Foster ◽  
Olusegun I. Alatise ◽  
Adewale O. Adisa ◽  
Oladejo O. Lawal ◽  
...  

Purpose In low- and middle-income countries like Nigeria, women present with advanced breast cancer at an earlier age. Given the limited resources, development of screening programs that parallel resource capabilities of low- and middle-income countries is imperative. The objective of this study was to evaluate the perceptions, practices, and barriers regarding clinical breast examination (CBE) screening in a low-income community in Nigeria. Materials and Methods A cross-sectional survey of women age 40 years or older in Ife, Nigeria, using multistaged sampling was performed. Information on sociodemographics, knowledge of breast cancer, screening practices, and willingness to participate in CBE screening was obtained using an interviewer-administered questionnaire. Results A total of 1,169 women whose ages ranged from 40 to 86 years (mean age, 47.7 years; standard deviation, 8.79 years) were interviewed. The majority of women (94%) knew about breast cancer, whereas 27.5% knew someone who had had breast cancer, the majority of whom (64.5%) had died of the disease. Of the 36% of women who had breast screening recommended to them, only 19.7% had an actual CBE. Of these, only 6% had it in the last year. The majority of women (65.4%) were willing to have regular CBEs and did not care about the sex of the examiner in most instances. Lack of perceived need was the reason cited by women unwilling to participate. Conclusion The majority of women were aware of breast cancer and knew it as a fatal disease. With the relatively encouraging number of those willing to be examined, a carefully designed CBE program coupled with advocacy to correct uneducated beliefs seems promising.


2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Michel Herranz ◽  
Alvaro Ruibal

Breast cancer is one of the most common cancers among the population of the Western world. Diagnostic methods include mammography, ultrasound, and magnetic resonance; meanwhile, nuclear medicine techniques have a secondary role, being useful in regional assessment and therapy followup. Optical imaging is a very promising imaging technique that uses near-infrared light to assess optical properties of tissues and is expected to play an important role in breast cancer detection. Optical breast imaging can be performed by intrinsic breast tissue contrast alone (hemoglobin, water, and lipid content) or with the use of exogenous fluorescent probes that target specific molecules for breast cancer. Major advantages of optical imaging are that it does not use any radioactive components, very high sensitivity, relatively inexpensive, easily accessible, and the potential to be combined in a multimodal approach with other technologies such as mammography, ultrasound, MRI, and positron emission tomography. Moreover, optical imaging agents could, potentially, be used as “theranostics,” combining the process of diagnosis and therapy.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 31s-31s
Author(s):  
S. Gioia ◽  
C. Torres ◽  
J. Cavalcanti ◽  
A. Heringer

Background: In Rio de Janeiro there is only the opportunistic screening program for women with breast cancer who arrive at health facilities and with a 14% rate of mammography coverage. In countries that have implemented effective screening programs, with coverage of the target population, quality of screening, and adequate treatment, breast cancer mortality has declined. Evidence of the impact of screening on mortality by this neoplasm justifies its adoption as a public health policy, as recommended by WHO. 80% of the population use the public health system (Sistema Unico de Saude - SUS), provided by the government. This system mainly provides conventional mammography. The private insurance system covers the remaining 20%, who have access to modern technologies such as digital mammography or MRI. Aim: The breast cancer organized screening program in the community of the Andaraí, RJ is committed in assisting women asymptomatic 50-69 years from SUS. Methods: The program foresees the participation of these women for an indefinite period, free of charge, and the accomplishment of biennial digital mammography, going through the stages of early detection and diagnosis. In case of positivity for malignant disease, it will be treated properly. Results: Since April 2014 have been 350 women with an average age of 54 years. 100% of them were asymptomatic and 49% had never done before mammography. Only 1 woman presented clinical suspect aged 44 years. The screening program organized by breast cancer in the community of Andaraí, RJ presented a mammographic coverage rate of 70%. The program is contemplated in the healthcare plan of the SUS. Conclusion: Preliminary results of the study suggest that population based organized screening are feasible and age of onset mammography screening should be 50 years in Rio de Janeiro.


Sensors ◽  
2019 ◽  
Vol 19 (10) ◽  
pp. 2373 ◽  
Author(s):  
Imad Abrao Nemeir ◽  
Joseph Saab ◽  
Walid Hleihel ◽  
Abdelhamid Errachid ◽  
Nicole Jafferzic-Renault ◽  
...  

Breast Cancer is one of the world’s most notorious diseases affecting two million women in 2018 worldwide. It is a highly heterogeneous disease, making it difficult to treat. However, its linear progression makes it a candidate for early screening programs, and the earlier its detection the higher the chance of recovery. However, one key hurdle for breast cancer screening is the fact that most screening techniques are expensive, time-consuming, and cumbersome, making them impractical for use in several parts of the world. One current trend in breast cancer detection has pointed to a possible solution, the use of salivary breast cancer biomarkers. Saliva is an attractive medium for diagnosis because it is readily available in large quantities, easy to obtain at low cost, and contains all the biomarkers present in blood, albeit in lower quantities. Affinity sensors are devices that detect molecules through their interactions with biological recognition molecules. Their low cost, high sensitivity, and selectivity, as well as rapid detection time make them an attractive alternative to traditional means of detection. In this review article, we discuss the current status of breast cancer diagnosis, its salivary biomarkers, as well as the current trends in the development of affinity sensors for their detection.


2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 31s-31s
Author(s):  
Olalekan Olasehinde ◽  
Olusegun I. Alatise ◽  
Olukayode A. Arowolo ◽  
Victoria L. Mango ◽  
Olalere S. Olajide ◽  
...  

Purpose Breast cancer outcomes are poor in most low- and middle-income countries. This is a result, in part, of delayed presentation. Critical to improving this gloomy picture is the promotion of breast cancer screening programs; however, designing a formidable screening program requires obtaining necessary background data. This survey evaluates breast cancer screening practices and barriers in two Nigerian communities with different geographic access to screening facilities. Methods We administered a 35-item questionnaire to women age 40 years and older—1,169 participants (52.6%) in the Ife Central Local Government, where mammography services are offered, and 1,053 (47.4%) in the Iwo Local Government, where there are no mammography units. Information on breast cancer screening practices and barriers to mammography screening were compared between the two communities. Results Most women had heard of breast cancer (Ife, 94%; Iwo, 97%), but few have had any form of breast cancer screening recommended to them—37.7% of Ife respondents and 36.6% of Iwo respondents. Few women were aware of mammography (Ife, 11.8%; Iwo, 11.4%), whereas mammography uptake was 2.8% Ife respondents and 1.8% in Iwo respondents, despite the latter offering mammography services. Awareness and practice of mammography were not statistically different between the two communities ( P = .74 and P = .1 for Ife and Iwo, respectively). Lack of awareness was the most common reason cited for not undergoing mammography in both communities. Cost was also identified as a barrier, as only 20% of respondents could afford mammography. Despite being offered at little or no cost, uptake of clinical breast examination (CBE) was poor in both communities—27.4% in Iwo and 19.7% in Ife; however, the majority were willing to participate in a routine CBE-based breast cancer screening program. Conclusion Access without awareness and community mobilization does not guarantee use of breast cancer screening services. Given the above findings, a comprehensive breast health program that incorporates awareness creation, routine CBE-based screening, and selective mammography is currently underway in a selected Nigerian community. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the author


2019 ◽  
Vol 39 (7) ◽  
pp. 738-754
Author(s):  
Yasmina Okan ◽  
Dafina Petrova ◽  
Samuel G. Smith ◽  
Vedran Lesic ◽  
Wändi Bruine de Bruin

Background. Organized screening programs often rely on written materials to inform the public. In the United Kingdom, women invited for cervical cancer screening receive a leaflet from the National Health Service (NHS) to support screening decisions. However, information about screening may be too complex for people to understand, potentially hindering informed decision making. Objectives. We aimed to identify women’s difficulties in interpreting the leaflet used in England and negative and positive responses to the leaflet. Methods. We used a sequential mixed-methods design involving 2 steps: cognitive think-aloud interviews ( n = 20), followed by an England-wide survey ( n = 602). Data were collected between June 2017 and December 2018, and participants included women aged 25 to 64 y with varying sociodemographics. Results. Interview results revealed misunderstandings concerning screening results, benefits, and additional tests and treatment, although participants tended to react positively to numerical information. Participants were often unfamiliar with the potential harms associated with screening (i.e., screening risks), key aspects of human papillomavirus, and complex terms (e.g., dyskaryosis). Survey results indicated that interpretation difficulties were common ( M correct items = 12.5 of 23). Lower understanding was associated with lower educational level (β’s >0.15, P’s <0.001), lower numeracy scores (β = 0.36, P < 0.001), and nonwhite ethnicity (β = 0.10, P = 0.007). The leaflet was evaluated positively overall. Conclusions. Despite previous user testing of the leaflet, key information may be too complex for some recipients. As a consequence, they may struggle to make informed decisions about screening participation based on the information provided. We discuss implications for the improvement of communications about screening and decision support.


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