Validity of process indicators of screening for breast cancer to predict mortality reduction

2005 ◽  
Vol 12 (1) ◽  
pp. 33-37 ◽  
Author(s):  
T Sarkeala ◽  
A Anttila ◽  
I Saarenmaa ◽  
M Hakama
Keyword(s):  
Breast Cancer ◽  
European Community ◽  
Cancer Detection ◽  
Detection Rate ◽  
Randomized Trials ◽  
Recall Rate ◽  
Cancer Detection Rate ◽  
Process Indicators ◽  
The Mean ◽  
Mean Compliance

The aim of the study was to empirically assess the acceptable levels of process indicators as described in the European Community Guidelines using materials from the mammography service screening programmes. The Finnish programme was evaluated for effectiveness with a prior estimateof 0.74 for RR in Finland and 0.81 in Helsinki. Hence, the Finnish programme was likely to be somewhat less effective in terms of reduction in mortality than implied on the basis of early randomized trials, but probably approaching the same level of effectiveness. Finland therefore providesbackground data on the applicability of the process indicators that are indicators of performance and surrogates for effectiveness. The performance data on 10 Finnish screening centres at subsequent screens were used. These centres invited 687,000 women aged 50–64 years in 1991–2000.The mean compliance was 93% and the corresponding recall rate was 2.3%. The benign to malignant biopsy ratio was 0.43:1. The average breast cancer detection rate was 0.36%, 2.1 compared with the background incidence. The proportion of screen-detected stage II+ cancers was 26%. Most, but notall, of these process indicators met the desirable reference values of the European Community. The specific criteria of the European Community on stage distribution, rates of screen-detected cancers by stage and detection rate to background incidence may need reconsideration.

scholarly journals Independent Double Reading of Screening Mammograms

1995 ◽  
Vol 2 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Stefano Ciatto ◽  
Marco Rosselli Del Turco ◽  
Doralba Morrone ◽  
Sandra Catarzi ◽  
Daniela Ambrogetti ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Recall Rate ◽  
Cancer Detection Rate ◽  
Diagnostic Assessment ◽  
Double Reading ◽  
Single Reading ◽  
The Mean ◽  
Screening Mammograms ◽  
The Cost

Objective — To evaluate the cost effectiveness of independent double reading of screening mammograms. Setting — Prospective study of 18817 women undergoing first or repeat screening in a population based programme in the Florence district. Methods — Mammograms were independently double read by experienced radiologists. Subjects with mammographic abnormalities reported by at least one reader were recalled for diagnostic assessment. The mean increase in recall rate, cancer detection rate, and screening costs attributable to double reading was calculated. Results — Eleven of 125 cancers were detected by only one reader. The mean increase in cancer detection rate attributable to double reading compared with single reading was 4·6% (95% confidence interval (CI) 1·1 to 8·9). From a total of 748 cases referred for diagnostic assessment, 196 subjects were referred by one reader only. The mean increase in referral rate attributable to double reading compared with single reading was 15·1% (CI 12·3 to 17·8). Double reading caused a marked increase in the cost for each woman screened −8·5% at the first screening and 6·2% at repeat screening and a more limited increase in the cost for each cancer detected −3·5% at the first screening and 2·7% at repeat screening. Cancers detected by only one screener were at an earlier stage than those detected by both screeners (P = 0·6, not significant). Conclusions — Independent double reading results in only a modest increase in the detection of cancers and therefore may not be cost effective.

Breast Cancer Detection Rate: Designing Imaging Trials to Demonstrate Improvements

Radiology ◽  
2007 ◽  
Vol 243 (2) ◽  
pp. 360-367 ◽  
Author(s):  
Yulei Jiang ◽  
Diana L. Miglioretti ◽  
Charles E. Metz ◽  
Robert A. Schmidt
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Detection Rate ◽  
Cancer Detection Rate ◽  
Breast Cancer Detection

Digital mammography in a screening programme and its implications for pathology: a comparative study

2010 ◽  
Vol 64 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Linda Feeley ◽  
Donal Kiernan ◽  
Therese Mooney ◽  
Fidelma Flanagan ◽  
Gormlaith Hargaden ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Digital Mammography ◽  
Detection Rate ◽  
Screening Programme ◽  
Ductal Carcinoma ◽  
Recall Rate ◽  
Primary Objective ◽  
Cancer Detection Rate ◽  
Detection Rates ◽  
Predictive Values

AimsMost studies comparing full-field digital mammography (FFDM) with conventional screen-film mammography (SFM) have been radiology-based. The pathological implications of FFDM have received little attention in the literature, especially in the context of screening programmes. The primary objective of this retrospective study is to compare FFDM with SFM in a population-based screening programme with regard to a number of pathological parameters.MethodsDuring the study period, 107 818 women underwent screening mammograms with almost equal numbers obtained with each technique (49.9% with SFM vs 50.1% with FFDM). We compared SFM with FFDM using the following parameters: recall rate, diagnostic core biopsy rate, cancer detection rates, B3 rate, B4 rate, preoperative diagnostic rate for malignancy, positive predictive values and tumour characteristics.ResultsThe recall rate was significantly higher with FFDM (4.21% vs 3.52%, p<0.0001). The overall cancer detection rate of 7.2 per 1000 women screened with FFDM was also significantly higher than the rate of 6.2 per 1000 women screened with SFM (p=0.04). The B3 rate in the SFM group was 1.3 per 1000 women screened versus 2.5 per 1000 women screened in the FFDM group (p<0.001). The recall rate and cancer detection rates (overall, invasive and pure ductal carcinoma in situ) were all significantly higher with FFDM for lesions presenting as microcalcifications.ConclusionsThe higher cancer detection rate with FFDM in this study was due to improved detection of microcalcifications. However, this was achieved at the cost of a higher recall rate and a higher B3 rate, indicating that overtreatment may be problematic with digital mammography.

scholarly journals Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

Radiology ◽  
2016 ◽  
Vol 278 (3) ◽  
pp. 698-706 ◽  
Author(s):  
Richard E. Sharpe ◽  
Shambavi Venkataraman ◽  
Jordana Phillips ◽  
Vandana Dialani ◽  
Valerie J. Fein-Zachary ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Detection Rate ◽  
Screening Program ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Population Based ◽  
Cancer Detection Rate ◽  
Breast Tomosynthesis

Detection rate is not higher for women with BBD history in breast cancer screening

2019 ◽  
Author(s):  
Penghuan Qu ◽  
Xueou Liu ◽  
Yubei Huang ◽  
Ziwei Feng ◽  
Xin Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Detection ◽  
Detection Rate ◽  
Breast Disease ◽  
Cancer Detection Rate ◽  
Breast Cancer Detection ◽  
Breast Cancer Patients ◽  
Contrast Analysis

Abstract Background To investigate whether women with benign breast disease (BBD) history have higher breast cancer detection rate in screening. Methods We reviewed data for 33 001 female participants in Multi-modality Independent Screening Trial (MIST). Corresponding data for 6823 breast cancer patients were retrieved from the Tianjin Breast Cancer Cases Cohort (TBCCC) and analyzed for comparison. Results The breast cancer detection rate was 2.83‰ among women with BBD history and 3.28‰ in women without. Moreover, the proportion of carcinoma in situ (CIS) was also lower in women with BBD history than women without (7.69 versus 20.31%). In contrast, analysis of TBCCC data revealed a higher proportion of CIS in patients with BBD history (5.05%) than patients without (3.26%). Our data showed that a larger proportion of women with BBD history had undergone previous breast examinations. Additionally, among participants diagnosed with both breast cancer and BBD in MIST, we found a lower proportion of CIS in women with BBD history (11.76%) compared to women without (32.14%). Conclusions Women with BBD history were not found to have higher detection rate in breast cancer screening. Women with BBD history were more likely to be proactive in seeking breast examinations and to have breast cancer be diagnosed in clinic.

Outcomes of an organized breast cancer screening program over the past 15 years.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 14-14
Author(s):  
Rasika Rajapakshe ◽  
Brent Parker ◽  
Cynthia Araujo ◽  
Christina Chu ◽  
Christine Wilson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
British Columbia ◽  
Cancer Detection ◽  
Detection Rate ◽  
Screening Program ◽  
Participation Rate ◽  
Screening Mammography ◽  
Cancer Detection Rate ◽  
Stable Range ◽  
The Past

14 Background: Founded in 1988, The Screening Mammography Program of British Columbia (SMPBC) is a large, and stable screening program and a formal review of its effectiveness provides suggestions for further improvements. The purpose of this study is to quantify and report trends of the SMPBC and to assess if there have been any major changes in outcomes over the past fifteen years as this program has matured. Methods: A retrospective review of the SMPBC was performed by extracting data from the past 15 years from the SMPBC Annual Reports. The changes and trends in percentage of eligible population screened/participation rate, number of screening exams and number of first screens performed, overall cancer detection rate, and DCIS detection rate was extracted and reported. Furthermore, cost analysis data was extracted, and adjusted to compensate for inflation using The Bank of Canada Inflation Calculator, which bases its calculations from the Canadian Consumer Price Index (CPI) from Statistics Canada. Results: Over the past 15 years, the total number of exams provided per year has almost doubled from 166,746 in 1996 to 303,157 in 2010, and this increase accommodates the overall and aging growth of the BC population. An increasing participation rate is seen from 1999-2009 for women from rural sites and traditionally underserved areas of British Columbia, while the overall participation rate over this time period remains stable (range 48%-51%). The cancer detection rate also remains stable (range: 3.4-4.5 cases per 1000 screens). After adjusting for inflation, a 12.6% increase in the cost per screen from 1995-2009 is observed. This increase is multifactorial and includes an increase in operating costs central services and physician reading fees. Conclusions: The province of British Columbia has consistently had the lowest rates of breast cancer related mortality in Canada, and this may be, in part, because of the long term stability of the BC Screening Mammography Program. Our report suggests that the SMPBC has been effective in accommodating the growing aging population, although there is still room for improvement, as a target participation of 70% is considered the standard to effectively reduce mortality through screening.

Breast MRI screening of women at average risk of breast cancer: An observational cohort study.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 1-1 ◽  
Author(s):  
Christiane K. Kuhl ◽  
Heribert Bieling ◽  
Kevin Strobel ◽  
Claudia Leutner ◽  
Hans H Schild ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Detection Rate ◽  
False Positive Rate ◽  
Interval Cancer ◽  
Breast Mri ◽  
Cancer Detection Rate ◽  
Average Risk ◽  
Cancer Rate ◽  
Interval Cancer Rate

1 Background: Breast-MRI is currently recommended for screening women at high-risk of breast-cancer only. However, despite decades of mammographic-screening, breast-cancer continues to represent a major cause of cancer-death also for women at average-risk – suggesting a need for improved methods for early diagnosis also for these women. Therefore, we investigated the utility of supplemental MRI-screening of women who carry an average-risk of breast-cancer. Methods: Prospective observational cohort-study conducted in two academic breast-centers on asymptomatic women at average-risk in the usual age range for screening-mammography (40 to 70). Women underwent DCE-breast-MRI in addition to mammography every 12, 24, or 36 months, plus follow-up of 2 years to establish a standard-of-reference. We report on the supplemental-cancer-yield, interval-cancer-rate, diagnostic accuracy of screening-MRI, and biologic profiles of additional, MRI-detected breast-cancers. Results: 2120 women underwent a total 3861 MRI-studies covering 7007 women-years. Breast-cancer was diagnosed in 61/2120 women (DCIS: 20, invasive: 41), and ADH/LIN in another 21. Interval-cancer-rate was 0%, irrespective of screening interval. Forty-eight women were diagnosed with breast-cancer at prevalence-screening by MRI alone (supplemental cancer-detection-rate: 22.6 per 1000); 13 women were diagnosed with breast-cancer in 1741 incidence-screening-rounds collected over 4887 women-years. A total 12 of these 13 incident cancers were diagnosed by screening-MRI alone (supplemental-cancer-detection-rate: 6.9 per 1000), one by MRI and mammography, none by mammography alone. Supplemental-cancer-detection-rate was independent of mammographic breast-density. Invasive cancers were small (mean size: 8mm), node-negative in 93.4%, ER/PR-negative in 32.8%, and de-differentiated in 41.7% at prevalence, and 46.0% at incidence-screening. Specificity of MRI-screening was 97.1%, False-Positive-Rate 2.9%. Conclusions: MRI-screening improves detection of biologically relevant breast-cancer in women at average-risk, and reduces the interval-cancer-rate down to 0%, at a low false-positive rate.

Integrating breast cancer screening into a cervical cancer screening program in three rural districts in Rwanda.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2025-2025
Author(s):  
Lydia E. Pace ◽  
Jean Marie Vianney Dusengimana ◽  
Jean Paul Balinda ◽  
Origene Benewe ◽  
Vestine Rugema ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cancer Detection ◽  
Detection Rate ◽  
Cancer Detection Rate ◽  
System Capacity ◽  
District Hospitals ◽  
Number Of Patients

2025 Background: In low-income countries where mammography is not widely available, optimal strategies to facilitate earlier breast cancer detection are not known. We previously conducted a cluster randomized clinical trial of clinician trainings in Burera District in rural Rwanda to facilitate earlier diagnosis among symptomatic women; 1.3% of women evaluated at intervention health centers (HCs) were diagnosed with cancer. Early stage breast cancer incidence was higher in intervention areas. Subsequently, Rwanda Biomedical Centre, Rwanda’s national health implementation agency, adapted the program in 3 other districts, offering screening clinical breast exams (CBE) to all women aged 30-50 years receiving cervical cancer screening and any other woman requesting CBE. A navigator facilitated patient tracking. We sought to examine patient volume, service provision and cancer detection rate in the adapted program. Methods: We abstracted data from weekly HC reports, facility registries, and the referral hospital’s electronic medical record to determine numbers of patients seen, referrals made, biopsies, and cancer diagnoses from July 2018-December 2019. Results: CBE was performed at 17,239 visits in Rwamagana, Rubavu and Kirehe Districts (total population 1.34 million) over 18, 17 and 7 months of program implementation respectively. At 722 visits (4.2%), CBE was abnormal. 571 patients were referred to district hospitals (DH); their average age was 35 years. Of those referred, 388 (68.0%) were seen at DH; 32% were not. Of those seen, 142 (36.6%) were referred to a referral facility; 121 of those referred (85.2%) actually went to the referral facility. Eighty-eight were recommended to have biopsies, 83 (94.3%) had biopsies, and 29 (34.9% of those biopsied; 0.17% of HC visits) were diagnosed with breast cancer. Conclusions: Integrating CBE screening into organized cervical cancer screening in rural Rwandan HCs led to a large number of patients receiving CBE. As expected, patients were young and the cancer detection rate was much lower than in a trial focused on symptomatic women. Even with navigation efforts, loss-to-follow-up was high. Analyses of stage, outcomes, patient and provider experience and cost are planned to characterize CBE screening’s benefits and harms in Rwanda. However, these findings suggest building health system capacity to facilitate referrals and retain patients in care are needed prior to further screening scaleup. In the interim, early diagnosis programs targeting symptomatic women may be more efficient and feasible.

scholarly journals Transrectal versus transperineal 14-core prostate biopsy in detection of prostate cancer: A comparative evaluation at the same Institution

2014 ◽  
Vol 86 (4) ◽  
pp. 284 ◽  
Author(s):  
Maria Angela Cerruto ◽  
Fabio Vianello ◽  
Carolina D’Elia ◽  
Walter Artibani ◽  
Giovanni Novella
Keyword(s):  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Cancer Detection Rate ◽  
Controlled Study ◽  
Pain Level ◽  
Prostatic Biopsy ◽  
Detection Rates ◽  
The Mean ◽  
Prospective Controlled Study

Background: The ideal bioptic strategy for CaP detection is still to be completely defined. The aim of our study is to compare transperineal (TP) and transrectal (TR) approaches, in a 14-core initial prostate biopsy for CaP detection. Material and methods: A prospective controlled study was conducted enrolling 108 consecutive patients with a PSA level greater than 4 ng/mL and/or an abnormal DRE. TR versus TP 14-core initial prostatic biopsies were performed on 54 and 54 patients, respectively, with a randomisation ratio of 1:1. Results: The cancer detection rates were 46.29 (25 out of 54 patients), and 44.44% (24 out of 54 patients), respectively, using the TR or the TP approach (p = 0.846). The overall cancer core rate was significantly higher when the TP approach was used: 21.43% (162 out of 756 cores) and 16.79% (127 out of 756 cores), with the TP and the TR approach, respectively (p = 0.022). The cores were significantly longer performing TP approach: at the site “1” (14.92 versus 12.97 mm, p = 0.02); at “5” (15.53 versus 13.69 mm, p = 0.037); at “7” (15.06 versus 12.86 mm, p = 0.001); at “9” (14.92 versus 13.38 mm, p = 0.038); at “11” (16.32 versus 12.31 mm, p = 0.0001); at “12” (15.14 versus 12.19 mm, p = 0.0001); at “13” (17.49 versus 13.98 mm, p = 0.0001); at “14” (16.77 versus 13.36 mm, p = 0.0001). As to the biopsy related pain, the mean pain level perceived by patients during the TR approach was 1.56 ± 1.73 versus 1.42 ± 1.37 registered during TP approach (p = 0.591). Conclusions: No significant differences were found in cancer detection rate, cancer core rate between TP and TR approaches for prostatic biopsy. Even in terms of complication rate or pain level, it cannot be concluded that one procedure is superior to the other one. Apparently, strictly following our protocol, TP approach seems to offer a better sampling at the level of the apex and the TZ, however without adding any significant advantage in terms of overall cancer detection rate.

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