scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
Vol 5 (3) ◽  
pp. 143 ◽  
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

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.

scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
pp. 143-147
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

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.

scholarly journals Developing a Breast Cancer Screening Program in Nigeria: Evaluating Current Practices, Perceptions, and Possible Barriers

2017 ◽  
Vol 3 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Olalekan Olasehinde ◽  
Carla Boutin-Foster ◽  
Olusegun I. Alatise ◽  
Adewale O. Adisa ◽  
Oladejo O. Lawal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Low Income ◽  
Screening Program ◽  
Cross Sectional Survey ◽  
Middle Income ◽  
Screening Programs ◽  
Middle Income Countries ◽  
Low And Middle Income

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.

scholarly journals Barriers to Mammography Screening in Nigeria: A Survey of Two Communities With Different Access to Screening Facilities

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 31s-31s
Author(s):  
Olalekan Olasehinde ◽  
Olusegun I. Alatise ◽  
Olukayode A. Arowolo ◽  
Victoria L. Mango ◽  
Olalere S. Olajide ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Local Government ◽  
Breast Cancer Screening ◽  
Mammography Screening ◽  
Conflicts Of Interest ◽  
Screening Program ◽  
Delayed Presentation ◽  
Screening Programs ◽  
Screening Practices

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

Simulated Lifetime Costs of Three Types of Employer-Based, Periodic, Breast Cancer Screening Programs for Working-Age Women

1994 ◽  
Vol 9 (2) ◽  
pp. 137-146 ◽  
Author(s):  
Robert I. Griffiths ◽  
Claudia B. Griffiths ◽  
Neil R. Powe
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Lifetime Cost ◽  
Decision Analysis Model ◽  
Screening Programs ◽  
Mean Lifetime ◽  
Lifetime Costs ◽  
The Cost

Purpose. To estimate the lifetime cost of three types of employer-sponsored breast cancer screening programs and to identify factors influencing cost. Design. A computerized decision analysis model was constructed to compare lifetime costs of providing breast cancer screening in each of three screening programs: on-site within an employer, mobile unit visiting the employer, and off-site. Subjects. Three hypothetical cohorts of 10,000 female employees 38 years of age at time of first screening. Intervention. A cohort was enrolled in each screening program and received screening from age 38 through age 64. Employees continued to receive benefits related to breast cancer until age 100 or death. Measures. Costs in the model included those for screening, workup for a suspicious mammogram, treatment for breast cancer, short-term losses in employee productivity, and disability due to breast cancer. Approach. The model was used to estimate the mean lifetime cost per employee, to the employer, of the On-Site program. This cost was compared to the cost of the other programs. Results. Mean lifetime cost per employee was $5,485 for the On-Site screening program. This cost was significantly (P<.0001) lower than in the Off-Site program (by $311) or the Mobile program (by $212). The baseline results for the On-Site program were quite sensitive to the cost of screening, the sensitivity and specificity of screening, age at initiation of screening, and the underlying incidence of breast cancer in the population. Conclusion. Employers and other entities should consider these factors such as location and content in selecting the most efficient and effective breast cancer screening program.

scholarly journals Breast Cancer Screening Among Medical Staff in Tehran, Iran: Improvement of Early Detection

2020 ◽  
Author(s):  
Hossein Yahyazadeh ◽  
Marzieh Beheshti ◽  
Azita Abdollahinejad ◽  
Maria Hashemian ◽  
Narges Sistany Allahabad ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Medical Staff ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Breast Diseases ◽  
Cross Sectional ◽  
Screening Programs

Breast cancer is the most prevalent Iranian female malignancy. Breast screening reduces the number of malignant breast diseases. We aimed to assess the results of the pilot breast cancer screening on early detection in female medical staff in Milad Hospital, Tehran, Iran. A cross-sectional study. Female medical staff from Milad Hospital, Tehran, Iran, were examined by a specialist in 2016. A checklist, including demographic data, was completed by the participants. If necessary, they referred to as sonography or mammography. Data were analyzed using SPSS software. Of 746 people enrolled, 137 had no pathological point, 609 had suspicious or positive findings that were referred for further investigation, 449 had normal findings, and 7 had suspicious mass and were biopsied, 6 were benign. One case had primary invasive cancer. Since screening for breast cancer helps to early detection of this disease, the implementation of cancer screening programs should be on the priority of health authorities.

scholarly journals NF1 Patients Receiving Breast Cancer Screening: Insights from The Ontario High Risk Breast Screening Program

Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 707 ◽  
Author(s):  
Nika Maani ◽  
Shelley Westergard ◽  
Joanna Yang ◽  
Anabel M. Scaranelo ◽  
Stephanie Telesca ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Breast Cancer Screening ◽  
Breast Screening ◽  
Screening Program ◽  
Type I ◽  
Screening Programs ◽  
Increased Risk ◽  
High Risk Breast

Neurofibromatosis Type I (NF1) is caused by variants in neurofibromin (NF1). NF1 predisposes to a variety of benign and malignant tumor types, including breast cancer. Women with NF1 <50 years of age possess an up to five-fold increased risk of developing breast cancer compared with the general population. Impaired emotional functioning is reported as a comorbidity that may influence the participation of NF1 patients in regular clinical surveillance despite their increased risk of breast and other cancers. Despite emphasis on breast cancer surveillance in women with NF1, the uptake and feasibility of high-risk screening programs in this population remains unclear. A retrospective chart review between 2014–2018 of female NF1 patients seen at the Elizabeth Raab Neurofibromatosis Clinic (ERNC) in Ontario was conducted to examine the uptake of high-risk breast cancer screening, radiologic findings, and breast cancer characteristics. 61 women with pathogenic variants in NF1 enrolled in the high-risk Ontario breast screening program (HR-OBSP); 95% completed at least one high-risk breast screening modality, and four were diagnosed with invasive breast cancer. Our findings support the integration of a formal breast screening programs in clinical management of NF1 patients.

Molecular profiles of screen-detected breast cancers from a Turkish breast cancer screening program.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12545-e12545
Author(s):  
Neslihan Cabioglu ◽  
Sibel Ozkan Gurdal ◽  
Arda Kayhan ◽  
Nilufer Ozaydin ◽  
Erkin Aribal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Screening Program ◽  
Breast Conservation ◽  
Breast Cancers ◽  
Luminal A ◽  
Screening Programs

e12545 Background: TurkishBahcesehir Breast Cancer Screening Project is a 10-year organized population based screening program carried out in one of the largest counties in Istanbul, Turkey. The aim of this study is to determine the biological features of screen detected breast cancers detected during the initial 4-year study period as an interim analysis. Methods: Between January 2009 and December 2012, a total of 5938 women with ages 40–69 years were recruited in this prospective study. Two-view mammographies were obtained by 2-year intervals, and classified according to Breast Imaging Reporting and Data System of the American College of Radiology (ACR). Patient and tumor characteristics were analysed for those diagnosed with breast cancer. Tumors were stained for estrogen (ER) and progesterone receptors (PR), HER2-neu and Ki-67 by immunohistochemistry. Results: A total of 49 breast cancers (% 0.83) were detected during the study period. The median age was 50 (40-70). The majority of patients (78%) were stage 0 or 1, whereas 23 patients (47%) were <50 age. Of 49 tumors, 38 (78%) were invasive cancers and 11 (22%) were ductal carcinoma in situ. Forty-four patients (90%) underwent breast conservation, whereas 35 patients (75%) had sentinel lymph node biopsy. Of 38 invasive cancers, 24 (63%) were ductal carcinoma and 8 (21%) were lobular cacinoma. Among 31 invasive cancers stained for ER, PR, HER2-neu and Ki67, the majority of them (92%) were hormone receptor positive, whereas 13% were HER2-neu positive and 58% had low Ki67 levels (<14). As molecular subtypes, the majority of them were found to be either luminal A (48%) or luminal B type (42%), whereas other nonluminal HER2 (7%) and triple negative cancers (3%) were less frequently detected. Conclusions: Our findings suggest that the majority of screen-detected breast cancers exhibit either luminal A or B subtype. However, more aggressive subtypes such as nonluminal HER2-neu or triple negative cancers are less likely to be detected by mammographic screening programs, requiring other preventive strategies.

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