Type and Extent of Surgery for Screen-Detected and Interval Cancers at Blinded Versus Nonblinded Double-Reading in a Population-Based Screening Mammography Program

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.

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Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: A prospected population based study in the south of The Netherlands

Breast Diseases A Year Book Quarterly ◽

10.1016/j.breastdis.2015.07.006 ◽

2015 ◽

Vol 26 (3) ◽

pp. 210-211

Author(s):

M.N. Linver

Keyword(s):

The Netherlands ◽

Population Based ◽

Screening Mammography ◽

The South ◽

Population Based Study ◽

Double Reading ◽

Programme Sensitivity

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Biennial screening mammography: How many women ask for more? Estimate of the interval mammogram rate in an organised population-based screening programme

La radiologia medica ◽

10.1007/s11547-020-01238-3 ◽

2020 ◽

Author(s):

Luca Alessandro Carbonaro ◽

Sighelgaita Sonia Rizzo ◽

Simone Schiaffino ◽

Anna Pisani Mainini ◽

Nicole Berger ◽

...

Keyword(s):

Screening Programme ◽

Population Based ◽

Screening Mammography

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Mammographic features and histopathological findings of interval breast cancers

Acta Radiologica ◽

10.1080/02841850802403730 ◽

2008 ◽

Vol 49 (9) ◽

pp. 975-981 ◽

Cited By ~ 37

Author(s):

S. Hofvind ◽

B. Geller ◽

P. Skaane

Keyword(s):

Screening Program ◽

Lymph Node Involvement ◽

Screening Mammography ◽

Tumor Characteristics ◽

Breast Cancers ◽

Interval Cancers ◽

True Negative ◽

Node Involvement ◽

Screening Mammograms ◽

Baseline Screening

Background: Interval cancers are considered a shortcoming in screening mammography due to less favorable prognostic tumor characteristics compared to screening-detected cancers and consequently a lower chance of survival from the disease. Purpose: To describe the mammographic features and prognostic histopathological tumor characteristics of interval breast cancers. Material and Methods: A total of 231 interval breast cancer cases diagnosed in prevalently screened women aged 50–69 years old were examined. Thirty-five percent of the cases were retrospectively classified as missed cancers, 23% as minimal sign, and 42% as true negative (including occult cancers) in a definitive classification performed by six experienced breast radiologists. The retrospective classification described the mammographic features of the baseline screening mammograms in missed and minimal-sign interval cancers, while histopathological reports were used to describe the tumor characteristics in all the subgroups of interval cancers. Results: Fifty percent of the missed and minimal-sign interval cancers combined presented poorly defined mass or asymmetric density, and 26% calcifications with or without associated density or mass at baseline screening. Twenty-seven percent of invasive tumors were <15 mm for missed and 47% for true interval cancers ( P<0.001). Lymph node involvement was more common in missed (49%) compared with the true cases (33%, P<0.05). Conclusion: Missed interval cancers have less prognostically favorable histopathological tumor characteristics compared with true interval cancers. Improving the radiologist's perception and interpretation by establishing systematic collection of features and implementation of organized reviews may decrease the number of interval cancers in a screening program.

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