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Sample records for breast cancer screening

  1. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... is performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  2. Risks of Breast Cancer Screening

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Screening (PDQ®)–Patient Version What is screening? ... cancer screening: Cancer Screening Overview General Information About Breast Cancer Key Points Breast cancer is a disease ...

  3. Screening for Breast Cancer.

    Science.gov (United States)

    Niell, Bethany L; Freer, Phoebe E; Weinfurtner, Robert Jared; Arleo, Elizabeth Kagan; Drukteinis, Jennifer S

    2017-11-01

    The goal of screening is to detect breast cancers when still curable to decrease breast cancer-specific mortality. Breast cancer screening in the United States is routinely performed with mammography, supplemental digital breast tomosynthesis, ultrasound, and/or MR imaging. This article aims to review the most commonly used breast imaging modalities for screening, discuss how often and when to begin screening with specific imaging modalities, and examine the pros and cons of screening. By the article's end, the reader will be better equipped to have informed discussions with patients and medical professionals regarding the benefits and disadvantages of breast cancer screening. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. breast cancer screening in

    African Journals Online (AJOL)

    Is Breast transillumination a viable option for breast cancer screening in limited resource settings? Authors: Elobu EA M.Med, Galukande M M M.Med, MSc, FCS, Namuguzi D M.Med, Muyinda Z M.Med. Affiliations: breast cancer screening in limited resource settings? Authors: Elobu EA1 M.Med, Galukande M1 M M.Med, ...

  5. [Organized breast cancer screening].

    Science.gov (United States)

    Rouëssé, Jacques; Sancho-Garnier, Hélèn

    2014-02-01

    Breast screening programs are increasingly controversial, especially regarding two points: the number of breast cancer deaths they avoid, and the problem of over-diagnosis and over-treatment. The French national breast cancer screening program was extended to cover the whole country in 2004. Ten years later it is time to examine the risk/benefit ratio of this program and to discuss the need for change. Like all forms of cancer management, screening must be regularly updated, taking into account the state of the art, new evidence, and uncertainties. All screening providers should keep themselves informed of the latest findings. In the French program, women aged 50-74 with no major individual or familial risk factors for breast cancer are offered screening mammography and clinical breast examination every two years. Images considered non suspicious of malignancy by a first reader are re-examined by a second reader. The devices and procedures are subjected to quality controls. Participating radiologists (both public and private) are required to read at least 500 mammographies per year. The program's national participation rate was 52.7 % in 2012. When individual screening outside of the national program is taken into account (nearly 15 % of women), coverage appears close to the European recommendation of 65 %. Breast cancer mortality has been falling in France by 0.6 % per year for over 30 years, starting before mass screening was implemented, and by 1.5 % since 2005. This decline can be attributed in part to earlier diagnosis and better treatment, so that the specific impact of screening cannot easily be measured. Over-treatment, defined as the detection and treatment of low-malignancy tumors that would otherwise not have been detected in a person's lifetime, is a major negative effect of screening, but its frequency is not precisely known (reported to range from 1 % to 30 %). In view of these uncertainties, it would be advisable to modify the program in order to

  6. Overdiagnosis in breast cancer screening

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Beau, Anna-Belle; Christiansen, Peer

    2017-01-01

    Overdiagnosis in breast cancer screening is an important issue. A recent study from Denmark concluded that one in three breast cancers diagnosed in screening areas in women aged 50-69 years were overdiagnosed. The purpose of this short communication was to disentangle the study's methodology...

  7. Overdiagnosis in breast cancer screening

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Beau, Anna-Belle; Christiansen, Peer

    2017-01-01

    Overdiagnosis in breast cancer screening is an important issue. A recent study from Denmark concluded that one in three breast cancers diagnosed in screening areas in women aged 50-69 years were overdiagnosed. The purpose of this short communication was to disentangle the study's methodology...... estimate of overdiagnosis. Screening affects cohorts of screened women. Danish registers allow very accurate mapping of the fate of every woman. We should be past the phase where studies of overdiagnosis are based on the fixed age groups from routine statistics....

  8. Breast Cancer Screening in Denmark

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl; Gøtzsche, Peter C; Kalager, Mette

    2017-01-01

    Background: Effective breast cancer screening should detect early-stage cancer and prevent advanced disease. Objective: To assess the association between screening and the size of detected tumors and to estimate overdiagnosis (detection of tumors that would not become clinically relevant). Design......) and nonadvanced (≤20 mm) breast cancer tumors in screened and nonscreened women were measured. Two approaches were used to estimate the amount of overdiagnosis: comparing the incidence of advanced and nonadvanced tumors among women aged 50 to 84 years in screening and nonscreening areas; and comparing...... rate ratio, 1.49 [95% CI, 1.43 to 1.54]). The first estimation approach found that 271 invasive breast cancer tumors and 179 ductal carcinoma in situ (DCIS) lesions were overdiagnosed in 2010 (overdiagnosis rate of 24.4% [including DCIS] and 14.7% [excluding DCIS]). The second approach, which accounted...

  9. Women with Disabilities and Breast Cancer Screening

    Science.gov (United States)

    ... Reasonable Accommodations (RA) Women with Disabilities and Breast Cancer Screening Language: English (US) Español (Spanish) Recommend on Facebook ... Mammogram During the Past Two Years 1 Breast Cancer Screening Recommendations 2 If you are between the ages ...

  10. Dutch digital breast cancer screening: implications for breast cancer care

    NARCIS (Netherlands)

    Timmers, Johanna M.; den Heeten, Gerard J.; Adang, Eddy M.; Otten, Johannes D.; Verbeek, André L.; Broeders, Mireille J.

    2012-01-01

    Background: In comparison to other European population-based breast cancer screening programmes, the Dutch programme has a low referral rate, similar breast cancer detection and a high breast cancer mortality reduction. The referral rate in the Netherlands has increased over time and is expected to

  11. Breast cancer screening in Korean woman with dense breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hee Jung [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ko, Eun Sook [Dept. of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Yi, Ann [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-11-15

    Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results.

  12. SCREENING FOR EARLY DETECTION OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    E. A. Rasskazova

    2014-01-01

    Full Text Available The article presents a brief overview of the main methods of breast cancer screening. Proven effectiveness of mammography as a screening method in reducing mortality from breast cancer, specified limits of the method. The main trend of increasing the effectiveness of screening is the transition to digital technologies. Properly organized screening with the active participation of the population reduces mortality from breast cancer by 30%.

  13. Outcome of breast cancer screening in Denmark

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Bak, Martin; von Euler-Chelpin, My

    2017-01-01

    Region than in the rest of Denmrk. Detection rate was slightly below 1% at first screen, 0.6% at subsequent screens, and one region had some fluctuation over time. Ductal carcinoma in situ (DCIS) constituted 13-14% of screen-detected cancers. In subsequent rounds, 80% of screen-detected invasive cancers...... were node negative and 40% ≤10 mm. False-positive rate was around 2%; higher for North Denmark Region than for the rest of Denmark. Three out of 10 breast cancers in screened women were diagnosed as interval cancers. Conclusions: High coverage by examination and low interval cancer rate are required...... for screening to decrease breast cancer mortality. Two pioneer local screening programs starting in the 1990s were followed by a decrease in breast cancer mortality of 22-25%. Coverage by examination and interval cancer rate of the national program were on the favorable side of values from the pioneer programs...

  14. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Jørgensen, Karsten Juhl

    2013-01-01

    A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary.......A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary....

  15. Breast cancer screening: ''reassuring'' the worried well?

    DEFF Research Database (Denmark)

    Brodersen, John; Siersma, Volkert; Ryle, Mette

    2011-01-01

    of women offered screening compared to a population of women not offered screening for breast cancer. METHODS: One thousand women, aged 50-69 years, were randomly drawn from the Danish Civil Registration System to receive part I of the questionnaire Consequences of Screening in Breast Cancer (COS-BC1......): the sample consisted of 500 women living in a geographical area where screening mammography had been offered for more than 10 years and 500 women living in an area where the public health authorities had never invited women to breast cancer screening. RESULTS: A total of 759 women returned the questionnaire....... Those living in areas where screening was not offered reported more negative psychosocial aspects compared to women living in areas where screening was offered. CONCLUSIONS: The results indicate that women tend to perceive breast cancer screening as a reassuring preventive initiative. Alternatively...

  16. Testing Precision Screening for Breast Cancer

    Science.gov (United States)

    An NCI research article about individualized approaches that could help identify those at risk of breast cancer who need to be screened and testing screening intervals that are appropriate for each person’s level of risk.

  17. Risk-based Breast Cancer Screening: Implications of Breast Density.

    Science.gov (United States)

    Lee, Christoph I; Chen, Linda E; Elmore, Joann G

    2017-07-01

    The approach to breast cancer screening has changed over time from a general approach to a more personalized, risk-based approach. Women with dense breasts, one of the most prevalent risk factors, are now being informed that they are at increased risk of developing breast cancer and should consider supplemental screening beyond mammography. This article reviews the current evidence regarding the impact of breast density relative to other known risk factors, the evidence regarding supplemental screening for women with dense breasts, supplemental screening options, and recommendations for physicians having shared decision-making discussions with women who have dense breasts. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Outcome of breast cancer screening in Denmark

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Bak, Martin; von Euler-Chelpin, My

    2017-01-01

    were node negative and 40% ≤10 mm. False-positive rate was around 2%; higher for North Denmark Region than for the rest of Denmark. Three out of 10 breast cancers in screened women were diagnosed as interval cancers. Conclusions: High coverage by examination and low interval cancer rate are required...... for screening to decrease breast cancer mortality. Two pioneer local screening programs starting in the 1990s were followed by a decrease in breast cancer mortality of 22-25%. Coverage by examination and interval cancer rate of the national program were on the favorable side of values from the pioneer programs...... calculated coverage by examination; participation after invitation; detection-, interval cancer- and false-positive rates; cancer characteristics; sensitivity and specificity, for Denmark and for the five regions. Results: At the national level coverage by examination remained at 75-77%; lower in the Capital...

  19. Dutch digital breast cancer screening: implications for breast cancer care.

    Science.gov (United States)

    Timmers, Johanna M; den Heeten, Gerard J; Adang, Eddy M; Otten, Johannes D; Verbeek, André L; Broeders, Mireille J

    2012-12-01

    In comparison to other European population-based breast cancer screening programmes, the Dutch programme has a low referral rate, similar breast cancer detection and a high breast cancer mortality reduction. The referral rate in the Netherlands has increased over time and is expected to rise further, mainly following nationwide introduction of digital mammography, completed in 2010. This study explores the consequences of the introduction of digital mammography on the balance between referral rate, detection of breast cancer, diagnostic work-up and associated costs. Detailed information on diagnostic work-up (chart review) was obtained from referred women (n = 988) in 2000-06 (100% analogue mammography) and 2007 (75% digital mammography) in Nijmegen, the Netherlands. The average referral rate increased from 15 (2000-06) to 34 (2007) per 1000 women screened. The number of breast cancers detected increased from 5.5 to 7.8 per 1000 screens, whereas the positive predictive value fell from 37% to 23%. A sharp rise in diagnostic work-up procedures and total diagnostic costs was seen. On the other hand, costs of a single work-up slightly decreased, as less surgical biopsies were performed. Our study shows that a low referral rate in combination with the introduction of digital mammography affects the balance between referral rate and detection rate and can substantially influence breast cancer care and associated costs. Referral rates in the Netherlands are now more comparable to other countries. This effect is therefore of value in countries where implementation of digital breast cancer screening has just started or is still under discussion.

  20. European Breast Cancer Service Screening Outcomes

    DEFF Research Database (Denmark)

    Paci, Eugenio; Broeders, Mireille; Hofvind, Solveig

    2014-01-01

    A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast...... seven to nine breast cancer deaths are avoided, four cases are overdiagnosed, 170 women have at least one recall followed by noninvasive assessment with a negative result, and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of a breast cancer...... cancer overdiagnosis, and false-positive results. On the basis of the studies reviewed, the authors present a first estimate of the benefit and harm balance sheet. For every 1,000 women screened biennially from ages 50 to 51 years until ages 68 to 69 years and followed up until age 79 years, an estimated...

  1. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Nielsen, Margrethe

    2009-01-01

    were significantly larger in the screened groups (RR 1.31, 95% CI 1.22 to 1.42) for the two adequately randomised trials that measured this outcome; the use of radiotherapy was similarly increased. AUTHORS' CONCLUSIONS: Screening is likely to reduce breast cancer mortality. As the effect was lowest...

  2. Breast transillumination a viable option for breast cancer screening ...

    African Journals Online (AJOL)

    Background: Mammography is an established screening tool for breast cancer in high-income countries but may not be feasible for most resource poor nations. Alternative modalities are needed to mitigate the impact of the increasing incidence and mortality due to breast cancer. This may require the development of new ...

  3. Ultrasound screening of contralateral breast after surgery for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ja [Department of Radiology, Seoul Metropolitan Government Seoul National University, Boramae Medical Center (Korea, Republic of); Chung, Se-Yeong; Chang, Jung Min; Cho, Nariya [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Han, Wonshik [Department of Surgery, Seoul National University Hospital (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University Hospital (Korea, Republic of)

    2015-01-15

    Highlights: • The addition of supplemental US to mammography depicted additional 5.0 cancers per 1000 postoperative women. • Positive biopsy rate of mammography-detected lesions was 66.7% (4 of 6) and that of US-detected lesions was 40.0% (6 of 15). • US can be helpful to detect mammographically occult breast cancer in the contralateral breast in women with previous history of cancer and dense breast. - Abstract: Objective: To determine whether supplemental screening ultrasound (US) to mammography could improve cancer detection rate of the contralateral breast in patients with a personal history of breast cancer and dense breasts. Materials and methods: During a one-year study period, 1314 screening patients with a personal history of breast cancer and dense breasts simultaneously underwent mammography and breast US. BI-RADS categories were given for mammography or US-detected lesions in the contralateral breast. The reference standard was histology and/or 1-year imaging follow-up, and the cancer rate according to BI-RADS categories and cancer detection rate and positive biopsy rate according to detection modality were analyzed. Results: Of 1314 patients, 84 patients (6.4%) were categorized as category 3 with one interval cancer and one cancer which was upgraded to category 4A after 6-month follow-up US (2.5% cancer rate, 95% CIs 1.5–9.1%). Fifteen patients (1.1%) had category 4A or 4B lesions in the contralateral breast. Four lesions were detected on mammography (two lesions were also visible on US) and 11 lesions were detected on US and 5 cancers were confirmed (33.3%, 95% CIs 15.0–58.5%). Six patients (0.5%) had category 4C lesions, 2 detected on mammography and 4 on US and 4 cancers were confirmed (66.7%, 95% CIs 29.6–90.8%). No lesions were categorized as category 5 in the contralateral breast. Cancer detection rate by mammography was 3.3 per 1000 patients and that by US was 5.0 per 1000 patients, therefore overall cancer detection rate by

  4. Breast cancer screening effect across breast density strata: A case-control study

    NARCIS (Netherlands)

    Waal, D. van der; Ripping, T.M.; Verbeek, A.L.M.; Broeders, M.J.

    2017-01-01

    Breast cancer screening is known to reduce breast cancer mortality. A high breast density may affect this reduction. We assessed the effect of screening on breast cancer mortality in women with dense and fatty breasts separately. Analyses were performed within the Nijmegen (Dutch) screening

  5. Cancer fatalism and breast cancer screening in African American women.

    Science.gov (United States)

    Spurlock, Wanda Raby; Cullins, Leah S

    2006-01-01

    Despite significant advances in science, medicine, and technology African American women are more likely to die from breast cancer than Caucasian women. There is a growing body of literature that describes strategies to improve breast cancer screening among African American women. However, data suggest that African American women, compared to Caucasian women, are less likely to participate in regular breast cancer screening. The belief that a diagnosis of cancer will result in death has been identified as a potential barrier to cancer screening in African American population groups. However, research examining the degree to which perceptions of fatalism influence breast cancer screening in culturally and ethnically diverse population groups is scant. This repot describes the outcomes of a study undertaken to examine relationships between perceptions of cancer fatalism and breast cancer screening in African American women. Findings support the postulation that fatalism negatively influences health promoting practices such as breast cancer screening. However, contrary to prior research findings age was observed to be inversely associated with cancer fatalism.

  6. The need for supplemental breast cancer screening modalities: a perspective of population-based breast cancer screening programs in Japan.

    Science.gov (United States)

    Uematsu, Takayoshi

    2017-01-01

    This article discusses possible supplemental breast cancer screening modalities for younger women with dense breasts from a perspective of population-based breast cancer screening program in Japan. Supplemental breast cancer screening modalities have been proposed to increase the sensitivity and detection rates of early stage breast cancer in women with dense breasts; however, there are no global guidelines that recommend the use of supplemental breast cancer screening modalities in such women. Also, no criterion standard exists for breast density assessment. Based on the current situation of breast imaging in Japan, the possible supplemental breast cancer screening modalities are ultrasonography, digital breast tomosynthesis, and breast magnetic resonance imaging. An appropriate population-based breast cancer screening program based on the balance between cost and benefit should be a high priority. Further research based on evidence-based medicine is encouraged. It is very important that the ethnicity, workforce, workflow, and resources for breast cancer screening in each country should be considered when considering supplemental breast cancer screening modalities for women with dense breasts.

  7. BREAST CANCER IN SLOVENIA: EPIDEMIOLOGY AND SCREENING

    Directory of Open Access Journals (Sweden)

    Maja Primic Žakelj

    2003-12-01

    Full Text Available Background. Breast is the most frequent cancer site in Slovenian female population. In the year 2000 there were 932 new breast cancer cases registered (91.2/100,000, the incidence is expected to increase in the next ten years. Primary prevention includes general recommendations for healthy life style, e.g. avoidance of obesity, diet, physical activity and moderate alcohol consumption. Randomised controlled trials conducted in the USA, Canada, Scotland and Sweden have shown that regular mammography, alone or in combination with clinical examination, is effective in reducing mortality for about 25% in women over the age of 50, and much less in younger population. However, mammography screening has several drawbacks, the major being its tendency towards false positive and false negative results with all their potential psychosocial consequences. High quality assurance and control, as well as effective and readily available diagnostics and treatment, all of which demand high investments, are indispensable for good results.Conclusions. In Slovenia there are standards for breast cancer screening units, but their implementation in every day’s work is still a problem. In any case, breast cancer control could be achieved only by combined efforts directed into primary prevention and early detection, as well as by improving availability of effective treatment.

  8. Knowledge and Practice of Breast Cancer Screening Among ...

    African Journals Online (AJOL)

    Background: Breast cancer is the most common cancer among African women. Most researchers have attributed the late presentation to poor knowledge of breast cancer symptoms. Objective: This study was designed to evaluate the relationship between knowledge and practice of breast cancer screening in two groups of ...

  9. Knowledge of breast cancer screening methods and the practice of ...

    African Journals Online (AJOL)

    Mammography still remains the best method for breast cancer screening. Objective: To assess the knowledge of female nursing students in a tertiary health institution on the screening methods for breast cancer as well as their practice of breast self-examination. Design: A descriptive cross-sectional study. Setting: School of ...

  10. Breast Cancer Screening (PDQ®)—Patient Version

    Science.gov (United States)

    Breast cancer screening is performed using mammogram, clinical breast exam (CBE), and MRI (magnetic resonance imaging) tests. Learn about these and other tests that have been studied to detect or screen for breast cancer in this expert-reviewed and evidence-based summary.

  11. Lay Epistemology of Breast Cancer Screening Guidelines Among Appalachian Women.

    Science.gov (United States)

    Record, Rachael A; Scott, Allison M; Shaunfield, Sara; Jones, M Grace; Collins, Tom; Cohen, Elisia L

    2017-09-01

    Recent changes to the U.S. Preventive Services Task Force guidelines for breast cancer screening have contributed to increased patient uncertainty regarding the timing and appropriateness of screening behaviors. To gain insight into the lay epistemology of women regarding breast cancer screening practices, we conducted in-depth, face-to-face interviews with 24 adult women living in a medically underserved Appalachian region. We found that women were unaware of breast cancer screening guidelines (i.e., start age, frequency, stop age). Qualitative analysis revealed two lay epistemological narratives establishing (a) uncertain knowledge and ambiguity about breast cancer screening guidelines but certain knowledge of other women's experiences with breast cancer diagnoses, and (b) feelings of knowing one's own body best and seeing the value in "overscreening" to save even one life. Our findings have theoretical and practical implications for scholars and practitioners seeking to improve knowledge or behavior regarding adherence to breast cancer screening recommendations.

  12. Overdiagnosis in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

    Puliti, Donella; Duffy, Stephen W; Miccinesi, Guido

    2012-01-01

    Overdiagnosis, the detection through screening of a breast cancer that would never have been identified in the lifetime of the woman, is an adverse outcome of screening. We aimed to determine an estimate range for overdiagnosis of breast cancer in European mammographic service screening programmes....

  13. Breast cancer mortality in mammographic screening in Europe

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Nyström, Lennarth; Moss, Sue

    2012-01-01

    To estimate the impact of service mammography screening on breast cancer mortality using European incidence-based mortality (IBM) studies (or refined mortality studies). IBM studies include only breast cancer deaths occurring in women with breast cancer diagnosed after their first invitation...

  14. Breast and cervical cancer screening programme implementation in 16 countries

    DEFF Research Database (Denmark)

    Dowling, Emily C; Klabunde, Carrie; Patnick, Julietta

    2010-01-01

    There is a continuing need to monitor and evaluate the impact of organized screening programmes on cancer incidence and mortality. We report results from a programme assessment conducted within the International Cancer Screening Network (ICSN) to understand the characteristics of cervical screening...... programmes within countries that have established population-based breast cancer screening programmes....

  15. Women's perceptions of breast cancer screening. Spanish screening programme survey.

    Science.gov (United States)

    Baena-Cañada, José M; Rosado-Varela, Petra; Expósito-Álvarez, Inmaculada; González-Guerrero, Macarena; Nieto-Vera, Juan; Benítez-Rodríguez, Encarnación

    2014-12-01

    Participants in breast cancer screening programmes may benefit from early detection but may also be exposed to the risks of overdiagnosis and false positives. We surveyed a sample of Spanish women to assess knowledge, information sources, attitudes and psychosocial impact. A total of 434 breast cancer screening programme participants aged 45-69 years were administered questionnaires regarding knowledge, information sources, attitudes and psychosocial impact. Scores of 5 or more (out of 10) and 12 or less (out of 24) were established as indicating adequate knowledge and a positive attitude, respectively. Psychosocial impact was measured using the Hospital Anxiety and Depression Scale and the Cancer Worry Scale. Only 42 women (9.7%) had adequate knowledge. The mean (SD) knowledge score was 2.97 (1.16). Better educated women and women without previous false positives had higher scores. The main sources of information were television, press, Andalusian Health Service documentation and family and friends. Most participants (99.1%) had a positive attitude, with a mean (SD) score of 3.21 (2.66). Mean (SD) scores for anxiety, depression and cancer worry were 1.86 (3.26), 0.72 (1.99) and 9.4 (3.04), respectively. Women have a very positive attitude to breast cancer screening, but are poorly informed and use television as their main information source. They experience no negative psychosocial impact from participation in such programmes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Automatically assessed volumetric breast density and breast cancer risk : The era of digital screening mammography

    NARCIS (Netherlands)

    Wanders, J.O.P .

    2017-01-01

    Breast cancer is the most frequently diagnosed cancer among females worldwide. As the burden of breast cancer is high, many countries have introduced a breast cancer screening program with the aim to find and treat breast cancers in an early stage. In the Netherlands, women between the ages of 50

  17. Screen-detected versus interval cancers: Effect of imaging modality and breast density in the Flemish Breast Cancer Screening Programme

    Energy Technology Data Exchange (ETDEWEB)

    Timmermans, Lore; Bacher, Klaus; Thierens, Hubert [Ghent University, Department of Basic Medical Sciences, QCC-Gent, Ghent (Belgium); Bleyen, Luc; Herck, Koen van [Ghent University, Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Ghent (Belgium); Lemmens, Kim; Ongeval, Chantal van; Steen, Andre van [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Martens, Patrick [Centrum voor Kankeropsporing, Bruges (Belgium); Brabander, Isabel de [Belgian Cancer Registry, Brussels (Belgium); Goossens, Mathieu [UZ Brussel, Dienst Kankerpreventie, Brussels (Belgium)

    2017-09-15

    To investigate if direct radiography (DR) performs better than screen-film mammography (SF) and computed radiography (CR) in dense breasts in a decentralized organised Breast Cancer Screening Programme. To this end, screen-detected versus interval cancers were studied in different BI-RADS density classes for these imaging modalities. The study cohort consisted of 351,532 women who participated in the Flemish Breast Cancer Screening Programme in 2009 and 2010. Information on screen-detected and interval cancers, breast density scores of radiologist second readers, and imaging modality was obtained by linkage of the databases of the Centre of Cancer Detection and the Belgian Cancer Registry. Overall, 67% of occurring breast cancers are screen detected and 33% are interval cancers, with DR performing better than SF and CR. The interval cancer rate increases gradually with breast density, regardless of modality. In the high-density class, the interval cancer rate exceeds the cancer detection rate for SF and CR, but not for DR. DR is superior to SF and CR with respect to cancer detection rates for high-density breasts. To reduce the high interval cancer rate in dense breasts, use of an additional imaging technique in screening can be taken into consideration. (orig.)

  18. Increasingly strong reduction in breast cancer mortality due to screening

    Science.gov (United States)

    van Schoor, G; Moss, S M; Otten, J D M; Donders, R; Paap, E; den Heeten, G J; Holland, R; Broeders, M J M; Verbeek, A L M

    2011-01-01

    Background: Favourable outcomes of breast cancer screening trials in the 1970s and 1980s resulted in the launch of population-based service screening programmes in many Western countries. We investigated whether improvements in mammography and treatment modalities have had an influence on the effectiveness of breast cancer screening from 1975 to 2008. Methods: In Nijmegen, the Netherlands, 55 529 women received an invitation for screening between 1975 and 2008. We designed a case–referent study to evaluate the impact of mammographic screening on breast cancer mortality over time from 1975 to 2008. A total number of 282 breast cancer deaths were identified, and 1410 referents aged 50–69 were sampled from the population invited for screening. We estimated the effectiveness by calculating the odds ratio (OR) indicating the breast cancer death rate for screened vs unscreened women. Results: The breast cancer death rate in the screened group over the complete period was 35% lower than in the unscreened group (OR=0.65; 95% CI=0.49–0.87). Analysis by calendar year showed an increasing effectiveness from a 28% reduction in breast cancer mortality in the period 1975–1991 (OR=0.72; 95% CI=0.47–1.09) to 65% in the period 1992–2008 (OR=0.35; 95% CI=0.19–0.64). Conclusion: Our results show an increasingly strong reduction in breast cancer mortality over time because of mammographic screening. PMID:21343930

  19. Communicating the balance sheet in breast cancer screening

    DEFF Research Database (Denmark)

    Giordano, Livia; Cogo, Carla; Patnick, Julietta

    2012-01-01

    Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening.......Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening....

  20. Intermittent attendance at breast cancer screening

    Directory of Open Access Journals (Sweden)

    Padraic Fleming

    2013-09-01

    Full Text Available Background. To determine why women skip rounds and factors influencing return of previous non attenders (PNAs to breast screening. Design and methods. Retrospective, quantitative, structured questionnaire posted to 2500 women. First PNAs did not attend their first screening appointment in 2007/2008 but then attended in 2010; First Controls first attended in 2010 without missed previous appointments. Women who attended screening in 2006 or earlier then skipped a round but returned in 2010 were Subsequent PNAs; Subsequent Controls attended all appointments.Results. More First Controls than First PNAs had family history of cancer (72.7% vs 63.2%; P=0.003; breast cancer (31.3% vs 24.8%; P=0.04. More PNAs lived rurally; more First PNAs had 3rd level education (33.2% vs 23.6%; P=0.002 and fewer had private insurance than First Controls (57.7% vs 64.8%; P=0.04. Excellent/good health was reported in First PNAs and First Controls (82.9% vs 83.2%, but fewer Subsequent PNAs than Subsequent Controls (72.7% vs 84.9%; P=0.000. Common considerations at time of missed appointment were had mammogram elsewhere (33% First PNA and postponed to next round (16% First PNA, 18.8% Subsequent PNA. Considerations when returning to screening were similar for First PNAs and Subsequent PNAs: I am older (35.4%, 29.6%, I made sure I remembered (29%, 23.6%, could reschedule (17.6%, 20.6%, illness of more concern (16.5%, 19%. More First PNAs stated my family/friends advised (22.3% vs 15.2% or my GP (12.6% vs 4.6% advised me to attend, heard good things about BreastCheck (28.8% vs 13.6%.Conclusions. Intermittent attenders do not fit socio-demographic patterns of non-attenders; GP recommendation and word of mouth were important in women’s return to screening. Fear and anxiety seem to act as a screening facilitator rather than an inhibitor.

  1. Interval cancer rates in the Irish national breast screening programme.

    Science.gov (United States)

    O'Brien, Katie M; Dwane, Fiona; Kelleher, Tracy; Sharp, Linda; Comber, Harry

    2015-09-01

    To compare interval cancer rates from the Irish breast screening programme, BreastCheck, for the period 2000-2007 with those from other European countries. Data from BreastCheck was linked to National Cancer Registry breast cancer registrations, to calculate numbers of women screened, screen-detected cancers, and interval cancers, by year of screening, in the first and second years after screening, and by initial or subsequent screen. Estimated underlying cancer incidence from the period 1996-1999 inclusive was used to calculate proportionate incidence. We calculated the interval cancer ratio as an alternative measure of the burden of interval cancers. There were 372,658 screening records for 178,147 women in the period 2000-2007. The overall interval rate was 9.6 per 10,000 screens. In the first year after screening, the interval cancer rate was 5.8 per 10,000 screens and this increased to 13.4 in the second year after screening. The screen detection rate for the period was 53.6 per 10,000 screened for all screens combined. Initial screens produced a higher detection rate at 66.9 per 10,000 screened compared with subsequent screens with a screen-detected rate of 41.4 per 10,000 screens. Interval breast cancer rates for the first years of the programme are within acceptable limits and are comparable with those in other European programmes. Nationwide roll-out together with the adoption of digital mammography may have an impact on interval cancer rates in future years. © The Author(s) 2015.

  2. Observed and Predicted Risk of Breast Cancer Death in Randomized Trials on Breast Cancer Screening.

    Directory of Open Access Journals (Sweden)

    Philippe Autier

    Full Text Available The role of breast screening in breast cancer mortality declines is debated. Screening impacts cancer mortality through decreasing the number of advanced cancers with poor diagnosis, while cancer treatment works through decreasing the case-fatality rate. Hence, reductions in cancer death rates thanks to screening should directly reflect reductions in advanced cancer rates. We verified whether in breast screening trials, the observed reductions in the risk of breast cancer death could be predicted from reductions of advanced breast cancer rates.The Greater New York Health Insurance Plan trial (HIP is the only breast screening trial that reported stage-specific cancer fatality for the screening and for the control group separately. The Swedish Two-County trial (TCT reported size-specific fatalities for cancer patients in both screening and control groups. We computed predicted numbers of breast cancer deaths, from which we calculated predicted relative risks (RR and (95% confidence intervals. The Age trial in England performed its own calculations of predicted relative risk.The observed and predicted RR of breast cancer death were 0.72 (0.56-0.94 and 0.98 (0.77-1.24 in the HIP trial, and 0.79 (0.78-1.01 and 0.90 (0.80-1.01 in the Age trial. In the TCT, the observed RR was 0.73 (0.62-0.87, while the predicted RR was 0.89 (0.75-1.05 if overdiagnosis was assumed to be negligible and 0.83 (0.70-0.97 if extra cancers were excluded.In breast screening trials, factors other than screening have contributed to reductions in the risk of breast cancer death most probably by reducing the fatality of advanced cancers in screening groups. These factors were the better management of breast cancer patients and the underreporting of breast cancer as the underlying cause of death. Breast screening trials should publish stage-specific fatalities observed in each group.

  3. Prevention of breast cancer in the context of a national breast screening programme

    National Research Council Canada - National Science Library

    Howell, A; Astley, S; Warwick, J; Stavrinos, P; Sahin, S; Ingham, S; McBurney, H; Eckersley, B; Harvie, M; Wilson, M; Beetles, U; Warren, R; Hufton, A; Sergeant, J; Newman, W; Buchan, I; Cuzick, J; Evans, D. G

    2012-01-01

    ...; and Cambridge Breast Unit, Addenbrooke’s Hospital, Cambridge; UK). Prevention of breast cancer in the context of a national breast screening programme (Review). J Intern Med 2012; 271 : 321–330...

  4. Beyond Mammography: New Frontiers in Breast Cancer Screening

    Science.gov (United States)

    Drukteinis, Jennifer S.; Mooney, Blaise P.; Flowers, Chris I.; Gatenby, Robert A

    2014-01-01

    Breast cancer screening remains a subject of intense and, at times, passionate debate. Mammography has long been the mainstay of breast cancer detection and is the only screening test proven to reduce mortality. Although it remains the gold standard of breast cancer screening, there is increasing awareness of subpopulations of women for whom mammography has reduced sensitivity. Mammography has also undergone increased scrutiny for false positives and excessive biopsies, which increase radiation dose, cost and patient anxiety. In response to these challenges, new technologies for breast cancer screening have been developed, including; low dose mammography; contrast enhanced mammography, tomosynthesis, automated whole breast ultrasound, molecular imaging and MRI. Here we examine some of the current controversies and promising new technologies that may improve detection of breast cancer both in the general population and in high-risk groups, such as women with dense breasts. We propose that optimal breast cancer screening will ultimately require a personalized approach based on metrics of cancer risk with selective application of specific screening technologies best suited to the individual’s age, risk, and breast density. PMID:23561631

  5. Breast Cancer Screening in an Era of Personalized Regimens

    Science.gov (United States)

    Onega, Tracy; Beaber, Elisabeth F.; Sprague, Brian L.; Barlow, William E.; Haas, Jennifer S.; Tosteson, Anna N.A.; Schnall, Mitchell D.; Armstrong, Katrina; Schapira, Marilyn M.; Geller, Berta; Weaver, Donald L.; Conant, Emily F.

    2014-01-01

    Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women’s health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for “overdiagnosis,” and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a “1-size-fits-all” guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women’s risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. PMID:24830599

  6.   Personal invitations for population-based breast cancer screening

    DEFF Research Database (Denmark)

    Saalasti-Koskinen, Ulla; Mäkelä, Marjukka; Saarenmaa, Irma

    2010-01-01

    . The objective of this study was to evaluate the information breast cancer screening units send to women invited for screening in Finland. MATERIALS AND METHODS: A questionnaire was sent to all breast cancer screening units in Finland in 2005 and 2008, and the information (eg, invitations, results letters...... optimizing participation. The high participation rate (approximately 88%) in Finland may be due partly to the prescriptive nature of the invitation letters. National templates for information letters would be useful....

  7. Breast and Cervical Cancers Awareness and Screening Practices ...

    African Journals Online (AJOL)

    Only 4/11(36.4%) of those who knew something about cervical cancer mentioned vaginal examination for cervical cancer screening and only one (0.1%) respondent mentioned Pap smear. The poor level of awareness and screening practices for breast and cervical cancers among women in these rural communities ...

  8. [Organized or individual breast cancer screening: what motivates women?].

    Science.gov (United States)

    Kalecinski, Julie; Régnier-Denois, Véronique; Ouédraogo, Samiratou; Dabakuyo-Yonli, Tienhan Sandrine; Dumas, Agnès; Arveux, Patrick; Chauvin, Franck

    2015-01-01

    The breast cancer screening programme, proposed to all women between 50 and 69 years, consisting of two-view mammography screening every two years, has been generalized in France since 2004. The programme coexists with opportunistic mammography screening, provided outside official frameworks. This qualitative study was designed to identify the pros and cons of these two screening modes. Three hundred and forty-five women were randomly selected from women who had participated in a previous quantitative study and who were invited to attend for breast cancer screening in 13 French departments between 2010 and 2011. These women were asked to participate in a face-to-face semistructured interview conducted by a sociologist. 48 women (17 from deprived areas) were interviewed. All chose to be screened for breast cancer either because they feared cancer, or because they wanted to control their own health. Twenty-seven women chose the organized screening programme, which they considered to be trustworthy, as negative mammograms are double checked by a second radiologist. Twenty-one women preferred individual screening, which they considered to be more reliable, less anonymous and providing them with more liberty to take control of their own health. Gynaecologists play an important role in women’s decision to undergo individual breast cancer screening. They also have an important role to play in the promotion of organized breast cancer screening programme with this public.

  9. Ring of Silence: African American Women's Experiences Related to Their Breasts and Breast Cancer Screening

    Science.gov (United States)

    Thomas, Eileen

    2006-01-01

    The purpose of this study was to explore women's memories and feelings concerning their breasts and breast cancer screening experiences in relation to their current breast cancer screening behaviors. Twelve African American women shared stories that were generated in written narratives and individual interviews. Two core themes emerged from the…

  10. Awareness Of Breast Cancer Screening Among Female ...

    African Journals Online (AJOL)

    The mortality and morbidity rate of carcinoma of the breast among Nigerian women is alarming and is a serious health issue to health professionals especially nurses. The high rate of mortality and morbidity associated with breast cancer can be reduced through early detection measures which include mammography, ...

  11. Cost-effectiveness of the Norwegian breast cancer screening program.

    Science.gov (United States)

    van Luijt, P A; Heijnsdijk, E A M; de Koning, H J

    2017-02-15

    The Norwegian Breast Cancer Screening Programme (NBCSP) has a nation-wide coverage since 2005. All women aged 50-69 years are invited biennially for mammography screening. We evaluated breast cancer mortality reduction and performed a cost-effectiveness analysis, using our microsimulation model, calibrated to most recent data. The microsimulation model allows for the comparison of mortality and costs between a (hypothetical) situation without screening and a situation with screening. Breast cancer incidence in Norway had a steep increase in the early 1990s. We calibrated the model to simulate this increase and included recent costs for screening, diagnosis and treatment of breast cancer and travel and productivity loss. We estimate a 16% breast cancer mortality reduction for a cohort of women, invited to screening, followed over their complete lifetime. Cost-effectiveness is estimated at NOK 112,162 per QALY gained, when taking only direct medical costs into account (the cost of the buses, examinations, and invitations). We used a 3.5% annual discount rate. Cost-effectiveness estimates are substantially below the threshold of NOK 1,926,366 as recommended by the WHO guidelines. For the Norwegian population, which has been gradually exposed to screening, breast cancer mortality reduction for women exposed to screening is increasing and is estimated to rise to ∼30% in 2020 for women aged 55-80 years. The NBCSP is a highly cost-effective measure to reduce breast cancer specific mortality. We estimate a breast cancer specific mortality reduction of 16-30%, at the cost of 112,162 NOK per QALY gained. © 2016 UICC.

  12. Breast cancer screening in a resource poor country: Ultrasound ...

    African Journals Online (AJOL)

    Background: Breast cancer is the commonest female cancer in Nigeria. Despite its increased awareness, affordability of available screening tools is a bane. Mammography, the goal standard for screening is costly and not widely available in terms of infrastructure, technical/personnel capabilities. Ultrasound is accessible ...

  13. [CBO guideline 'Breast cancer: screening and diagnosis'

    NARCIS (Netherlands)

    Rutgers, E.; Tuut, M.K.; Verbeek, A.L.M.

    2001-01-01

    New developments in the diagnostic procedures for women with an increased risk for, or symptoms related to breast cancer led to development of new guidelines by a working group under the auspices of the Dutch Institute for Health Care Improvement, the Organisation of Comprehensive Cancer Centres and

  14. Evaluation of The Netherlands breast cancer screening programme.

    NARCIS (Netherlands)

    Verbeek, A.L.M.; Broeders, M.J.M.

    2003-01-01

    The Netherlands breast cancer screening programme for women aged 50-75 years was gradually implemented during 1989-1997. Short-term indicators for this mammography screening are 80% attendance (800 000 examinations yearly), and for the subsequent screening examinations 7.4 referrals for clinical

  15. [The effectiveness of population-based breast cancer screening programme].

    Science.gov (United States)

    Szynglarewicz, Bartłomiej; Matkowski, Rafał; Kasprzak, Piotr; Kotowska, Jolanta; Forgacz, Józef; Pudełko, Marek; Kornafel, Jan

    2009-02-01

    Well-organised mammography screening programme can significantly reduce the breast cancer mortality However, changes in mortality rates take a long time thus some early indicators are usually used to monitor the effectiveness of the programme. If these operational objectives are accomplished then the programme can replicate the mortality reduction achieved in randomised trials. To evaluate the quality of breast cancer screening programme in the region of Lower Silesia during the first year of its operating. Centrally organised breast cancer screening has been introduced since the beginning of the year 2007. This population-based programme is designed for women aged 50-69. Females undergoing treatment or being followed-up due to breast cancer are not invited. Screen-film two-view mammography without clinical examination is used as a screening test which is to be performed every two years. The second level diagnostic tools are breast clinical examination and additional imaging (mammography and ultrasound). Following further assessment women are referred to the examination at the routine round length of the programme, at the less interval (short-term recall) or biopsy procedures. Quality assessment was done via early indicators according to the European guidelines. The attendance rate was 41% (79,143 women screened within 192,613 eligible population for one year). Technical repeat rate, further assessment rate, and short-term recall rate were: 0.26%, 6.85%, and 0.91%, respectively. Pathologically confirmed breast cancer was revealed in 364 women giving the detection rate 4.59 for 1000. Cancer detection rate to expected incidence ratio was 3.35. Mammography service performed during the first year of breast cancer screening programme in the region of Lower Silesia conforms to quality assessment parameters recommended by the European guidelines at the acceptable level. The main problem at the start of this programme is too low coverage. Invitation process must be

  16. [Screening for breast cancer: worries about its effectiveness].

    Science.gov (United States)

    Autier, Philippe

    2013-12-01

    Breast cancer screening in France is done though two parallel systems: individualized screening and a national programme of organized screening. The latter is free of charge and manages a double-reading of mammography films. Since 2004, a steadily greater proportion of French women 50 to 74 years of age participate to the national programme. Justification of screening in France is based on Swedish randomised trials that documented the ability of mammography screening to reduce the risk to die from breast cancer. However, since 3 years, a growing number of studies indicate that screening seems not to have much influence on the incidence of advanced breast cancer and on mortality from breast cancer Moreover, numerous breast cancers are detected that would have never clinically surfaced and would have never been life threatening (overdiagnosis). In view of current doubts, it is better to inform women on health benefits, limitations and possible side effects of mammography screening. For women willing to be screened, it is recommended to invite them to participate to the national programme.

  17. Optimal breast cancer screening strategies for older women: current perspectives

    Directory of Open Access Journals (Sweden)

    Braithwaite D

    2016-02-01

    Full Text Available Dejana Braithwaite,1 Joshua Demb,1 Louise M Henderson2 1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 2Department of Radiology, University of North Carolina, Chapel Hill, NC, USA Abstract: Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models. Keywords: aging, breast cancer, precision cancer screening

  18. Mammographic density and breast cancer risk in breast screening assessment cases and women with a family history of breast cancer.

    Science.gov (United States)

    Duffy, Stephen W; Morrish, Oliver W E; Allgood, Prue C; Black, Richard; Gillan, Maureen G C; Willsher, Paula; Cooke, Julie; Duncan, Karen A; Michell, Michael J; Dobson, Hilary M; Maroni, Roberta; Lim, Yit Y; Purushothaman, Hema N; Suaris, Tamara; Astley, Susan M; Young, Kenneth C; Tucker, Lorraine; Gilbert, Fiona J

    2018-01-01

    Mammographic density has been shown to be a strong independent predictor of breast cancer and a causative factor in reducing the sensitivity of mammography. There remain questions as to the use of mammographic density information in the context of screening and risk management, and of the association with cancer in populations known to be at increased risk of breast cancer. To assess the association of breast density with presence of cancer by measuring mammographic density visually as a percentage, and with two automated volumetric methods, Quantra™ and VolparaDensity™. The TOMosynthesis with digital MammographY (TOMMY) study of digital breast tomosynthesis in the Breast Screening Programme of the National Health Service (NHS) of the United Kingdom (UK) included 6020 breast screening assessment cases (of whom 1158 had breast cancer) and 1040 screened women with a family history of breast cancer (of whom two had breast cancer). We assessed the association of each measure with breast cancer risk in these populations at enhanced risk, using logistic regression adjusted for age and total breast volume as a surrogate for body mass index (BMI). All density measures showed a positive association with presence of cancer and all declined with age. The strongest effect was seen with Volpara absolute density, with a significant 3% (95% CI 1-5%) increase in risk per 10 cm 3 of dense tissue. The effect of Volpara volumetric density on risk was stronger for large and grade 3 tumours. Automated absolute breast density is a predictor of breast cancer risk in populations at enhanced risk due to either positive mammographic findings or family history. In the screening context, density could be a trigger for more intensive imaging. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. BREAST CANCER SCREENING KNOWLEDGE AND PRACTICE AMONG WOMEN IN SOUTHEAST OF IRAN

    OpenAIRE

    Heidari, Z; H. R Mahmoudzadeh-Sagheb; N Sakhavar

    2008-01-01

    "nBreast cancer is the most common cancer occurring among women. The mortality rate of breast cancer can be reduced by regular breast cancer screening program. This study was carried out to identify the knowledge and practice of women about breast cancer screening in Zahedan, southeast of Iran. In this cross- sectional study, 384 women were selected as an improbability sample of women referring to Qouds maternity hospital. Knowledge and practice of them about breast cancer screening were...

  20. Breast cancer screening: An outpatient clinic study

    Directory of Open Access Journals (Sweden)

    Mustafa Girgin

    2017-03-01

    Conclusion: A multidisciplinary cancer screening program should be maintained. With such a process, the aim is to reduce the morbidity and mortality of the disease without adversely affecting the health conditions of asymptomatic individuals based on the screening. Success is brought about by the combination of individual features. [Arch Clin Exp Surg 2017; 6(1.000: 23-27

  1. Breast cancer screening and the changing population pyramid of Japan.

    Science.gov (United States)

    Uchida, Ken; Ohashi, Hitoshi; Kinoshita, Satoki; Nogi, Hiroko; Kato, Kumiko; Toriumi, Yasuo; Yamashita, Akinori; Kamio, Makiko; Mimoto, Rei; Takeyama, Hiroshi

    2015-03-01

    Breast cancer has been the most prevalent cancer in Japan since the 1990s. The mortality from breast cancer is increasing in Japan, whereas in other industrialized countries it has been decreasing since 1990. On the other hand, Japan faces unparalleled growth in its aging population. The aim of this study was to report the mammography screening among Japanese women and the related upcoming changes in the population pyramid of Japan. The reference data for our study were obtained from the Center for Cancer Control and Information Services, Japan Ministry of Internal Affairs and Communications, Ministry of Health, Labour and Welfare, the Japanese Cancer Society, and the National Institute of Population and Social Security. The survey data were obtained from breast cancer and mammography screenings in the Tokyo Prefecture in 2008. The following parameters were analyzed: annual breast cancer incidence, current screening rates, average life-span, and predicted demographic statistics. Our results showed that breast cancer incidence and mortality have been increasing annually in Japan. The average age of breast cancer patients increased to 58.40 years in 2010. The incidence of breast cancer in women aged 65 years and older increased from 25.3 to 32.9 % in the last 10 years and is expected to continue to increase in the future. The check-up rate was 16.0-20.0 % for women aged 65-74 years and 43.0-46.0 % for women aged 40-54 years. According to our questionnaire survey, concerns about breast cancer and mammography screening were high in the young and low in the elderly women. The Japanese population aged 65 years and older was 30,740 (24.1 %) in 2012 and is estimated to increase by 40 % over the next 20 years despite Japan's declining population size. Breast cancer incidence has increased in Japan, even among patients aged 65 years and older. Breast cancer has become increasingly prevalent in older Japanese women. As the population pyramid of Japan changes, women aged 65

  2. Overdiagnosis of breast cancer in population screening: does it make breast screening worthless?

    Science.gov (United States)

    Houssami, Nehmat

    2017-01-01

    The risk of breast cancer (BC) overdiagnosis attributed to mammography screening is an unresolved issue, complicated by heterogeneity in the methodology of quantifying its magnitude, and both political and scientific elements surrounding interpretation of the evidence on this phenomenon. Evidence from randomized trials and also from observational studies shows that mammography screening reduces the risk of BC death; similarly, these studies provide sufficient evidence that overdiagnosis represents a serious harm from population breast screening. For both these outcomes of screening, BC mortality reduction and overdiagnosis, estimates of magnitude vary between studies however overdiagnosis estimates are associated with substantial uncertainty. The trade-off between the benefit and the collective harms of BC screening, including false-positives and overdiagnosis, is more finely balanced than initially recognized, however the snapshot of evidence presented on overdiagnosis does not mean that breast screening is worthless. Future efforts should be directed towards (a) ensuring that any changes in the implementation of BC screening optimize the balance between benefit and harms, including assessing how planned or actual changes modify the risk of overdiagnosis; (b) informing women of all the outcomes that may affect them when they participate in screening using well-crafted and balanced information; and (c) investing in research that will help define and reduce the ensuing overtreatment of screen-detected BC. PMID:28443199

  3. Breast and cervical cancer screening behaviours among colorectal cancer survivors in Nova Scotia

    Science.gov (United States)

    Corkum, M.; Urquhart, R.; Kephart, G.; Hayden, J.A.; Porter, G.

    2014-01-01

    Purpose We analyzed patterns and factors associated with receipt of breast and cervical cancer screening in a cohort of colorectal cancer survivors. Methods Individuals diagnosed with colorectal cancer in Nova Scotia between January 2001 and December 2005 were eligible for inclusion. Receipt of breast and cervical cancer screening was determined using administrative data. General-population age restrictions were used in the analysis (breast: 40–69 years; cervical: 21–75 years). Kaplan–Meier and Cox proportional hazards models were used to assess time to first screen. Results Of 318 and 443 colorectal cancer survivors eligible for the breast and cervical cancer screening analysis respectively, 30.1% [95% confidence interval (ci): 21.2% to 39.0%] never received screening mammography, and 47.9% (95% ci: 37.8% to 58.0%) never received cervical cancer screening during the study period. Receipt of screening before the colorectal cancer diagnosis was strongly associated with receipt of screening after diagnosis (hazard ratio for breast cancer screening: 4.71; 95% ci: 3.42 to 6.51; hazard ratio for cervical cancer screening: 6.83; 95% ci: 4.58 to 10.16). Conclusions Many colorectal cancer survivors within general-population screening age recommendations did not receive breast and cervical cancer screening. Future research should focus on survivors who meet age recommendations for population-based cancer screening. PMID:25302037

  4. The association between general practitioners' attitudes towards breast cancer screening and women's screening participation.

    Science.gov (United States)

    Jensen, Line Flytkjær; Mukai, Thomas Ostersen; Andersen, Berit; Vedsted, Peter

    2012-06-18

    Breast cancer screening in Denmark is organised by the health services in the five regions. Although general practitioners (GPs) are not directly involved in the screening process, they are often the first point of contact to the health care system and thus play an important advisory role. No previous studies, in a health care setting like the Danish system, have investigated the association between GPs' attitudes towards breast cancer screening and women's participation in the screening programme. Data on women's screening participation was obtained from the regional screening authorities. Data on GPs' attitudes towards breast cancer screening was taken from a previous survey among GPs in the Central Denmark Region. This study included women aged 50-69 years who were registered with a singlehanded GP who had participated in the survey. The survey involved 67 singlehanded GPs with a total of 13,288 women on their lists. Five GPs (7%) had a negative attitude towards breast cancer screening. Among registered women, 81% participated in the first screening round. Multivariate analyses revealed that women registered with a GP with a negative attitude towards breast cancer screening were 17% (95% CI: 2-34%) more likely to be non-participants compared with women registered with a GP with a positive attitude towards breast cancer screening. The GPs' attitudes may influence the participation rate even in a system where GPs are not directly involved in the screening process. However, further studies are needed to investigate this association.

  5. Breast Cancer Screening in Albania During 2007-2008

    Science.gov (United States)

    Kopeci, Aurel; Çanaku, Dorina; Muja, Herion; Petrela, Kreshnik; Mone, Iris; Qirjako, Gentiana; Hyska, Jolanda; Preza, Krenar

    2013-01-01

    Aim: Our aim was to assess the prevalence of breast cancer among women who showed up and participated in the breast cancer screening program during October 2007-October 2008 in Tirana, the Albanian capital city. Methods: A breast cancer prevention and treatment campaign was undertaken in Tirana, Albania, in 2007 which included also mammography examination for the early detection of breast cancer. All women residing in Tirana municipality were invited to undergo a mammography examination free of charge. Results: A total number of 5224 women underwent mammography examination during October 2007 – October 2008 time period in Tirana. The highest number of mammography tests were performed in October 2008 (1284 tests), followed by June 2008 with 746 mammography examinations realized. In general, the prevalence of breast cancer positive mammography readings where higher among women older than 60 years, followed by the 51-60 and 41-50 years age-groups. Conclusion: Our findings indicate that, among 5224 examined women during a one-year period, 1.9% had a positive reading in mammography. This is one of the few reports large-scale breast cancer screening in Albania. The increasing of breast cancer rates necessitates implementation of multi-directional programs to prevent, early diagnose and control this condition in Albanian women. PMID:24511273

  6. Barriers to uptake of breast cancer screening in Kenya | Wachira ...

    African Journals Online (AJOL)

    Subjects: Community members (18 years and older) who did not attend the screening events. Outcome Measure: The outcome measure was having heard about the breast cancer screening events. Both structured and open-ended questions were used for data collection. Item frequency, correlations, and content analyses ...

  7. Attitudes of women about breast cancer and cervical cancern screening

    Directory of Open Access Journals (Sweden)

    ilknur Aydin Avci

    2015-06-01

    Conclusion: This research revealed that the women had moderate knowlege about breast and cervical cancer screening and artcipation in screening is low. Beside, the women who had BSE and mammography had more PAP smear. [TAF Prev Med Bull 2015; 14(3.000: 235-239

  8. Compliance after 17 years of breast cancer screening

    NARCIS (Netherlands)

    Scaf-Klomp, W.; van Sonderen, F.L.P.; van den Heuvel, W.J.A.

    1997-01-01

    The motives and reasons for regular attendance, irregular attendance and drop-out were studied in women who were enrolled in a biennial breast cancer screening programme in 1975 and who were invited to each subsequent screening round until 1992. Three compliance groups were compared: 'attended all

  9. Breast cancer screening programme: experience from Eastern province, Saudi Arabia.

    Science.gov (United States)

    Al Mulhim, F A; Syed, A; Bagatadah, W A; Al Muhanna, A F

    2015-04-02

    Programmes for early diagnosis of breast cancer are lacking in most countries in the Eastern Mediterranean Region. This paper reviews a nongovernmental screening programme launched in October 2009 in the Eastern Province of Saudi Arabia, in which 14 health centres were covered by 2 mobile mammography machines. Annual screening was offered to all women aged 40 years and above. Up to February 2014 a total of 8061 women were screened, an uptake rate of 15.0%. The recall rate was 7.9%. The number of cancers detected was 47, a cancer detection rate of 5.83 per 1000 women screened; 70.2% of the cancers detected had either no mass or the lesions were smaller than 2 cm. The mean age of women with cancer was 50.4 (SD 7.6) years. The screening parameters of our study correlated well with international standards. Despite the controversies regarding universal breast cancer screening, a national breast cancer screening programme for Saudi Arabia is needed.

  10. Breast Cancer Prevention

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Prevention (PDQ®)–Patient Version What is prevention? Go ... from starting. Risk-reducing surgery . General Information About Breast Cancer Key Points Breast cancer is a disease in ...

  11. Breast Cancer Screening for Average-Risk Women: Recommendations From the ACR Commission on Breast Imaging.

    Science.gov (United States)

    Monticciolo, Debra L; Newell, Mary S; Hendrick, R Edward; Helvie, Mark A; Moy, Linda; Monsees, Barbara; Kopans, Daniel B; Eby, Peter R; Sickles, Edward A

    2017-09-01

    Breast cancer is the most common non-skin cancer and the second leading cause of cancer death for women in the United States. Before the introduction of widespread mammographic screening in the mid-1980s, the death rate from breast cancer in the US had remained unchanged for more than 4 decades. Since 1990, the death rate has declined by at least 38%. Much of this change is attributed to early detection with mammography. ACR breast cancer screening experts have reviewed data from RCTs, observational studies, US screening data, and other peer-reviewed literature to update our recommendations. Mammography screening has consistently been shown to significantly reduce breast cancer mortality over a variety of study designs. The ACR recommends annual mammography screening starting at age 40 for women of average risk of developing breast cancer. Our recommendation is based on maximizing proven benefits, which include a substantial reduction in breast cancer mortality afforded by regular screening and improved treatment options for those diagnosed with breast cancer. The risks associated with mammography screening are also considered to assist women in making an informed choice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Breast cancer screening with tomosynthesis--initial experiences.

    Science.gov (United States)

    Tingberg, A; Förnvik, D; Mattsson, S; Svahn, T; Timberg, P; Zackrisson, S

    2011-09-01

    Experiences gained so far using tomosynthesis for breast cancer screening will be reported. A short summary of results from preparatory studies will also be presented. The sensitivity and specificity of breast tomosynthesis (BT) will be compared with conventional two-dimensional digital mammography (DM) for breast cancer screening in a population-based study. Over 2000 women have been examined so far with BT and DM. The BT reading is significantly more time-consuming than the DM reading. Preparatory studies have shown that BT has a higher diagnostic precision and higher accuracy of size measurements and stage determination than DM. There is potential to use lower compression force with BT compared with DM, without decreasing the diagnostic accuracy. BT might play an important role in clinical as well as screening mammography. A large-scale population-based study to investigate BT as a screening modality is underway.

  13. Predictors of competing mortality to invasive breast cancer incidence in the Canadian National Breast Screening study

    Directory of Open Access Journals (Sweden)

    Taghipour Sharareh

    2012-07-01

    Full Text Available Abstract Background Evaluating the cost-effectiveness of breast cancer screening requires estimates of the absolute risk of breast cancer, which is modified by various risk factors. Breast cancer incidence, and thus mortality, is altered by the occurrence of competing events. More accurate estimates of competing risks should improve the estimation of absolute risk of breast cancer and benefit from breast cancer screening, leading to more effective preventive, diagnostic, and treatment policies. We have previously described the effect of breast cancer risk factors on breast cancer incidence in the presence of competing risks. In this study, we investigate the association of the same risk factors with mortality as a competing event with breast cancer incidence. Methods We use data from the Canadian National Breast Screening Study, consisting of two randomized controlled trials, which included data on 39 risk factors for breast cancer. The participants were followed up for the incidence of breast cancer and mortality due to breast cancer and other causes. We stratified all-cause mortality into death from other types of cancer and death from non-cancer causes. We conducted separate analyses for cause-specific mortalities. Results We found that “age at entry” is a significant factor for all-cause mortality, and cancer-specific and non-cancer mortality. “Menstruation length” and “number of live births” are significant factors for all-cause mortality, and cancer-specific mortality. “Ever noted lumps in right/left breasts” is a factor associated with all-cause mortality, and non-cancer mortality. Conclusions For proper estimation of absolute risk of the main event of interest common risk factors associated with competing events should be identified and considered.

  14. Life expectancy of screen-detected invasive breast cancer patients compared with women invited to the Nijmegen Screening Program

    NARCIS (Netherlands)

    J.D.M. Otten; M.J.M. Broeders (Mireille); G.J. den Heeten (Gerard); R. Holland (Roland); J. Fracheboud (Jacques); H.J. de Koning (Harry); A.L.M. Verbeek (Andre)

    2010-01-01

    textabstractBACKGROUND: Screening can lead to earlier detection of breast cancer and thus to an improvement in survival. The authors studied the life expectancy of women with screen-detected invasive breast cancer (patients) compared with women invited to the breast cancer screening program in

  15. Life expectancy of screen-detected invasive breast cancer patients compared with women invited to the Nijmegen screening program

    NARCIS (Netherlands)

    Otten, Johannes D. M.; Broeders, Mireille J. M.; den Heeten, Gerard J.; Holland, Roland; Fracheboud, Jacques; de Koning, Harry J.; Verbeek, André L. M.

    2010-01-01

    BACKGROUND:: Screening can lead to earlier detection of breast cancer and thus to an improvement in survival. The authors studied the life expectancy of women with screen-detected invasive breast cancer (patients) compared with women invited to the breast cancer screening program in Nijmegen, the

  16. Breast cancer screening effect across breast density strata: A case-control study.

    Science.gov (United States)

    van der Waal, Daniëlle; Ripping, Theodora M; Verbeek, André L M; Broeders, Mireille J M

    2017-01-01

    Breast cancer screening is known to reduce breast cancer mortality. A high breast density may affect this reduction. We assessed the effect of screening on breast cancer mortality in women with dense and fatty breasts separately. Analyses were performed within the Nijmegen (Dutch) screening programme (1975-2008), which invites women (aged 50-74 years) biennially. Performance measures were determined. Furthermore, a case-control study was performed for women having dense and women having fatty breasts. Breast density was assessed visually with a dichotomized Wolfe scale. Breast density data were available for cases. The prevalence of dense breasts among controls was estimated with age-specific rates from the general population. Sensitivity analyses were performed on these estimates. Screening performance was better in the fatty than in the dense group (sensitivity 75.7% vs 57.8%). The mortality reduction appeared to be smaller for women with dense breasts, with an odds ratio (OR) of 0.87 (95% CI 0.52-1.45) in the dense and 0.59 (95% CI 0.44-0.79) in the fatty group. We can conclude that high density results in lower screening performance and appears to be associated with a smaller mortality reduction. Breast density is thus a likely candidate for risk-stratified screening. More research is needed on the association between density and screening harms. © 2016 UICC.

  17. [Population-based breast cancer screening is not worthwhile. Screening has little effect on mortality].

    Science.gov (United States)

    Bonneux, Luc G A; Autier, Philippe

    2011-01-01

    Comparison of breast cancer mortality between pairs of similar countries (Sweden and Norway, Northern Ireland and the Irish Republic, the Netherlands and Belgium or Flanders), each of which had implemented its population-wide breast cancer screening programme at a different point in time, demonstrated little effect of screening on mortality. In the Netherlands, a well-organised population-wide screening programme was started in the early nineties, ten years before such a programme was introduced in Flanders. We used the 1989-1992 period as a baseline and compared breast cancer mortality in the Netherlands with that in Flanders during the 2005-2008 period. The added value of organised screening was low: 11% in the target age group of 55-79 years, or 180 prevented breast-cancer deaths annually. A total of 5000 screening mammograms were needed to prevent one death from breast cancer. Breast cancer screening is not a public health priority. Impartial and transparent information on the disadvantages and benefits of breast cancer screening is urgently needed.

  18. The benefits and harms of screening for cancer with a focus on breast screening

    DEFF Research Database (Denmark)

    Brodersen, John; Juhl Jørgensen, Karsten; Gøtzsche, Peter C.

    2010-01-01

    . The effects of routine clinical breast examination are unknown, but considering the results of the breast self-examination trials, it is likely that it is harmful. The effects of screening for breast cancer with thermography, ultrasound or magnetic resonance imaging are unknown. It is not clear whether......The balance between benefits and harms is delicate for cancer screening programs. By attending screening with mammography some women will avoid dying from breast cancer or receive less aggressive treatment. But many more women will be overdiagnosed, receive needless treatment, have a false...... and will be treated unnecessarily. Furthermore, more than 200 women will experience substantial psychosocial distress for months because of false-positive findings. Regular breast self-examination does not reduce breast cancer mortality, but doubles the number of biopsies, and it therefore cannot be recommended...

  19. Breast-Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness.

    Science.gov (United States)

    Welch, H Gilbert; Prorok, Philip C; O'Malley, A James; Kramer, Barnett S

    2016-10-13

    The goal of screening mammography is to detect small malignant tumors before they grow large enough to cause symptoms. Effective screening should therefore lead to the detection of a greater number of small tumors, followed by fewer large tumors over time. We used data from the Surveillance, Epidemiology, and End Results (SEER) program, 1975 through 2012, to calculate the tumor-size distribution and size-specific incidence of breast cancer among women 40 years of age or older. We then calculated the size-specific cancer case fatality rate for two time periods: a baseline period before the implementation of widespread screening mammography (1975 through 1979) and a period encompassing the most recent years for which 10 years of follow-up data were available (2000 through 2002). After the advent of screening mammography, the proportion of detected breast tumors that were small (invasive tumors measuring <2 cm or in situ carcinomas) increased from 36% to 68%; the proportion of detected tumors that were large (invasive tumors measuring ≥2 cm) decreased from 64% to 32%. However, this trend was less the result of a substantial decrease in the incidence of large tumors (with 30 fewer cases of cancer observed per 100,000 women in the period after the advent of screening than in the period before screening) and more the result of a substantial increase in the detection of small tumors (with 162 more cases of cancer observed per 100,000 women). Assuming that the underlying disease burden was stable, only 30 of the 162 additional small tumors per 100,000 women that were diagnosed were expected to progress to become large, which implied that the remaining 132 cases of cancer per 100,000 women were overdiagnosed (i.e., cases of cancer were detected on screening that never would have led to clinical symptoms). The potential of screening to lower breast cancer mortality is reflected in the declining incidence of larger tumors. However, with respect to only these large tumors

  20. The benefits and harms of screening for cancer with a focus on breast screening

    DEFF Research Database (Denmark)

    Brodersen, John; Juhl Jørgensen, Karsten; Gøtzsche, Peter C.

    2010-01-01

    . The effects of routine clinical breast examination are unknown, but considering the results of the breast self-examination trials, it is likely that it is harmful. The effects of screening for breast cancer with thermography, ultrasound or magnetic resonance imaging are unknown. It is not clear whether...

  1. Thermography is not a feasible method for breast cancer screening.

    Science.gov (United States)

    Brkljacić, Boris; Miletić, Damir; Sardanelli, Francesco

    2013-06-01

    Breast cancer is a common malignancy causing high mortality in women especially in developed countries. Due to the contribution of mammographic screening and improvements in therapy, the mortality rate from breast cancer has decreased considerably. An imaging-based early detection of breast cancer improves the treatment outcome. Mammography is generally established not only as diagnostic but also as screening tool, while breast ultrasound plays a major role in the diagnostic setting in distinguishing solid lesions from cysts and in guiding tissue sampling. Several indications are established for contrast-enhanced magnetic resonance imaging. Thermography was not validated as a screening tool and the only study performed long ago for evaluating this technology in the screening setting demonstrated very poor results. The conclusion that thermography might be feasible for screening cannot be derived from studies with small sample size, unclear selection of patients, and in which mammography and thermography were not blindly compared as screening modalities. Thermography can not be used to aspirate, biopsy or localize lesions preoperatively since no method so far was described to accurately transpose the thermographic location of the lesion to the mammogram or ultrasound and to surgical specimen. Thermography cannot be proclaimed as a screening method, without any evidence whatsoever.

  2. Breast Cancer Treatment

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  3. Stages of Breast Cancer

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  4. Reasons why patients fail screening in Indian breast cancer trials

    Directory of Open Access Journals (Sweden)

    P Mahajan

    2015-01-01

    Full Text Available Introduction: An increased number of screen failure patients in a clinical trial increases time and cost required for the recruitment. Assessment of reasons for screen failure can help reduce screen failure rates and improve recruitment. Materials and Methods: We collected retrospective data of human epidermal growth factor receptor (HER2 positive Indian breast cancer patients, who failed screening for phase 3 clinical trials and ascertained their reasons for screen failure from screening logs. Statistical comparison was done to ascertain if there are any differences between private and public sites. Results: Of 727 patients screened at 14 sites, 408 (56.1% failed screening. The data on the specific reasons for screen failures was not available at one of the public sites (38 screen failures out of 83 screened patients. Hence, after excluding that site, further analysis is based on 644 patients, of which 370 failed screening. Of these, 296 (80% screen failure patients did not meet selection criteria. The majority -266 were HER2 negative. Among logistical issues, 39 patients had inadequate breast tissue sample. Sixteen patients withdrew their consent at private sites as compared to six at public sites. The difference between private and public sites for the above three reasons was statistically significant. Conclusion: Use of prescreening logs to reduce the number of patients not meeting selection criteria and protocol logistics, and patient counseling to reduce consent withdrawals could be used to reduce screen failure rate.

  5. Simulation models in population breast cancer screening : A systematic review

    NARCIS (Netherlands)

    Koleva-Kolarova, Rositsa G; Zhan, Zhuozhao; Greuter, Marcel J W; Feenstra, Talitha L; De Bock, Geertruida H

    The aim of this review was to critically evaluate published simulation models for breast cancer screening of the general population and provide a direction for future modeling. A systematic literature search was performed to identify simulation models with more than one application. A framework for

  6. Awareness level and attitude towards breast cancer screening ...

    African Journals Online (AJOL)

    This study investigated breast cancer screening practices among female health workers in Esanland, Edo State. The study was descriptive and adopted the survey research design. The participants were 750 females from the five local government areas of Esanland, Edo State. The instrument used was a questionnaire, ...

  7. breast cancer screening in a resource poor country: ultrasound ...

    African Journals Online (AJOL)

    dence rates, due to lack of early detection programmes with late presentation of the disease, inadequate diag- nostic and treatment facilities in the developing coun- tries.3 Early detection improves the outcomes or surviv- al rates of breast cancer, hence screening of asympto- matic, apparently healthy women is very ...

  8. The effects and costs of breast cancer screening

    NARCIS (Netherlands)

    H.J. de Koning (Harry)

    1993-01-01

    textabstractIn 1986, the Dutch Ministry of Welfare, Health and Cultural Affairs asked a research group to investigate the expected effect of breast cancer screening on mortality and possibly morbidity, if implemented in the Netherlands. The research group consisted of members from 3 centres, the

  9. Risk-benefit analysis for mass screening of breast cancer utilizing mammography as a screening test

    Energy Technology Data Exchange (ETDEWEB)

    Iinuma, T.A.; Tateno, Yukio (National Inst. of Radiological Sciences, Chiba (Japan))

    1989-09-01

    Incidence of breast cancers in Japanese women is increasing steadily. Mass screening of breast cancer was started in Japan under auspices of Adult Health Promotion Act of the Japanese Government from 1987. As the first screening method, the palpation of breasts is employed at present, but it is expected to be replaced by the mammography. In this report, the risk-benefit analysis is presented between risk of breast carcinogenesis due to radiation and benefit of mass screening of breast cancer. The benefit of mass screening is taken as the net elongation of average life expectancy of women due to survival from breast cancers. The risk of mammography is taken as the net loss of average life expectancy of women due to breast carcinogenesis. In the latter, the latency time and plateau period of radiation carcinogenesis were taken into consideration in the calculation. The results show that the ages at which the benefit and risk become equal are between 30 and 35 years old when dose equivalent of mammography is between 10 and 20 mSv, that are conventionally used. However, the critical age will be reduced to 20 years old if the dose equivalent becomes 1 mSv. Therefore, it is strongly recommended that a low dose mammographic system should be developed in order to achieve 1 mSv for the mass screening of breast cancer of Japanese women. In author's opinion, this is quite feasible by employing a new digital radiography with imaging plate. (author).

  10. Decision aid for women considering breast cancer screening

    DEFF Research Database (Denmark)

    Pasternack, Iris; Saalasti-Koskinen, Ulla; Mäkelä, Marjukka

    2011-01-01

    relevant content and format for the decision aid for breast cancer screening. Feedback from women was sought for the draft documents. RESULTS: A decision aid attached to the invitation letter for screening was considered the best way to ensure access to information. In addition, tailored letter templates...... for all phases of the screening program, a poster, and a public website were developed. Initial feedback from users (women, professionals, and service providers), was mainly positive. Six months after publishing, the implementation of the decision aid was still incomplete. CONCLUSIONS: Providing balanced...... information for women invited to breast cancer screening is demanding and requires careful planning. Professionals and service providers need to be engaged in the HTA process to ensure proper dissemination and implementation of the information. End user participation is essential in the formulation...

  11. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Alex C [ORNL; Hitt, Austin N [ORNL; Voisin, Sophie [ORNL; Tourassi, Georgia [ORNL

    2013-01-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  12. Family History of Breast Cancer, Breast Density, and Breast Cancer Risk in a U.S. Breast Cancer Screening Population.

    Science.gov (United States)

    Ahern, Thomas P; Sprague, Brian L; Bissell, Michael C S; Miglioretti, Diana L; Buist, Diana S M; Braithwaite, Dejana; Kerlikowske, Karla

    2017-06-01

    Background: The utility of incorporating detailed family history into breast cancer risk prediction hinges on its independent contribution to breast cancer risk. We evaluated associations between detailed family history and breast cancer risk while accounting for breast density.Methods: We followed 222,019 participants ages 35 to 74 in the Breast Cancer Surveillance Consortium, of whom 2,456 developed invasive breast cancer. We calculated standardized breast cancer risks within joint strata of breast density and simple (1st-degree female relative) or detailed (first-degree, second-degree, or first- and second-degree female relative) breast cancer family history. We fit log-binomial models to estimate age-specific breast cancer associations for simple and detailed family history, accounting for breast density.Results: Simple first-degree family history was associated with increased breast cancer risk compared with no first-degree history [Risk ratio (RR), 1.5; 95% confidence interval (CI), 1.0-2.1 at age 40; RR, 1.5; 95% CI, 1.3-1.7 at age 50; RR, 1.4; 95% CI, 1.2-1.6 at age 60; RR, 1.3; 95% CI, 1.1-1.5 at age 70). Breast cancer associations with detailed family history were strongest for women with first- and second-degree family history compared with no history (RR, 1.9; 95% CI, 1.1-3.2 at age 40); this association weakened in higher age groups (RR, 1.2; 95% CI, 0.88-1.5 at age 70). Associations did not change substantially when adjusted for breast density.Conclusions: Even with adjustment for breast density, a history of breast cancer in both first- and second-degree relatives is more strongly associated with breast cancer than simple first-degree family history.Impact: Future efforts to improve breast cancer risk prediction models should evaluate detailed family history as a risk factor. Cancer Epidemiol Biomarkers Prev; 26(6); 938-44. ©2017 AACR. ©2017 American Association for Cancer Research.

  13. Screening for breast cancer in England: a review.

    Science.gov (United States)

    Hogben, Rosalyn Katy F

    2008-12-01

    This year, the National Health Service Breast Screening Programme in the UK (NHSBSP) celebrates its 20th anniversary. Since 1988, it has evolved with the help of randomized control studies to become more efficient at picking up in-situ disease and small invasive cancers. This review will address these new developments and discuss their impact on screening. The introduction of extra mammographic views, the reading of films by two specialists and digital mammography as well as age extension have all made significant differences to the detection of breast cancer through screening. A discussion of how less obvious factors such as organization and structure as well as rigorous national audit have improved matters is also included. Controversial topics such as the screening interval and screening women under 50 will also be addressed in this review. Population-based breast screening will continue to evolve in England. It is unique and with its annual national audit it continues to drive the development of breast services nationally.

  14. Mammography Screening Among African-American Women with a Family History of Breast Cancer

    National Research Council Canada - National Science Library

    Lipkus, Issac

    1997-01-01

    Comparisons were made between African-American women with and without a family history of breast cancer with respect to mammography screening, attitudes towards mammography screening and perceptions...

  15. The Effect of Telephone Counseling and Education on Breast Cancer Screening in Family Caregivers of Breast Cancer Patients.

    Science.gov (United States)

    Nasiriani, Khadijeh; Motevasselian, Monireh; Farnia, Farahnaz; Shiryazdi, Seyed Mostafa; Khodayarian, Mahsa

    2017-10-01

    Breast cancer is the most common form of malignancy among females. Family history is a key risk factor for breast cancer. Breast cancer screening practices are vital in patients with family history of breast cancer. Telephone counseling and education may be appropriate for improved breast cancer screening. This study was done to determine family caregiver patients' knowledge of risk factors for breast cancer and practice of breast cancer screening and also to assess the effect of telephone counseling and education on mammography screening. This study was a community-based trial. The participants of the study were 90 caregivers who were randomly divided into an experimental group, telephone counseling and education, and a control group. The intervention group received counseling and education phone calls. A three-section questionnaire was responded and filled out through telephone interviews with the participants. The collected data were analyzed with SPSS18, using descriptive and inferential statistics. The results showed that 88.9% of the participants did not know when to do breast self-exam (BSE). Mammography was performed by the participants before and after the telephone counseling in intervention group (Ppatients was low. Telephone counseling and educating may provide a suitable technique for earlier detection of breast cancer in family caregivers of breast cancer patients and it can influence the decision making regarding mammography screening among 40-year-old or older women. Trial Registration Number: 2017052316870N3.

  16. Benefits and Harms of Breast Cancer Screening: A Systematic Review.

    Science.gov (United States)

    Myers, Evan R; Moorman, Patricia; Gierisch, Jennifer M; Havrilesky, Laura J; Grimm, Lars J; Ghate, Sujata; Davidson, Brittany; Mongtomery, Ranee Chatterjee; Crowley, Matthew J; McCrory, Douglas C; Kendrick, Amy; Sanders, Gillian D

    2015-10-20

    Patients need to consider both benefits and harms of breast cancer screening. To systematically synthesize available evidence on the association of mammographic screening and clinical breast examination (CBE) at different ages and intervals with breast cancer mortality, overdiagnosis, false-positive biopsy findings, life expectancy, and quality-adjusted life expectancy. We searched PubMed (to March 6, 2014), CINAHL (to September 10, 2013), and PsycINFO (to September 10, 2013) for systematic reviews, randomized clinical trials (RCTs) (with no limit to publication date), and observational and modeling studies published after January 1, 2000, as well as systematic reviews of all study designs. Included studies (7 reviews, 10 RCTs, 72 observational, 1 modeling) provided evidence on the association between screening with mammography, CBE, or both and prespecified critical outcomes among women at average risk of breast cancer (no known genetic susceptibility, family history, previous breast neoplasia, or chest irradiation). We used summary estimates from existing reviews, supplemented by qualitative synthesis of studies not included in those reviews. Across all ages of women at average risk, pooled estimates of association between mammography screening and mortality reduction after 13 years of follow-up were similar for 3 meta-analyses of clinical trials (UK Independent Panel: relative risk [RR], 0.80 [95% CI, 0.73-0.89]; Canadian Task Force: RR, 0.82 [95% CI, 0.74-0.94]; Cochrane: RR, 0.81 [95% CI, 0.74-0.87]); were greater in a meta-analysis of cohort studies (RR, 0.75 [95% CI, 0.69 to 0.81]); and were comparable in a modeling study (CISNET; median RR equivalent among 7 models, 0.85 [range, 0.77-0.93]). Uncertainty remains about the magnitude of associated mortality reduction in the entire US population, among women 40 to 49 years, and with annual screening compared with biennial screening. There is uncertainty about the magnitude of overdiagnosis associated with

  17. A simple way to measure the burden of interval cancers in breast cancer screening

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Lynge, Elsebeth

    2014-01-01

    BACKGROUND: The sensitivity of a mammography program is normally evaluated by comparing the interval cancer rate to the expected breast cancer incidence without screening, i.e. the proportional interval cancer rate (PICR). The expected breast cancer incidence in absence of screening is, however......, difficult to estimate when a program has been running for some time. As an alternative to the PICR we propose the interval cancer ratio ICR=intervalcancersintervalcancers+screendetectedcancers. We validated this simple measure by comparing it with the traditionally used PICR. METHOD: We undertook...... a systematic review and included studies: 1) covering a service screening program, 2) women aged 50-69 years, 3) observed data, 4) interval cancers, women screened, or interval cancer rate, screen detected cases, or screen detection rate, and 5) estimated breast cancer incidence rate of background population...

  18. Appalachian women's perspectives on breast and cervical cancer screening.

    Science.gov (United States)

    Schoenberg, Nancy E; Kruger, Tina M; Bardach, Shoshana; Howell, Britteny M

    2013-01-01

    Although breast and cervical cancer screening rates have been increasing over the three past decades, many Appalachian women in the USA do not receive screening, leading to disproportionate mortality rates. The aims of this study were to: (1) better understand barriers to and facilitators of breast and cervical cancer screening among Appalachian women; and (2) identify strategies to increase cancer screening. Eight focus groups and 19 key informant interviews were conducted with 79 participants. Tape-recorded session were transcribed and content analyzed. Findings consistent with screening determinants research include: inadequate personal and community resources, attitudinal and knowledge barriers, and competing demands. Less commonly described factors include family cancer history, personal health habits, and the multiple influences of healthcare providers. Interpreting findings in terms of consumer information processing theory, healthcare providers and supports play a key role in educating and influencing the screening uptake among Appalachian Kentucky women. These findings have the potential to inform innovative and culturally consonant intervention approaches capable of increasing screening and decreasing mortality rates.

  19. Mammographic breast density: impact on breast cancer risk and implications for screening.

    Science.gov (United States)

    Freer, Phoebe E

    2015-01-01

    Mammographic breast density is rapidly becoming a hot topic in both the medical literature and the lay press. In the United States, recent legislative changes in 19 states now require radiologists to notify patients regarding breast density as well as the possible need for supplemental screening. Federal legislation regarding breast density notification has been introduced, and its passage is likely on the horizon. An understanding of the context, scientific evidence, and controversies surrounding the topic of breast density as a risk factor for breast cancer is critical for radiologists. The current state of evidence is presented regarding supplemental screening for women with dense breasts, including the use of digital breast tomosynthesis, whole-breast ultrasonography, and gadolinium-enhanced magnetic resonance imaging. A review of current practice guidelines and additional sources of information will improve radiologists' understanding of the relevant subject of breast density and enable them to respond appropriately to questions from patients, clinicians, and the media. (©)RSNA, 2015.

  20. Breast cancer screening: Evidence of the effect of adjunct ultrasound screening in women with unilateral mammography-negative dense breasts

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2015-01-01

    Full Text Available Background: Patients with the previous history of breast cancer are in risk of contralateral breast cancer. On the other hand, increased breast density is a risk factor for breast cancer and the sensitivity of detecting nonpalpable cancers in screening mammography in radiographically dense breasts is low. The use of ultrasonography in dense breast remains a controversial topic. The purpose of this study was to assess the usefulness of routine ultrasonography in follow-up of women with the previous history of breast cancer and negative mammography but dense breasts. Materials and Methods: In a cross-sectional study, a total of 267 individuals with unilateral postmastectomy mammogram screened and 153 subjects assigned to study. There were 28 subjects with American College of Radiology (ACR breast density 2 and 125 with ACR breast density 3-4, which there was no new finding in their mammogram in comparison to previous studies. We assumed subjects with ACR breast density 3-4 as mammographic Breast Imaging Reporting and Data System (BI-RADS category 0 for malignancy. Standard two-view mammogram was performed for all participants, and breast ultrasound (US examinations were performed by an expert radiologist in radial and anti-radial planes. The data were analyzed using SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA. Results: The results showed that in subjects with ACR breast density 3-4, when there was no new density in two consecutive mammograms in comparison to previous studies, US also showed no possibility for malignancy (BI-RADS 1-2. And also in subjects with ACR breast density 2, when the mammographic results were BI-RADS 1-2, the US results was the same. Conclusion: Our data indicate that for the detection of breast cancer, sensitivity of US was not greater than mammography in patients with postmastectomy unilateral dense breast if there is not any new density.

  1. Breast cancer screening: Evidence of the effect of adjunct ultrasound screening in women with unilateral mammography-negative dense breasts.

    Science.gov (United States)

    Adibi, Atoosa; Golshahi, Maryam; Sirus, Mehri; Kazemi, Kimia

    2015-03-01

    Patients with the previous history of breast cancer are in risk of contralateral breast cancer. On the other hand, increased breast density is a risk factor for breast cancer and the sensitivity of detecting nonpalpable cancers in screening mammography in radiographically dense breasts is low. The use of ultrasonography in dense breast remains a controversial topic. The purpose of this study was to assess the usefulness of routine ultrasonography in follow-up of women with the previous history of breast cancer and negative mammography but dense breasts. In a cross-sectional study, a total of 267 individuals with unilateral postmastectomy mammogram screened and 153 subjects assigned to study. There were 28 subjects with American College of Radiology (ACR) breast density 2 and 125 with ACR breast density 3-4, which there was no new finding in their mammogram in comparison to previous studies. We assumed subjects with ACR breast density 3-4 as mammographic Breast Imaging Reporting and Data System (BI-RADS) category 0 for malignancy. Standard two-view mammogram was performed for all participants, and breast ultrasound (US) examinations were performed by an expert radiologist in radial and anti-radial planes. The data were analyzed using SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA). The results showed that in subjects with ACR breast density 3-4, when there was no new density in two consecutive mammograms in comparison to previous studies, US also showed no possibility for malignancy (BI-RADS 1-2). And also in subjects with ACR breast density 2, when the mammographic results were BI-RADS 1-2, the US results was the same. Our data indicate that for the detection of breast cancer, sensitivity of US was not greater than mammography in patients with postmastectomy unilateral dense breast if there is not any new density.

  2. Will supplemental screening ultrasound increase breast cancer overdiagnosis?

    Science.gov (United States)

    Molleran, Virginia M

    2015-08-01

    Overdiagnosis refers to the detection of cancers that would never come to light in a patient's lifetime and are only identified by means of screening. Exactly how much overdiagnosis currently exists with screening mammography is uncertain. Because we do not know for certain which tumors would ultimately lead to death if left untreated and which would not, we cannot directly measure overdiagnosis and how best to estimate it is a matter of controversy. A conservative estimate of overdiagnosis with mammography would be on the order of 10%, but estimates have ranged as high as 54%. We know from multiple studies that ultrasound (US) screening mostly detects small, invasive, node-negative cancers; and in the ACRIN 6666 study, there was a greater tendency for US-only-detected tumors to be low grade than those detected with mammography. However, the population of patients undergoing screening US can be expected to differ from the average screening mammography population in that they will have higher breast density, they will be younger, and they may also have higher breast cancer risk than the population undergoing screening mammography. These factors may be associated with more aggressive tumors. There is no way to know whether we will be increasing overdiagnosis without performing a large randomized controlled study with very long-term follow-up. Even if some cancers are overdiagnosed with US, there will be a greater proportion of lethal breast cancers that are successfully treated because of screening US. The more important task is to learn how to correctly diagnose and appropriately treat nonlethal cancers. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  3. The association between general practitioners’ attitudes towards breast cancer screening and women’s screening participation

    Directory of Open Access Journals (Sweden)

    Jensen Line

    2012-06-01

    Full Text Available Abstract Background Breast cancer screening in Denmark is organised by the health services in the five regions. Although general practitioners (GPs are not directly involved in the screening process, they are often the first point of contact to the health care system and thus play an important advisory role. No previous studies, in a health care setting like the Danish system, have investigated the association between GPs’ attitudes towards breast cancer screening and women’s participation in the screening programme. Methods Data on women’s screening participation was obtained from the regional screening authorities. Data on GPs’ attitudes towards breast cancer screening was taken from a previous survey among GPs in the Central Denmark Region. This study included women aged 50-69 years who were registered with a singlehanded GP who had participated in the survey. Results The survey involved 67 singlehanded GPs with a total of 13,288 women on their lists. Five GPs (7% had a negative attitude towards breast cancer screening. Among registered women, 81% participated in the first screening round. Multivariate analyses revealed that women registered with a GP with a negative attitude towards breast cancer screening were 17% (95% CI: 2-34% more likely to be non-participants compared with women registered with a GP with a positive attitude towards breast cancer screening. Conclusion The GPs' attitudes may influence the participation rate even in a system where GPs are not directly involved in the screening process. However, further studies are needed to investigate this association.

  4. Improving Breast Cancer Outcomes among Women in China: Practices, Knowledge, and Attitudes Related to Breast Cancer Screening

    OpenAIRE

    Tsu-Yin Wu; Yi-Lan Liu; Scott Chung

    2012-01-01

    Background. Breast cancer is a major public health issue and the most commonly diagnosed cancer for women worldwide. Despite lower incidence rates than those living in Western countries, breast cancer incidence among Chinese women has increased dramatically in the past 20 years. Nevertheless, there is a paucity of studies reporting the attitudes toward and practices of breast cancer screening among Chinese women. Methods. This cross-sectional study examined the practices, knowledge, and attit...

  5. Sociodemographic gradients in breast and cervical cancer screening in Korea: the Korean National Cancer Screening Survey (KNCSS) 2005-2009.

    Science.gov (United States)

    Park, Mi Jin; Park, Eun-Cheol; Choi, Kui Son; Jun, Jae Kwan; Lee, Hoo-Yeon

    2011-06-17

    Cancer screening rates in Korea for five cancer types have increased steadily since 2002. With regard to the life-time cancer screening rates in 2009 according to cancer sites, the second highest was breast cancer (78.1%) and the third highest was cervical cancer (76.1%). Despite overall increases in the screening rate, disparities in breast and cervical cancer screening, based on sociodemographic characteristics, still exist. Data from 4,139 women aged 40 to 74 years from the 2005 to 2009 Korea National Cancer Screening Survey were used to analyze the relationship between sociodemographic characteristics and receiving mammograms and Pap smears. The main outcome measures were ever having had a mammogram and ever having had a Pap smear. Using these items of information, we classified women into those who had had both types of screening, only one screening type, and neither screening type. We used logistic regression to investigate relationships between screening history and sociodemographic characteristics of the women. Being married, having a higher education, a rural residence, and private health insurance were significantly associated with higher rates of breast and cervical cancer screening after adjusting for age and sociodemographic factors. Household income was not significantly associated with mammograms or Pap smears after adjusting for age and sociodemographic factors. Disparities in breast and cervical cancer screening associated with low sociodemographic status persist in Korea.

  6. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

    NARCIS (Netherlands)

    J. Fracheboud (Jacques); S.J. Otto (Suzie); J.A.A.M. van Dijck; M.J.M. Broeders (Mireille); A.L.M. Verbeek (Andre); H.J. de Koning (Harry)

    2004-01-01

    textabstractThe effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The

  7. Overdiagnosis by mammographic screening for breast cancer studied in birth cohorts in The Netherlands

    NARCIS (Netherlands)

    Ripping, T.M.; Verbeek, A.L.; Fracheboud, J.; Koning, H.J. de; Ravesteyn, N.T. van; Broeders, M.J.

    2015-01-01

    A drawback of early detection of breast cancer through mammographic screening is the diagnosis of breast cancers that would never have become clinically detected. This phenomenon, called overdiagnosis, is ideally quantified from the breast cancer incidence of screened and unscreened cohorts of women

  8. The Effect of Telephone Counseling and Education on Breast Cancer Screening in Family Caregivers of Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Khadijeh Nasiriani

    2017-10-01

    Full Text Available Background: Breast cancer is the most common form of malignancy among females. Family history is a key risk factor for breast cancer. Breast cancer screening practices are vital in patients with family history of breast cancer. Telephone counseling and education may be appropriate for improved breast cancer screening. This study was done to determine family caregiver patients’ knowledge of risk factors for breast cancer and practice of breast cancer screening and also to assess the effect of telephone counseling and education on mammography screening. Methods: This study was a community-based trial. The participants of the study were 90 caregivers who were randomly divided into an experimental group, telephone counseling and education, and a control group. The intervention group received counseling and education phone calls. A three-section questionnaire was responded and filled out through telephone interviews with the participants. The collected data were analyzed with SPSS18, using descriptive and inferential statistics. Results: The results showed that 88.9% of the participants did not know when to do breast self-exam (BSE. Mammography was performed by the participants before and after the telephone counseling in intervention group (P<0.00, which were 13.3% and 77.8% respectively. Moreover, the major cause of failure to participate in mammography was lack of enough knowledge in 73.3% of the participants. Conclusion: This study concluded that knowledge and practice on breast cancer screening in family caregiver of breast cancer patients was low. Telephone counseling and educating may provide a suitable technique for earlier detection of breast cancer in family caregivers of breast cancer patients and it can influence the decision making regarding mammography screening among 40-year-old or older women. Trial Registration Number: 2017052316870N3

  9. Artificial intelligence for breast cancer screening: Opportunity or hype?

    Science.gov (United States)

    Houssami, Nehmat; Lee, Christoph I; Buist, Diana S M; Tao, Dacheng

    2017-12-01

    Interpretation of mammography for breast cancer (BC) screening can confer a mortality benefit through early BC detection, can miss a cancer that is present or fast growing, or can result in false-positives. Efforts to improve screening outcomes have mostly focused on intensifying imaging practices (double instead of single-reading, more frequent screens, or supplemental imaging) that may add substantial resource expenditures and harms associated with population screening. Less attention has been given to making mammography screening practice 'smarter' or more efficient. Artificial intelligence (AI) is capable of advanced learning using large complex datasets and has the potential to perform tasks such as image interpretation. With both highly-specific capabilities, and also possible un-intended (and poorly understood) consequences, this viewpoint considers the promise and current reality of AI in BC detection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Trends in surgery for screen-detected and interval breast cancers in a national screening programme.

    Science.gov (United States)

    Nederend, J; Duijm, L E M; Louwman, M W J; Roumen, R M H; Jansen, F H; Voogd, A C

    2014-07-01

    This population-based study aimed to evaluate trends in surgical approach for screen-detected cancer versus interval breast cancer, and to determine the factors associated with positive resection margins. Screening mammograms of women aged 50-75 years, who underwent biennial screening in a Dutch breast-screening region between 1997 and 2011, were included. Patient and tumour characteristics were compared between women who underwent mastectomy or breast-conserving surgery (BCS) for screen-detected or interval cancer, and women with a negative or positive resection margin after BCS. Some 417,013 consecutive screening mammograms were included. A total of 2224 screen-detected and 825 interval cancers were diagnosed. The BCS rate remained stable (mean 6.1 per 1000 screened women; P = 0.099), whereas mastectomy rates increased significantly during the study from 0.9 (1997-1998) to 1.9 (2009-2010) per 1000 screened women (P breasts, preoperative magnetic resonance imaging, microcalcifications, architectural distortion, tumour size over 20 mm, axillary lymph node metastasis and treating hospital were independent risk factors for mastectomy. Interval cancer, image-guided tumour localization, microcalcifications, breast parenchyma asymmetry, tumour size greater than 20 mm, lobular tumour histology, low tumour grade, extensive invasive component and treating hospital were independent risk factors for positive resection margins. Mastectomy rates doubled during a 14-year period of screening mammography and the proportion of positive resection margins decreased, with variation among hospitals. The latter observation stresses the importance of quality control programmes for hospitals treating women with breast cancer. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  11. Benefit-to-harm ratio of the Danish breast cancer screening programme

    DEFF Research Database (Denmark)

    Beau, Anna-Belle; Lynge, Elsebeth; Njor, Sisse Helle

    2017-01-01

    The primary aim of breast cancer screening is to reduce breast cancer mortality, but screening also has negative side-effects as overdiagnosis. To evaluate a screening programme, both benefits and harms should be considered. Published estimates of the benefit-to-harm ratio, the number of breast...... cancer deaths prevented divided by the number of overdiagnosed breast cancer cases, varied considerably. The objective of the study was to estimate the benefit-to-harm ratio of breast cancer screening in Denmark. The numbers of breast cancer deaths prevented and overdiagnosed cases [invasive and ductal...... carcinoma in situ (DCIS)] were estimated per 1,000 women aged 50-79, using national published estimates for breast cancer mortality and overdiagnosis, and national incidence and mortality rates. Estimations were made for both invited and screened women. Among 1,000 women invited to screening from age 50...

  12. Beliefs related to breast cancer and breast cancer screening among Lebanese Armenian women.

    Science.gov (United States)

    Arevian, Mary; Noureddine, Samar; Abboud, Sarah

    2011-11-01

    Our purpose of this article was to investigate women's beliefs about breast cancer, breast cancer screening, and intervention programs. We designed the study using a cross-sectional/descriptive correlation. The participants were drawn from a convenience sample (N=94). The instrument included Champion's Revised Health Belief Model Scale (CHBMS). Analysis was performed using SPSS (2005), 15.0. More than sixty-four percent (64.8%) of women surveyed were over 41. Results showed that 80.9% of women surveyed had heard of breast self-exams (BSEs), while 76.6% had heard of mammography. However, 53.2% never practiced breast self-examinations, and 79.6% never underwent mammography. Mean belief scores follow: low susceptibility (14.32), barriers to BSE (15.24), barriers to mammography (14.85), high seriousness (23.42), benefits to breast self-examination (22.7), confidence (36.45), health motivation (27.27), and benefits to mammography (24.28). Significant relationships included the relationship between barriers to breast self-examination and whether women had heard about breast self-examinations (p=.02); the relationship between susceptibility and whether women had heard of or underwent mammography (p=.027); the relationship between confidence and whether women had heard of mammography (p=.056); the relationship between confidence and perceived financial status (p=.05); and benefits of mammography (p=.05). Appropriate interventions are developed.

  13. Breast cancer and breast screening: perceptions of Chinese migrant women living in New Zealand

    Directory of Open Access Journals (Sweden)

    Zhang W

    2014-06-01

    Full Text Available INTRODUCTION: Migrant Chinese constitute a significant and increasing proportion of New Zealand women. They have lower rates of participation in breast cancer screening than other New Zealanders, but reasons for this are unknown. The aim of this study was to investigate factors affecting Chinese women’s understanding of, and access to, breast health services, to better understand reasons for low participation in screening and their experiences of breast cancer clinic care. METHODS: The participants were 26 Chinese migrant women—19 recruited in the community and seven recruited from 17 eligible women attending a breast clinic between 2008 and 2010 in Wellington, New Zealand. The design was that of a qualitative study, using semi-structured interviews and thematic content analysis. FINDINGS: There were low levels of awareness about the national breast screening programme and limited engagement with preventive primary care services. Concerns about privacy and a range of communication difficulties were identified that related to oral language, lack of written information in Chinese, and limited understanding about Chinese perceptions of ill health and traditional Chinese medicine by New Zealand health professionals. CONCLUSION: Addressing communication barriers for Chinese migrant women has the potential to raise awareness about breast cancer and breast health, and to increase successful participation in breast cancer screening. Greater efforts are needed to ensure this group has an understanding of, and is engaged with a primary care provider. Such efforts are key to improving health for this growing sector of the New Zealand population.

  14. Breast cancer and breast screening: perceptions of Chinese migrant women living in New Zealand.

    Science.gov (United States)

    Zhang, Wei; Rose, Sally B; Foster, Alison; Pullon, Sue; Lawton, Beverley

    2014-06-01

    Migrant Chinese constitute a significant and increasing proportion of New Zealand women. They have lower rates of participation in breast cancer screening than other New Zealanders, but reasons for this are unknown. The aim of this study was to investigate factors affecting Chinese women's understanding of, and access to, breast health services, to better understand reasons for low participation in screening and their experiences of breast cancer clinic care. The participants were 26 Chinese migrant women-19 recruited in the community and seven recruited from 17 eligible women attending a breast clinic between 2008 and 2010 in Wellington, New Zealand. The design was that of a qualitative study, using semi-structured interviews and thematic content analysis. There were low levels of awareness about the national breast screening programme and limited engagement with preventive primary care services. Concerns about privacy and a range of communication difficulties were identified that related to oral language, lack of written information in Chinese, and limited understanding about Chinese perceptions of ill health and traditional Chinese medicine by New Zealand health professionals. Addressing communication barriers for Chinese migrant women has the potential to raise awareness about breast cancer and breast health, and to increase successful participation in breast cancer screening. Greater efforts are needed to ensure this group has an understanding of, and is engaged with a primary care provider. Such efforts are key to improving health for this growing sector of the New Zealand population.

  15. Breast cancer screening, outside the population-screening program, of women from breast cancer families without proven BRCA1/BRCA2 mutations : a simulation study

    NARCIS (Netherlands)

    Jacobi, C.E.; Nagelkerke, N.J.D.; van Houwelingen, J.C.; de Bock, G.H.

    Purpose: We assessed the cost-effectiveness of mammography screening for women under the age of 50, from breast cancer families without proven BRCA1./BRCA2 mutations, because current criteria for screening healthy women from breast cancer families are not evidence-based. Methods: We did simulation

  16. Breast cancer screening, outside the population-screening program, of women from breast cancer families without proven BRCA1/BRCA2 mutations: a simulation study

    NARCIS (Netherlands)

    Jacobi, C.E.; Nagelkerke, N.J.D.; van Houwelingen, J.C.; de Bock, Truuske

    2006-01-01

    Purpose: We assessed the cost-effectiveness of mammography screening for women under the age of 50, from breast cancer families without proven BRCA1./BRCA2 mutations, because current criteria for screening healthy women from breast cancer families are not evidence-based. Methods: We did simulation

  17. Breast cancer screening implementation and reassurance

    DEFF Research Database (Denmark)

    Østerø, J; Siersma, Volkert Dirk; Brodersen, John

    2013-01-01

    with the previous survey. CONCLUSION: An implementation of a screening mammography programme provides reassurance for those women invited to the screening. This reassurance is in contrast to the unbalanced proportion between the intended benefits and the unintended harms of the screening programme.......BACKGROUND: Women not offered screening mammography reported higher levels of negative psychosocial aspects than women offered screening. This was demonstrated in a questionnaire survey where 1000 women were included: 500 women living in areas where the public authorities had never offered...... screening mammography and 500 women living in areas where women had been invited to screening mammography for >10 years. After this baseline survey, nationwide screening mammography was implemented. The aim of this follow-up study was to resurvey the 1000 women and to investigate if the identified...

  18. Value of audits in breast cancer screening quality assurance programmes.

    Science.gov (United States)

    Geertse, Tanya D; Holland, Roland; Timmers, Janine M H; Paap, Ellen; Pijnappel, Ruud M; Broeders, Mireille J M; den Heeten, Gerard J

    2015-11-01

    Our aim was to retrospectively evaluate the results of all audits performed in the past and to assess their value in the quality assurance of the Dutch breast cancer screening programme. The audit team of the Dutch Reference Centre for Screening (LRCB) conducts triennial audits of all 17 reading units. During audits, screening outcomes like recall rates and detection rates are assessed and a radiological review is performed. This study investigates and compares the results of four audit series: 1996-2000, 2001-2005, 2003-2007 and 2010-2013. The analysis shows increased recall rates (from 0.66%, 1.07%, 1.22% to 1.58%), increased detection rates (from 3.3, 4.5, 4.8 to 5.4 per 1000) and increased sensitivity (from 64.5%, 68.7%, 70.5% to 71.6%), over the four audit series. The percentage of 'missed cancers' among interval cancers and advanced screen-detected cancers did not change (p = 0.4). Our audits not only provide an opportunity for assessing screening outcomes, but also provide moments of self-reflection with peers. For radiologists, an accurate understanding of their performance is essential to identify points of improvement. We therefore recommend a radiological review of screening examinations and immediate feedback as part of an audit. • Radiological review and immediate feedback are recommended as part of an audit. • For breast screening radiologists, audits provide moments of self-reflection with peers. • Radiological review of screening examinations provides insights in recall behaviour. • Accurate understanding of radiologists' performance is essential to identify points of improvement.

  19. Breast cancer screening: comparison of radiologists' performance in a self-assessment scheme and in actual breast screening

    Science.gov (United States)

    Cowley, Helen C.; Gale, Alastair G.

    1999-05-01

    The PERFORMS self-assessment scheme is used by the UK Breast Screening Programme as an educational tool. From this scheme a radiologist can gain insight into their own sensitivity, specificity, feature and cancer detection performance. Such data may, however, be questionable if they are not well related to the radiologist's performance in actual breast screening. Consequently, data from the scheme were compared with those from actual breast screening performance. Some correlations were found in performance, this indicates that continued use of the scheme is important to identify any areas of individual difficulty.

  20. Cancer Screening

    OpenAIRE

    Krishna Prasad

    2004-01-01

    Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  1. [Attendance in the Norwegian Breast Cancer Screening Programme].

    Science.gov (United States)

    Sebuødegård, Sofie; Sagstad, Silje; Hofvind, Solveig

    2016-09-01

    A high rate of attendance among women invited to the Norwegian Breast Cancer Screening Programme (NBCSP) is essential to achieve optimal effect, including reduction in breast cancer mortality. This article describes attendance in the programme by county, period and women’s age at invitation. All women in the age group 50 – 69 years who are registered in the National Population Register are invited to attend the NBCSP every second year. In the study period 2007 – 2014, 2 142 369 invitations were sent, and 1 600 293 screening examinations were performed for 710 169 women. Use of the data is pursuant to the Cancer Registry Regulations. Altogether 84 % of the women invited attended at least once in the study period. The average attendance rate per screening round was 75 %. In Rogaland, Nordland and Sogn og Fjordane counties more than 80 % attended, while in Oslo the figure was 62 %. The highest rate of attendance recorded was for women in the age group 62 – 67 years. The attendance in the prior screening round was of influence for reattendance. The mammography screening programme has a high level of acceptance among women in the target group. Possible reasons for the variation in attendance among the county districts should be identified.

  2. Attending the breast screening programme after breast cancer treatment: a population-based study.

    Science.gov (United States)

    de Munck, Linda; Kwast, Annemiek; Reiding, Dick; de Bock, Geertruida H; Otter, Renée; Willemse, Pax H B; Siesling, Sabine

    2013-12-01

    In the Netherlands, breast cancer patients are treated and followed at least 5 years after diagnosis. Furthermore, all women aged 50-74 are invited biennially for mammography by the nationwide screening programme. The relation between the outpatient follow-up (follow-up visits in the outpatient clinic for 5 years after treatment) and the screening programme is not well established and attending the screening programme as well as outpatient follow-up is considered undesirable. This study evaluates potential factors influencing women to attend the screening programme during their outpatient follow-up (overlap) and the (re-)attendance to the screening programme after 5 years of outpatient follow-up. Data of breast cancer patients aged 50-74 years, treated for primary breast cancer between 1996 and 2007 were selected from the Netherlands Cancer Registry and linked to the National Breast Cancer Screening Programme in the Northern region. Cox regression analyses were used to study women (re-)attending the screening programme over time, possible overlap with the outpatient follow-up and factors influencing this. In total 11227 breast cancer patients were included, of whom 19% attended the screening programme after breast cancer treatment, 4.4% within 5 years and 15.4% after more than 5 years. Factors that independently influenced attendance within 5 years as well as more than 5 years after treatment were: interval tumours (HR 0.77; 95%CI 0.61-0.97 and HR 0.69; 95%CI 0.53-0.88, ref: screen-detected tumours), receiving adjuvant radiotherapy (HR 0.65; 95%CI 0.47-0.90 and HR 0.66; 95%CI 0.47-0.93; ref: none) and diagnosis of in situ tumours (HR 1.67; 95%CI 1.25-2.23 and HR 1.39; 95%CI 1.05-1.85; ref: stage I tumours). Non-screen related tumours (HR 0.41; 95%CI 0.29-0.58) and recent diagnosis (HR 0.89 per year; 95%CI 0.86-0.92) were only associated with attendance within 5 years after treatment. The interrelation between outpatient follow-up and screening should be improved to

  3. The Effect of California's Breast Density Notification Legislation on Breast Cancer Screening.

    Science.gov (United States)

    Chau, Stephanie Lynn; Alabaster, Amy; Luikart, Karin; Brenman, Leslie Manace; Habel, Laurel A

    2017-04-01

    Half of US states mandate women be notified if they have dense breasts on their mammogram, yet guidelines and data on supplemental screening modalities are limited. Breast density (BD) refers to the extent that breast tissue appears radiographically dense on mammograms. High BD reduces the sensitivity of screening mammography and increases breast cancer risk. The aim of this study was to determine the potential impact of California's 2013 BD notification legislation on breast cancer screening patterns. We conducted a cohort study of women aged 40 to 74 years who were members of a large Northern California integrated health plan (approximately 3.9 million members) in 2011-2015. We calculated pre- and post-legislation rates of screening mammography and magnetic resonance imaging (MRI). We also examined whether women with dense breasts (defined as BI-RADS density c or d) had higher MRI rates than women with nondense breasts (defined as BI-RADS density a or b). After adjustment for race/ethnicity, age, body mass index, medical facility, neighborhood median income, and cancer history, there was a relative 6.6% decrease (relative risk [RR] 0.934, confidence interval [CI] 0.92-0.95) in the rate of screening mammography, largely driven by a decrease among women breasts (BI-RADS d) had 2.77 times (CI 1.93-3.95) the odds of a MRI within 9 months of a screening mammogram compared with women with nondense breasts (BI-RADS b). In this setting, MRI rates increased in the postlegislation period. In addition, women with higher BD were more likely to have supplementary MRI. The decrease in mammography rates seen primarily among younger women may have been due to changes in national screening guidelines.

  4. Scarce information about breast cancer screening: An Italian websites analysis.

    Science.gov (United States)

    Attena, Francesco; Cancellieri, Mariagrazia; Pelullo, Concetta Paola

    2016-12-01

    Although the public should have complete and correct information about risk/benefit ratio of breast cancer screening, public knowledge appears generally scarce and oriented to overestimate benefits, with little awareness of possible disadvantages of the screening.We evaluated any document specifically addressed to the general female public and posted on internet by Italian public health services. The presence of false positive, false positive after biopsy, false negative, interval cancer, overdiagnosis, lead-time bias, exposure to irradiation, and mortality reduction was analyzed.Of the 255 websites consulted, 136 (53.3%) had sites addressed to the female public. The most commonly reported information points were the false-positive (30.8% of sites) and radiation exposure (29.4%) rates. Only 11 documents mentioned overdiagnosis, 2 mentioned risk of false positive with biopsy, and only 1 mentioned lead-time bias. Moreover, only 15 sites (11.0%) reported quantitative data for any risk variables.Most documents about breast cancer screening published on the web for the female public contained little or no information about risk/benefit ratio and were biased in favor of screening.

  5. BREAST CANCER SCREENING KNOWLEDGE AND PRACTICE AMONG WOMEN IN SOUTHEAST OF IRAN

    Directory of Open Access Journals (Sweden)

    Z Heidari

    2008-08-01

    Full Text Available "nBreast cancer is the most common cancer occurring among women. The mortality rate of breast cancer can be reduced by regular breast cancer screening program. This study was carried out to identify the knowledge and practice of women about breast cancer screening in Zahedan, southeast of Iran. In this cross- sectional study, 384 women were selected as an improbability sample of women referring to Qouds maternity hospital. Knowledge and practice of them about breast cancer screening were investigated through face-to-face interview based on a purposed questionnaire, and data were analyzed using descriptive and analytical statistics. Only 8.3% of women were aware of breast cancer screening methods. About breast self-examination 21.6%, and about mammography 3.4% had good knowledge. Overall knowledge of breast cancer screening was insufficient in 67.4%. There was statistically significant relationship between knowledge of breast cancer screening and level of education, history of individual breast disease, and history of breast cancer in their families (P < 0.001. There was statistically significant and inverse relationship between knowledge of how to examine the breasts and knowledge about mammography with age (P < 0.001. Practices of women in Zahedan about Breast cancer screening were very low. Only 4.5% of women performed breast self examination (BSE, on a regular basis, 4.1% had ever had a clinical breast examination (CBE, and %1.3 had a mammography throughout their life. Our findings suggest that knowledge and practice about breast cancer screening was relatively in a weak level and it needs to be improved.

  6. Understanding barriers to organized breast cancer screening in France: women's perceptions, attitudes, and knowledge.

    Science.gov (United States)

    Ferrat, Emilie; Le Breton, Julien; Djassibel, Memtolom; Veerabudun, Kalaivani; Brixi, Zahida; Attali, Claude; Renard, Vincent

    2013-08-01

    The participation rate in organized breast cancer screening in France is lower than recommended. Non-participants either use opportunistic screening or do not use either screening modality. To assess any differences in perceptions, attitudes and knowledge related to breast cancer screening between users of opportunistic screening and non-users of any screening mammograms and to identify potential barriers to participation in organized screening. Six focus groups were conducted in May 2010 with 34 French non-participants in organized screening, 15 who used opportunistic screening (OpS group) and 19 who used no screening (NoS group). The guide used for both groups explored perceptions and attitudes related to health, cancer and screening; perceptions of femininity; and knowledge about breast cancer screening. Thematic content analysis was performed. Perceptions, attitudes and knowledge differed between the two groups. Women in the OpS group perceived a high susceptibility to breast cancer, visited their gynaecologist regularly, were unfamiliar with organized screening modalities and had doubts about its quality. NoS women had very high- or low-perceived susceptibility to breast cancer, knew about screening modalities, had doubts about its usefulness and expressed negative opinions of mammograms. Differences in perceptions and attitudes related to breast cancer screening partially explain why some women choose opportunistic screening or no screening. General practitioners and gynaecologists are in a unique position to provide individually tailored preventative messages to improve participation in organized screening.

  7. Natural history of breast cancers detected in the Swedish mammography screening programme: a cohort study

    DEFF Research Database (Denmark)

    Zahl, Per-Henrik; Gøtzsche, Peter C; Mæhlen, Jan

    2011-01-01

    The natural history of screen-detected breast cancers is not well understood. A previous analysis of the incidence change during the introduction of the Norwegian screening programme in the late 1990s suggested that the natural history of many screen-detected invasive breast cancers is to regress...

  8. The impact of a breast cancer screening programme on quality-adjusted life-years

    NARCIS (Netherlands)

    de Haes, J. C.; de Koning, H. J.; van Oortmarssen, G. J.; van Agt, H. M.; de Bruyn, A. E.; van der Maas, P. J.

    1991-01-01

    Trials have shown that breast cancer screening is effective in reducing breast cancer mortality and gaining life-years. The question is whether taking into account the impact of a screening programme on quality of life would lead to a less positive view. Screening may have effects on quality of life

  9. Development and implementation of guidelines for quality assurance in breast cancer screening: The European experience.

    Directory of Open Access Journals (Sweden)

    Lawrence von Karsa

    2013-05-01

    Full Text Available In Europe, as in many other regions of the world, breast cancer is a major cause of suffering and death. Early detection of breast cancer by systematic mammography screening can find lesions for which treatment is more effective and generally more favourable for quality of life. Comprehensive quality assurance guidelines for breast cancer screening based on mammography have been developed in the Europe Against Cancer programme with the aim of maximising screening benefits while minimising adverse effects, such as unnecessary examination or treatment resulting from false-positive screening tests. The present report provides an overview of the European experience in developing and implementing quality assurance guidelines for breast cancer screening. It highlights implications relevant to those regions of the world in which the burden of breast cancer in the coming years will make population-based screening an option for cancer control.

  10. Seventeen-years overview of breast cancer inside and outside screening in Denmark

    DEFF Research Database (Denmark)

    Domingo, Laia; Jacobsen, Katja Kemp; von Euler-Chelpin, My Catarina

    2013-01-01

    Background. Long-term data on breast cancer detection in mammography screening programs are warranted to better understand the mechanisms by which screening changes the breast cancer pattern in the population. We aimed to analyze 17 years of breast cancer detection rates inside and outside...... to women aged 50-69 years. We identified targeted, eligible, invited and participating women. We calculated screening detection and interval cancer rates for participants, and breast cancer incidence in non-screened women (= targeted women excluding participants) by biennial invitation rounds. Tumor...... characteristics were tabulated for each of the three groups of cancers. Results. Start of screening resulted in a prevalence peak in participants, followed by a decrease to a fairly stable detection rate in subsequent invitation rounds. A similar pattern was found for breast cancer incidence in non-screened women...

  11. Benefit-to-harm ratio of the Danish breast cancer screening programme

    DEFF Research Database (Denmark)

    Beau, Anna-Belle; Lynge, Elsebeth; Njor, Sisse Helle

    2017-01-01

    The primary aim of breast cancer screening is to reduce breast cancer mortality, but screening also has negative side-effects as overdiagnosis. To evaluate a screening programme, both benefits and harms should be considered. Published estimates of the benefit-to-harm ratio, the number of breast...... carcinoma in situ (DCIS)] were estimated per 1,000 women aged 50-79, using national published estimates for breast cancer mortality and overdiagnosis, and national incidence and mortality rates. Estimations were made for both invited and screened women. Among 1,000 women invited to screening from age 50...

  12. The Effect of Personal Characteristics, Perceived Threat, Efficacy and Breast Cancer Anxiety on Breast Cancer Screening Activation

    Directory of Open Access Journals (Sweden)

    Patrick De Pelsmacker

    2017-09-01

    Full Text Available In order to activate women to participate in breast cancer screening programs, a good understanding is needed of the personal characteristics that influence how women can be activated to search for more information, consult friends and doctors, and participate in breast cancer screening programs. In the current study, we investigate the effect of six personal characteristics that have in previous research been identified as important triggers of health behavior on breast cancer screening activation: Health awareness, Need for Cognition, Affect Intensity, Breast cancer knowledge, Topic involvement, and the Perceived breast cancer risk. We test the effect of these factors on four activation variables: intention of future information seeking, forwarding the message to a friend, talking to a doctor, and actual breast cancer screening attendance. Additionally, we try to unravel the process by means of which the antecedents (the six personal characteristics lead to activation. To that end, we test the mediating role of perceived breast cancer threat, perceived efficacy of screening, and the evoked breast cancer anxiety as mediators in this process. The data were collected by means of a cross-sectional survey in a sample of 700 Flemish (Belgium women who were invited to the free-of-charge breast cancer population screening. Screening attendance of this sample was provided by the government agency in charge of the organisation of the screening. Health awareness, affects intensity, topic involvement, and perceived risk have the strongest influence on activation. Breast cancer anxiety and perceived breast cancer threat have a substantial mediation effect on these effects. Efficacy perceptions are less important in the activation process. Increased health awareness and a higher level of perceived risk lead to less participation in the free of charge population based breast screening program. Implications for theory and practice are offered. The limitation

  13. The Effect of Personal Characteristics, Perceived Threat, Efficacy and Breast Cancer Anxiety on Breast Cancer Screening Activation.

    Science.gov (United States)

    De Pelsmacker, Patrick; Lewi, Martine; Cauberghe, Veroline

    2017-09-27

    In order to activate women to participate in breast cancer screening programs, a good understanding is needed of the personal characteristics that influence how women can be activated to search for more information, consult friends and doctors, and participate in breast cancer screening programs. In the current study, we investigate the effect of six personal characteristics that have in previous research been identified as important triggers of health behavior on breast cancer screening activation: Health awareness, Need for Cognition, Affect Intensity, Breast cancer knowledge, Topic involvement, and the Perceived breast cancer risk. We test the effect of these factors on four activation variables: intention of future information seeking, forwarding the message to a friend, talking to a doctor, and actual breast cancer screening attendance. Additionally, we try to unravel the process by means of which the antecedents (the six personal characteristics) lead to activation. To that end, we test the mediating role of perceived breast cancer threat, perceived efficacy of screening, and the evoked breast cancer anxiety as mediators in this process. The data were collected by means of a cross-sectional survey in a sample of 700 Flemish (Belgium) women who were invited to the free-of-charge breast cancer population screening. Screening attendance of this sample was provided by the government agency in charge of the organisation of the screening. Health awareness, affects intensity, topic involvement, and perceived risk have the strongest influence on activation. Breast cancer anxiety and perceived breast cancer threat have a substantial mediation effect on these effects. Efficacy perceptions are less important in the activation process. Increased health awareness and a higher level of perceived risk lead to less participation in the free of charge population based breast screening program. Implications for theory and practice are offered. The limitation of the study is

  14. The Impact of Tumour Characteristics on Hereditary Breast Cancer Screening

    NARCIS (Netherlands)

    M.M.A. Tilanus-Linthorst (Madeleine)

    2006-01-01

    textabstractIn the Western world breast cancer is a fairly common disease in women, nearly one in ten is diagnosed with breast cancer during her life. Worldwide 1.200.000 women are diagnosed with breast cancer annually, in the Netherlands about 12.000, 25% of them before age 50 years 1. Worldwide

  15. Rising incidence of breast cancer after completion of the first prevalent round of the breast cancer screening programme.

    NARCIS (Netherlands)

    Schouten, L.J.; Rijke, J.M. de; Huveneers, J.A.M.; Verbeek, A.L.M.

    2002-01-01

    OBJECTIVES: After completion of the prevalent screening round of the breast cancer screening programme in Limburg, The Netherlands, incidences started rising once again. This increase was contrary to expectations, which had predicted a slightly higher, but stable, incidence after the first screening

  16. Breast cancer screening in an urban population in northern Italy.

    Science.gov (United States)

    Alghisi, A; Donato, F; Lucini, L; Marcianò, P; Miccichè, C; Nardi, G; Nardi, M E; Pasini, M; Spiazzi, R

    1990-02-28

    A mammographic and clinical screening for breast cancer started in June 1987 in the Health District of Brescia, Northern Italy, including the town and 23 surrounding municipalities. This paper describes the organization and the results of the first 12 months of screening. Of 7791 invited women aged 50-60 years, 5217 (67%) agreed to participate. There was a trend for response rates to decline with increasing age and education. Of the 5217 women examined, 66 (1.3%) were referred for biopsy and 64 (1.2%) underwent this procedure. A histologically confirmed malignancy was found in 42 women, corresponding to a prevalence of 8.1/1000. Positive predictive value of the screening was 65.6%. Among the 42 breast cancers, 4.8% were carcinoma in situ and 42.9% invasive tumors up to 10 mm in size. According to the p-TNM classification, 92.9% of all cancers were either TIS or in stage T1, 4.8% were in T2 and one tumor was classified in T4. Lymph node involvement was assessed in 41 cases, and 71.4% of all cancers detected by screening were negative for lymph node metastasis. In comparison, the classification of tumors found in women of the same age group and living in Brescia, histologically diagnosed in the urban hospitals during 1986, one year before the beginning of the screening, was as follows: 7.1% carcinoma in situ, and 16.7% invasive tumors up to 10 mm in size. 38.1%, 2.4% and 2.4% of all tumors were in stages T2, T3 and T4 respectively.

  17. Improving Breast Cancer Outcomes among Women in China: Practices, Knowledge, and Attitudes Related to Breast Cancer Screening

    Directory of Open Access Journals (Sweden)

    Tsu-Yin Wu

    2012-01-01

    Full Text Available Background. Breast cancer is a major public health issue and the most commonly diagnosed cancer for women worldwide. Despite lower incidence rates than those living in Western countries, breast cancer incidence among Chinese women has increased dramatically in the past 20 years. Nevertheless, there is a paucity of studies reporting the attitudes toward and practices of breast cancer screening among Chinese women. Methods. This cross-sectional study examined the practices, knowledge, and attitudes toward breast cancer screening (BCS on a convenience sample of 400 Chinese women. Results. Among study participants, 75% of the women never had a mammogram and the top three barriers reported were low priority, feeling OK, and lack of awareness/knowledge toward breast cancer screening. The results from the logistic regression model showed increased self-efficacy; having performed monthly self-exams, and having had clinical breast exams in the past two years were significant correlates while demographic variables were not correlated with screening behaviors. Conclusion. The findings provide a foundation to better understand beliefs and practices of Chinese women toward BCS and highlight the critical need for general public, health professionals, and the health care system to work collaboratively toward improving the quality of breast cancer care in this population.

  18. Digital compared to screen-film mammography: breast cancer prognostic features in an organized screening program.

    Science.gov (United States)

    Prummel, Maegan V; Done, Susan J; Muradali, Derek; Majpruz, Vicky; Brown, Patrick; Jiang, Hedy; Shumak, Rene S; Yaffe, Martin J; Holloway, Claire M B; Chiarelli, Anna M

    2014-09-01

    Our previous study found cancer detection rates were equivalent for direct radiography compared to screen-film mammography, while rates for computed radiography were significantly lower. This study compares prognostic features of invasive breast cancers by type of mammography. Approved by the University of Toronto Research Ethics Board, this study identified invasive breast cancers diagnosed among concurrent cohorts of women aged 50-74 screened by direct radiography, computed radiography, or screen-film mammography from January 1, 2008 to December 31, 2009. During the study period, 816,232 mammograms were performed on 668,418 women, and 3,323 invasive breast cancers were diagnosed. Of 2,642 eligible women contacted, 2,041 participated (77.3 %). The final sample size for analysis included 1,405 screen-detected and 418 interval cancers (diagnosed within 24 months of a negative screening mammogram). Polytomous logistic regression was performed to evaluate the association between tumour characteristics and type of mammography, and between tumour characteristics and detection method. Odds ratios (OR) and 95 % confidence intervals (CI) were recorded. Cancers detected by computed radiography compared to screen-film mammography were significantly more likely to be lymph node positive (OR 1.94, 95 %CI 1.01-3.73) and have higher stage (II:I, OR 2.14, 95 %CI 1.11-4.13 and III/IV:I, OR 2.97, 95 %CI 1.02-8.59). Compared to screen-film mammography, significantly more cancers detected by direct radiography (OR 1.64, 95 %CI 1.12-2.38) were lymph node positive. Interval cancers had worse prognostic features compared to screen-detected cancers, irrespective of mammography type. Screening with computed radiography may lead to the detection of cancers with a less favourable stage distribution compared to screen-film mammography that may reflect a delayed diagnosis. Screening programs should re-evaluate their use of computed radiography for breast screening.

  19. Retrospective Proteomic Screening of 100 Breast Cancer Tissues

    Science.gov (United States)

    Pucci-Minafra, Ida; Di Cara, Gianluca; Musso, Rosa; Albanese, Nadia Ninfa; Roz, Elena; Minafra, Salvatore

    2017-01-01

    The present investigation has been conducted on one hundred tissue fragments of breast cancer, collected and immediately cryopreserved following the surgical resection. The specimens were selected from patients with invasive ductal carcinoma of the breast, the most frequent and potentially aggressive type of mammary cancer, with the objective to increase the knowledge of breast cancer molecular markers potentially useful for clinical applications. The proteomic screening; by 2D-IPG and mass spectrometry; allowed us to identify two main classes of protein clusters: proteins expressed ubiquitously at high levels in all patients; and proteins expressed sporadically among the same patients. Within the group of ubiquitous proteins, glycolytic enzymes and proteins with anti-apoptotic activity were predominant. Among the sporadic ones, proteins involved in cell motility, molecular chaperones and proteins involved in the detoxification appeared prevalent. The data of the present study indicates that the primary tumor growth is reasonably supported by concurrent events: the inhibition of apoptosis and stimulation of cellular proliferation, and the increased expression of glycolytic enzymes with multiple functions. The second phase of the evolution of the tumor can be prematurely scheduled by the occasional presence of proteins involved in cell motility and in the defenses of the oxidative stress. We suggest that this approach on large-scale 2D-IPG proteomics of breast cancer is currently a valid tool that offers the opportunity to evaluate on the same assay the presence and recurrence of individual proteins, their isoforms and short forms, to be proposed as prognostic indicators and susceptibility to metastasis in patients operated on for invasive ductal carcinoma of the breast. PMID:28686225

  20. Retrospective observation on contribution and limitations of screening for breast cancer with mammography in Korea: detection rate of breast cancer and incidence rate of interval cancer of the breast

    OpenAIRE

    Lee, Kunsei; Kim, Hyeongsu; Lee, Jung Hyun; Jeong, Hyoseon; Shin, Soon Ae; Han, Taehwa; Seo, Young Lan; Yoo, Youngbum; Nam, Sang Eun; Park, Jong Heon; Park, Yoo Mi

    2016-01-01

    Background The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography. Methods Descriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rat...

  1. MRI screening for breast cancer in women with familial or genetic predisposition : design of the Dutch National Study (MRISC)

    NARCIS (Netherlands)

    Kriege, M; Brekelmans, C T; Boetes, C; Rutgers, E J; Oosterwijk, J C; Tollenaar, R A; Manoliu, R A; Holland, R; de Koning, H J; Klijn, J G

    2001-01-01

    Mammography screening of women aged 50-70 years for breast cancer has proven to be effective in reducing breast cancer mortality. There is no consensus about the value of breast cancer screening in women aged 40-49 years. Five to ten per cent of all breast cancers are hereditary. One of the options

  2. Thermography--a feasible method for screening breast cancer?

    Science.gov (United States)

    Kolarić, Darko; Herceg, Zeljko; Nola, Iskra Alexandra; Ramljak, Vesna; Kulis, Tomislav; Holjevac, Jadranka Katancić; Deutsch, Judith A; Antonini, Svetlana

    2013-06-01

    Potential use of thermography for more effective detection of breast carcinoma was evaluated on 26 patients scheduled for breast carcinoma surgery. Ultrasonographic scan, mammography and thermography were performed at the University Hospital for Tumors. Thermographic imaging was performed using a new generation of digital thermal cameras with high sensitivity and resolution (ThermoTracer TH7102WL, NEC). Five images for each patient were recorded: front, right semi-oblique, right oblique, left- semi oblique and left oblique. While mammography detected 31 changes in 26 patients, thermography was more sensitive and detected 6 more changes in the same patients. All 37 changes were subjected to the cytological analysis and it was found that 16 of samples were malignant, 8 were suspected malignant and 11 were benign with atypia or proliferation while only 2 samples had benign findings. The pathohistological method (PHD) recorded 75.75% malignant changes within the total number of samples. Statistical analysis of the data has shown a probability of a correct mammographic finding in 85% of the cases (sensitivity of 85%, specificity of 84%) and a probability of a correct thermographic finding in 92% of the cases (sensitivity of 100%, specificity of 79%). As breast cancer remains the most prevalent cancer in women and thermography exhibited superior sensitivity, we believe that thermography should immediately find its place in the screening programs for early detection of breast carcinoma, in order to reduce the sufferings from this devastating disease.

  3. Compliance after 17 years of breast cancer screening - Factors associated with reattendance for periodic breast screening

    NARCIS (Netherlands)

    ScafKlomp, W; VanSonderen, E; VandenHeuvel, W

    The motives and reasons for regular attendance, irregular attendance and drop-out were studied in women who were enrolled in a biennial breast screening programme in 1975 and who were invited to each subsequent screening round until 1992. Three compliance groups were compared: 'attended all rounds'

  4. Knowledge of Breast Cancer and Need for its Screening Among ...

    African Journals Online (AJOL)

    Background: Breast cancer is the most commonly diagnosed cancer among women worldwide and the most common among African women. The WHO, recent global cancer statistics indicate a rising global incidence of breast cancer in populations of the developing countries that previously enjoyed a low incidence of the ...

  5. Association between documented family history of cancer and screening for breast and colorectal cancer.

    Science.gov (United States)

    Carney, Patricia A; O'Malley, Jean P; Gough, Andrea; Buckley, David I; Wallace, James; Fagnan, Lyle J; Morris, Cynthia; Mori, Motomi; Heintzman, John D; Lieberman, David

    2013-11-01

    Previous research on ascertainment of cancer family history and cancer screening has been conducted in urban settings. To examine whether documented family history of breast or colorectal cancer is associated with breast or colorectal cancer screening. Medical record reviews were conducted on 3433 patients aged 55 and older from four primary care practices in two rural Oregon communities. Data collected included patient demographic and risk information, including any documentation of family history of breast or colorectal cancer, and receipt of screening for these cancers. A positive breast cancer family history was associated with an increased likelihood of being up-to-date for mammography screening (OR 2.09, 95% CI 1.45-3.00 relative to a recorded negative history). A positive family history for colorectal cancer was associated with an increased likelihood of being up-to-date with colorectal cancer screening according to U.S. Preventive Services Task Force low risk guidelines for males (OR 2.89, 95% CI 1.15-7.29) and females (OR 2.47, 95% CI 1.32-4.64) relative to a recorded negative family history. The absence of any recorded family cancer history was associated with a decreased likelihood of being up-to-date for mammography screening (OR 0.70, 95% CI 0.56-0.88 relative to recorded negative history) or for colorectal cancer screening (OR 0.75, 95% CI 0.60-0.96 in females, OR 0.68, 95% CI 0.53-0.88 in males relative to recorded negative history). Further research is needed to determine if establishing routines to document family history of cancer would improve appropriate use of cancer screening. © 2013.

  6. Benefit-to-harm ratio of the Danish breast cancer screening programme.

    Science.gov (United States)

    Beau, Anna-Belle; Lynge, Elsebeth; Njor, Sisse Helle; Vejborg, Ilse; Lophaven, Søren Nymand

    2017-08-01

    The primary aim of breast cancer screening is to reduce breast cancer mortality, but screening also has negative side-effects as overdiagnosis. To evaluate a screening programme, both benefits and harms should be considered. Published estimates of the benefit-to-harm ratio, the number of breast cancer deaths prevented divided by the number of overdiagnosed breast cancer cases, varied considerably. The objective of the study was to estimate the benefit-to-harm ratio of breast cancer screening in Denmark. The numbers of breast cancer deaths prevented and overdiagnosed cases [invasive and ductal carcinoma in situ (DCIS)] were estimated per 1,000 women aged 50-79, using national published estimates for breast cancer mortality and overdiagnosis, and national incidence and mortality rates. Estimations were made for both invited and screened women. Among 1,000 women invited to screening from age 50 to age 69 and followed until age 79, we estimated that 5.4 breast cancer deaths would be prevented and 2.1 cases overdiagnosed, under the observed scenario in Denmark of a breast cancer mortality reduction of 23.4% and 2.3% of the breast cancer cases being overdiagnosed. The estimated benefit-to-harm ratio was 2.6 for invited women and 2.5 for screened women. Hence, 2-3 women would be prevented from dying from breast cancer for every woman overdiagnosed with invasive breast cancer or DCIS. The difference between the previous published ratios and 2.6 for Denmark is probably more a reflection of the accuracy of the underlying estimates than of the actual screening programmes. Therefore, benefit-to-harm ratios should be used cautiously. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

  7. A review of interval breast cancers diagnosed among participants of the Nova Scotia Breast Screening Program.

    Science.gov (United States)

    Payne, Jennifer I; Caines, Judy S; Gallant, Julie; Foley, Theresa J

    2013-01-01

    To conduct a radiologic review of interval breast cancer cases to determine rates of true interval and missed cancers in Nova Scotia, Canada. This quality assurance project was exempt from institutional review board approval. Interval cancer cases were identified among women aged 40-69 years who were participants in the Nova Scotia Breast Screening Program from 1991 to 2004. For each case, the index negative screening mammogram was reviewed blindly by three radiologists from a pool of experienced radiologists. Cases were identified as those with normal or abnormal findings, the latter being a case that required further investigation. True interval cases were identified as cases in which a minimum of two radiologists reviewed the findings as normal. True interval and missed cancer rates were calculated separately for women according to age group and screening interval (for ages 40-49 years, a 1-year interval; for ages 50-69 years, a 1-year and a 2-year interval). The rate of missed cancers per 1000 women screened was one-half of the true interval rate among women screened annually (for ages 40-49 years, 0.45 vs 0.93; for ages 50-69 years, 1.08 vs 2.22). Among women aged 50-69 years who were screened biennially, the rate of missed cancers per 1000 women screened was one-third of the true interval rate (0.90 vs 3.15). Similarly, the rate of missed cancers per 10,000 screening examinations was one-half of the true interval rate among those 40-49 years old (1.95 vs 3.99) and one-third of the true interval rate among those 50-69 years old (3.34 vs 10.44). In screening programs, true interval cancer rates should be differentiated from missed cancer rates as part of ongoing quality assurance. RSNA, 2012

  8. The transtheoretical model, health belief model, and breast cancer screening among Iranian women with a family history of breast cancer.

    Science.gov (United States)

    Farajzadegan, Ziba; Fathollahi-Dehkordi, Fariba; Hematti, Simin; Sirous, Reza; Tavakoli, Neda; Rouzbahani, Reza

    2016-01-01

    Participation of Iranian women with a family history of breast cancer in breast cancer screening programs is low. This study evaluates the compliance of women having a family history of breast cancer with clinical breast exam (CBE) according to the stage of transtheoretical model (TTM) and health belief model (HBM). In this cross-sectional study, we used Persian version of champion's HBM scale to collect factors associated with TTM stages applied to screening from women over 20 years and older. The obtained data were analyzed by SPSS, using descriptive statistics, Chi-square test, independent t-test, and analysis of covariance. Final sample size was 162 women. Thirty-three percent were in action/maintenance stage. Older women, family history of breast cancer in first-degree relatives, personal history of breast disease, insurance coverage, and a history of breast self-examination were associated with action/maintenance stage. Furthermore, women in action/maintenance stages had significantly fewer perceived barriers in terms of CBE in comparison to women in other stages (P 0.05). The finding indicates that the rate of women in action/maintenance stage of CBE is low. Moreover, results show a strong association between perceived barriers and having a regular CBE. These clarify the necessity of promoting national target programs for breast cancer screening, which should be considered as the first preference for reducing CBE barriers.

  9. Treatment Option Overview (Breast Cancer)

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  10. General Information about Breast Cancer

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  11. [Classification and characteristics of interval cancers in the Principality of Asturias's Breast Cancer Screening Program].

    Science.gov (United States)

    Prieto García, M A; Delgado Sevillano, R; Baldó Sierra, C; González Díaz, E; López Secades, A; Llavona Amor, J A; Vidal Marín, B

    2013-09-01

    To review and classify the interval cancers found in the Principality of Asturias's Breast Cancer Screening Program (PDPCM). A secondary objective was to determine the histological characteristics, size, and stage of the interval cancers at the time of diagnosis. We included the interval cancers in the PDPCM in the period 2003-2007. Interval cancers were classified according to the breast cancer screening program protocol, with double reading without consensus, without blinding, with arbitration. Mammograms were interpreted by 10 radiologists in the PDPCM. A total of 33.7% of the interval cancers could not be classified; of the interval cancers that could be classified, 40.67% were labeled true interval cancers, 31.4% were labeled false negatives on screening, 23.7% had minimal signs, and 4.23% were considered occult. A total of 70% of the interval cancers were diagnosed in the year of the period between screening examinations and 71.7% were diagnosed after subsequent screening. A total of 76.9% were invasive ductal carcinomas, 61.1% were stage II when detected, and 78.7% were larger than 10mm when detected. The rate of interval cancers and the rate of false negatives in the PDPCM are higher than those recommended in the European guidelines. Interval cancers are diagnosed later than the tumors detected at screening. Studying interval cancers provides significant training for the radiologists in the PDPCM. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  12. Comparison of digital mammography and screen-film mammography in breast cancer screening: a review in the Irish breast screening program.

    Science.gov (United States)

    Hambly, Niamh M; McNicholas, Michelle M; Phelan, Niall; Hargaden, Gormlaith C; O'Doherty, Ann; Flanagan, Fidelma L

    2009-10-01

    Clinical trials to date into the use of full-field digital mammography (FFDM) for breast cancer screening have shown variable results. The aim of this study was to review the use of FFDM in a population-based breast cancer screening program and to compare the results with screen-film mammography. The study included 188,823 screening examinations of women between 50 and 64 years old; 35,204 (18.6%) mammograms were obtained using FFDM. All films were double read using a 5-point rating scale to indicate the probability of cancer. Patients with positive scores were recalled for further workup. The recall rate, cancer detection rate, and positive predictive value (PPV) of FFDM were compared with screen-film mammography. The cancer detection rate was significantly higher for FFDM than screen-film mammography (6.3 vs 5.2 per 1,000, respectively; p = 0.01). The cancer detection rate for FFDM was higher than screen-film mammography for initial screening and subsequent screening, for invasive cancer and ductal carcinoma in situ, and across all age groups. The cancer detection rate for cancers presenting as microcalcifications was significantly higher for FFDM than for screen-film mammography (1.9 vs 1.3 per 1,000, p = 0.01). The recall rate was significantly higher for FFDM than screen-film mammography (4.0% vs 3.1%, p film mammography (15.7% and 16.7%, p = 0.383). FFDM resulted in significantly higher cancer detection and recall rates than screen-film mammography in women 50-64 years old. The PPVs of FFDM and screen-film mammography were comparable. The results of this study suggest that FFDM can be safely implemented in breast cancer screening programs.

  13. Attending the breast screening programme after breast cancer treatment: a population-based study

    NARCIS (Netherlands)

    de Munck, L.; Kwast, A.; Reiding, D.; de Bock, G.H.; Otter, R.; Willemse, P.H.B.; Siesling, Sabine

    2013-01-01

    Introduction: In the Netherlands, breast cancer patients are treated and followed at least 5 years after diagnosis. Furthermore, all women aged 50-74 are invited biennially for mammography by the nationwide screening programme. The relation between the outpatient follow-up (follow-up visits in the

  14. Attending the breast screening programme after breast cancer treatment : A population-based study

    NARCIS (Netherlands)

    de Munck, Linda; Kwast, Annemiek; Reiding, Dick; de Bock, Geertruida H.; Otter, Renee; Willemse, Pax H. B.; Siesling, Sabine

    2013-01-01

    Introduction: In the Netherlands, breast cancer patients are treated and followed at least 5 years after diagnosis. Furthermore, all women aged 50-74 are invited biennially for mammography by the nationwide screening programme. The relation between the outpatient follow-up (follow-up visits in the

  15. Is mammography screening history a predictor of future breast cancer risk?

    Science.gov (United States)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini; Von Euler-Chelpin, My; Njor, Sisse Helle

    2015-02-01

    Inspired by the model by Walter and Day for risk of cervical cancer following negative screens, one might hypothesize that women in a mammography screening programme with a certain number of negative screens had a lower remaining breast cancer risk than that of women in general. We studied whether number of negative screens was a predictor for a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Copenhagen and Funen. Data were collected from the mammography screening programmes in Stockholm, Sweden (1989-2012), Copenhagen, Denmark (1991-2009) and Funen, Denmark (1993-2009), and linked to the respective cancer registries. We calculated cumulative hazard rates for breast cancer in women in cohorts defined by age at entry and number of negative screens for the maximum follow-up period in each screening centre. For all centres and cohorts, the cumulative hazard were parallel for all number of negative screens, from after the time, when the women were scheduled to be invited for the next screen. This means that the remaining breast cancer risk is similar no matter how many negative screens a woman have had. Number of negative screens was not a predictor of a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Sweden, Copenhagen and Funen, Denmark. The history of previous negative screens is therefore not suitable for personalisation of mammography screening.

  16. Screening for Breast Cancer Using Near Field Infrared Spectroscopy of a Single Strand of Hair

    National Research Council Canada - National Science Library

    Erramilli, Shyamsunder

    2001-01-01

    ... predisposition to breast cancer because of the breast of a mutation of the BRCA1 gene. We would like to develop a new method for the screening of breast cancer based on infrared spectroscopy of a single strand of human hair...

  17. Experience with breast cancer, pre-screening perceived susceptibility and the psychological impact of screening

    DEFF Research Database (Denmark)

    Absetz, Pilvikki; Aro, Arja R; Sutton, Stephen R

    2003-01-01

    This prospective study examined whether the psychological impact of organized mammography screening is influenced by women's pre-existing experience with breast cancer and perceived susceptibility (PS) to the disease. From a target population of 16,886, a random sample of women with a normal...... responded to the follow-ups. Psychological impact was measured as anxiety (STAI-S), depression (BDI), health-related concerns (IAS), and breast cancer-specific beliefs and concerns. Data was analyzed with repeated measures analyses of variance, with estimates of effect size based on Eta-squared. Women...

  18. Cervical and Breast Cancer-Screening Knowledge of Women with Developmental Disabilities

    Science.gov (United States)

    Parish, Susan L.; Swaine, Jamie G.; Luken, Karen; Rose, Roderick A.; Dababnah, Sarah

    2012-01-01

    Women with developmental disabilities are significantly less likely than women without disabilities to receive cervical and breast cancer screening according to clinical guidelines. The reasons for this gap are not understood. The present study examined the extent of women's knowledge about cervical and breast cancer screening, with the intention…

  19. The impact of mammographic screening on breast cancer mortality in Europe

    DEFF Research Database (Denmark)

    Broeders, Mireille; Moss, Sue; Nyström, Lennarth

    2012-01-01

    To assess the impact of population-based mammographic screening on breast cancer mortality in Europe, considering different methodologies and limitations of the data.......To assess the impact of population-based mammographic screening on breast cancer mortality in Europe, considering different methodologies and limitations of the data....

  20. Radiation-induced breast cancer incidence and mortality from digital mammography screening a modeling study

    NARCIS (Netherlands)

    D.L. Miglioretti (Diana); J. Lange (Jane); J.J. Van Den Broek (Jeroen J.); C.I. Lee (Christoph I.); N.T. van Ravesteyn (Nicolien); D. Ritley (Dominique); K. Kerlikowske (Karla); J.J. Fenton (Joshua J.); J. Melnikow (Joy); H.J. de Koning (Harry); R.A. Hubbard (Rebecca)

    2016-01-01

    textabstractBackground: Estimates of risk for radiation-induced breast cancer from mammography screening have not considered variation in dose exposure or diagnostic work-up after abnormal screening results. Objective: To estimate distributions of radiation-induced breast cancer incidence and

  1. Overdiagnosis in mammographic screening for breast cancer in Europe: A literature review

    NARCIS (Netherlands)

    D. Puliti (Donella); S.W. Duffy (Stephen); G. Miccinesi (Guido); H.J. de Koning (Harry); E. Lynge (Elsebeth); M. Zappa (Marco); E. Paci (Eugenio)

    2012-01-01

    textabstractObjectives Overdiagnosis, the detection through screening of a breast cancer that would never have been identified in the lifetime of the woman, is an adverse outcome of screening. We aimed to determine an estimate range for overdiagnosis of breast cancer in European mammographic service

  2. Breast Cancer Screening Behaviors of First Degree Relatives of Women Receiving Breast Cancer Treatment and the Affecting Factors

    Science.gov (United States)

    Kırca, Nurcan; Tuzcu, Ayla; Gözüm, Sebahat

    2018-01-01

    Objective First-degree relatives of women with breast cancer are under higher risk when compared with the general population. The aim of this study is to evaluate breast cancer screening behaviors of women who are first-degree relatives of women with breast cancer and factors affecting these behaviors. Materials and Methods This descriptive study included 240 patient relatives, who agreed to participate in the study through contact with first-degree relatives of 133 patients who were receiving breast cancer treatment at the Oncology and Chemotherapy unit of an university hospital in Turkey. Data were collected using the “Descriptive Characteristics Form,” which consisted of socio-demographic characteristics, health history, breast cancer risk level and health beliefs as well as the “Breast Cancer Screening Behavior Evaluation Form”. Results Out of the subjects, 17% reported doing breast self examination (BSE), 18% reported getting clinic breast examination (CBE) and 17% reported getting mammography. Logistic regression analysis showed that perceived susceptibility increased BSE by 0.57 times and increased mammography by 0.77 times. Physical exercise increased CBE by 0.21 times and increased mammography by 0.13 times. Conclusions It was found that women with familial breast cancer history (FBCH) had lower participation in screening behaviors. Higher susceptibility perception and regular physical exercise are the determinant variables. Women with a higher susceptibility can be led towards the screening and their participation can be increased. In women with family history, the development of healthy lifestyle behaviors like physical exercise should be supported. PMID:29322115

  3. Mammography screening and breast cancer mortality in Australia: an aggregate cohort study.

    Science.gov (United States)

    Morrell, Stephen; Taylor, Richard; Roder, David; Dobson, Annette

    2012-03-01

    Evidence that mammography screening reduces breast cancer mortality derives from trials, with observational studies broadly supporting trial findings. The purpose of this study was to evaluate the national mammographic screening programme, BreastScreen Australia, using aggregate screening and breast cancer mortality data. Breast cancer mortality from 1990 to 2004 in the whole Australian population was assessed in relation to screening exposure in the target of women aged 50-69 years. Population cohorts were defined by year of screening (and diagnosis), five-year age group at screening (and diagnosis), and local area of residence at screening (and diagnosis). Biennial screening data for BreastScreen Australia were related to cumulated mortality from breast cancer in an event analysis using Poisson regression, and in a time-to-event analysis using Cox proportional hazards regression. Results were adjusted for repeated measures and the potential effects of mammography outside BreastScreen Australia, regionality, and area socio-economic status. From the adjusted Poisson regression model, a 22% (95% CI:12-31%) reduction in six-year cumulated mortality from breast cancer was predicted for screening participation of approximately 60%, compared with no screening; 21% (95% CI:11-30%) for the most recently reported screening participation of 56%; and 25% (95% CI:15-35%) for the programme target of 70% biennial screening participation. Corresponding estimates from the Cox proportional hazard regression model were 30% (95% CI:17-41%), 28% (95% CI:16-38%) and 34% (95% CI:20-46%). Despite data limitations, the results of this nationwide study are consistent with the trial evidence, and with results of other service studies of mammography screening. With sufficient participation, mammography screening substantially reduces mortality from breast cancer.

  4. A theory-based intervention to improve breast cancer awareness and screening in Jamaica.

    Science.gov (United States)

    Anakwenze, Chidinma P; Coronado-Interis, Evelyn; Aung, Maung; Jolly, Pauline E

    2015-05-01

    Despite declines in breast cancer mortality rates in developed countries, mortality rates remain high in Jamaica due to low levels of screening and lack of early detection. We hypothesized that a theory-based health educational intervention would increase awareness of breast cancer and intention to screen among women in Western Jamaica. Two hundred and forty six women attending hospitals or clinics were enrolled in an educational intervention consisting of a pretest, breast cancer presentation, and posttest if they had never been screened or had not been screened in 5 years or more. The questionnaires assessed attitudes and knowledge of risk factors and symptoms related to breast cancer. Participants were followed approximately 6 months after the intervention to determine whether they accessed breast cancer screening. There were statistically significant increases (p Jamaica and other developing countries.

  5. The impact of mammographic screening on breast cancer mortality in Europe

    DEFF Research Database (Denmark)

    Moss, S M; Nyström, L; Jonsson, H.

    2012-01-01

    Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value.......Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value....

  6. A case control study on the effectiveness of breast cancer screening by clinical breast examination in Japan.

    Science.gov (United States)

    Kanemura, S; Tsuji, I; Ohuchi, N; Takei, H; Yokoe, T; Koibuchi, Y; Ohnuki, K; Fukao, A; Satomi, S; Hisamichi, S

    1999-06-01

    A case-control study was conducted in Miyagi and Gunma prefectures, Japan, to evaluate the effectiveness of breast cancer screening by clinical breast examination (CBE) alone in reducing breast cancer mortality. Case subjects, who were female and had died of breast cancer, were collected from residential registry files and medical records. Control subjects matched in sex, age and residence were randomly selected from residential registry files. The screening histories during 5 years prior to the cases having been diagnosed as breast cancer were surveyed using the examinee files of the screening facilities. Finally, the data of 93 cases and 375 controls were analyzed. The odds ratio (OR) of breast cancer death for participating in screening at least once during 5 years was 0.93 (95% confidence interval (95% CI) 0.48-1.79). The cases were more symptomatic than the controls when screened. If the participants who had had symptoms in their breasts were classified as not screened, the OR decreased to 0.56 (95% CI 0.27-1.18). The case control study suggests that the current screening modality (CBE) lacks effectiveness (OR = 0.93), although it might be effective for an asymptomatic population (OR = 0.56). The number of cases was small, and a larger case-control study is desirable to define whether CBE is effective or not. However, it is necessary to consider the introduction of mammographic screening to reduce breast cancer mortality in Japan.

  7. Factors Affecting Preferences of Iranian Women for Breast Cancer Screening Based on Marketing Mix Components.

    Science.gov (United States)

    Pourfarzi, Farhad; Fouladi, Nasrin; Amani, Firouz; Ahari, Saeid Sadegieh; Roshani, Zohre; Alimohammadi, Sara

    2016-01-01

    According to recent statistics, the breast cancer rate is growing fast in developing countries. In North West Iran, the incidence of breast cancer after esophageal and gastric cancers has the highest rate. Previous studies have also indicated that women in this region show reluctance to do breast cancer screening. There is a great need for change to promote breast cancer screening among women. Social marketing is a discipline that uses the systematic application of commercial marketing techniques to promote the adoption of behavior by the target audience. In the present qualitative study, thirty-two women with breast cancer were interviewed about their experiences of breast cancer screening. A semi-structured interview guide was designed to elicit information specific to the 4 P's in social marketing. Three main categories emerged from the analysis: price, service and promotion. Subcategories related to these main categories included factors effective in increasing and decreasing cost of screening, current and desirable features of screening services, and weakness of promotion. Screening programs should be designed to be of low cost, to meet patients' needs and should be provided in suitable places. Furthermore, it is essential that the cultural beliefs of society be improved through education. It seems necessary to design an executive protocol for breast cancer screening at different levels of primary health care to increase the women's willingness to undergo screening.

  8. Parameter estimates for invasive breast cancer progression in the Canadian National Breast Screening Study.

    Science.gov (United States)

    Taghipour, S; Banjevic, D; Miller, A B; Montgomery, N; Jardine, A K S; Harvey, B J

    2013-02-19

    The aim of screening is to detect a cancer in the preclinical state. However, a false-positive or a false-negative test result is a real possibility. We describe invasive breast cancer progression in the Canadian National Breast Screening Study and construct progression models with and without covariates. The effect of risk factors on transition intensities and false-negative probability is investigated. We estimate the transition rates, the sojourn time and sensitivity of diagnostic tests for women aged 40-49 and 50-59. Although younger women have a slower transition rate from healthy state to preclinical, their screen-detected tumour becomes evident sooner. Women aged 50-59 have a higher mortality rate compared with younger women. The mean sojourn times for women aged 40-49 and 50-59 are 2.5 years (95% CI: 1.7, 3.8) and 3.0 years (95% CI: 2.1, 4.3), respectively. Sensitivity of diagnostic procedures for older women is estimated to be 0.75 (95% CI: 0.55, 0.88), while women aged 40-49 have a lower sensitivity (0.61, 95% CI: 0.42, 0.77). Age is the only factor that affects the false-negative probability. For women aged 40-49, 'age at entry', 'history of breast disease' and 'families with breast cancer' are found to be significant for some of the transition rates. For the age-group 50-59, 'age at entry', 'history of breast disease', 'menstruation length' and 'number of live births' are found to affect the transition rates. Modelling and estimating the parameters of cancer progression are essential steps towards evaluating the effectiveness of screening policies. The parameters include the transition rates, the preclinical sojourn time, the sensitivity, and the effect of different risk factors on cancer progression.

  9. Is mammography screening history a predictor of future breast cancer risk?

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini

    2015-01-01

    Inspired by the model by Walter and Day for risk of cervical cancer following negative screens, one might hypothesize that women in a mammography screening programme with a certain number of negative screens had a lower remaining breast cancer risk than that of women in general. We studied whether...... number of negative screens was a predictor for a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Copenhagen and Funen. Data were collected from the mammography screening programmes in Stockholm, Sweden (1989-2012), Copenhagen, Denmark (1991...... was not a predictor of a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Sweden, Copenhagen and Funen, Denmark. The history of previous negative screens is therefore not suitable for personalisation of mammography screening....

  10. Stage distribution of breast cancer diagnosed before and after implementation of population-based mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Hofvind, S. [Cancer Registry of Norway, Oslo (Norway). Research; Skaane, P. [Oslo Univ. Hospital Ullevaal (Norway). Dept. of Radiology

    2012-05-15

    Purpose: The German mammographic screening program is very similar to the Norwegian Breast Cancer Screening Program (NBCSP), which started about 10 years earlier. This study analyzes the stage distribution of invasive breast cancers diagnosed in the pre-screening and screening period, and evaluates the overall mortality in women aged 55 - 74 in the pilot and non-pilot counties of the NBCSP. Materials and Methods: The NBCSP invites women aged 50 - 69 to participate in two-view mammography biennially. Chi-square statistics were used to compare percentages of the stage and treatment of invasive breast cancers diagnosed in women residing in the four pilot counties in the pre-screening (1984 - 1995) and screening (1996 - 2007) period. An ecological approach was used to analyze the age-specific mortality in the pilot and non-pilot counties for the period 1970 - 2007. Results: 50 % of the breast cancers diagnosed in the pre-screening period, 70 % of the cases detected with screening, 43 % of the interval cancers, and 52 % of the cancers diagnosed outside the NBCSP were stage I. Stage III + was present in 11 % of the cancers in the pre-screening period, and in 1 % of the cancers detected with screening. In the screening period, the breast cancer mortality rate decreased substantially more in the pilot counties than in the non-pilot counties. Conclusion: The stage distribution of breast cancer diagnosed in the NBCSP is prognostically favorable compared to cancers diagnosed outside the screening program. The reduction in the breast cancer mortality rate was more pronounced in the four pilot counties compared to the non-pilot counties. It is necessary to evaluate the program based on individual data. (orig.)

  11. What's the Buzz: Tell Me What's Happening in Breast Cancer Screening.

    Science.gov (United States)

    Byrne, Sharon K

    2017-01-01

    Many controversies have come to light related to breast cancer screening recommendations for average- and high-risk populations. This manuscript focuses on factors to consider when coordinating and conducting breast cancer screening programs in an average or "healthy women" population. As presented at the 2016 ONS Congress, a brief comparison of current screening recommendations among various organizations for early detection of breast cancer is provided. Lessons learned regarding key components of successful screening programs such as being patient focused, accessible, and sustainable are shared. Practice implications such as gaining confidence in providing individualized patient education, encouraging every woman to discuss her risk of breast cancer with her health-care provider, advocating for patients needs and being involved in or aware of clinical and translational research on the efficacy of the clinical breast examination and screening services are critical roles for nurses and advanced practice nurse providers.

  12. What's the buzz: Tell me what's happening in breast cancer screening

    Directory of Open Access Journals (Sweden)

    Sharon K Byrne

    2017-01-01

    Full Text Available Many controversies have come to light related to breast cancer screening recommendations for average- and high-risk populations. This manuscript focuses on factors to consider when coordinating and conducting breast cancer screening programs in an average or “healthy women” population. As presented at the 2016 ONS Congress, a brief comparison of current screening recommendations among various organizations for early detection of breast cancer is provided. Lessons learned regarding key components of successful screening programs such as being patient focused, accessible, and sustainable are shared. Practice implications such as gaining confidence in providing individualized patient education, encouraging every woman to discuss her risk of breast cancer with her health-care provider, advocating for patients needs and being involved in or aware of clinical and translational research on the efficacy of the clinical breast examination and screening services are critical roles for nurses and advanced practice nurse providers.

  13. Intrinsic motivation factors based on the self-determinant theory for regular breast cancer screening.

    Science.gov (United States)

    Jung, Su Mi; Jo, Heui-Sug

    2014-01-01

    The purpose of this study was to identify factors of intrinsic motivation that affect regular breast cancer screening and contribute to development of a program for strategies to improve effective breast cancer screening. Subjects were residing in South Korea Gangwon-Province and were female over 40 and under 69 years of age. For the investigation, the Intrinsic Motivation Inventory (IMI) was modified to the situation of cancer screening and was used to survey 905 inhabitants. Multinominal logistic regression analyses were conducted for regular breast cancer screening (RS), one-time breast cancer screening (OS) and non-breast cancer screening (NS). For statistical analysis, IBM SPSS 20.0 was utilized. The determinant factors between RS and NS were "perceived effort and choice" and "stress and strain" - internal motivations related to regular breast cancer screening. Also, determinant factors between RS and OS are "age" and "perceived effort and choice" for internal motivation related to cancer screening. To increase regular screening, strategies that address individual perceived effort and choice are recommended.

  14. Stage of breast cancer at diagnosis in New Zealand: impacts of socio-demographic factors, breast cancer screening and biology.

    Science.gov (United States)

    Seneviratne, Sanjeewa; Lawrenson, Ross; Harvey, Vernon; Ramsaroop, Reena; Elwood, Mark; Scott, Nina; Sarfati, Diana; Campbell, Ian

    2016-02-19

    Examination of factors associated with late stage diagnosis of breast cancer is useful to identify areas which are amenable to intervention. This study analyses trends in cancer stage at diagnosis and impact of socio-demographic, cancer biological and screening characteristics on cancer stage in a population-based series of women with invasive breast cancer in New Zealand. All women diagnosed with invasive breast cancer between 2000 and 2013 were identified from two regional breast cancer registries. Factors associated with advanced (stages III and IV) and metastatic (stage IV) cancer at diagnosis were analysed in univariate and multivariate models adjusting for covariates. Of the 12390 women included in this study 2448 (19.7%) were advanced and 575 (4.6%) were metastatic at diagnosis. Māori (OR = 1.86, 1.39-2.49) and Pacific (OR = 2.81, 2.03-3.87) compared with NZ European ethnicity, other urban (OR = 2.00, 1.37-2.92) compared with main urban residency and non-screen (OR = 6.03, 4.41-8.24) compared with screen detection were significantly associated with metastatic cancer at diagnosis in multivariate analysis. A steady increase in the rate of metastatic cancer was seen which has increased from 3.8% during 2000-2003 to 5.0% during 2010-2013 period (p = 0.042). Providing equitable high quality primary care and increasing mammographic screening coverage needs to be looked at as possible avenues to reduce late-stage cancer at diagnosis and to reduce ethnic, socioeconomic and geographical disparities in stage of breast cancer at diagnosis in New Zealand.

  15. Breast cancer screening in older women: law and patient rights.

    Science.gov (United States)

    Annas, G J

    1992-11-01

    Legal principles that apply to breast cancer in older women have been developed in judicial decisions related to other medical screening tests. There are no special legal rules for either mammography or older women, although older women seldom file malpractice suits. The general standard is that a screening test must be offered to any particular age group when it is considered "reasonably prudent" to do so, and this almost always means when the medical profession--usually speaking though its specialty boards--declares it the standard of care. The standard of care should be set by medical professionals, with open opportunity for public input, rather than by lawyers or risk managers. In actual practice, private regulation may not be sufficient to protect the public, and both state and federal regulation of mammography facilities now seems inevitable. Patients have the right to be fully informed prior to screening, the right to refuse screening, and the right to have full knowledge of the consequences of such refusal. Mammography is not a consumer good, but American women should be actively involved in determining issues of costs and benefits, as well as helping to develop the best strategies for counseling and informed consent.

  16. Cytotoxicity Screening of Plants of Genus Piper in Breast Cancer ...

    African Journals Online (AJOL)

    DNA smears of MCF-7 and MDA-MB-468 cells treated with fraction DE and DF were observed within 7 days. Conclusions: These results indicate that the compounds isolated from P. nigrum, viz, DE and DF, have cytotoxic effect on breast cancer cell lines. These fractions could be promising agent for breast cancer treatment.

  17. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

    2014-09-15

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  18. Evaluating the correlation between film mammography and MRI for screening women with increased breast cancer risk.

    Science.gov (United States)

    Lee, Janie M; Halpern, Elkan F; Rafferty, Elizabeth A; Gazelle, G Scott

    2009-11-01

    Breast magnetic resonance imaging (MRI) is increasingly being added to mammography for screening asymptomatic women at increased risk of breast cancer. Because the direction and extent of correlation between mammography and MRI could potentially result in over- or underestimation of the diagnostic gain related to using MRI as an adjunct to mammographic screening, we performed an analysis to evaluate the extent of correlation between mammography and MRI. We reviewed the published literature to identify multimodality breast cancer screening studies reporting the sensitivity of mammography and MRI, alone and in combination, for breast cancer diagnosis. After calculating the expected sensitivity of combined mammography and MRI under conditions of test independence (no correlation), we compared the calculated and observed sensitivities for combined mammography and MRI. We then calculated correlation coefficients for mammography and MRI. Seven studies of multimodality screening in women at increased risk of developing breast cancer were included for analysis. Of these studies, the correlation between film mammography and MRI was positive in three studies, negative in two studies, and not identified in two studies. The calculated correlation coefficients ranged from -0.38 to 0.18. In six of seven studies, the 95% confidence interval for the correlation coefficient included 0.0, indicating no significant correlation. Evidence from published trials of multimodality breast cancer screening identified no statistically significant correlation between film mammography and MRI. Using both tests for breast cancer screening is likely to improve the early detection of breast cancer in women at increased risk.

  19. Is breast compression associated with breast cancer detection and other early performance measures in a population-based breast cancer screening program?

    Science.gov (United States)

    Moshina, Nataliia; Sebuødegård, Sofie; Hofvind, Solveig

    2017-06-01

    We aimed to investigate early performance measures in a population-based breast cancer screening program stratified by compression force and pressure at the time of mammographic screening examination. Early performance measures included recall rate, rates of screen-detected and interval breast cancers, positive predictive value of recall (PPV), sensitivity, specificity, and histopathologic characteristics of screen-detected and interval breast cancers. Information on 261,641 mammographic examinations from 93,444 subsequently screened women was used for analyses. The study period was 2007-2015. Compression force and pressure were categorized using tertiles as low, medium, or high. χ 2 test, t tests, and test for trend were used to examine differences between early performance measures across categories of compression force and pressure. We applied generalized estimating equations to identify the odds ratios (OR) of screen-detected or interval breast cancer associated with compression force and pressure, adjusting for fibroglandular and/or breast volume and age. The recall rate decreased, while PPV and specificity increased with increasing compression force (p for trend cancer, PPV, sensitivity, and specificity decreased with increasing compression pressure (p for trend breast cancer compared with low compression pressure (1.89; 95% CI 1.43-2.48). High compression force and low compression pressure were associated with more favorable early performance measures in the screening program.

  20. Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.

    Directory of Open Access Journals (Sweden)

    Jari Haukka

    Full Text Available BACKGROUND: Incidence-based mortality modelling comparing the risk of breast cancer death in screened and unscreened women in nine Swedish counties has suggested a 39% risk reduction in women 40 to 69 years old after introduction of mammography screening in the 1980s and 1990s. OBJECTIVE: We evaluated changes in breast cancer mortality in the same nine Swedish counties using a model approach based on official Swedish breast cancer mortality statistics, robust to effects of over-diagnosis and treatment changes. Using mortality data from the NordCan database from 1974 until 2003, we estimated the change in breast cancer mortality before and after introduction of mammography screening in at least the 13 years that followed screening start. RESULTS: Breast mortality decreased by 16% (95% CI: 9 to 22% in women 40 to 69, and by 11% (95% CI: 2 to 20% in women 40 to 79 years of age. DISCUSSION: Without individual data it is impossible to completely separate the effects of improved treatment and health service organisation from that of screening, which would bias our results in favour of screening. There will also be some contamination of post-screening mortality from breast cancer diagnosed prior to screening, beyond our attempts to adjust for delayed benefit. This would bias against screening. However, our estimates from publicly available data suggest considerably lower benefits than estimates based on comparison of screened versus non-screened women.

  1. Knowledge, attitudes and practices toward breast cancer screening in a rural South African community.

    Science.gov (United States)

    Ramathuba, Dorah U; Ratshirumbi, Confidence T; Mashamba, Tshilidzi M

    2015-02-27

    The study assessed the knowledge, attitudes and breast cancer screening practices amongst women aged 30-65 years residing in a rural South African community. A quantitative, descriptive cross-sectional design was used and a systematic sampling technique was employed to select 150 participants. The questionnaire was pretested for validity and consistency. Ethical considerations were adhered to in protecting the rights of participants. Thereafter, data were collected and analysed descriptively using the Predictive Analytics Software program. Findings revealed that the level of knowledge about breast cancer of women in Makwarani Community was relatively low. The attitude toward breast cancer was negative whereas the majority of women had never performed breast cancer diagnostic methods. Health education on breast cancer screening practices is lacking and the knowledge deficit can contribute negatively to early detection of breast cancer and compound late detection. Based on the findings, community-based intervention was recommended in order to bridge the knowledge gap.

  2. Obesity and screening for breast, cervical, and colorectal cancer in women: a review.

    Science.gov (United States)

    Cohen, Sarah S; Palmieri, Rachel T; Nyante, Sarah J; Koralek, Daniel O; Kim, Sangmi; Bradshaw, Patrick; Olshan, Andrew F

    2008-05-01

    The literature examining obesity as a barrier to screening for breast, cervical, and colorectal cancer has not been evaluated systematically. With the increasing prevalence of obesity and its impact on cancer incidence and mortality, it is important to determine whether obesity is a barrier to screening so that cancers among women at increased risk because of their body size can be detected early or prevented entirely. On the basis of 32 relevant published studies (10 breast cancer studies, 14 cervical cancer studies, and 8 colorectal cancer studies), the authors reviewed the literature regarding associations between obesity and recommended screening tests for these cancer sites among women in the U.S. The most consistent associations between obesity and screening behavior were observed for cervical cancer. Most studies reported an inverse relation between decreased cervical cancer screening and increasing body size, and several studies reported that the association was more consistent among white women than among black women. For breast cancer, obesity was associated with decreased screening behavior among white women but not among black women. The literature regarding obesity and colorectal cancer screening adherence was mixed, with some studies reporting an inverse effect of body size on screening behavior and others reporting no effect. Overall, the results indicated that obesity most likely is a barrier to screening for breast and cervical cancers, particularly among white women; the evidence for colorectal cancer screening was inconclusive. Thus, efforts to identify barriers and increase screening for breast and cervical cancers may be targeted toward obese women, whereas outreach to all women should remain the objective for colorectal cancer screening programs.

  3. The transtheoretical model, health belief model, and breast cancer screening among Iranian women with a family history of breast cancer

    Directory of Open Access Journals (Sweden)

    Ziba Farajzadegan

    2016-01-01

    Full Text Available Background: Participation of Iranian women with a family history of breast cancer in breast cancer screening programs is low. This study evaluates the compliance of women having a family history of breast cancer with clinical breast exam (CBE according to the stage of transtheoretical model (TTM and health belief model (HBM. Materials and Methods: In this cross-sectional study, we used Persian version of champion's HBM scale to collect factors associated with TTM stages applied to screening from women over 20 years and older. The obtained data were analyzed by SPSS, using descriptive statistics, Chi-square test, independent t-test, and analysis of covariance. Results: Final sample size was 162 women. Thirty-three percent were in action/maintenance stage. Older women, family history of breast cancer in first-degree relatives, personal history of breast disease, insurance coverage, and a history of breast self-examination were associated with action/maintenance stage. Furthermore, women in action/maintenance stages had significantly fewer perceived barriers in terms of CBE in comparison to women in other stages (P < 0.05. There was no significant difference in other HBM subscales scores between various stages of CBE screening behavior (P < 0.05. Conclusion: The finding indicates that the rate of women in action/maintenance stage of CBE is low. Moreover, results show a strong association between perceived barriers and having a regular CBE. These clarify the necessity of promoting national target programs for breast cancer screening, which should be considered as the first preference for reducing CBE barriers.

  4. Breast cancer screening (BCS) chart: a basic and preliminary model for making screening mammography more productive and efficient.

    Science.gov (United States)

    Poorolajal, Jalal; Akbari, Mohammad Esmaeil; Ziaee, Fatane; Karami, Manoochehr; Ghoncheh, Mahshid

    2017-05-15

    The breast cancer screening (BCS) chart is suggested as a basic and preliminary tool to improve efficiency of screening mammography. We conducted this case-control study in 2016 and enrolled 1422 women aged 30-75 years, including 506 women with breast cancer (cases) and 916 women without breast cancer (controls). We developed the BCS chart using a multiple logistic regression analysis. We combined the risks of breast cancer to predict the individual risk of breast cancer. Then, we stratified and colored the predicted risk probabilities as follows: chart provides the risk probability of breast cancer, based on age, body mass index, late menopause, having a benign breast disease and a positive family history of breast cancer among the first-degree or the second/third-degree relatives. According to this chart, an individual can be classified in a category of low risk (green), medium risk (yellow and orange), high risk (red and brown) and very high risk (black) for breast cancer. This chart is a flexible and easy to use tool that can detect high-risk subjects and make the screening program more efficient and productive.

  5. What we need to know about dense breasts: implications for breast cancer screening.

    Science.gov (United States)

    Carreira Gómez, M C; Estrada Blan, M C

    High breast density and its relationship to the risk of breast cancer has become a hot topic in the medical literature and in the lay press, especially in the United States, where it has brought about changes in the legal framework that require radiologists to inform clinicians and patients about breast density. Radiologists, who are mainly responsible for this information, need to know the scientific evidence and controversies regarding this subject. The discussion is centered on the real importance of the risk, the limitation that not having standardized methods of measurement represents, and the possible application of complementary screening techniques (ultrasound, magnetic resonance imaging, or tomosynthesis) for which clear recommendations have yet to be established. We need controlled studies that evaluate the application of these techniques in women with dense breasts, including the possibility that they can lead to overdiagnosis. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. The association of breast density with breast cancer mortality in African American and white women screened in community practice.

    Science.gov (United States)

    Zhang, Shengfan; Ivy, Julie S; Diehl, Kathleen M; Yankaskas, Bonnie C

    2013-01-01

    The effect of breast density on survival outcomes for American women who participate in screening remains unknown. We studied the role of breast density on both breast cancer and other cause of mortality in screened women. Data for women with breast cancer, identified from the community-based Carolina Mammography Registry, were linked with the North Carolina cancer registry and NC death tapes for this study. Cause-specific Cox proportional hazards models were developed to analyze the effect of several covariates on breast cancer mortality-namely, age, race (African American/White), cancer stage at diagnosis (in situ, local, regional, and distant), and breast density (BI-RADS( ® ) 1-4). Two stratified Cox models were considered controlling for (1) age and race, and (2) age and cancer stage, respectively, to further study the effect of density. The cumulative incidence function with confidence interval approximation was used to quantify mortality probabilities over time. For this study, 22,597 screened women were identified as having breast cancer. The non-stratified and stratified Cox models showed no significant statistical difference in mortality between dense tissue and fatty tissue, while controlling for other covariate effects (p value = 0.1242, 0.0717, and 0.0619 for the non-stratified, race-stratified, and cancer stage-stratified models, respectively). The cumulative mortality probability estimates showed that women with dense breast tissues did not have significantly different breast cancer mortality than women with fatty breast tissue, regardless of age (e.g., 10-year confidence interval of mortality probabilities for whites aged 60-69 white: 0.056-0.090 vs. 0.054-0.083). Aging, African American race, and advanced cancer stage were found to be significant risk factors for breast cancer mortality (hazard ratio >1.0). After controlling for cancer incidence, there was not a significant association between mammographic breast density and mortality, adjusting

  7. Breast Cancer Characteristics Associated With Digital Versus Film-Screen Mammography for Screen-Detected and Interval Cancers.

    Science.gov (United States)

    Henderson, Louise M; Miglioretti, Diana L; Kerlikowske, Karla; Wernli, Karen J; Sprague, Brian L; Lehman, Constance D

    2015-09-01

    The purpose of this study was to determine whether pathologic findings of screen-detected and interval cancers differ for digital versus film mammography. Breast Cancer Surveillance Consortium data from 2003-2011 on 3,021,515 screening mammograms (40.3% digital, 59.7% film) of women 40-89 years old were reviewed. Cancers were considered screen detected if diagnosed within 12 months of an examination with positive findings and interval if diagnosed within 12 months of an examination with negative findings. Tumor characteristics for screen-detected and interval cancers were compared for digital versus film mammography by use of logistic regression models to estimate the odds ratio and 95% CI with adjustment for age, race and ethnicity, hormone therapy use, screening interval, examination year, and registry. Generalized estimating equations were used to account for correlation within facilities. Among 15,729 breast cancers, 85.3% were screen detected and 14.7% were interval. Digital and film mammography had similar rates of screen-detected (4.47 vs 4.42 per 1000 examinations) and interval (0.73 vs 0.79 per 1000 examinations) cancers for digital versus film. In adjusted analyses, interval cancers diagnosed after digital examinations with negative findings were less likely to be American Joint Committee on Cancer stage IIB or higher (odds ratio, 0.69; 95% CI, 0.52-0.93), have positive nodal status (odds ratio, 0.78; 95% CI, 0.64-0.95), or be estrogen receptor negative (odds ratio, 0.71; 95% CI, 0.56-0.91) than were interval cancers diagnosed after a film examination with negative findings. Screen-detected cancers diagnosed after digital and film mammography had similar rates of unfavorable tumor characteristics. Interval-detected cancers diagnosed after a digital examination were less likely to have unfavorable tumor features than those diagnosed after film mammography, but the absolute differences were small.

  8. Stages of Male Breast Cancer

    Science.gov (United States)

    ... Breast & Gynecologic Cancers Breast Cancer Screening Research Male Breast Cancer Treatment (PDQ®)–Patient Version General Information about Male Breast Cancer Go to Health Professional Version Key Points Male ...

  9. Breast cancer mortality in Norway after the introduction of mammography screening

    DEFF Research Database (Denmark)

    Olsen, Anne Helene; Lynge, Elsebeth; Njor, Sisse H

    2013-01-01

    An organized mammography screening program was gradually implemented in Norway during the period 1996-2004. Norwegian authorities have initiated an evaluation of the program. Our study focused on breast cancer mortality. Using Poisson regression, we compared the change in breast cancer mortality...... from before to during screening in four counties starting the program early controlling for change in breast cancer mortality during the same time in counties starting the program late. A follow-up model included death in all breast cancers diagnosed during the follow-up period. An evaluation model...... to the program, the implementation of the organized mammography screening program was associated with a statistically nonsignificant decrease in breast cancer mortality of around 11%....

  10. Breast cancer characteristics associated with digital versus screen-film mammography for screen-detected and interval cancers

    Science.gov (United States)

    Miglioretti, Diana L.; Kerlikowske, Karla; Wernli, Karen J.; Sprague, Brian L.; Lehman, Constance M.

    2015-01-01

    Purpose To determine if pathologic findings of screen-detected and interval cancers differ for digital versus film mammography. Materials and Methods This study was institutional review board approved and HIPAA compliant. Using 2003–2011 Breast Cancer Surveillance Consortium data, we included 3,021,515 screening mammograms (40.3% digital and 59.7% film) for women ages 40 to 89 years. Cancers were considered screen-detected if diagnosed within 12 months of a positive examination and interval if diagnosed within 12 months of a negative examination. Tumor characteristics for screen-detected and interval cancers were compared for digital versus film mammography using logistic regression models to estimate the odds ratio (OR) and 95% confidence interval (95%CI), adjusting for age, race/ethnicity, hormone therapy use, screening interval, examination year, and registry while accounting for correlation within facilities using generalized estimating equations. Results Among 15,729 breast cancers, 85.3% were screen-detected and 14.7% were interval. Digital and film mammography had similar rates of screen-detected (4.47 vs. 4.42 per 1000 examinations) and interval cancers (0.73 vs. 0.79 per 1000 examinations) for digital versus film, respectively. In adjusted analyses, interval cancers following a negative digital examination were less likely to be AJCC stage IIB or higher (OR=0.69, 95%CI:0.52–0.93), have positive nodal status (OR=0.78, 95%CI:0.64–0.95), or be estrogen receptor-negative (OR=0.71, 95%CI:0.56–0.91) compared with interval cancers following a negative film examination. Conclusions Screen-detected cancers following digital and film mammography had similar rates of unfavorable tumor characteristics. Interval-detected cancers after a digital examination were less likely to have unfavorable tumor features than those diagnosed after film, but absolute differences were small. PMID:26295657

  11. A prospective study of the screening for breast cancer by using DMR; Collaboration with four institutes

    Energy Technology Data Exchange (ETDEWEB)

    Endo, Tokiko; Kido, Choichiro; Horita, Katsuhei (Aichi Cancer Center, Nagoya (Japan). Hospital) (and others)

    1991-05-01

    Digital mammoradiography (DMR) is a new apparatus for mammography. Three thousands and six hundred seventy four breasts, including 192 cancer lesions, were evaluated by DMR and palpation in each institute. Screening ability for breast cancer was discussed by ROC analysis in the each group. Results were as follows: (1) DMR group showed inferior results compared with palpation group; (2) But, true positive rate was not enough for screening; (3) By a good education, higher true positive rate could be acquired in DMR group. In conclusion, DMR is an useful apparatus for mass screening for breast cancer in combination with palpation. (author).

  12. Evaluating the knowledge of breast cancer screening and prevention among Arab-American women in Michigan.

    Science.gov (United States)

    Arshad, Samia; Williams, Karen Patricia; Mabiso, Athur; Dey, Subhojit; Soliman, Amr S

    2011-03-01

    Arab-American women are more likely to be diagnosed with advanced staged breast cancer. We analyzed data from 100 women utilizing a breast cancer literacy assessment tool aimed at understanding functional literacy levels about breast-self exams (BSE), clinical breast exams (CBE), and mammograms. The educational program improved women's knowledge of BSE (OR = 0.15; 95% CI = 0.04, 0.50) and CBE (OR = 0.15; 95% CI = 0.04, 0.54), more for women with higher education. Consideration of women's educational status is an important factor in planning educational programs to improve knowledge on breast cancer screening and prevention in this minority population.

  13. Predicting regular breast cancer screening in African-American women with a family history of breast cancer.

    Science.gov (United States)

    Laing, Sharon S; Makambi, Kepher

    2008-11-01

    To evaluate the impact of socioeconomic, personal and affective factors on regular breast cancer screening in at-risk African-American women. The study was a cross-sectional analysis assessing socioeconomic and affective predictors of breast cancer screening practices. Unaffected African-American women ages 40-64 with a family history of breast cancer were recruited from community settings. The main outcome measures were recent mammography, regular mammography and regular breast self-examinations. The majority of women reported having a recent mammogram (73%) and yearly mammograms (71%). More than half (56%) reported monthly breast self-examinations (BSEs). Available health insurance and risk perception had significant independent associations with regular mammography screening so that women having a mammogram every 6-12 months were more likely to have health insurance [odds ratio (OR)=4.99, 95% confidence interval (CI): 1.05-23.52], and women not engaged in regular screenings were less likely to perceive future breast cancer risk (OR=0.10, 95% CI: 0.01-0.96). Access to regular healthcare had a significant independent association with recent mammography so that women having a mammogram in the past 12 months were more likely to have access to regular healthcare (OR=6.59, 95% CI: 1.01-42.79). A significant majority of this subset of African-American women engage in repeat mammography screenings with cognitive and economic factors predicting noncompliance. Additional research with repeat mammography users is required so that regular screening practices can be encouraged among all at-risk women.

  14. Does lack of resources impair access to breast and cervical cancer screening in Japan?

    Science.gov (United States)

    Sano, Hiroshi; Goto, Rei; Hamashima, Chisato

    2017-01-01

    To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.

  15. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography.

    NARCIS (Netherlands)

    Saslow, D.; Boetes, C.; Burke, W.; Harms, S.; Leach, M.O.; Lehman, C.D.; Morris, E.; Pisano, E.; Schnall, M.; Sener, S.; Smith, R.A.; Warner, E.; Yaffe, M.; Andrews, K.S.; Russell, C.A.

    2007-01-01

    New evidence on breast Magnetic Resonance Imaging (MRI) screening has become available since the American Cancer Society (ACS) last issued guidelines for the early detection of breast cancer in 2003. A guideline panel has reviewed this evidence and developed new recommendations for women at

  16. BMI and breast cancer prognosis benefit: mammography screening reveals differences between normal weight and overweight women.

    Science.gov (United States)

    Crispo, Anna; Grimaldi, Maria; D'Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Amore, Alfonso; D'Aiuto, Giuseppe; Giudice, Aldo; Ciliberto, Gennaro; Montella, Maurizio

    2015-02-01

    Few studies are available on the potential impact of body weight on breast cancer prognosis in screen-detected patients. Moreover, it is not known whether body mass index (BMI) could have a different prognostic impact in screen-detected versus symptomatic breast cancer patients. To investigate these unsolved issues, we carried out a retrospective study evaluating the effect of BMI on breast cancer prognosis in screen-detected vs symptomatic breast cancer patients. We conducted a follow-up study on 448 women diagnosed with incident, histologically-confirmed breast cancer. Patients were categorized according to their BMI as normal weight, overweight and obese. Disease free survival (DFS), overall survival (OS), and BMI curves were compared according to mode of cancer detection. Among screen-detected patients, higher BMI was associated with a significant lower DFS, whereas no significant difference was observed among symptomatic patients. OS showed similar results. In the multivariate analysis adjusting for age, education, tumor size, nodal status, estrogen receptor (ER), progesterone receptor (PR) and menopausal status, the risk for high level of BMI among screen-detected patients did not reach the statistical significance for either recurrence or survival. Our study highlights the potential impact of high bodyweight in breast cancer prognosis, the findings confirm that obesity plays a role in women breast cancer prognosis independently from diagnosis mode. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging.

    Science.gov (United States)

    Tieu, Minh Thi; Cigsar, Candemir; Ahmed, Sameera; Ng, Andrea; Diller, Lisa; Millar, B-A; Crystal, Pavel; Hodgson, David C

    2014-08-15

    Female survivors of pediatric Hodgkin lymphoma (HL) who have received chest radiotherapy are at increased risk of breast cancer. Guidelines for early breast cancer screening among these survivors are based on little data regarding clinical outcomes. This study reports outcomes of breast cancer screening with MRI and mammography (MMG) after childhood HL. We evaluated the results of breast MRI and MMG screening among 96 female survivors of childhood HL treated with chest radiotherapy. Outcomes measured included imaging sensitivity and specificity, breast cancer characteristics, and incidence of additional imaging and breast biopsy. Median age at first screening was 30 years, and the median number of MRI screening rounds was 3. Ten breast cancers were detected in 9 women at a median age of 39 years (range, 24-43 years). Half were invasive and half were preinvasive. The median size of invasive tumors was 8 mm (range, 3-15 mm), and none had lymph node involvement. Sensitivity and specificity of the screening modalities were as follows: for MRI alone, 80% and 93.5%, respectively; MMG alone, 70% and 95%, respectively; both modalities combined, 100% and 88.6%, respectively. All invasive tumors were detected by MRI. Additional investigations were required in 52 patients, (54%), and 26 patients (27%) required breast biopsy, with 10 patients requiring more than 1 biopsy. Screening including breast MRI with MMG has high sensitivity and specificity in pediatric HL survivors, with breast cancers detected at an early stage, although it is associated with a substantial rate of additional investigations. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  18. Breast cancer screening results 5 years after introduction of digital mammography in a population-based screening program.

    NARCIS (Netherlands)

    Karssemeijer, N.; Bluekens, A.M.; Beijerinck, D.; Deurenberg, J.J.; Beekman, M.; Visser, R.; Engen, R. van; Bartels-Kortland, A.; Broeders, M.J.M.

    2009-01-01

    PURPOSE: To compare full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) with screen-film mammography (SFM) in a population-based breast cancer screening program for initial and subsequent screening examinations. MATERIALS AND METHODS: The study was approved by the regional

  19. Breast and cervical cancer screening in obese minority women.

    Science.gov (United States)

    Ferrante, Jeanne M; Chen, Ping-Hsin; Jacobs, Abbie

    2006-06-01

    Studies using survey data from mostly white women showed that obese women are less likely than nonobese women to undergo breast and cervical cancer screening. It is unclear if these findings are true in nonwhite women. Using chart audit data, we examined the relationship between obesity and mammography and Pap smear screening among minority women. Data from retrospective chart review of women in three urban New Jersey academic family medicine practices were analyzed (n = 1809) using hierarchical logistic regression models. Outcome measures were being up-to-date in mammography and Pap smears among obese and nonobese women. There was no difference in mammography rates among obese and nonobese women. Independent risk factors for not being up-to-date in mammography included age 40-49, smoking, and comorbidity. Obese women were less likely than nonobese women to be upto- date in Pap smears (69% vs. 77%, p = 0.001). In multivariate analysis, obesity was associated with 25% decreased odds of being up-to-date on Pap smears (OR, 0.75, 95% CI, 0.58-0.99, p = 0.041). Age >or=65 years was also associated with decreased odds of being up-to-date in Pap smears. Hispanic women had increased odds of being up-to-date in mammography (OR 2.43, 95% CI 1.63-3.63) and Pap smears (OR 1.94, 95% CI 1.24-3.03) compared with white women. Obesity was associated with decreased Pap smear screening but not with decreased mammography. Further studies are needed to determine barriers and effective interventions to improve screening in obese minority women.

  20. From Cancer Screening to Treatment: Service Delivery and Referral in the National Breast and Cervical Cancer Early Detection Program

    Science.gov (United States)

    Miller, Jacqueline W.; Hanson, Vivien; Johnson, Gale D.; Royalty, Janet E.; Richardson, Lisa C.

    2015-01-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897

  1. The relationship of mammographic density and age: implications for breast cancer screening.

    Science.gov (United States)

    Checka, Cristina M; Chun, Jennifer E; Schnabel, Freya R; Lee, Jiyon; Toth, Hildegard

    2012-03-01

    Breast density is increasingly recognized as an independent risk factor for the development of breast cancer, because it has been shown to be associated with a four- to sixfold increase in a woman's risk of malignant breast disease. Increased breast density as identified on mammography is also known to decrease the diagnostic sensitivity of the examination, which is of great concern to women at increased risk for breast cancer. Dense tissue has generally been associated with younger age and premenopausal status, with the assumption that breast density gradually decreases after menopause. However, the actual proportion of older women with dense breasts is unknown. The purpose of this study was to examine the relationship between age and breast density, particularly focusing on postmenopausal women. All screening mammograms completed at the New York University Langone Medical Center in 2008 were retrospectively reviewed. Analysis of variance and descriptive analyses were used to evaluate the relationship between patient age and breast density. A total of 7007 screening mammograms were performed. The median age of our cohort was 57 years. Within each subgroup categorized by decade of age, there was a normal distribution among the categories of breast density. There was a significant inverse relationship between age and breast density (p breasts. This percentage decreased to 57% of women in their 50s. However, 44% of women in their 60s and 36% of women in their 70s had dense breasts as characterized on their screening mammograms. In general, we found an inverse relationship between patient age and mammographic breast density. However, there were outliers at the extremes of age. A meaningful proportion of young women had predominantly fatty breasts and a subset of older women had extremely dense breasts. Increased density renders mammography a less sensitive tool for early detection. Breast density should be considered when evaluating the potential benefit of extended

  2. Validation of the Korean Version of the Breast Cancer Screening Beliefs Questionnaire.

    Science.gov (United States)

    Kwok, Cannas; Lee, Mi-Joung; Lee, Chun Fan

    Korean immigrant women have been consistently reported as having low participation in breast cancer screening practices. A valid and reliable instrument to explore factors that affect their cancer screening behaviors is essential. The aim of this study was to report the psychometric properties of the Korean version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A convenience sample of 249 Korean Australian women was recruited through a number of Korean community organizations in Sydney. Exploratory factor analysis supports a similar fit for the original 3-factor structure of our data set. A significant association was found between the attitudes of these women toward general health checkups and the frequency of their performance of the breast awareness practices and having mammograms. Furthermore, it was found that knowledge and perceptions about the breast cancer scales were significantly associated with education level and that barriers to mammographic screening were much less evident among women who engaged in the 3 screening practices. The results indicated that the Korean version of the BCSBQ had satisfactory validity and internal consistency. The Cronbach's α of the 3 subscales ranged between .80 and .88. The Korean version of the BCSBQ was confirmed to be a culturally appropriate, valid, and reliable instrument for assessing the beliefs, knowledge, and attitudes to breast cancer and breast cancer screening practices among women of Korean background living in Australia. The Korean version of the BCBSQ can provide nurses with insights into the development of culturally sensitive breast health education programs.

  3. Balancing the benefits and detriments among women targeted by the Norwegian Breast Cancer Screening Program.

    Science.gov (United States)

    Hofvind, Solveig; Román, Marta; Sebuødegård, Sofie; Falk, Ragnhild S

    2016-12-01

    To compute a ratio between the estimated numbers of lives saved from breast cancer death and the number of women diagnosed with a breast cancer that never would have been diagnosed during the woman's lifetime had she not attended screening (epidemiologic over-diagnosis) in the Norwegian Breast Cancer Screening Program. The Norwegian Breast Cancer Screening Program invites women aged 50-69 to biennial mammographic screening. Results from published studies using individual level data from the programme for estimating breast cancer mortality and epidemiologic over-diagnosis comprised the basis for the ratio. The mortality reduction varied from 36.8% to 43% among screened women, while estimates on epidemiologic over-diagnosis ranged from 7% to 19.6%. We computed the average estimates for both values. The benefit-detriment ratio, number of lives saved, and number of women over-diagnosed were computed for different scenarios of reduction in breast cancer mortality and epidemiologic over-diagnosis. For every 10,000 biennially screened women, followed until age 79, we estimated that 53-61 (average 57) women were saved from breast cancer death, and 45-126 (average 82) were over-diagnosed. The benefit-detriment ratio using average estimates was 1:1.4, indicating that the programme saved about one life per 1-2 women with epidemiologic over-diagnosis. The benefit-detriment ratio estimates of the Norwegian Breast Cancer Screening Program, expressed as lives saved from breast cancer death and epidemiologic over-diagnosis, should be interpreted with care due to substantial uncertainties in the estimates, and the differences in the scale of values of the events compared. © The Author(s) 2016.

  4. Cultural Beliefs and Attitudes About Breast Cancer and Screening Practices Among Arabic Women in Australia.

    Science.gov (United States)

    Kwok, Cannas; Endrawes, Gihane; Lee, Chun Fan

    2016-01-01

    Arabic women have been consistently reported as having remarkably low participation rates in breast cancer screening measures in their home countries and after migration to Western countries. Little is known about the screening behaviors of Arabic women in Australia. This study aimed to report breast cancer screening practices among Arabic women in Australia and to examine the relationship between (1) demographic factors and (2) the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) score and women's breast screening behaviors. A descriptive cross-sectional method was used. Both English and Arabic versions of the BCSBQ were administered to the 251 Arabic Australian women 18 years or older who participated in the study. The majority of participants (62.9%-92%) had heard of breast awareness, clinical breast examination, and mammography. However, only 7.6% practiced breast awareness monthly, 21.4% had undergone clinical breast examination annually, and 40.3% had biannual mammography. Length of stay in Australia, being retired, and being unemployed were positively associated with the recommended performance of breast awareness and mammography. In terms of BCSBQ scores, women who engaged in the 3 screening practices had significantly higher scores on the attitudes to health check-ups and barriers to mammography subscales. Attitudes toward health check-ups and perceived barriers to mammography were important determinants of breast cancer screening practices among Arabic Australian women. To fully understand barriers discouraging Arabic Australian women from participating in breast cancer screening practices, efforts should be focused on specific subgroup (ie, working group) of Arabic Australian women.

  5. Risk modeling and screening for BRCA1 mutations among Filipino breast cancer patients

    CERN Document Server

    Nato, A Q J

    2003-01-01

    Breast cancer susceptibility gene, type 1(BRCA1) has been thought to be responsible for approx 45% of families with multiple breast carcinomas and for approx 80% of breast and ovarian cancer families. In this study, we investigated 34 familial Filipino breast cancer (BC) patients to: (a) estimate breast cancer risks and BRCA1/2 mutation carrier probabilities using risk assessment and prior probability models, respectively; (b) screen for putative polymorphisms at selected smaller exons of BRCA1 by single-strand conformation polymorphism (SSCP) analysis; (c) screen for truncated mutations at BRCA1 exon 11 by radioactive protein truncation test (PTT); and (d) estimate posterior probabilities upon incorporation of screening results. SSCP analysis revealed 8 unique putative polymorphisms. Low prevalence of unique putative polymorphisms at exon 2, 5, 17, and 22 may indicate probable mutations. Contrastingly, high prevalence of unique putative polymorphisms at exons 13, 15, and 16 may suggest true polymorphisms whi...

  6. Health seeking behavioral analysis associated with breast cancer screening among Asian American women

    Directory of Open Access Journals (Sweden)

    Ma GX

    2012-05-01

    Full Text Available Grace X Ma,1 Wanzhen Gao,1 Sunmin Lee,2 MinQi Wang,3 Yin Tan,1 Steven E Shive,1,41Department of Public Health, Center for Asian Health, College of Health Professions, Temple University, Philadelphia, PA, USA; 2Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA; 3Department of Public and Community Health, University of Maryland, College Park, Maryland, MD, USA; 4East Stroudsburg University, East Stroudsburg, PA, USAObjective: The purpose of this community-based study was to apply a Sociocultural Health Behavior Model to determine the association of factors proposed in the model with breast cancer screening behaviors among Asian American women.Methods: A cross-sectional design included a sample of 682 Chinese, Korean, and Vietnamese women aged 40 years and older. The frequency distribution analysis and Chi-square analysis were used for the initial screening of the following variables: sociodemographic, cultural, enabling, environmental, and social support. Univariate and multivariate analyses were conducted on factors for breast cancer screening using multinomial logistic regression analysis.Results: Correlates to positive breast cancer screening included demographics (ethnicity, cultural factors (living in the United States for 15 years or more, speaking English well, enabling factors (having a regular physician to visit, health insurance covering the screening, and family/social support factors (those who had a family/friend receiving a mammogram.Conclusions: The results of this study suggest that breast cancer screening programs will be more effective if they include the cultural and health beliefs, enabling, and social support factors associated with breast cancer screening. The use of community organizations may play a role in helping to increase breast cancer screening rates among Asian American women.Keywords: breast cancer screening, Vietnamese, Korean, Chinese, breast

  7. Breast Cancer Screening in Women with Learning Disabilities: Current Knowledge and Considerations

    Science.gov (United States)

    Willis, Diane S.; Kennedy, Catriona M.; Kilbride, Lynn

    2008-01-01

    As people with learning disabilities now live longer, they will experience the same age-related illnesses as the general population and cancer is a prime example of this. In women, cancer screening is used to detect early on-set of cancer of the breast and abnormalities of the cervix which might, if left untreated, develop into cancer.…

  8. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women: e0145492

    National Research Council Canada - National Science Library

    Waseem Khaliq; Ali Aamar; Scott M Wright

    2015-01-01

    .... Patients and Methods A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years...

  9. Factors Affecting Preferences of Iranian Women for Breast Cancer Screening Based on Marketing Mix Components

    National Research Council Canada - National Science Library

    Pourfarzi, Farhad; Fouladi, Nasrin; Amani, Firouz; Ahari, Saeid Sadegieh; Roshani, Zohre; Alimohammadi, Sara

    2016-01-01

    .... There is a great need for change to promote breast cancer screening among women. Social marketing is a discipline that uses the systematic application of commercial marketing techniques to promote the adoption of behavior by the target audience...

  10. Natural history of breast cancers detected in the Swedish mammography screening programme: a cohort study.

    Science.gov (United States)

    Zahl, Per-Henrik; Gøtzsche, Peter C; Mæhlen, Jan

    2011-11-01

    The natural history of screen-detected breast cancers is not well understood. A previous analysis of the incidence change during the introduction of the Norwegian screening programme in the late 1990s suggested that the natural history of many screen-detected invasive breast cancers is to regress spontaneously but the study was possibly confounded by use of hormone replacement therapy in the population. We did a similar analysis of data collected during an earlier period when few women were exposed to hormone replacement therapy. We compared cumulative breast cancer incidence in age-matched cohorts of women living in seven Swedish counties before and after the initiation of public mammography screening between 1986 and 1990. Women aged 40-49 years were invited to screening every year and women aged 50-74 years were invited every 2 years. A screened group including all women aged 40-69 years (n=328,927) was followed-up for 6 years after the first invitation to the programme. A control group including all women in the same age range (n=317,404) was also followed-up for 6 years--4 years without screening and 2 years when they entered the screening programme. Screening attendance was much the same in both groups (close to 80%). Counts of incident invasive breast cancers were obtained from the Swedish Cancer Registry (in-situ cancers were excluded). Before the age-matched controls were invited to be screened at the end of their follow-up period, the 4-year cumulative incidence of invasive breast cancer was significantly higher in the screened group (982 per 100,000) than it was in the control group (658 per 100,000) (relative risk [RR] 1·49, 95% CI 1·41-1·58). Even after prevalence screening in the control group, the screened group had higher 6-year cumulative incidence of invasive breast cancer (1443 per 100,000 vs 1269 per 100,000; RR 1·14, 1·10-1·18). Because the cumulative incidence among controls did not reach that of the screened group, we believe that many

  11. Breast and cervical cancer screening and associated factors among older adult women in South Africa.

    Science.gov (United States)

    Peltzer, Karl; Phaswana-Mafuya, Nancy

    2014-01-01

    Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic conditions were associated with breast cancer screening. Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention

  12. Inequalities in breast cancer stage at diagnosis in the Trent region, and implications for the NHS Breast Screening Programme.

    Science.gov (United States)

    Cuthbertson, Sarah A; Goyder, Elizabeth C; Poole, Jason

    2009-09-01

    This study investigates risk factors for diagnosis with late-stage breast cancer in order to identify inequalities and inform the understanding of barriers affecting access to mammography screening. Data from the Trent Cancer Registry were used to identify all women with invasive breast cancer, diagnosed in 1998-2006. Risk of diagnosis with late-stage breast cancer was calculated to quantify strength of association between exposure and outcome. Women outside the age group for routine screening were approximately 30% [70 years, RR = 1.27 (95% CI: 1.19-1.36)] more likely to be diagnosed with late-stage breast cancer; the most deprived women were 37% [RR = 1.37 (95% CI: 1.01-2.56)] more likely to be diagnosed with Stage IV breast cancer; ethnic minority women were 15% [RR = 1.15 (95% CI: 1.09-1.22)] more likely to be diagnosed with late-stage breast cancer and women resident in 5 of 11 Trent Primary Care Trusts (PCT) had a greater than 30% increased risk of diagnosis with late-stage breast cancer than those in Nottingham City PCT. These findings highlight the need for appropriate targeted interventions to address compositional and contextual inequalities that are evident in breast cancer stage at diagnosis.

  13. Interval breast cancers have worse tumor characteristics and survival compared to screen-detected breast cancers

    NARCIS (Netherlands)

    de Munck, L.; Siesling, S.; Pijnappel, R. M.; van der Vegt, B.; de Bock, G. H.

    2016-01-01

    Background There is debate to what extend screen-detected cancers (SDC) differ in tumor characteristics and survival from tumors that are detected not trough screening. These can be divide into three groups. Firstly, tumors who manifest clinically in the period between two screens after a negative

  14. Breast cancer screening practices of African migrant women in Australia: a descriptive cross-sectional study.

    Science.gov (United States)

    Ogunsiji, Olayide Oluyemisi; Kwok, Cannas; Fan, Lee Chun

    2017-04-17

    Breast cancer is the most diagnosed cancer among women and a leading cause of mortality and morbidity, globally. Breast cancer mortality can be improved through routine cancer screening, yet migrant populations have lower participation rates. While African migrants are among the fastest growing migrant population in Australia, their breast cancer screening behaviour is under-studied. The aims of this study were to report breast cancer screening status of African migrant women and factors associated with their breast cancer screening behaviour in Australia. A descriptive, cross-sectional approach was utilised for this study. Two hundred and sixty four African migrant women aged 18-69 years and recruited from a number of organisations responded to a self-reported African version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Main research variables are breast cancer screening practices and demographic characteristics and total scores on each of the BCSBQ subscales. Multivariable logistic regression analyses were performed to investigate the impact of the demographic variables on the likelihood of women in the target age range 50-74 years having screening practices as recommended. While most of the participants heard of breast awareness (76.1%) and mammogram (85.2%), only 11.4% practised monthly breast awareness, whereas 65.9% had ever had a mammogram as frequently as recommended. Age and employment were determining factors for participating in mammogram. Significant different scores were found in the "Practical barriers" between women at the target age who had and had not performed breast awareness (80.4 versus 77.5, p-value = 0.002) and mammogram (77.1 versus 70.3, p-value = 0.009) regularly as recommended. Moreover, attitudes towards general health check-ups subscale scores were significantly higher in women who had performed clinical breast examination as frequently as recommended than those who had not. The research reveals that practical

  15. Breast cancer – early detection and screening in South African ...

    African Journals Online (AJOL)

    Background Breast cancer is one of the most common cancers, rating among the most frequent causes of mortality in women worldwide, including in South Africa. Although curative treatment is increasingly successful, early detection and intervention are critical in reducing mortality rates. Early diagnosis is facilitated via ...

  16. Obesity and screening compliance for breast and cervical cancer in Korean women.

    Science.gov (United States)

    Park, Jin Kyun; Park, Hyun Ah; Park, Jin Joo; Cho, Young Gyu

    2012-01-01

    This study was performed to assess whether the weight status is associated with screening rates of breast and cervical cancer in Korean women. Study participants included women aged between 30 and 80 years from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Body mass index was classified into ~18.4 kg/m2 (underweight), 18.5~22.9 kg/m2 (normal), 23~24.9 kg/m2 (overweight), 25.0~29.9 kg/m2 (moderate obesity) and 30.0 kg/m2~ (severe obesity) according to the Asia Pacific Standards of WHO recommended definition of obesity. Screening rates of breast and cervical cancer were estimated by the recommendation of the National Cancer Screening Program of the National Cancer Center, Korea. The overall screening rates for breast and cervical cancer were 51.3% and 50.1%, respectively. After covariate adjustment, the screening rates for breast cancer (adjusted odds ratio, 0.70; 95% confidence interval, 0.51 to 0.97) and cervical cancer (adjusted odds ratio, 0.71; 95% confidence interval, 0.53 to 0.94) were significantly lower in the women with severe obesity. Obesity is associated with lower compliance with breast and cervical cancer screening guidelines in Korean women.

  17. Breast Cancer Risk in American Women

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Risk in American Women On This Page What ... risk of developing the disease. Personal history of breast cancer : Women who have had breast cancer are more ...

  18. Risk of breast cancer after false-positive test results in screening mammography

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My Catarina; Risør, Louise Madeleine; Thorsted, Brian Larsen

    2012-01-01

    Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests...

  19. Mammography requests in general practice during the introduction of nationwide breast cancer screening, 1988-1995.

    NARCIS (Netherlands)

    Beemsterboer, P.M.M.; Koning, H.J. de; Looman, C.W.N.; Borsboom, G.J.J.M.; Bartelds, A.I.M.; Maas, P.J. van der

    1999-01-01

    Introducing an organised breast cancer screening programme for certain age groups in a population might induce opportunistic screening in adjacent (non-invited) age groups and influence health behaviour in the target population. We analysed the effect of the start of the Dutch national screening

  20. Breast cancer in Pacific Islander women: overcoming barriers to screening and treatment.

    Science.gov (United States)

    Mounga, Va; Maughan, Erin

    2012-01-01

    This literature review identifies the health beliefs and practices that affect breast cancer screening and care among Pacific Islander women-specifically native Hawaiian, Samoan and Tongan women living in the continental United States-and provides suggestions for how nurses can address these issues. Several themes emerged in the literature regarding culture, language, health beliefs and health care access among Pacific Islander women. Nurses will be more successful in assisting Pacific Islander women to obtain timely breast cancer screening and treatment when they better understand Pacific Islander culture and provide culturally appropriate education materials on breast cancer. © 2012 AWHONN.

  1. Breast cancer incidence after the introduction of mammography screening: what should be expected?

    DEFF Research Database (Denmark)

    Svendsen, Anne Louise; Olsen, Anne Helene; von Euler-Chelpin, My

    2006-01-01

    that would otherwise not have arisen clinically). In the current study, the authors examined breast cancer incidence after the introduction of mammography screening in Denmark. METHODS: Denmark has 2 regional screening programs targeting women ages 50 years to 69 years. The programs were initiated in 1991......BACKGROUND: A prevalence peak is expected in breast cancer incidence when mammography screening begins, but afterward the incidence still may be elevated compared with prescreening levels. It is important to determine whether this is due to overdiagnosis (ie, the detection of asymptomatic disease...... and 1993, respectively. No screening takes place in the 13 other Danish regions. Data regarding incident breast cancers detected between 1979 and 2001 were retrieved from the Danish Cancer Registry for each screening region and for the rest of Denmark, and time trends in rates for women ages 50 years to 69...

  2. Effect of educational level on knowledge and use of breast cancer screening practices in Bangladeshi women.

    Science.gov (United States)

    Rasu, Rafia S; Rianon, Nahid J; Shahidullah, Sheikh M; Faisel, Abu J; Selwyn, Beatrice J

    2011-03-01

    The Breast Health Global Initiative 2007 emphasized education and cultural values for promoting breast cancer screening in developing countries. This cross-sectional study investigated if educational level and cultural beliefs affect breast cancer screening practices in 152 women 40 years or older in Dhaka, Bangladesh. Women with a higher (>12 years) educational level were more likely to know about breast self-examination (BSE; OR(adj), 95%CI = 22, 6.39-76.76), to know about mammograms (6, 2.49-15.70), and to practice BSE (3, 1.27-6.83) compared with those with a lower educational level. Breast cancer screening practices or knowledge was not affected by perceiving barriers to having mammograms.

  3. Breast cancer epidemiology according to recognized breast cancer risk factors in the Prostate, Lung, Colorectal and Ovarian (PLCO Cancer Screening Trial Cohort

    Directory of Open Access Journals (Sweden)

    Leitzmann Michael F

    2009-03-01

    Full Text Available Abstract Background Multidisciplinary attempts to understand the etiology of breast cancer are expanding to increasingly include new potential markers of disease risk. Those efforts may have maximal scientific and practical influence if new findings are placed in context of the well-understood lifestyle and reproductive risk factors or existing risk prediction models for breast cancer. We therefore evaluated known risk factors for breast cancer in a cancer screening trial that does not have breast cancer as a study endpoint but is large enough to provide numerous analytic opportunities for breast cancer. Methods We evaluated risk factors for breast cancer (N = 2085 among 70,575 women who were randomized in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Using Poisson regression, we calculated adjusted relative risks [RRs, with 95% confidence intervals (CIs] for lifestyle and reproductive factors during an average of 5 years of follow-up from date of randomization. Results As expected, increasing age, nulliparity, positive family history of breast cancer, and use of menopausal hormone therapy were positively associated with breast cancer. Later age at menarche (16 years or older vs. 2 35 or more vs. 18.5–24.9: RR = 1.21, 95% CI, 1.02–1.43] was statistically significantly associated with breast cancer. Conclusion The ongoing PLCO trial offers continued opportunities for new breast cancer investigations, but these analyses suggest that the associations between breast cancer and age at menarche, age at menopause, and obesity might be changing as the underlying demographics of these factors change. Clinical Trials Registration http://www.clinicaltrials.gov, NCT00002540.

  4. Factors associated with breast and cervical cancer screening behavior among African immigrant women in Minnesota.

    Science.gov (United States)

    Harcourt, Nonyelum; Ghebre, Rahel G; Whembolua, Guy-Lucien; Zhang, Yan; Warfa Osman, S; Okuyemi, Kolawole S

    2014-06-01

    Immigrant populations in the United States (US) have lower cancer screening rates compared to none immigrant populations. The purpose of this study was to assess the rates of cancer screening and examine factors associated with cancer screening behavior among African immigrant women in Minnesota. A cross sectional survey of a community based sample was conducted among African immigrants in the Twin Cities. Cancer screening outcome measures were mammography and Papanicolau smear test. The revised theoretical model of health care access and utilization and the behavioral model for vulnerable populations were utilized to assess factors associated with cancer screening. Only 61 and 52% of the age eligible women in the sample had ever been screened for breast and cervical cancer respectively. Among these women, duration of residence in the US and ethnicity were significant determinants associated with non-screening. Programs to enhance screening rates among this population must begin to address barriers identified by the community.

  5. Effect of screening mammography on breast-cancer mortality in Norway.

    Science.gov (United States)

    Kalager, Mette; Zelen, Marvin; Langmark, Frøydis; Adami, Hans-Olov

    2010-09-23

    A challenge in quantifying the effect of screening mammography on breast-cancer mortality is to provide valid comparison groups. The use of historical control subjects does not take into account chronologic trends associated with advances in breast-cancer awareness and treatment. The Norwegian breast-cancer screening program was started in 1996 and expanded geographically during the subsequent 9 years. Women between the ages of 50 and 69 years were offered screening mammography every 2 years. We compared the incidence-based rates of death from breast cancer in four groups: two groups of women who from 1996 through 2005 were living in counties with screening (screening group) or without screening (nonscreening group); and two historical-comparison groups that from 1986 through 1995 mirrored the current groups. We analyzed data from 40,075 women with breast cancer. The rate of death was reduced by 7.2 deaths per 100,000 person-years in the screening group as compared with the historical screening group (rate ratio, 0.72; 95% confidence interval [CI], 0.63 to 0.81) and by 4.8 deaths per 100,000 person-years in the nonscreening group as compared with the historical nonscreening group (rate ratio, 0.82; 95% CI, 0.71 to 0.93; Pscreening group (P=0.13). Thus, the difference in the reduction in mortality between the current and historical groups that could be attributed to screening alone was 2.4 deaths per 100,000 person-years, or a third of the total reduction of 7.2 deaths. The availability of screening mammography was associated with a reduction in the rate of death from breast cancer, but the screening itself accounted for only about a third of the total reduction. (Funded by the Cancer Registry of Norway and the Research Council of Norway.)

  6. Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods

    Directory of Open Access Journals (Sweden)

    Montazeri Ali

    2008-12-01

    Full Text Available Abstract Background Breast cancer remains an important public health problem. This study aimed to investigate about female knowledge of breast cancer and self-reported practice of breast self-examination in Iran. Methods This was a population-based survey carried out in Tehran, Iran. Data were collected via a structured questionnaire containing 15 questions on demographic status, history of personal and family breast problems, subjective knowledge about breast cancer covering its symptoms, the screening methods and practice of breast self-examination (BSE. A trained female nurse interviewed each respondent. Analysis included descriptive statistics and the Chi-squared test where necessary. Results A total of 1402 women were interviewed. The mean age of respondents was 43.4 (SD = 14.4 years; most were married (85%, and without any personal (94% and family history (90% of breast problems. It was found that 64% of the respondents were familiar with breast cancer and 61% (n = 851 believed that 'the disease is relatively common among women in Iran'. Most women (44% perceived a painless mass as a breast cancer symptom. Overall, 61% of the respondents stated that they knew about breast cancer screening programs and most indicated that electronic media (television 34% and radio 14% were their source of information. Only 17% of women said that 'they were conducting regular breast self-examination'. The main reason for women not doing breast self-examination was due to the fact that they did not know how to do it (64%. The findings indicated that performing breast self-examination is significantly related to: age, marital status, education, knowledge of breast cancer and knowledge about breast cancer screening programs (p Conclusion This descriptive study provides useful information that could be utilized by both researchers and those involved in public health programmes. The findings indicated that the women awareness of breast cancer warning signs

  7. Confirmatory factor analysis of the Chinese Breast Cancer Screening Beliefs Questionnaire.

    Science.gov (United States)

    Kwok, Cannas; Fethney, Judith; White, Kate

    2012-01-01

    Chinese women have been consistently reported as having low breast cancer screening practices. The Chinese Breast Cancer Screening Beliefs Questionnaire (CBCSB) was designed to assess Chinese Australian women's beliefs, knowledge, and attitudes toward breast cancer and screening practices. The objectives of the study were to confirm the factor structure of the CBCSB with a new, larger sample of immigrant Chinese Australian women and to report its clinical validity. A convenience sample of 785 Chinese Australian women was recruited from Chinese community organizations and shopping malls. Cronbach α was used to assess internal consistency reliability, and Amos v18 was used for confirmatory factor analysis. Clinical validity was assessed through linear regression using SPSS v18. The 3-factor structure of the CBCSB was confirmed, although the model required respecification to arrive at a suitable model fit as measured by the goodness-of-fit index (0.98), adjusted goodness-of-fit index (0.97), normed fit index (0.95), and root mean square error of approximation (0.031). Internal consistency reliability coefficients were satisfactory (>.6). Women who engaged in all 3 types of screening had more proactive attitudes to health checkups and perceived less barriers to mammographic screening. The CBCSB is a valid and reliable tool for assessing Chinese women's beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices. The CBCSB can be used for providing practicing nurses with insights into the provision of culturally sensitive breast health education.

  8. Determinants of breast cancer screening uptake in Kurdishwomen of Iran

    Directory of Open Access Journals (Sweden)

    Nayyereh Aminisani

    2016-03-01

    Conclusion: It was found that the level of breast screening uptake was low among Kurdish women compared to those reported in the previous studies. Designing participation enhancing interventions with a specific focus on older, illiterate and post-menopausal women are recommended.

  9. Testing novel patient financial incentives to increase breast cancer screening.

    Science.gov (United States)

    Merrick, Elizabeth Levy; Hodgkin, Dominic; Horgan, Constance M; Lorenz, Laura S; Panas, Lee; Ritter, Grant A; Kasuba, Paul; Poskanzer, Debra; Nefussy, Renee Altman

    2015-11-01

    To examine the effects of 3 types of low-cost financial incentives for patients, including a novel "person-centered" approach on breast cancer screening (mammogram) rates. Randomized controlled trial with 4 arms: 3 types of financial incentives ($15 gift card, entry into lottery for $250 gift card, and a person-centered incentive with choice of $15 gift card or lottery) and a control group. Sample included privately insured Tufts Health Plan members in Massachusetts who were women aged 42 to 69 years with no mammogram claim in ≥ 2.6 years. A sample of 4700 eligible members were randomized to 4 study arms. The control group received a standard reminder letter and the incentive groups received a reminder letter plus an incentive offer for obtaining a mammogram within the next 4 months. Bivariate tests and multivariate logistic regression were used to assess the incentives' impact on mammogram receipt. Data were analyzed for 4427 members (after exclusions such as undeliverable mail). The percent of members receiving a mammogram during the study was 11.7% (gift card), 12.1% (lottery), 13.4% (person-centered/choice), and 11.9% (controls). Differences were not statistically significant in bivariate or multivariate full-sample analyses. In exploratory subgroup analyses of members with a mammogram during the most recent year prior to the study-defined gap, person-centered incentives were associated with a higher likelihood of mammogram receipt. None of the low-cost incentives tested had a statistically significant effect on mammogram rates in the full sample. Exploratory findings for members who were more recently screened suggest that they may be more responsive to person-centered incentives.

  10. Comparison of breast and bowel cancer screening uptake patterns in a common cohort of South Asian women in England

    Directory of Open Access Journals (Sweden)

    Gumber Anil K

    2010-04-01

    Full Text Available Abstract Background Inequalities in uptake of cancer screening by ethnic minority populations are well documented in a number of international studies. However, most studies to date have explored screening uptake for a single cancer only. This paper compares breast and bowel cancer screening uptake for a cohort of South Asian women invited to undertake both, and similarly investigates these women's breast cancer screening behaviour over a period of fifteen years. Methods Screening data for rounds 1, 2 and 5 (1989-2004 of the NHS breast cancer screening programme and for round 1 of the NHS bowel screening pilot (2000-2002 were obtained for women aged 50-69 resident in the English bowel screening pilot site, Coventry and Warwickshire, who had been invited to undertake breast and bowel cancer screening in the period 2000-2002. Breast and bowel cancer screening uptake levels were calculated and compared using the chi-squared test. Results 72,566 women were invited to breast and bowel cancer screening after exclusions. Of these, 3,539 were South Asian and 69,027 non-Asian; 18,730 had been invited to mammography over the previous fifteen years (rounds 1 to 5. South Asian women were significantly less likely to undertake both breast and bowel cancer screening; 29.9% (n = 1,057 compared to 59.4% (n = 40,969 for non-Asians (p Conclusions Culturally appropriate targeted interventions are required to reduce observed disparities in cancer screening uptakes.

  11. European breast cancer service screening outcomes: a first balance sheet of the benefits and harms

    NARCIS (Netherlands)

    Paci, E.; Broeders, M.J.M.; Hofvind, S.; Puliti, D.; Duffy, S.W.

    2014-01-01

    A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast

  12. Screening sensitivity and sojourn time from breast cancer early detection clinical trials: mammograms and physical examinations.

    Science.gov (United States)

    Shen, Y; Zelen, M

    2001-08-01

    To estimate sensitivities of breast cancer screening modalities and preclinical duration of the disease from eight breast cancer screening clinical trials. Screening programs invariably lead to diagnosis of disease before signs or symptoms are present. Two key quantities of screening programs are the sensitivity of the disease detection modality and the mean sojourn time (MST). The observed screening histories in a periodically screened cohort make it possible to estimate these quantities of interest. We applied recently developed statistical methods to data from eight randomized breast cancer screening trials to estimate the sensitivities of early detection modalities and MST. Moreover, when a screening trial involved two screening modalities, our methods enabled the estimation of the individual sensitivity of each screening modality. We analyzed breast cancer data from several screening trials and have relatively complete data from the Health Insurance Plan (HIP), Edinburgh, and two Canadian studies. The screening sensitivity for mammography, physical examination, and MST were, respectively, HIP: 0.39, 0.47, and 2.5 years; Edinburgh: 0.63, 0.40, and 4.3 years; Canadian (age 40 to 49 at entry): 0.61, 0.59, and 1.9 years; Canadian (age 50 to 59 at entry): 0.66, 0.39, and 3.1 years. The public debate on early breast cancer detection is mainly centered on mammograms. However, the current study indicates that a physical examination is of comparable importance. Cautious interpretation of trial differences is required as a result of various experimental designs and the age dependency of screening sensitivity and MST.

  13. Relation between breast cancer mortality and screening effectiveness: systematic review of the mammography trials

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C

    2011-01-01

    an advanced stage. I performed a systematic review of the mammography screening trials using metaregression. Finding many cancers was not related to the size of the reduction in breast cancer mortality (p = 0.19 after seven and p = 0.73 after 13 years of follow-up). In contrast, finding few cancers in stage......The mammography screening trials have shown varying results. This could be because screening was better in some trials than in others at advancing the time of diagnosis. If so, more cancers would be identified in such trials relative to the control group, and fewer of the cancers would have reached...

  14. Prototype of Microwave Imaging System for Breast-Cancer Screening

    DEFF Research Database (Denmark)

    Rubæk, Tonny; Zhurbenko, Vitaliy

    2009-01-01

    Microwave imaging for breast-cancer detection has received the attention of a large number of research groups in the last decade. In this paper, the imaging system currently being developed at the Technical university of Denmark is presented. This includes a description of the antenna system, the...

  15. Rethinking breast cancer screening strategies in resource-limited ...

    African Journals Online (AJOL)

    The incidence of breast cancer in sub-Saharan nations is increasing. There is a worsening scarcity of Human Resource for Health in Uganda in particular and Sub Saharan Africa in general. Resources available for health care are predominantly spent on infectious disease care such as (HIV/AIDS, Tuberculosis and ...

  16. Miniature and Molecularly Specific Optical Screening Technologies for Breast Cancer

    Science.gov (United States)

    2006-10-01

    animal model of breast cancer undergoing a perturbation using carbogen inhalation . Statement of work for year 1 Physiological and metabolic...LED chips Wavelength range: 365 - 940 nm (Standard & Custom wavelength) Output power: 0.8 ~ 5.3 mW / each J.Y. Horiba A 450-W xenon lamp & a

  17. Preconceptions influence women's perceptions of information on breast cancer screening: a qualitative study.

    Science.gov (United States)

    Henriksen, Mikael Johannes Vuokko; Guassora, Ann Dorrit; Brodersen, John

    2015-09-03

    Screening for breast cancer has been subject to intense debate in recent decades regarding benefits and risks. Participation in breast cancer screening should be based on informed choice, and most countries approach this by sending information leaflets with invitations to attend screening. However, very little attention has been paid to the decision-making process and how the information leaflets are used and understood by women. The aim of this study is twofold. First, we use a theoretical framework to explore how the framing of information influences the intention to participate in breast cancer screening. Second, we discuss how information and attitudes held prior to receiving the invitation influence the perception of the balance between the benefits and risks harms of screening. We used a qualitative design and interviewed six women who were soon to receive their first invitation to participate in the breast screening programme in Denmark. The selected women received a copy of the official information leaflet 1 week before we interviewed them. The six women were interviewed individually using an interview guide based on the theory of planned behaviour. We used meaning condensation for our initial analysis, and further analysis was guided by the theory of cognitive dissonance. For our participants, the decision-making process was dominated by the attitudes of the women's circle of acquaintances and, to a lesser extent, by the information that accompanied the screening invitation. Information that conflicted with attitudes the women already held was actively disregarded. The risk of overdiagnosis as a potentially harmful effect of participation in mammography screening was unknown to the women in our study. An isolated framing effect was not found. Women have expectations about breast cancer screening that are formed before they receive information from the screening programme. These expectations compromise the perception of balance between screening benefits

  18. Changing patterns of microcalcification on screening mammography for prediction of breast cancer.

    Science.gov (United States)

    Kim, Kwan Il; Lee, Kyung Hee; Kim, Tae Ryung; Chun, Yong Soon; Lee, Tae Hoon; Choi, Hye Young; Park, Heung Kyu

    2016-05-01

    The presence of microcalcification on mammography is one of the earliest signs in breast cancer detection. However, it is difficult to distinguish malignant calcifications from benign calcifications. The aim of this study is to evaluate correlation between changing patterns of microcalcification on screening mammography and malignant breast lesions. Medical records and diagnostic images of 67 women who had previously undergone at least two digital mammograms at least 6 months apart and underwent mammography-guided needle localization and surgical excision between 2011 and 2013 were retrospectively reviewed and analyzed. Breast cancer was detected in the surgical specimens of 20 patients (29.9 %). Annual change of extent of microcalcification on mammography showed statistically significant correlation with pathologic outcome (P = 0.023). The changing pattern of new appearance or increased extent of microcalcification on mammography had positive predictive value of 54.8 % for breast cancer, and it was a statistically significant predictor for breast cancer (P = 0.012). Shape or number change of microcalcification without increased extent had less accurate predictive value for breast cancer, particularly in women younger than 50 years (P microcalcification on screening mammography was a significant predictor for breast cancer. We suggest that mammography-guided needle localization and surgical excision should be considered when increased extent of microcalcification is observed on screening mammography and closed follow-up without pathologic confirmation can be permitted if absence of extension of microcalcification was confirmed in women younger than 50 years.

  19. Breast cancer screening behaviors among Korean American immigrant women: findings from the Health Belief Model.

    Science.gov (United States)

    Lee, Hee Yun; Stange, Mia Ju; Ahluwalia, Jasjit S

    2015-11-01

    This study examined the utilization of clinical breast examinations (CBEs) and mammograms among Korean American immigrant women and investigated how the six constructs of Health Belief Model (HBM) are associated with the receipt of breast cancer screening. Using a quota sampling strategy, 202 Korean American immigrant women were recruited in metropolitan areas in the northeastern United States. Approximately 64% of the participants reported having had at least one CBE in their lifetime, and about 81% of the sample had undergone at least one mammogram in their lifetime. Women who perceived themselves to be susceptible to breast cancer were more likely to have undergone a CBE, and women who had lower barriers to screening or demonstrated a higher level of confidence were more likely than their counterparts to undergo a mammogram. Findings suggest that HBM constructs such as susceptibility, barriers, and confidence should be considered when designing interventions aimed at promoting breast cancer screening. © The Author(s) 2014.

  20. Effect of screening and adjuvant therapy on mortality from breast cancer.

    Science.gov (United States)

    Berry, Donald A; Cronin, Kathleen A; Plevritis, Sylvia K; Fryback, Dennis G; Clarke, Lauren; Zelen, Marvin; Mandelblatt, Jeanne S; Yakovlev, Andrei Y; Habbema, J Dik F; Feuer, Eric J

    2005-10-27

    We used modeling techniques to assess the relative and absolute contributions of screening mammography and adjuvant treatment to the reduction in breast-cancer mortality in the United States from 1975 to 2000. A consortium of investigators developed seven independent statistical models of breast-cancer incidence and mortality. All seven groups used the same sources to obtain data on the use of screening mammography, adjuvant treatment, and benefits of treatment with respect to the rate of death from breast cancer. The proportion of the total reduction in the rate of death from breast cancer attributed to screening varied in the seven models from 28 to 65 percent (median, 46 percent), with adjuvant treatment contributing the rest. The variability across models in the absolute contribution of screening was larger than it was for treatment, reflecting the greater uncertainty associated with estimating the benefit of screening. Seven statistical models showed that both screening mammography and treatment have helped reduce the rate of death from breast cancer in the United States. Copyright 2005 Massachusetts Medical Society.

  1. Breast cancer screening in England and the United States: a comparison of provision and utilisation.

    Science.gov (United States)

    Williams, Joseph; Garvican, Linda; Tosteson, Anna N A; Goodman, David C; Onega, Tracy

    2015-12-01

    Comparing breast cancer screening across countries within the context of some of the benefits and harms offers the opportunity to improve effectiveness through mutual learning. This paper describes the provision of breast cancer screening in England and the United States. The various recommendations for accessing breast cancer screening in the two countries are set out and the organisation of services including quality assurance, incentives and performance mechanisms considered. In the United States, younger women are routinely screened; they are less likely to benefit and more likely to be harmed. The utilisation of breast cancer screening amongst eligible women is broadly comparable in the two countries. However, there are differences in technical performance; the reasons for these including radiological reading procedures and cultural factors are explored. Despite a well-functioning screening programme, breast cancer mortality and survival in England are poor relative to other countries. Emphasis for American improvement should be on reducing false-positive recall rates, while the English NHS could supplement existing efforts to understand and improve comparatively poor survival and mortality.

  2. Breast cancer screening in BRCA1 and BRCA2 mutation carriers after risk reducing salpingo-oophorectomy

    NARCIS (Netherlands)

    Fakkert, I.E.; Jansen, L.; Meijer, K.; Kok, Theo; Oosterwijk, J.C.; Mourits, M.J.E.; de Bock, G.H.

    Breast cancer screening is offered to BRCA1 and BRCA2 mutation carriers from the age of 25 years because of their increased risk of breast cancer. As ovarian cancer screening is not effective, risk-reducing salpingho-oophorectomy (RRSO) is offered after child bearing age. RRSO before menopause

  3. Cost-Effectiveness Comparison of Breast Cancer Screening and Vascular Event Primary Prevention with Aspirin in Wales

    Science.gov (United States)

    Morgan, Gareth

    2011-01-01

    Aim: For the first time, this article presents a cost-effectiveness comparison of a breast cancer screening programme with a possible health education programme with aspirin for vascular event primary prevention. Background: Breast cancer screening is a well established part of cancer control programmes yet recent evidence on this intervention has…

  4. Effectiveness of peer education for breast cancer screening and health beliefs in eastern Turkey.

    Science.gov (United States)

    Gözüm, Sebahat; Karayurt, Ozgul; Kav, Sultan; Platin, Nurgun

    2010-01-01

    The primary site of cancer in Turkish women is breast cancer. The incidence of breast cancer is increasing in Turkey. The aim of the research was to educate women 40 years and older to increase their awareness on early detection and diagnosis, to facilitate the use of the early diagnosis methods, to improve the women's beliefs in relation breast cancer, and to increase the use of Cancer Early Diagnosis and Screening Centers available in the city. The target population of the research was 5000 women. Forty selected women were educated as peer educators. Twenty-five of them were selected as principal peer educator. Each peer educator was expected to educate 200 women. Peer trainers educated their peer and also arranged for the mammography appointment of the women who decided to have theirs taken. Data were obtained before and after the training by Champion's Health Belief Model Scale, questionnaire forms, and Cancer Early Diagnosis and Screening Centers data for mammography practice. Breast cancer was detected in 8 women. Statistical analyses showed positive changes in women's health beliefs and breast self-examination knowledge. There were 20.4% of women (n = 1040) who did get mammograms, and 8% (n = 8) of women were found to have cancer in all of those screened. Peer education was found to be effective for increasing the knowledge, beliefs, and practice of women related to breast cancer. Peers can reinforce learning through ongoing contact. Peer education can be used to improve early diagnosis of breast cancer and breast cancer awareness in asymptomatic women.

  5. Survey of the Role of Combined Screening Method with Ultrasonography in the Diagnosis of Breast Cancer

    Directory of Open Access Journals (Sweden)

    F. Gharekhanloo

    2011-01-01

    Full Text Available Introduction & Objective: The breast cancer is the most common malignancy in women and in recent years it is seen in younger ages. Because of dense breast tissue in these ages, the mammography sensitivity for breast cancer detection is reduced, so high quality ultrasonography (US as a combined screening method is effective. The aim of this study is the evaluation of the mammographic finding with the positive finding of ultrasonogarphy.Materials & Methods: In this cross-sectional study 300 cases were referred to the Mehr Medical Imaging Center for breast US and sonography of breast and axilla was performed. Mammography before or after US was also performed by another radiologist. All suspicious patients were referred for biopsy or surgery.Results: Mean age of patients was 46 y/o with the range of 32-76 y/o. Pathologic specimens approved malignancy in 21 patients and abscess in 1 patient. The most frequent symptom was palpable breast mass with mean diameter of 29 mm. Mean diameter of lymph nodes was 17.3 mm. Positive mammographic findings were seen in 85.7%and negative findings or only an asymmetric density in 14.3%.Conclusion: According to dense breast tissue especially in young women sensitivity of single screening by mammography is reduced in breast cancer detection, so combined screening with sonography and mammography especially in younger women improves the detection rate of breast carcinoma. (Sci J Hamadan Univ Med Sci 2011;17(4:57-60

  6. Performance of screening mammography: A report of the alliance for breast cancer screening in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Hye [Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kim, Keum Woo [Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of); Kim, Young Joong [Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of); and others

    2016-07-15

    To analyze the diagnostic accuracy and trend in screening mammography in Korea. We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI). We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR. The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations.

  7. Intention to Receive Breast Cancer Screening and Related Factors of Influence Among Vietnamese Women in Transnational Marriages.

    Science.gov (United States)

    Lee, Fang-Hsin

    2017-08-10

    Breast cancer is a major global health issue. Receivingregular breast cancer screenings aids in the early detection and treatment of breast cancer. Numerous factors influence whether a Vietnamese woman receives breast cancer screening. The aims of this study were to understand current rates of breast cancer screening and explore the factors that influence intention to undergo breast cancer screening among Vietnamese women in transnational marriages. This was a cross-sectional, community-based study. Data were collected via snowball sampling. We enrolled 250 women aged 18 years and over from September to December 2015. The percentage of participants who had received a breast self-examination, breast palpation, or breast ultrasound within the past year were 25.6%, 9.6%, and 21.2%, respectively. Moreover, only 6.8% of participants had received a mammography within the past 2 years. Participants with strong perceptions of breast cancer being a serious illness, who had fewer barriers to obtaining a breast cancer screening, or who had been advised by healthcare personnel to undergo screenings were more likely to report an intention to receive periodic breast self-examinations during the subsequent 1-year period. Participants who had lived in Taiwan for a longer period, had higher levels of perceived susceptibility to breast cancer, had prior experience with breast diseases, or had fewer barriers toobtaining a breast cancer screening were more likely to reportan intention to receive a breast ultrasound during the subsequent 1-year period. Finally, participants who were older, perceived greater benefits from receiving breast cancer screening, and had not entered menopause were more likely to report an intention to receive a mammography during the following 2 years. Medical care personnel should promote breast cancer screening among Vietnamese women in transnational marriages. The results may be useful in promoting greater awareness among medical care personnel of breast

  8. Breast cancer incidence and mortality in Tyrol/Austria after fifteen years of opportunistic mammography screening

    Directory of Open Access Journals (Sweden)

    Frede Thomas

    2010-02-01

    Full Text Available Abstract Background The aim of this study was to analyse breast cancer incidence and mortality in Tyrol from 1970 to 2006, namely after performing more than a decade of opportunistic mammography screening and just before piloting an organised screening programme. Our investigation was conducted on a population level. Methods To study time trends in breast cancer incidence and mortality, we applied the age-period-cohort model by Poisson regression to the official mortality data covering more than three decades from 1970 to 2006 and to the incidence data ranging from 1988 to 2006. In addition, for incidence data we analysed data on breast cancer staging and compared these with EU guidelines. Results For the analysis of time trend in breast cancer mortality in age groups 40-79, an age-period-cohort model fits well and shows for years 2002-2006 a statistically significant reduction of 26% (95% CI 13%-36% in breast cancer mortality as compared to 1992-1996. We see only slight non-significant increases in breast cancer incidence. For the past five years, incidence data show a 10% proportion of in situ cases, and of 50% for cases in stages II+. Conclusions The opportunistic breast cancer screening programme in Tyrol has only in part exploited the mortality reduction known for organised screening programmes. There seems to be potential for further improvement, and we recommend that an organised screening programme and a detailed screening database be introduced to collect all information needed to analyse the quality indicators suggested by the EU guidelines.

  9. National Breast Cancer Screening Programme, Singapore: evaluation of participation and performance indicators.

    Science.gov (United States)

    Loy, En Yun; Molinar, Darko; Chow, Khuan Yew; Fock, Christine

    2015-12-01

    To evaluate participation rates and performance indicators in the National Breast Cancer Screening Programme, BreastScreen Singapore (BSS). Data on women aged 40-69 screened in the period 2002-2009 was obtained from BSS and from the Singapore Cancer Registry. Participation rates and performance indicators (including screen detection rates, small tumour detection rates, recall rates, accuracy and interval cancer rates) were examined. BSS participation rate has remained above 10% since 2005. Based on health surveys, national mammography rates have increased from 29.7% before BSS to 39.6% in 2010 after BSS. Performance indicators, with the exception of recall rates, specificity, and interval cancer rate (for first screen), generally improved from 2002-2006 to 2007-2009 and are comparable with organized breast screening programmes in other developed countries. BSS breast cancer screening coverage and rescreen rates in Singapore could be improved. Mechanisms to monitor recall rates are in place, and training opportunities are provided to aid the professional development of radiologists. © The Author(s) 2015.

  10. Disparities in cancer screening in individuals with a family history of breast or colorectal cancer.

    Science.gov (United States)

    Ponce, Ninez A; Tsui, Jennifer; Knight, Sara J; Afable-Munsuz, Aimee; Ladabaum, Uri; Hiatt, Robert A; Haas, Jennifer S

    2012-03-15

    Understanding racial/ethnic disparities in cancer screening by family history risk could identify critical opportunities for patient and provider interventions tailored to specific racial/ethnic groups. The authors evaluated whether breast cancer (BC) and colorectal cancer (CRC) disparities varied by family history risk using a large, multiethnic population-based survey. By using the 2005 California Health Interview Survey, BC and CRC screening were evaluated separately with weighted multivariate regression analyses, and stratified by family history risk. Screening was defined for BC as mammogram within the past 2 years for women aged 40 to 64 years; for CRC, screening was defined as annual fecal occult blood test, sigmoidoscopy within the past 5 years, or colonoscopy within the past 10 years for adults aged 50 to 64 years. The authors found no significant BC screening disparities by race/ethnicity or income in the family history risk groups. Racial/ethnic disparities were more evident in CRC screening, and the Latino-white gap widened among individuals with family history risk. Among adults with a family history for CRC, the magnitude of the Latino-white difference in CRC screening (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.11-0.60) was more substantial than that for individuals with no family history (OR, 0.74; 95% CI, 0.59-0.92). Knowledge of their family history widened the Latino-white gap in CRC screening among adults. More aggressive interventions that enhance the communication between Latinos and their physicians about family history and cancer risk could reduce the substantial Latino-white screening disparity in Latinos most susceptible to CRC. Copyright © 2011 American Cancer Society.

  11. The Association of Social Support and Education with Breast and Cervical Cancer Screening

    Science.gov (United States)

    Documet, Patricia; Bear, Todd M.; Flatt, Jason D.; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M.

    2015-01-01

    Background: Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose:…

  12. Adaptive Computer-Assisted Mammography Training for Improved Breast Cancer Screening

    Science.gov (United States)

    2015-03-01

    detection in mammography ." Medical Physics 31: 958. Timp, S., N. Karssemeijer and J. Hendriks (2003). Analysis of changes in masses using contrast and...Award Number: W81XWH-11-1-0755 TITLE: Adaptive Computer-Assisted Mammography Training for Improved Breast Cancer Screening PRINCIPAL...14Dec2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-11-1-0755 Adaptive Computer-Assisted Mammography Training for Improved Breast Cancer

  13. Evaluation of the knowledge of women and registered nurses in Japan regarding the benefits and risks of breast cancer screening.

    Science.gov (United States)

    Shimada, Tomoyuki; Takahashi, Masayuki; Shimizu, Yuki; Hashimoto, Masaji

    2017-11-01

    Objective: Routine, population-based mammographic screening for breast cancer has been implemented nationally in Japan for the past decade. The objective of this study was to evaluate the knowledge of the general public and of nurses concerning breast screening practices in Japan, especially with regards to the benefits and risks of breast cancer screening. Methods: In 2014, a questionnaire regarding the benefits and risks of breast cancer screening was administered to women who underwent breast cancer screening and to registered nurses. The questionnaire was distributed to 1,649 women and 1,905 registered nurses. Results: Completed questionnaires were returned by 1,552 (94.1%) of the screened participants and 1,710 (89.8%) nurses. The majority of the screened participants and registered nurses believed that screening prevented or reduced the risk of developing breast cancer (86% and 62%, respectively); that screening reduced the mortality risk of breast cancer by more than 50% (69% and 60%, respectively); and that 10 years of regular screening for 50-year-old women could prevent ≥ 10 breast cancer deaths per 1,000 women (62% and 61%, respectively). Conclusions: Women in the target population and registered nurses were aware that earlier diagnosis led to better prognosis, but demonstrated misconceptions regarding other aspects of the benefits and risks of breast cancer screening. In Japan, all women should be educated on both the benefits and risks of breast cancer screening to enable them to make an informed decision on whether to participate in the mammographic breast cancer screening program.

  14. Predicting breast and colon cancer screening among English-as-a-second-language older Chinese immigrant women to Canada.

    Science.gov (United States)

    Todd, Laura; Harvey, Erin; Hoffman-Goetz, Laurie

    2011-03-01

    Little is known about the cancer screening behaviors of older ESL Chinese immigrant women. To explore predictors of colon and breast cancer screening in this population, 103 Mandarin- and Cantonese-speaking immigrant women ages 50 years and older were recruited. Participants completed questionnaires to evaluate screening behaviors, health literacy, and demographic characteristics. Eighty-five percent self-reported that they were current breast cancer screeners, and 75% were current colon cancer screeners. Recommendation from a physician, having a female physician, and high or moderate proficiency in English predicted current mammography screening. Physician recommendation, first language, and self-efficacy predicted use of colon cancer screening. Bivariate analyses also revealed an association between use of colon cancer screening and greater health literacy and longer residency in Canada. Important predictors of screening emerged that potentially informs interventions to increase cancer prevention among older Chinese immigrants. The essential role of physician recommendation was identified for both breast and colon cancer screening.

  15. Factors affecting recall rate and false positive fraction in breast cancer screening with breast tomosynthesis - A statistical approach.

    Science.gov (United States)

    Rosso, Aldana; Lång, Kristina; Petersson, Ingemar F; Zackrisson, Sophia

    2015-10-01

    In this study, we investigate which factors affect the false positive fraction (FPF) for digital breast tomosynthesis (DBT) compared to digital mammography (DM) in a screening population by using classification and regression trees (C&RT) and binary marginal generalized linear models. The data was obtained from the Malmö Breast Tomosynthesis Screening Trial, which aimed to compare the performance of DBT to DM in breast cancer screening. By using data from the first half of the study population (7500 women), a tree with the recall probability for different groups was calculated. The effect of age and breast density on the FPF was estimated using a binary marginal generalized linear model. Our results show that breast density and breast cancer were the main factors influencing recall. The FPF is mainly affected by breast density and increases with breast density for DBT and DM. In conclusion, the results obtained with C&RT are easy to interpret and similar to those obtained using binary marginal generalized linear models. The FPF is approximately 40% higher for DBT compared to DM for all breast density categories. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Simulation of reduced breast cancer mortality in breast cancer screening programs; Simulacion de la reduccion de mortalidad por cancer de mama en programas de cribado mamografico

    Energy Technology Data Exchange (ETDEWEB)

    Zamora, L. I.; Forastero, C.; Guirado, D.; Lallena, A. M.

    2011-07-01

    The breast cancer screening programs are an essential tool in the fight against breast cancer. Currently, many questions concerning the setup of these programs are open, namely: age range of women who undergo the same, frequency of mammography, ... The effectiveness of a program should be evaluated in terms of mortality reduction is its systematic implementation in the population. In this sense, we performed Monte Carlo simulations to assess that these reductions.

  17. Evaluation of Breast Cancer Cases Diagnosed In the Breast Cancer Screening Program In the Near East University Hospital of North Cyprus

    Science.gov (United States)

    Durdiyeva, Muhabbet Koralp; Besim, Hasan; Arslan, Kalbim; Özkayalar, Hanife; Yılmaz, Güliz; Mocan, Gamze Kuzey; Bulakbaşı, Nail

    2015-01-01

    Objective This study is about determination and eveluation of the breast cancer cases which were diagnosed during the early diagnosis and screening programs covering a three years of digital mammography images at the Near East University Hospital. Materials and Methods This study covers 2136 women patients who applied to the early diagnosis and screening program of the Near East University Hospital between July 2010 and July 2013. The mamographic images were re evaluated retrospectively according to ACR’s (The American College of Radiology) BİRADS (Breast Imaging Reporting and Data System). The mamographic results as required were correlated with breast ultrasound (US) and compared with the pathologic results of materials obtained by surgery or biopsy. The results were analyzed statistically in comparison with the literature data. Results The women who were screened aged between 34–73 years with a median of 53.5 (SD = 27.5). Suspected malignancy were evaluated in 54 patients, which 42 of them were diagnosed BIRADS 4 and 12 patients BIRADS 5 and 21 patients were correleted breast cancer based on histopathologic examination. 17 patients had the breast-conserving surgery and 4 patients were treated with mastectomy. Conclusion Breast cancers that are detected at early stages by breast cancer screening tests are more likely to be smaller and still confined to the breast resulting in more simple operations and more succesfull treatment. Promoting the breast cancer screening and registration programs in our country will help to control the desease at our region. PMID:28331685

  18. Health Beliefs and Breast Cancer Screening in Rural Appalachia: An Evaluation of the Health Belief Model.

    Science.gov (United States)

    VanDyke, Santana D; Shell, Madelynn D

    2017-09-01

    This study explored the role of the Health Belief Model in predicting breast cancer screening among women in rural Appalachia. Health beliefs (perceived susceptibility to breast cancer, severity of breast cancer, and benefits and barriers to screening) were used to predict health behavior (mammogram frequency). A total of 170 women aged 18-78 were recruited at a free health clinic in central Appalachia. Women completed surveys that assessed demographic characteristics, mammogram frequency, and perceived susceptibility, severity, and benefits and barriers to mammography. Consistent with expectations, women with objectively elevated risks for breast cancer (history of abnormal mammograms or family history of breast cancer) perceived themselves to be at higher risk for breast cancer, and those with a history of abnormal mammograms were more likely to receive mammograms regularly. In addition, older women expected their prognosis to be marginally poorer following a diagnosis, perceived greater benefits and fewer barriers to mammography, and were significantly more likely to receive mammograms regularly. Consistent with the Health Belief Model, fewer perceived barriers to mammography predicted greater mammogram frequency. However, the model was not fully supported because perceived susceptibility, severity, and benefits to mammography did not predict mammogram frequency. Results highlight the importance of reducing real and perceived barriers to screening in order to improve mammography rates among rural populations. © 2016 National Rural Health Association.

  19. Comparing barriers to colorectal cancer screening with barriers to breast and cervical screening: a population-based survey of screening-age women in Great Britain.

    Science.gov (United States)

    Lo, Siu Hing; Waller, Jo; Wardle, Jane; von Wagner, Christian

    2013-06-01

    Uptake of cancer screening tends to be lower for colorectal cancer (CRC) than cervical or breast cancer. Dislike of the test itself has often been identified as a barrier to CRC screening with the Faecal Occult Blood (FOB) test, but there have been no head-to-head comparisons of the three tests. Women aged 50-80 (n = 890) were recruited in spring 2012 as part of a population-based TNS Research International survey in Great Britain. Those in the eligible age range were asked if they had ever participated in breast, cervical or CRC screening. For each screening test, women who had never participated were asked for their 'main reason' using a checklist of barriers. Among eligible women, 67%, 83% and 90% reported ever having been screened for CRC, cervical and breast cancer respectively. More socioeconomically deprived women were less likely to report any screening, and single women were less likely to report CRC or breast screening than married women. Age was not associated with participation. Overall there were few differences between tests in the reported barriers, but dislike of the test was endorsed more often for CRC screening. This was the first study to compare barriers to participation in organised screening programmes for CRC, breast and cervical cancer. Cancer screening tests share many barriers, but dislike of the test appears to be a stronger barrier to CRC screening. Women who are non-participants in more than one programme may have more global barriers to screening, such as cancer fatalism. The findings suggest that uptake of CRC screening could be improved by targeting the unpleasantness of stool sampling.

  20. Breast Cancer Screening in Denmark: A Cohort Study of Tumor Size and Overdiagnosis.

    Science.gov (United States)

    Jørgensen, Karsten Juhl; Gøtzsche, Peter C; Kalager, Mette; Zahl, Per-Henrik

    2017-03-07

    Effective breast cancer screening should detect early-stage cancer and prevent advanced disease. To assess the association between screening and the size of detected tumors and to estimate overdiagnosis (detection of tumors that would not become clinically relevant). Cohort study. Denmark from 1980 to 2010. Women aged 35 to 84 years. Screening programs offering biennial mammography for women aged 50 to 69 years beginning in different regions at different times. Trends in the incidence of advanced (>20 mm) and nonadvanced (≤20 mm) breast cancer tumors in screened and nonscreened women were measured. Two approaches were used to estimate the amount of overdiagnosis: comparing the incidence of advanced and nonadvanced tumors among women aged 50 to 84 years in screening and nonscreening areas; and comparing the incidence for nonadvanced tumors among women aged 35 to 49, 50 to 69, and 70 to 84 years in screening and nonscreening areas. Screening was not associated with lower incidence of advanced tumors. The incidence of nonadvanced tumors increased in the screening versus prescreening periods (incidence rate ratio, 1.49 [95% CI, 1.43 to 1.54]). The first estimation approach found that 271 invasive breast cancer tumors and 179 ductal carcinoma in situ (DCIS) lesions were overdiagnosed in 2010 (overdiagnosis rate of 24.4% [including DCIS] and 14.7% [excluding DCIS]). The second approach, which accounted for regional differences in women younger than the screening age, found that 711 invasive tumors and 180 cases of DCIS were overdiagnosed in 2010 (overdiagnosis rate of 48.3% [including DCIS] and 38.6% [excluding DCIS]). Regional differences complicate interpretation. Breast cancer screening was not associated with a reduction in the incidence of advanced cancer. It is likely that 1 in every 3 invasive tumors and cases of DCIS diagnosed in women offered screening represent overdiagnosis (incidence increase of 48.3%). None.

  1. Comparative analysis of breast cancer mortality following mammography screening in Denmark and Norway.

    Science.gov (United States)

    Kalager, M; Løberg, M; Bretthauer, M; Adami, H-O

    2014-06-01

    Denmark and Norway are the best countries to study effects of mammography screening, because they are the only countries with stepwise introduction of nationwide mammography screening, enabling comparative effectiveness studies of high quality. Although Denmark and Norway are countries with similar populations and health care systems, reported reductions in breast cancer mortality (incidence-based) caused by screening differed vastly; 25% in Denmark versus 10% in Norway. This study explores reasons for this difference. We compared two published studies from the Danish and Norwegian screening programs (Olsen et al., 2005; Kalager et al., 2010) investigating biennial mammography screening for women age 50-69 years. Four comparison groups of women were constructed ('current' and 'historical screening groups'; 'current' and 'historical nonscreening groups') based on county of residence. We calculated incidence-based breast cancer mortality in the current versus the historical period for screening and nonscreening groups, using mortality rate ratios (MRR) in the two countries, accounting for concomitant changes in breast cancer mortality. In the screening groups, similar reductions in breast cancer mortality were found when periods preceding and following start of screening were compared, in Denmark [25%; MRR 0.75; 95% confidence interval (CI) 0.64% to 0.88%] and in Norway (28%; MRR 0.72; 95% CI 0.63% to 0.81%). However, mortality increased in Denmark in the current nonscreening group compared with the historical nonscreening group; for women >59 years, breast cancer mortality increased by 14% (MRR 1.14, 95% CI 1.07-1.22), whereas in Norway a 19% reduction was seen (MRR 0.81, 95% CI 0.72-0.92). This increase accounts for the different relative effect of screening in Denmark and Norway; 25% breast cancer mortality reduction in Denmark, 10% in Norway. The seemingly larger effect of screening in Denmark may not be solely attributable to screening itself, but to increased

  2. FDG-PET/CT detection of very early breast cancer in women with breast microcalcification lesions found in mammography screening.

    Science.gov (United States)

    Peng, Nan-Jing; Chou, Chen-Pin; Pan, Huay-Ben; Chang, Tsung-Hsien; Hu, Chin; Chiu, Yu-Li; Fu, Ting-Ying; Chang, Hong-Tai

    2015-08-01

    To assess the efficacy of positron emission tomography/computed tomography with the glucose analogue 2-[(18) F]fluoro-2-deoxy-D-glucose (FDG-PET/CT) in Taiwanese women with early breast cancer detected by mammography screening. Dual-time-point imaging of whole-body supine and breast prone scans using FDG-PET/CT were performed sequentially in the pre-operative stage. A total of 11,849 patients underwent screening mammography, of whom 1,209 (10.2%) displayed positive results. After further investigation, 54 patients underwent FDG-PET/CT. Post-operative pathology examinations revealed malignancies in 26 lesions, including invasive breast cancer in 11 cases and non-invasive breast cancer in 15 cases, as well as benign disease in 30 lesions. The FDG-PET/CT findings from the whole-body scans were positive for 9 of 11 invasive breast cancers (81.8%) and 3 of 15 non-invasive cancers (20%), and they were negative for all benign lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDG-PET/CT with whole-body supine imaging were 46.2%, 100%, 100% and 68.2%, respectively. Breast prone imaging revealed another patient with ductal carcinoma in situ, increasing the sensitivity to 50%. Importantly, positive PET findings were significantly correlated with tumour histology (P = 0.006), tumour size (P = 0.039) and Ki-67 expression (P = 0.011). FDG-PET/CT with whole-body scanning demonstrated high sensitivity to invasive breast cancer, limited sensitivity to non-invasive breast cancer, and high specificity for breast cancer. FDG-PET/CT might be useful for differentiating tumour invasiveness. However, the good PPV but poor NPV do not allow the physician to discard the biopsy. © 2015 The Royal Australian and New Zealand College of Radiologists.

  3. Understanding Hmong women's beliefs, feelings, norms, and external conditions about breast and cervical cancer screening.

    Science.gov (United States)

    Lor, Maichou; Khang, Pa Yiar; Xiong, Pa; Moua, Kao Feng; Lauver, Diane

    2013-01-01

    To describe the beliefs, feelings, norms, and external conditions regarding breast and cervical cancer screening in a sample of Hmong women. In a descriptive design, female Hmong researchers recruited 16 Hmong women (ages 24-73) at a community center. Guided by the Theory of Care Seeking Behavior (TCSB), researchers asked participants semi-structured questions about their beliefs, feelings, norms, and external conditions in a group setting. Researchers documented responses in writing and audio recordings. Guided by theory, we used directed content analysis to categorize responses. Participants' beliefs' about screening included uncertainty about causes of breast and cervical cancer, uncertainty about Western forms of treatments, and terminal illness as outcomes of such cancer. Many felt embarrassed about breast and cervical cancer screening. Their cultural norms about undressing for an exam and listening to authority figures were different from Western norms. External conditions that influenced participants' for screenings included difficulties in communicating with interpreters and clinicians. Consistent with the TCSB, Hmong women's beliefs, affect, cultural norms and external conditions helped to understand their use of breast and cervical screening. Findings could guide nursing and public health interventions to improve culturally sensitive, cancer screening for Hmong women. © 2013 Wiley Periodicals, Inc.

  4. Risk of breast cancer after false-positive results in mammographic screening

    DEFF Research Database (Denmark)

    Roman, Marta; Castells, Xavier; Hofvind, Solveig

    2016-01-01

    Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level...... of 2.42 (95% CI: 2.21–2.64). The RR of breast cancer at the screening test after the false-positive result was 3.95 (95% CI: 3.71–4.21), whereas it decreased to 1.25 (95% CI: 1.17–1.34) three or more screens after the false-positive result. Women with false-positive results had a twofold risk of screen......-detected breast cancer compared to women with negative tests. The risk remained significantly higher three or more screens after the false-positive result. The increased risk should be considered when discussing stratified screening strategies....

  5. A brief nursing intervention reduces anxiety before breast cancer screening mammography.

    Science.gov (United States)

    Fernández-Feito, Ana; Lana, Alberto; Baldonedo-Cernuda, Ricardo; Mosteiro-Díaz, María Pilar

    2015-01-01

    Anxiety experienced by women during their participation in breast cancer screening programs can condition their adherence to the program. The aim was to determine whether a brief nursing intervention could reduce anxiety before screening mammography. A randomized controlled trial carried out with 436 Spanish women aged between 50-69 years, who attended a population breast cancer screening program. The experimental group received an ad-hoc tailored intervention, which consisted of offering information about the screening program and the mammography exam, as well as of providing personal emotional support. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Fear of screening outcome and fear of breast cancer were also assessed. Women of the experimental group had 60% less probability of having a high anxiety state (OR = 0.40; 95%: CI [0.25, 0.65]), after adjusting for sociodemographic and clinical variables. Regarding trait anxiety, no differences were observed between groups. The stratified analysis showed that this positive impact was greater in women who did not fear the screening outcome (OR = 0.24; 95% CI [0.11, 0.52]) or breast cancer (OR = 0.07; 95% CI [0.01, 0.41]). A protocolized nursing intervention reduced the probability of being anxious when undergoing a screening mammography.

  6. Change in Breast Cancer Screening Intervals Since the 2009 USPSTF Guideline.

    Science.gov (United States)

    Wernli, Karen J; Arao, Robert F; Hubbard, Rebecca A; Sprague, Brian L; Alford-Teaster, Jennifer; Haas, Jennifer S; Henderson, Louise; Hill, Deidre; Lee, Christoph I; Tosteson, Anna N A; Onega, Tracy

    2017-08-01

    In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended biennial mammography for women aged 50-74 years and shared decision-making for women aged 40-49 years for breast cancer screening. We evaluated changes in mammography screening interval after the 2009 recommendations. We conducted a prospective cohort study of women aged 40-74 years who received 821,052 screening mammograms between 2006 and 2012 using data from the Breast Cancer Surveillance Consortium. We compared changes in screening intervals and stratified intervals based on whether the mammogram at the end of the interval occurred before or after the 2009 recommendation. Differences in mean interval length by woman-level characteristics were compared using linear regression. The mean interval (in months) minimally decreased after the 2009 USPSTF recommendations. Among women aged 40-49 years, the mean interval decreased from 17.2 months to 17.1 months (difference -0.16%, 95% confidence interval [CI] -0.30 to -0.01). Similar small reductions were seen for most age groups. The largest change in interval length in the post-USPSTF period was declines among women with a first-degree family history of breast cancer (difference -0.68%, 95% CI -0.82 to -0.54) or a 5-year breast cancer risk ≥2.5% (difference -0.58%, 95% CI -0.73 to -0.44). The 2009 USPSTF recommendation did not lengthen the average mammography interval among women routinely participating in mammography screening. Future studies should evaluate whether breast cancer screening intervals lengthen toward biennial intervals following new national 2016 breast cancer screening recommendations, particularly among women less than 50 years of age.

  7. Worry Is Good for Breast Cancer Screening: A Study of Female Relatives from the Ontario Site of the Breast Cancer Family Registry

    Directory of Open Access Journals (Sweden)

    Li Rita Zhang

    2012-01-01

    Full Text Available Background. Few prospective studies have examined associations between breast cancer worry and screening behaviours in women with elevated breast cancer risks based on family history. Methods. This study included 901 high familial risk women, aged 23–71 years, from the Ontario site of the Breast Cancer Family Registry. Self-reported breast screening behaviours at year-one followup were compared between women at low (N=305, medium (N=433, and high (N=163 levels of baseline breast cancer worry using logistic regression. Nonlinear relationships were assessed using likelihood ratio tests. Results. A significant non-linear inverted “U” relationship was observed between breast cancer worry and mammography screening (P=0.034 for all women, where women at either low or high worry levels were less likely than those at medium to have a screening mammogram. A similar significant non-linear inverted “U” relationship was also found among all women and women at low familial risk for worry and screening clinical breast examinations (CBEs. Conclusions. Medium levels of cancer worries predicted higher rates of screening mammography and CBE among high-risk women.

  8. Breast Cancer Screening Disparity among Korean American Immigrant Women in Midwest

    Science.gov (United States)

    Lee, Hee Yun; Lee, Mi Hwa; Jang, Yoo Jeong; Lee, Do Kyung

    2017-10-26

    Purpose: Using three breast cancer screening methods such as mammogram, Clinical Breast Examination (CBE), and Breast Self-Examination (BSE), this study investigated breast cancer screening rates and its associated factors in Korean American immigrant women. Method: Cross-sectional data were obtained from 168 Korean immigrant women aged 40 and older in Midwest. The Andersen’s Behavioral Model (1995) theoretically guided this study and logistic regression was used to examine factors associated with screening receipt and performance. Results: Study participants reported low screening rates, specifically mammography and CBE uptake. About 71% of the women had a mammography at least once in their lifetime, while about 36% indicating receipt of a mammogram in the last three years. About 59% of the women received a CBE at least once in their lifetime, while about 32% had CBE in the past three years. About 74% of study participants have performed BSE at least once in their life time, while about 68% have done it in the past three years. Knowledge of screening method was consistently correlated with participant’s three breast cancer screening uptake. Additional factors that were positively associated with screening included older age, low barriers to mammograms, and lower educational attainment. Conclusions: Overall, study participants reported low rates of breast cancer screening receipt and performance. It is required to promote screening uptake among Korean immigrant women, especially women with young age, a lower level of education, and lack of health accessibility. A community-based language-appropriate health education program should be developed to increase health care access. Creative Commons Attribution License

  9. Stage and survival in breast cancer patients in screened and non-screened Danish and Swedish populations

    DEFF Research Database (Denmark)

    Jensen, Anni R; Garne, Jens P; Storm, Hans H

    2003-01-01

    approach those of the Swedish registry. Complete population-based cohorts of patients with breast cancer in the years 1996-1997 from well-defined areas in Denmark and Sweden were compared. The study regions were a Danish (Funen) and a Swedish (Malmö) county with mammography screening and two Danish...... of populations provided with a screening programme. Five-year survival was 5-6%, higher in screening populations than in Danish non-screening counties. Corresponding disease-specific survival enhanced the difference. In a multivariate analysis increasing age, tumour size and stage decreased survival. Adjusting......Comparisons between the Danish and Swedish Cancer Registry revealed a 9% difference in 5-year survival for breast cancer patients diagnosed between 1983 and 1989. The purpose of this study was to determine whether previous differences in survival and stage still exist or whether the Danish figures...

  10. Values in breast cancer screening: an empirical study with Australian experts

    Science.gov (United States)

    Parker, Lisa; Rychetnik, Lucie; Carter, Stacy

    2015-01-01

    Objective To explore what Australian experts value in breast screening, how these values are conceptualised and prioritised, and how they inform experts’ reasoning and judgement about the Australian breast-screening programme. Design Qualitative study based on interviews with experts. Participants 33 experts, including clinicians, programme managers, policymakers, advocates and researchers selected for their recognisable influence in the Australian breast-screening setting. Setting Australian breast-screening policy, practice and research settings. Results Experts expressed 2 types of values: ethical values (about what was good, important or right) and epistemological values (about how evidence should be created and used). Ethical values included delivering benefit, avoiding harm, promoting autonomy, fairness, cost effectiveness, accountability, professionalism and transparency. Epistemological values informed experts’ arguments about prioritising and evaluating evidence methodology, source population and professional interests. Some values were conceptualised differently by experts: for example, delivering benefit could mean reducing breast cancer mortality, reducing all-cause mortality, reducing mortality in younger women, reducing need for aggressive treatment, and/or reassuring women they were cancer free. When values came into conflict, experts prioritised them differently: for example, when experts perceived a conflict between delivering benefits and promoting autonomy, there were differences in which value was prioritised. We explain the complexity of the relationship between held values and experts’ overall views on breast cancer screening. Conclusions Experts’ positions in breast screening are influenced by evidence and a wide range of ethical and epistemological values. We conclude that discussions about values should be a regular part of breast-screening review in order to build understanding between those who hold different positions, and

  11. Values in breast cancer screening: an empirical study with Australian experts.

    Science.gov (United States)

    Parker, Lisa; Rychetnik, Lucie; Carter, Stacy

    2015-05-20

    To explore what Australian experts value in breast screening, how these values are conceptualised and prioritised, and how they inform experts' reasoning and judgement about the Australian breast-screening programme. Qualitative study based on interviews with experts. 33 experts, including clinicians, programme managers, policymakers, advocates and researchers selected for their recognisable influence in the Australian breast-screening setting. Australian breast-screening policy, practice and research settings. Experts expressed 2 types of values: ethical values (about what was good, important or right) and epistemological values (about how evidence should be created and used). Ethical values included delivering benefit, avoiding harm, promoting autonomy, fairness, cost effectiveness, accountability, professionalism and transparency. Epistemological values informed experts' arguments about prioritising and evaluating evidence methodology, source population and professional interests. Some values were conceptualised differently by experts: for example, delivering benefit could mean reducing breast cancer mortality, reducing all-cause mortality, reducing mortality in younger women, reducing need for aggressive treatment, and/or reassuring women they were cancer free. When values came into conflict, experts prioritised them differently: for example, when experts perceived a conflict between delivering benefits and promoting autonomy, there were differences in which value was prioritised. We explain the complexity of the relationship between held values and experts' overall views on breast cancer screening. Experts' positions in breast screening are influenced by evidence and a wide range of ethical and epistemological values. We conclude that discussions about values should be a regular part of breast-screening review in order to build understanding between those who hold different positions, and provide a mechanism for responding to these differences. Published by

  12. Cost-Effective Screening for Breast Cancer Worldwide: Current State and Future Directions

    Directory of Open Access Journals (Sweden)

    A. Sarvazyan

    2008-01-01

    Full Text Available Affordability of healthcare is highly limited by its skyrocketing cost. Access to screening and diagnostic medical equipment and medicine in developing countries is inadequate for the majority of the population. There is a tremendous worldwide need to detect breast cancer at its earliest stage. These needs must be balanced by the ability of countries to provide breast cancer screening technology to their populations. We reviewed the diagnostic accuracy, procedure cost and cost-effectiveness of currently available technique for breast screening and diagnosis including clinical breast examination, mammography, ultrasound, magnetic resonance imaging, biopsy and a new modality for cancer diagnostics termed elasticity imaging that has emerged in the last decade. Clinical results demonstrate that elasticity imaging even in its simplest and least sophisticated versions, like tactile imaging, has significant diagnostic potential comparable and exceeding that of conventional imaging techniques. In view of many countries with limited resources, effective yet less expensive modes of screening must be considered worldwide. The tactile imaging is one method that has the potential to provide cost-effective breast cancer screening and diagnostics.

  13. Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme.

    Science.gov (United States)

    Lobbes, Marc B I; Lalji, Ulrich; Houwers, Janneke; Nijssen, Estelle C; Nelemans, Patty J; van Roozendaal, Lori; Smidt, Marjolein L; Heuts, Esther; Wildberger, Joachim E

    2014-07-01

    Feasibility studies have shown that contrast-enhanced spectral mammography (CESM) increases diagnostic accuracy of mammography. We studied diagnostic accuracy of CESM in patients referred from the breast cancer screening programme, who have a lower disease prevalence than previously published papers on CESM. During 6 months, all women referred to our hospital were eligible for CESM. Two radiologists blinded to the final diagnosis provided BI-RADS classifications for conventional mammography and CESM. Statistical significance of differences between mammography and CESM was calculated using McNemar's test. Receiver operating characteristic (ROC) curves were constructed for both imaging modalities. Of the 116 eligible women, 113 underwent CESM. CESM increased sensitivity to 100.0% (+3.1%), specificity to 87.7% (+45.7%), PPV to 76.2% (+36.5%) and NPV to 100.0% (+2.9%) as compared to mammography. Differences between conventional mammography and CESM were statistically significant (p mammography, AUC was 0.779. With CESM, AUC increased to 0.976 (p mammography, even in lower prevalence patient populations such as referrals from breast cancer screening. • CESM is feasible in the workflow of referrals from routine breast screening. • CESM is superior to mammography, even in low disease prevalence populations. • CESM has an extremely high negative predictive value for breast cancer. • CESM is comparable to MRI in assessment of breast cancer extent. • CESM is comparable to histopathology in assessment of breast cancer extent.

  14. Overdiagnosis in breast cancer screening: the importance of length of observation period and lead time.

    Science.gov (United States)

    Duffy, Stephen W; Parmar, Dharmishta

    2013-05-16

    Overdiagnosis in breast cancer screening is a controversial topic. One difficulty in estimation of overdiagnosis is the separation of overdiagnosis from lead time that is the advance in the time of diagnosis of cancers, which confers an artificial increase in incidence when a screening programme is introduced. We postulated a female population aged 50-79 with a similar age structure and age-specific breast cancer incidence as in England and Wales before the screening programme. We then imposed a two-yearly screening programme; screening women aged 50-69, to run for twenty years, with exponentially distributed lead time with an average of 40 months in screen-detected cancers. We imposed no effect of the screening on incidence other than lead time. Comparison of age- and time-specific incidence between the screened and unscreened populations showed a major effect of lead time, which could only be adjusted for by follow-up for more than two decades and including ten years after the last screen. From lead time alone, twenty-year observation at ages 50-69 would confer an observed excess incidence of 37%. The excess would only fall below 10% with 25 years or more follow-up. For the excess to be nullified, we would require 30 year follow-up including observation up to 10 years above the upper age limit for screening. Studies using shorter observation periods will overestimate overdiagnosis by inclusion of cancers diagnosed early due to lead time among the nominally overdiagnosed tumours.

  15. Breast cancer screening in Saudi Arabia: free but almost no takers.

    Directory of Open Access Journals (Sweden)

    Charbel El Bcheraoui

    Full Text Available Mammography ensures early diagnosis and a better chance for treatment and recovery from breast cancer. We conducted a national survey to investigate knowledge and practices of breast cancer screening among Saudi women aged 50 years or older in order to inform the breast cancer national health programs.The Saudi Health Interview Survey is a national multistage survey of individuals aged 15 years or older. The survey included questions on socio-demographic characteristics, tobacco consumption, diet, physical activity, health-care utilization, different health-related behaviors, and self-reported chronic conditions. Female respondents were asked about knowledge and practices of self and clinical breast exams, as well as mammography.Between April and June 2013, a total of 10,735 participants completed the survey. Among respondents, 1,135 were women aged 50 years or older and were included in this analysis. About 89% of women reported not having a clinical breast exam in the past year, and 92% reported never having a mammogram. Women living in Al Sharqia had the highest rate of mammography use. Women who were educated, those who had received a routine medical exam within the last two years, and those who were diagnosed with hypertension were more likely to have had a mammogram in the past two years.Our results show very low rates of breast cancer screening in the Kingdom of Saudi Arabia, a country with free health services. This calls for educational campaigns to improve breast cancer screening. Addressing the barriers for breast cancer screening is a public health imperative.

  16. Unifying Screening Processes Within the PROSPR Consortium: A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening

    Science.gov (United States)

    Kim, Jane J.; Schapira, Marilyn M.; Tosteson, Anna N. A.; Zauber, Ann G.; Geiger, Ann M.; Kamineni, Aruna; Weaver, Donald L.; Tiro, Jasmin A.

    2015-01-01

    General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute–funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast, cervical, and colorectal cancer and includes seven research centers and a statistical coordinating center. Given current health care reform initiatives in the United States, this conceptual model can facilitate the development of comprehensive quality metrics for cancer screening and promote trans-organ comparative cancer screening research. PROSPR findings will support the design of interventions that improve screening outcomes across multiple cancer sites. PMID:25957378

  17. The role of pre-invasive disease in overdiagnosis: A microsimulation study comparing mass screening for breast cancer and cervical cancer

    NARCIS (Netherlands)

    P.A. van Luijt (Paula); K. Rozemeijer (Kirsten); S.K. Naber (Steffie); E.A.M. Heijnsdijk (Eveline); J.M. van Rosmalen (Joost); M. van Ballegooijen (Marjolein); H.J. de Koning (Harry)

    2016-01-01

    textabstractObjective: Although early detection of cancer through screening can prevent cancer deaths, a drawback of screening is overdiagnosis. Overdiagnosis has been much debated in breast cancer screening, but less so in cervical cancer screening. We examined the impact of overdiagnosis by

  18. Molecular imaging of breast cancer

    NARCIS (Netherlands)

    Munnink, T. H. Oude; Nagengast, W. B.; Brouwers, A. H.; Schroder, C. P.; Hospers, G. A.; Lub-de Hooge, M. N.; van der Wall, E.; van Diest, P. J.; de Vries, E. G. E.

    2009-01-01

    Molecular imaging of breast cancer can potentially be used for breast cancer screening, staging, restaging, response evaluation and guiding therapies. Techniques for molecular breast cancer imaging include magnetic resonance imaging (MRI), optical imaging, and radionuclide imaging with positron

  19. Role Playing for Improving Women’s Knowledge of Breast Cancer Screening and Performance of Breast Self-Examination

    Science.gov (United States)

    Savabi-Esfahani, Mitra; Taleghani, Fariba; Noroozi, Mahnaz; Tabatabaeian, Maryam

    2017-09-27

    Background: To enhance knowledge and performance of screening as a strategy to control breast cancer, use of effective teaching methods is necessary. The objective of this study was to determine the effect of role-playing on knowledge of breast cancer screening and performance of breast self-examination (BSE). Methods: A quasi experimental design was used. Women enrolled in community cultural centers (n=314) were randomly divided into two educational groups: role playing (intervention) and lecture (control). Data were collected using a structured questionnaire before and after intervention. Reliability of the questionnaire was determined as 0.80 by Cronbach’s alpha. The women were followed up regarding performance of BSE one month later. Results: Of the 314 women, 113 (36%) and 132 (42%) had low and medium levels of knowledge, respectively. More than a third (38.2%) reported that TV and radio were the most important information sources for breast cancer and screening. There were significant differences between mean scores of knowledge before and after the intervention in both groups, but change was greater with role playing (31.3±1.9 as compared to 23.5±1.3) (P=0.001). After a month of educational intervention, 75.7% and 69.8% of those in role playing and control groups had undergone BSE. Conclusion: It appears that application of a role playing method by providers improves women’s knowledge and behavior with respect to breast cancer screening. Creative Commons Attribution License

  20. A survey study of women's responses to information about overdiagnosis in breast cancer screening in Britain

    OpenAIRE

    Waller, J.; Whitaker, KL; Winstanley, K; Power, E.; Wardle, J.

    2014-01-01

    Background: There is concern about public understanding of overdiagnosis in breast cancer screening, and uncertainty about the likely impact on screening participation. Methods: In a population-based survey of 2272 women, we assessed understanding of overdiagnosis and screening intentions before and after exposure to an explanation of overdiagnosis, and one of the three information formats providing an estimate of the rate of overdiagnosis based on the findings of the UK Independent Review. R...

  1. [Attendance of the fourth (2008-2009) screening round of the Hungarian organized, nationwide breast cancer screening program].

    Science.gov (United States)

    Boncz, Imre; Döbrőssy, Lajos; Péntek, Zoltán; Kovács, Attila; Budai, András; Imre, László; Vajda, Réka; Sebestyén, Andor

    2013-12-01

    Organised, nationwide screening for breast cancer with mammography in the age group between 45 and 65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyze the attendance rate of nationwide breast screening programme for the 2008-2009 years. The data derive from the database of the National Health Insurance Fund Administration. The ratio of women in the age group 45-65 years was calculated having either a screening mammography or a diagnostic mammography in the 4th screening round of the programme. In the years 2000-2001, 7.6% of the women had an opportunistic screening mammography while in 2008-2009 31.2% of the target population had screening mammography within the organized programme. During the same periods 20.2% (2000-2001) and 20.4% (2008-2009) of women had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.6% (2000-2001) to 50.1% (2008-2009). The attendance rate failed to change between 2002 and 2009. In order to decrease the mortality due to breast cancer, the attendance rate of mammography screening programme should be increased. Orv. Hetil., 154(50), 1975-1983.

  2. Impact of risk factors on different interval cancer subtypes in a population-based breast cancer screening programme.

    Directory of Open Access Journals (Sweden)

    Jordi Blanch

    Full Text Available BACKGROUND: Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers. METHODS: We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000-2006 and followed-up until 2009. A total of 5,309 screen-detected and 1,653 interval cancers were diagnosed. Among the latter, 1,012 could be classified on the basis of findings in screening and diagnostic mammograms, consisting of 489 true interval cancers (48.2%, 235 false-negatives (23.2%, 172 minimal-signs (17.2% and 114 occult tumors (11.3%. Information on the screening protocol and women's characteristics were obtained from the screening program registry. Cause-specific Cox regression models were used to estimate the hazard ratios (HR of risks factors for interval cancer and incident screen-detected cancer. A multinomial regression model, using screen-detected tumors as a reference group, was used to assess the effect of breast density and other factors on the occurrence of interval cancer subtypes. RESULTS: A previous false-positive was the main risk factor for interval cancer (HR = 2.71, 95%CI: 2.28-3.23; this risk was higher for false-negatives (HR = 8.79, 95%CI: 6.24-12.40 than for true interval cancer (HR = 2.26, 95%CI: 1.59-3.21. A family history of breast cancer was associated with true intervals (HR = 2.11, 95%CI: 1.60-2.78, previous benign biopsy with a false-negatives (HR = 1.83, 95%CI: 1.23-2.71. High breast density was mainly associated with occult tumors (RRR = 4.92, 95%CI: 2.58-9.38, followed by true intervals (RRR = 1.67, 95%CI: 1.18-2.36 and false-negatives (RRR = 1.58, 95%CI: 1.00-2.49. CONCLUSION: The role of women's characteristics differs among

  3. Impact of risk factors on different interval cancer subtypes in a population-based breast cancer screening programme.

    Science.gov (United States)

    Blanch, Jordi; Sala, Maria; Ibáñez, Josefa; Domingo, Laia; Fernandez, Belén; Otegi, Arantza; Barata, Teresa; Zubizarreta, Raquel; Ferrer, Joana; Castells, Xavier; Rué, Montserrat; Salas, Dolores

    2014-01-01

    Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers. We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000-2006 and followed-up until 2009. A total of 5,309 screen-detected and 1,653 interval cancers were diagnosed. Among the latter, 1,012 could be classified on the basis of findings in screening and diagnostic mammograms, consisting of 489 true interval cancers (48.2%), 235 false-negatives (23.2%), 172 minimal-signs (17.2%) and 114 occult tumors (11.3%). Information on the screening protocol and women's characteristics were obtained from the screening program registry. Cause-specific Cox regression models were used to estimate the hazard ratios (HR) of risks factors for interval cancer and incident screen-detected cancer. A multinomial regression model, using screen-detected tumors as a reference group, was used to assess the effect of breast density and other factors on the occurrence of interval cancer subtypes. A previous false-positive was the main risk factor for interval cancer (HR = 2.71, 95%CI: 2.28-3.23); this risk was higher for false-negatives (HR = 8.79, 95%CI: 6.24-12.40) than for true interval cancer (HR = 2.26, 95%CI: 1.59-3.21). A family history of breast cancer was associated with true intervals (HR = 2.11, 95%CI: 1.60-2.78), previous benign biopsy with a false-negatives (HR = 1.83, 95%CI: 1.23-2.71). High breast density was mainly associated with occult tumors (RRR = 4.92, 95%CI: 2.58-9.38), followed by true intervals (RRR = 1.67, 95%CI: 1.18-2.36) and false-negatives (RRR = 1.58, 95%CI: 1.00-2.49). The role of women's characteristics differs among interval cancer subtypes. This information could be

  4. Which strategies reduce breast cancer mortality most? Collaborative modeling of optimal screening, treatment, and obesity prevention.

    Science.gov (United States)

    Mandelblatt, Jeanne; van Ravesteyn, Nicolien; Schechter, Clyde; Chang, Yaojen; Huang, An-Tsun; Near, Aimee M; de Koning, Harry; Jemal, Ahmedin

    2013-07-15

    US breast cancer mortality is declining, but thousands of women still die each year. Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on incidence and obesity prevalence, competing causes of death, mammography characteristics, treatment effects, and survival/cure. Parameters are modified based on obesity (defined as BMI  ≥  30 kg/m(2) ). Outcomes are presented for the year 2025 among women aged 25+ and include numbers of cases, deaths, mammograms and false-positives; age-adjusted incidence and mortality; breast cancer mortality reduction and deaths averted; and probability of dying of breast cancer. If current patterns continue, the models project that there would be about 50,100-57,400 (range across models) annual breast cancer deaths in 2025. If 90% of women were screened annually from ages 40 to 54 and biennially from ages 55 to 99 (or death), then 5100-6100 fewer deaths would occur versus current patterns, but incidence, mammograms, and false-positives would increase. If all women received the indicated systemic treatment (with no screening change), then 11,400-14,500 more deaths would be averted versus current patterns, but increased toxicity could occur. If 100% received screening plus indicated therapy, there would be 18,100-20,400 fewer deaths. Eliminating obesity yields 3300-5700 fewer breast cancer deaths versus continuation of current obesity levels. Maximal reductions in breast cancer deaths could be achieved through optimizing treatment use, followed by increasing screening use and obesity prevention. © 2013 American Cancer Society.

  5. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit

    2015-01-01

    and subsequent non-participation in breast cancer screening. Methods This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50–69 years) for the first organised breast cancer screening programme -3 years later in the Central...

  6. Knowledge, attitudes and practices toward breast cancer screening in a rural South African community

    Directory of Open Access Journals (Sweden)

    Dorah U. Ramathuba

    2015-02-01

    Full Text Available Objectives: The study assessed the knowledge, attitudes and breast cancer screening practices amongst women aged 30–65 years residing in a rural South African community.Method: A quantitative, descriptive cross-sectional design was used and a systematic sampling technique was employed to select 150 participants. The questionnaire was pretested for validity and consistency. Ethical considerations were adhered to in protecting the rights of participants. Thereafter, data were collected and analysed descriptively using the Predictive Analytics Software program.Results: Findings revealed that the level of knowledge about breast cancer of women in Makwarani Community was relatively low. The attitude toward breast cancer was negative whereas the majority of women had never performed breast cancer diagnostic methods.Conclusion: Health education on breast cancer screening practices is lacking and the knowledge deficit can contribute negatively to early detection of breast cancer and compound late detection. Based on the findings, community-based intervention was recommended in order to bridge the knowledge gap

  7. [Mammography breast cancer screening in Italy: 2010 survey].

    Science.gov (United States)

    Giorgi, Daniela; Giordano, Livia; Ventura, Leonardo; Frigerio, Alfonso; Paci, Eugenio; Zappa, Marco

    2012-01-01

    This report is an update of similar previous papers that have been published by the ONS (Osservatorio nazionale screening, National Centre for Screening Monitoring) since 2002. Data for the survey come from several different programmes that may have changed over time, and may have different settings of organisation and management. During 2010, the first slight decrease in theoretical extension was recorded. Currently, all Italian regions have implemented screening programmes. In 2010, almost 2,496,000 women aged 50-69 years were invited to have a screening mammogram, and more than 1,382,000 were screened. Theoretical extension was 91.7%, while actual extension was 69.1%. An imbalance in extension is still present when comparing northern and central Italy to southern Italy, which only has a 75% coverage by organised screening. The Italian mean value (69%) of two-year extension (period 2009-2010) suggests that, at full capacity, Italian programmes are able to invite only three quarters of the target population. The percentage of women screened during 2010 was 36.7% of the national target population. During the last few years, participation rates were substantially stable, around 55-57% for crude rate, and 59-61% for adjusted rate, respectively. A decreasing trend towards the South of Italy is evident for this parameter, too. Many programmes work with low volumes of activity (below 10,000 or even 5,000 examinations per year), and only one region surpassed the desirable level of at least 20,000 examinations for each programme. Referral rates of 8.8% at first screening and 4.6% at repeat screening were recorded. Direct standardised detection rate was 6.2x1,000 at first screening and 4.3x1,000 at repeat screening, while benign to malignant ratio for first and repeat screening was 0.26 and 0.12, respectively. Detection rate of invasive cancers ≤10 mm was 1.36x1,000 at first screening and 1.49x1,000 at repeat screening; the proportion of in situ carcinomas was 13.9% and

  8. Organizational Change: A Case Study in Implementing a Breast Cancer Screening Clinic

    Science.gov (United States)

    1993-08-01

    ANO SUBTITLE S. FUNDING NUMBERS ORGANIZATIONAL CHANGE : A CASE STUDY IN IMPLEMENTING A BREAST CANCER SCREENING CLINIC 4. AUTHOR(S) i MAJ PATRICIA A...4psrANcsrBbed by ANS. SWOIl. UM-E S 6.~~ AUHO1S ORGANIZATIONAL CHANGE : A CASE STUDY IN IMPLEMENTING A BREAST CANCER SCREENING CLINIC A Graduate Management...Major Patricia A. Hayes, AN May 1993 Running head : ORGANIZATIONAL CHANGE 94-13 74BIH|iU •9 4 ,5 0 2 00 6 I] ACKNOWLEDGEMENTS A special thanks to COL

  9. Demographic changes in breast cancer incidence, stage at diagnosis and age associated with population-based mammographic screening.

    Science.gov (United States)

    Verdial, Francys C; Etzioni, Ruth; Duggan, Catherine; Anderson, Benjamin O

    2017-04-01

    Breast cancer incidence and mortality are influenced by early-detection methods, including mammographic screening. Demographic changes in US statistics serve as a model for changes that can be anticipated in countries where mammographic screening has not been implemented. SEER statistics (1973-2013) for breast cancer mortality, incidence, stage at diagnosis, and age at diagnosis were examined. Temporal associations between screening changes and breast cancer demographics in the US were documented. Before 1982 (pre-screening), breast cancer incidence in the US remained stable, with similar incidence of localized and regional cancers, and with in-situ disease comprising breast cancer incidence increased. In 1991, breast cancer age-adjusted mortality rates began decreasing and have continued to decrease. In the post-screening phase, stage distribution stabilized, but now with localized and in-situ disease representing the majority of diagnosed cases. The median age at diagnosis has increased to 61 years. Mammographic screening increases breast cancer incidence, shifts the stage distribution toward earlier stage disease, and in high-income countries, is associated with improved survival. Whether similar improvement in breast cancer survival can be achieved in the absence of mammographic screening has yet to be conclusively demonstrated. © 2017 Wiley Periodicals, Inc.

  10. Effect of population breast screening on breast cancer mortality up to 2005 in England and Wales: an individual-level cohort study.

    Science.gov (United States)

    Johns, Louise E; Coleman, Derek A; Swerdlow, Anthony J; Moss, Susan M

    2017-01-17

    Population breast screening has been implemented in the UK for over 25 years, but the size of benefit attributable to such programmes remains controversial. We have conducted the first individual-based cohort evaluation of population breast screening in the UK, to estimate the impact of the NHS breast screening programme (NHSBSP) on breast cancer mortality. We followed 988 090 women aged 49-64 years in 1991 resident in England and Wales, who because of the staggered implementation of the NHSBSP, included both invited subjects and an uninvited control group. Individual-level breast screening histories were linked to individual-level mortality and breast cancer incidence data from national registers. Risk of death from breast cancer was investigated by incidence-based mortality analyses in relation to intention to screen and first round attendance. Overdiagnosis of breast cancer following a single screening round was also investigated. Invitation to NHSBSP screening was associated with a reduction in breast cancer mortality in 1991-2005 of 21% (RR=0.79, 95% CI: 0.73-0.84, PBreast cancer deaths among first invitation attenders were 46% lower than among non-attenders (RR=0.54, 95% CI: 0.51-0·57, Pscreen. The results indicate a substantial, statistically significant reduction in breast cancer mortality between 1991 and 2005 associated with NHSBSP activity. This is important in public health terms.

  11. A failure analysis of invasive breast cancer: most deaths from disease occur in women not regularly screened.

    Science.gov (United States)

    Webb, Matthew L; Cady, Blake; Michaelson, James S; Bush, Devon M; Calvillo, Katherina Zabicki; Kopans, Daniel B; Smith, Barbara L

    2014-09-15

    Mortality reduction from mammographic screening is controversial. Individual randomized trials and meta-analyses demonstrate statistically significant mortality reductions in all age groups invited to screening. In women actually screened, mortality reductions are greater. Individual trials and meta-analyses show varying rates of mortality reduction, leading to questions about screening's value and whether treatment advances have diminished the importance of early detection. This study hypothesized that breast cancer deaths predominantly occurred in unscreened women. Invasive breast cancers diagnosed between 1990 and 1999 were followed through 2007. Data included demographics, mammography use, surgical and pathology reports, and recurrence and death dates. Mammograms were categorized as screening or diagnostic based on absence or presence of breast signs or symptoms, and were substantiated by medical records. Breast cancer deaths were defined after documentation of prior distant metastases. Absence of recurrent cancer and lethal other diseases defined death from other causes. Invasive breast cancer failure analysis defined 7301 patients between 1990 and 1999, with 1705 documented deaths from breast cancer (n = 609) or other causes (n = 905). Among 609 confirmed breast cancer deaths, 29% were among women who had been screened (19% screen-detected and 10% interval cancers), whereas 71% were among unscreened women, including > 2 years since last mammogram (6%), or never screened (65%). Overall, 29% of cancer deaths were screened, whereas 71% were unscreened. Median age at diagnosis of fatal cancers was 49 years; in deaths not from breast cancer, median age at diagnosis was 72 years. Most deaths from breast cancer occur in unscreened women. To maximize mortality reduction and life-years gained, initiation of regular screening before age 50 years should be encouraged. Copyright © 2013 American Cancer Society.

  12. Teaching strategies to facilitate breast cancer screening by African-American women.

    Science.gov (United States)

    Gibson, Lynette M

    2008-12-01

    The objective of this paper is to report on the recent literature concerning coverage of breast cancer epidemiology, the barriers to breast cancer screening, and the strategies to facilitate screening by African-American women. Based on these findings, the author suggests culturally appropriate techniques to be used to promote breast cancer screening in African-American women. Barriers to breast cancer screening in African-American women include emotional reasons, spiritual/religious reasons, fatalism, logistic concerns, lack of knowledge, and lack of follow-up by health-care professionals. Numerous strategies that have been targeted toward African-American women are reported. These include storytelling, witnessing, and testimonies; providing social support and having social support networks; and conducting multifaceted programs that include culturally specific breast health information. Based on the literature reviewed, the author suggests some examples of creative and culturally appropriate techniques that have been implemented with African-American women and that have resulted in positive feedback. These examples include the use of testimonies, photographs, prose, narratives, poetry, and quotations.

  13. Breast and cervical cancer screening among Latinas attending culturally specific educational programs.

    Science.gov (United States)

    Jandorf, Lina; Bursac, Zoran; Pulley, Leavonne; Trevino, Michelle; Castillo, Anabella; Erwin, Deborah O

    2008-01-01

    Latinas in the United States have higher morbidity and mortality rates for breast and cervical cancers (compared with non-Latina Whites), often due to lower screening rates. A community-based participatory research (CBPR) approach could help to improve screening rates by creating a culturally customized educational program for Latino men and women addressing low knowledge, gender roles, and spirituality. This study was designed to assess the effectiveness of a culturally customized program (Esperanza y Vida [Hope and Life]) in increasing breast and cervical cancer screening among Latinas, and to examine how screening rates related to changes in cancer knowledge, differences in ethnic origins, and geographic location. Participants were recruited to attend either a breast and cervical (intervention) or diabetes (control) education program, within a randomized plan. Sixty-nine programs (44 intervention; 25 control) were conducted in Arkansas (AR; n = 39) and New York City (NYC; n = 30) with a total of 847 Latino men and women. Telephone follow-up data were collected on 49% of the women who consented to being contacted 2 months postintervention. At the 2-month follow-up call, screening rates were significantly higher for the intervention versus the control group for clinical breast examination (CBE; 48% vs. 31%; adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.1-4.2), breast self-examination (45% vs. 27%; aOR, 2.3; 95% CI, 1.1-5.0), and Pap testing (51% vs. 30%; aOR, 3.9; 95% CI, 1.1-14.1), but not for mammography (67% vs. 58%; aOR, 0.7; 95% CI, 0.1-3.6). The aORs accounted for the significant effects of study site (AR vs. NYC) and marital status. Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection.

  14. Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey

    OpenAIRE

    Constantinou, Panayotis; Dray-Spira, Rosemary; Menvielle, Gwenn

    2016-01-01

    Background Comorbidity at the time of diagnosis is an independent prognostic factor for survival among women suffering from cervical or breast cancer. Although cancer screening practices have proven their efficacy for mortality reduction, little is known about adherence to screening recommendations for women suffering from chronic conditions. We investigated the association between eleven chronic conditions and adherence to cervical and breast cancer screening recommendations in France. Metho...

  15. Breast Cancer Knowledge and Screening Practice and Barriers Among Women in Madinah, Saudi Arabia.

    Science.gov (United States)

    Al-Zalabani, Abdulmohsen H; Alharbi, Khalid D; Fallatah, Nahid I; Alqabshawi, Reem I; Al-Zalabani, Ahmad A; Alghamdi, Suliman M

    2016-06-07

    A breast screening program may help to reduce cancer mortality rates among women. However, the use of the screening program by women in Madinah city is low, and studies examining its practice and barriers of low uptake are sparse. To identify breast cancer knowledge, practice and screening barriers among women attending primary health centers (PHC) in Madinah, Saudi Arabia. A primary health center-based cross-sectional study was performed in Madinah city in 2015. A multistage stratified cluster sample was obtained and included 465 women (15 years and older) from five PHC. Data concerning socio-demographics, knowledge about breast cancer, and practice and barriers of mammography use were collected using a structured questionnaire. The mean age of the studied 465 women was 34.9 ± 12.2 years. Of these women, 27.7 and 38.5 % received mammography and performed breast self-examination, respectively. A high level of poor knowledge about breast cancer was detected in the overall studied women and those who never received a mammography, particularly knowledge related to the risk factors of breast cancer. The most important predictors of the barriers to mammography were incorrect beliefs about mammography and its procedures. A belief that mammography is painful was significantly associated with a 56 % reduction in its use (OR = 0.44; 95 % CI = 0.22-0.88). The high levels of poor knowledge about cancer breast observed in this study reflect the need for greater efforts to increase breast awareness education.

  16. Overdiagnosis in breast cancer screening: The impact of study design and calculations.

    Science.gov (United States)

    Lynge, Elsebeth; Beau, Anna-Belle; Christiansen, Peer; von Euler-Chelpin, My; Kroman, Niels; Njor, Sisse; Vejborg, Ilse

    2017-07-01

    Overdiagnosis in breast cancer screening is an important issue. A recent study from Denmark concluded that one in three breast cancers diagnosed in screening areas in women aged 50-69 years were overdiagnosed. The purpose of this short communication was to disentangle the study's methodology in order to evaluate the soundness of this conclusion. We found that both the use of absolute differences as opposed to ratios; the sole focus on non-advanced tumours and the crude allocation of tumours and person-years by screening history for women aged 70-84 years, all contributed to the very high estimate of overdiagnosis. Screening affects cohorts of screened women. Danish registers allow very accurate mapping of the fate of every woman. We should be past the phase where studies of overdiagnosis are based on the fixed age groups from routine statistics. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  17. Barriers and facilitators to breast cancer screening among migrant women within Turkey.

    Science.gov (United States)

    Tuzcu, Ayla; Bahar, Zuhal

    2015-01-01

    The purpose of this study was to examine facilitators and barriers that migrant women in Turkey identified related to breast self-examination, clinical breast examination, and mammography. Focus group method was conducted with 39 women. An interview guide based on the Health Belief Model (HBM) and the Health Promotion Model (HPM) was used. Three main themes became apparent as a result of data analysis: (a) knowledge and awareness about breast cancer, (b) personal factors, and (c) medical service provider and social environment. Focus groups conducted in line with HBM and HPM were effective in explaining barriers and facilitators toward participation of women in screening behaviors. Lack of information, indifference, and cultural factors are the most important barriers of women. The study will shed light on health care professionals working in primary health care organizations for developing the health training programs and consulting strategies in order to increase breast cancer screening practices of migrant women. © The Author(s) 2014.

  18. Comparative pathology of breast cancer in a randomised trial of screening.

    Science.gov (United States)

    Anderson, T J; Lamb, J; Donnan, P; Alexander, F E; Huggins, A; Muir, B B; Kirkpatrick, A E; Chetty, U; Hepburn, W; Smith, A

    1991-07-01

    In the Edinburgh Randomised Breast Screening Project (EBSP) to December 1988 there were 500 cancers in the study population invited to screening and 340 cancers identified in the control population. The size and negative lymph node status characteristics of invasive cancers from the two populations were significantly different (P less than 0.05). The cancers detected by screening were predominantly 'early stage', with 16% noninvasive (PTIS) and 42% invasive stage I (pT1 node negative), whereas cancers were frequently 'late stage' (more than pT2) and inoperable in nonattenders (44%) and controls (36%). Grouped according to customary size ranges of invasive cancers, the proportion of cases lymph node positive differed in those screen detected compared with controls, but the benefit in favour of screen detection was not constant. In comparisons of cancers detected at prevalence and incidence screens, as a test of conformity with screening theory, no significant differences were apparent according to size and lymph node status, yet the characteristics of histological type of cancer discriminated significantly (P less than 0.05). When these same histological characteristics were used to compare survival, the capacity to separate invasive cancers into two groups having good and poor survival probabilities was evident, with a significant improvement for the screen detected poor survival group compared with controls (P less than 0.05).

  19. BRCA1 and BRCA2 Gene Mutations Screening In Sporadic Breast Cancer Patients In Kazakhstan.

    Directory of Open Access Journals (Sweden)

    Ainur R. Akilzhanova

    2013-05-01

    Full Text Available Background: A large number of distinct mutations in the BRCA1 and BRCA2 genes have been reported worldwide, but little is known regarding the role of these inherited susceptibility genes in breast cancer risk among Kazakhstan women. Aim: To evaluate the role of BRCA1/2 mutations in Kazakhstan women presenting with sporadic breast cancer. Methods: We investigated the distribution and nature of polymorphisms in BRCA1 and BRCA2 entire coding regions in 156 Kazakhstan sporadic breast cancer cases and 112 age-matched controls using automatic direct sequencing. Results: We identified 22 distinct variants, including 16 missense mutations and 6 polymorphisms in BRCA1/2 genes. In BRCA1, 9 missense mutations and 3 synonymous polymorphisms were observed. In BRCA2, 7 missense mutations and 3 polymorphisms were detected. There was a higher prevalence of observed mutations in Caucasian breast cancer cases compared to Asian cases (p<0.05; higher frequencies of sequence variants were observed in Asian controls. No recurrent or founder mutations were observed in BRCA1/2 genes. There were no statistically significant differences in age at diagnosis, tumor histology, size of tumor, and lymph node involvement between women with breast cancer with or without the BRCA sequence alterations. Conclusions: Considering the majority of breast cancer cases are sporadic, the present study will be helpful in the evaluation of the need for the genetic screening of BRCA1/2 mutations and reliable genetic counseling for Kazakhstan sporadic breast cancer patients. Evaluation of common polymorphisms and mutations and breast cancer risk in families with genetic predisposition to breast cancer is ongoing in another current investigation. 

  20. Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey.

    Science.gov (United States)

    Constantinou, Panayotis; Dray-Spira, Rosemary; Menvielle, Gwenn

    2016-03-31

    Comorbidity at the time of diagnosis is an independent prognostic factor for survival among women suffering from cervical or breast cancer. Although cancer screening practices have proven their efficacy for mortality reduction, little is known about adherence to screening recommendations for women suffering from chronic conditions. We investigated the association between eleven chronic conditions and adherence to cervical and breast cancer screening recommendations in France. Using data from a cross-sectional national health survey conducted in 2008, we analyzed screening participation taking into account self-reported: inflammatory systemic disease, cancer, cardiovascular disease, chronic respiratory disease, depression, diabetes, dyslipidemia, hypertension, obesity, osteoarthritis and thyroid disorders. We first computed age-standardized screening rates among women who reported each condition. We then estimated the effect of having reported each condition on adherence to screening recommendations in logistic regression models, with adjustment for sociodemographic characteristics, socioeconomic position, health behaviours, healthcare access and healthcare use. Finally, we investigated the association between chronic conditions and opportunistic versus organized breast cancer screening using multinomial logistic regression. The analyses were conducted among 4226 women for cervical cancer screening and 2056 women for breast cancer screening. Most conditions studied were not associated with screening participation. Adherence to cervical cancer screening recommendations was higher for cancer survivors (OR = 1.73 [0.98-3.05]) and lower for obese women (OR = 0.73 [0.57-0.93]), when accounting for our complete range of screening determinants. Women reporting chronic respiratory disease or diabetes participated less in cervical cancer screening, except when adjusting for socioeconomic characteristics. Adherence to breast cancer screening recommendations was lower for

  1. Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care?

    Science.gov (United States)

    Wee, C C; McCarthy, E P; Davis, R B; Phillips, R S

    2000-05-02

    Compared with thinner women, obese women have higher mortality rates for breast and cervical cancer. In addition, obesity leads to adverse social and psychological consequences. Whether obesity limits access to screening for breast and cervical cancer is unclear. To examine the relation between obesity and screening with Papanicolaou (Pap) smears and mammography. Population-based survey. United States. 11 435 women who responded to the "Year 2000 Supplement" of the 1994 National Health Interview Survey. Screening with Pap smears and mammography was assessed by questionnaire. In women 18 to 75 years of age who had not previously undergone hysterectomy (n = 8394), fewer overweight women (78%) and obese women (78%) than normal-weight women (84%) had had Pap smears in the previous 3 years (P obese women (-5.3% [CI, -8.0% to -2.6%]). In women 50 to 75 years of age (n = 3502), fewer overweight women (64%) and obese women (62%) than normal-weight women (68%) had had mammography in the previous 2 years (P obese women. Overweight and obese women were less likely to be screened for cervical and breast cancer with Pap smears and mammography, even after adjustment for other known barriers to care. Because overweight and obese women have higher mortality rates for cervical and breast cancer, they should be targeted for increased screening.

  2. The National Cancer Screening Program for breast cancer in the Republic of Korea: is it cost-effective?

    Science.gov (United States)

    Kang, Moon Hae; Park, Eun-Cheol; Choi, Kui Son; Suh, Mina; Jun, Jae Kwan; Cho, Eun

    2013-01-01

    This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

  3. Application of health behavior theories to breast cancer screening among Asian women.

    Science.gov (United States)

    Ahmadian, Maryam; Samah, Asnarulkhadi Abu

    2013-01-01

    Although breast cancer is a major public health worry among Asian women, adherence to screening for the disease remains an obstacle to its prevention. A variety of psycho-social and cultural factors predispose women to delay or avoidance of screening for breast cancer symptoms at the early stages when cure is most likely to be successful. Yet few interventions implemented to date to address this condition in this region have drawn on health behavior theory. This paper reviews the existing literature on several cognitive theories and models associated with breast cancer screening, with an emphasis on the work that has been done in relation to Asian women. To conduct this review, a number of electronic databases were searched with context-appropriate inclusion criteria. Little empirical work was found that specifically addressed the applicability of health theories in promoting adherence to the current breast cancer prevention programs Among Asian women. However, a few studies were found that addressed individual cognitive factors that are likely to encourage women's motivation to protect themselves against breast cancer in this region of the world. The findings suggest that multi-level, socio-cultural interventions that focus on cognitive factors have much promise with this issue. Interventions are needed that effectively and efficiently target the personal motivation of at-risk Asian women to seek out and engage in breast cancer prevention. Concerning implications, personal motivation to seek out and engage in individual preventive actions for breast cancer prevention among Asian women is a timely, high priority target with practical implications for community development and health promotion. Further studies using qualitative, anthropologic approaches shaped for implementation in multi-ethnic Asian settings are needed to inform and guide these interventions.

  4. The Breast Imaging Reporting and Data System (BI-RADS) in the Dutch breast cancer screening programme: its role as an assessment and stratification tool

    NARCIS (Netherlands)

    Timmers, J. M. H.; van Doorne-Nagtegaal, H. J.; Zonderland, H. M.; van Tinteren, H.; Visser, O.; Verbeek, A. L. M.; den Heeten, G. J.; Broeders, M. J. M.

    2012-01-01

    To assess the suitability of the Breast Imaging Reporting and Data System (BI-RADS) as a quality assessment tool in the Dutch breast cancer screening programme. The data of 93,793 screened women in the Amsterdam screening region (November 2005-July 2006) were reviewed. BI-RADS categories, work-up,

  5. Breast cancer incidence and mortality in the Nordic capitals, 1970-1998. Trends related to mammography screening programmes

    DEFF Research Database (Denmark)

    Törnberg, Sven; Kemetli, Levent; Lynge, Elsebeth

    2006-01-01

    was expected in Oslo due to too short an observation period. The study showed that the population-based breast cancer mortality trend is too crude a measure to detect the effect of screening on breast cancer mortality during the first years after the start of a programme.......The aim of the present study was to relate the time trends in breast cancer incidence and mortality to the introduction of mammography screening in the Nordic capitals. Helsinki offered screening to women aged 50-59 starting in 1986. The other three capitals offered screening to women aged 50......-69 starting in 1989 in Stockholm, 1991 in Copenhagen, and 1996 in Oslo. Prevalence peaks in breast cancer incidence depended on the age groups covered by the screening, the length of the implementation of screening, and the extent of background opportunistic screening. No mortality reduction following...

  6. Treatment Options for Male Breast Cancer

    Science.gov (United States)

    ... Breast & Gynecologic Cancers Breast Cancer Screening Research Male Breast Cancer Treatment (PDQ®)–Patient Version General Information about Male Breast Cancer Go to Health Professional Version Key Points Male ...

  7. Participation and retention in the breast cancer screening program in New Brunswick Canada

    Directory of Open Access Journals (Sweden)

    James Ted McDonald

    2017-06-01

    Full Text Available New Brunswick (NB Canada uses its breast cancer screening service program to assess the extent to which eligible NB women are complying with mammography guidelines. While many studies have investigated factors associated with participation in periodic breast cancer screening in Canada and elsewhere, most work has relied on self-reported surveys or smaller scale primary data collection. Using a longitudinal administrative dataset for NB over the period 1996–2011 of 255,789 eligible women aged 45–69, this study examined demographic, socioeconomic and geographic factors associated with initial participation in regular screening at age 50 and ongoing retention in the program. Logistic regression was used to examine correlates of initial screening, while rescreening participation was estimated using survival analysis accounting for rescreening episodes. Initial screening participation was lower for women born outside of NB, many women living farther away from screening centers, women in rural areas, and higher for married women. In contrast, retention was higher for rural women and women recently arrived in NB. For both participation and retention, regional disparities across health zone persisted after controlling for observable personal and locational factors. The analysis highlights important characteristics to be targeted to increase screening but also that how health zones operate their screening programs exerts a very significant effect on the use of screening services by eligible women. This offers lessons for the design and evaluation of any cancer screening program.

  8. Comparison of early performance indicators for screening projects within the European Breast Cancer Network: 1989-2000.

    NARCIS (Netherlands)

    Broeders, M.J.M.; Scharpantgen, A.; Ascunce, N.; Gairard, B.; Olsen, A.H.; Mantellini, P.; Mota, T.C.; Limbergen, E. van; Seradour, B.; Ponti, A.; Trejo, L.S.; Nystrom, L.

    2005-01-01

    In 1989 the European Breast Cancer Network (EBCN) was established by the first pilot projects for breast cancer screening, co-funded by the Europe Against Cancer programme. We report early performance indicators for these EBCN projects while taking into account their organizational setting. Out of

  9. Reproductive factors and lung cancer risk among women in the Singapore Breast Cancer Screening Project.

    Science.gov (United States)

    Tan, Hui Shan; Tan, Min-Han; Chow, Khuan Yew; Chay, Wen Yee; Lim, Wei-Yen

    2015-12-01

    A growing body of literature suggests that female hormones play a role in lung cancer risk. Our study aims to examine the relationship between reproductive factors and lung cancer incidence in a large prospectively enrolled cohort in Singapore. Multivariate Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of lung cancer for each exposure, adjusting for smoking, age at entry, ethnicity and body mass index. Among 28,222 women aged 50-64 years enrolled in the Singapore Breast Cancer Screening Project from October 1994 to February 1997, we identified 311 incident lung cancer cases (253 in non-smokers) over an average of 15.8 years of follow-up to 31 December 2011. Higher parity was associated with decreased lung cancer risk. Compared with nulliparous women, those with 1-2, 3-4, and ≥5 deliveries had a hazard ratio (HR) of 0.56, 0.55 and 0.45, respectively (P(trend)cancer. Our findings add to the existing evidence that parous women have a lower lung cancer risk than nulliparous women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Applying the Health Belief Model in Predicting Breast Cancer Screening Behavior of Women

    Directory of Open Access Journals (Sweden)

    Masoudiyekta

    2015-10-01

    Full Text Available Background Breast cancer is the most common cancer among Iranian women. However, early detection of this cancer leads to a timely treatment and better prognosis, which significantly improves the survival rate in patients. Objectives The purpose of this study was to predict the breast cancer screening behavior of women who referred to health centers in Dezful, Iran, using the health belief model (HBM. Patients and Methods This descriptive-analytical study was conducted on 226 women who were selected with cluster sampling method from those referred to Dezful health centers. Data collection tool was a researcher made questionnaire based on the constructs of the HBM. Data analysis was performed using SPSS software and through methods of descriptive statistics, Pearson correlation, and regression. Results According to the findings of the study, the knowledge and performance of women were poor, and there was a significant relationship between women’s performance and variables of knowledge, perceived sensitivity, perceived benefits, perceived barriers, self-efficacy, and cues to action. In addition, variables of knowledge (P = 0.001, perceived sensitivity (P = 0.022, and self-efficacy (P = 0.001 were predictors of performance in women participating in this study. Conclusions Poor knowledge and performance of women indicates a crucial need for formal educational programs to sensitize women regarding the importance of breast cancer screening. These educational programs should consider factors affecting breast cancer screening behaviors.

  11. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.

    Directory of Open Access Journals (Sweden)

    Waseem Khaliq

    Full Text Available Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women.A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography.Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89, current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67, and history of stroke (OR = 2.83, 95%CI; 1.21-6.60. By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34.Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

  12. Using a state cancer registry to recruit young breast cancer survivors and high-risk relatives: protocol of a randomized trial testing the efficacy of a targeted versus a tailored intervention to increase breast cancer screening.

    Science.gov (United States)

    Katapodi, Maria C; Northouse, Laurel L; Schafenacker, Ann M; Duquette, Debra; Duffy, Sonia A; Ronis, David L; Anderson, Beth; Janz, Nancy K; McLosky, Jennifer; Milliron, Kara J; Merajver, Sofia D; Duong, Linh M; Copeland, Glenn

    2013-03-01

    The Michigan Prevention Research Center, the University of Michigan Schools of Nursing, Public Health, and Medicine, and the Michigan Department of Community Health propose a multidisciplinary academic-clinical practice three-year project to increase breast cancer screening among young breast cancer survivors and their cancer-free female relatives at greatest risk for breast cancer. The study has three specific aims: 1) Identify and survey 3,000 young breast cancer survivors (diagnosed at 20-45 years old) regarding their breast cancer screening utilization. 2) Identify and survey survivors' high-risk relatives regarding their breast cancer screening utilization. 3) Test two versions (Targeted vs. Enhanced Tailored) of an intervention to increase breast cancer screening among survivors and relatives. Following approval by human subjects review boards, 3,000 young breast cancer survivors will be identified through the Michigan Cancer Registry and mailed an invitation letter and a baseline survey. The baseline survey will obtain information on the survivors': a) current breast cancer screening status and use of genetic counseling; b) perceived barriers and facilitators to screening; c) family health history. Based on the family history information provided by survivors, we will identify up to two high-risk relatives per survivor. Young breast cancer survivors will be mailed consent forms and baseline surveys to distribute to their selected high-risk relatives. Relatives' baseline survey will obtain information on their: a) current breast cancer screening status and use of genetic counseling; and b) perceived barriers and facilitators to screening. Young breast cancer survivors and high-risk relatives will be randomized as a family unit to receive two versions of an intervention aiming to increase breast cancer screening and use of cancer genetic services. A follow-up survey will be mailed 9 months after the intervention to survivors and high-risk relatives to evaluate

  13. Preoperative MR Imaging in Women with Breast Cancer Detected at Screening US.

    Science.gov (United States)

    Bae, Min Sun; Lee, Su Hyun; Chu, A Jung; Shin, Sung Ui; Ryu, Han Suk; Moon, Woo Kyung

    2017-03-01

    Purpose To determine additional cancer yield of magnetic resonance (MR) imaging in women with breast cancer detected at screening ultrasonography (US) and to identify a subgroup of women who are likely to benefit from preoperative MR imaging. Materials and Methods This study was approved by the institutional review board, and the requirement for informed consent was waived. A retrospective review of 374 women (median age, 48 years; age range, 30-74 years) with breast cancer detected at screening US (invasive, n = 321) who underwent preoperative breast MR imaging between 2007 and 2013 was performed. Cancer yield and positive predictive value of biopsy were calculated. Multivariate logistic regression analysis was performed to identify clinical-pathologic features associated with additional cancer detected at MR imaging. Results Of 374 women, 21 (5.6%; 95% confidence interval [CI]: 3.5%, 8.5%) were diagnosed with additional cancer (positive predictive value of biopsy, 42.0% [21 of 50 women]; 95% CI: 28%, 57%). Index invasive lobular cancer (ILC) histologic type was significantly associated with additional cancer detected at MR imaging (odds ratio, 4.0; 95% CI: 1.2, 13.6; P = .03). In women with index invasive cancer, premenopausal status (odds ratio, 5.7; 95% CI: 1.2, 35.8; P = .03) and lobular histologic type (odds ratio, 3.9; 95% CI: 1.1, 12.3; P = .03) were factors associated with additional cancer detected at MR imaging. Conclusion Preoperative MR imaging helped to detect additional sites of cancer in 5.6% of women with breast cancer detected at screening US. Women with index ILC and premenopausal women are more likely to benefit from preoperative MR imaging. (©) RSNA, 2016 Online supplemental material is available for this article.

  14. Overdiagnosis associated with breast cancer screening: A simulation study to compare lead-time adjustment methods.

    Science.gov (United States)

    Seigneurin, A; Labarère, J; Duffy, S W; Colonna, M

    2015-12-01

    Estimating overdiagnosis associated with breast cancer screening may use annual incidence rates of cancer. We simulated populations invited to screening programmes to assess two lead-time adjustment methods. Overdiagnosis estimates were computed using the compensatory drop method, which considered the decrease in incidence of cancers among older age groups no longer offered screening, and the method based on the decrease in incidence of late-stage cancers. The true value of overdiagnosis was 0% in all the data sets simulated. The compensatory drop method yielded an overdiagnosis estimate of -0.1% (95% credibility interval -0.5% to 0.5%) when participation rates among the population and risk of cancers were constant. However, if participation rates increased with calendar year as well as risk of cancer with birth cohorts, the overdiagnosis estimated was 11.0% (10.5-11.6%). Using the method based on the incidence of early- and late-stage cancers, overdiagnosis estimates were 8.9% (8.5-9.3%) and 17.6% (17.4-17.9%) when participation rates and risks of cancer were constant or increased with time, respectively. Adjustment for lead time based on the compensatory drop method is accurate only when participation rates and risks of cancer remain constant, whereas the adjustment method based on the incidence of early- and late-stage cancers results in overestimating overdiagnosis regardless of stability of participation rates and breast cancer risk. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Asymptomatic breast cancer in non-participants of the national screening programme in Norway: a confounding factor in evaluation?

    Science.gov (United States)

    Hoff, Solveig R; Klepp, Olbjørn; Hofvind, Solveig

    2012-12-01

    To evaluate the extent and histopathological characteristics of asymptomatic breast cancer detected outside the Norwegian Breast Cancer Screening Program (NBCSP) in women targeted by the programme. Our study included 568 primary breast cancers (523 invasive and 45 ductal carcinoma in situ) diagnosed in 553 women aged 50-70, residing in Møre og Romsdal County, 2002-2008. The cancers were divided into screening-detected cancers in the NBCSP, interval cancers (ICs) and cancers detected in women not participating in the NBCSP (never participated and lapsed attendees), and further into asymptomatic and symptomatic cancers. Nottingham Prognostic Index (NPI) was used for comparisons across the groups and the distributions were compared using chi-square tests for statistical significance. Twenty percent (19/97) of the ICs and 32% (69/213) of the breast cancers in non-participants were asymptomatic, with opportunistic screening as the most frequent detection method (42%, 8/19 for ICs and 54%, 37/69 for non-participants). There were no differences in distribution of NPI prognostic categories across subgroups of asymptomatic invasive cancers (screening-detected cancers in the NBCSP, asymptomatic ICs and asymptomatic cancers in non-participants) or between subgroups of symptomatic invasive cancers (symptomatic ICs and symptomatic cancers in non-participants). Asymptomatic cancers had a significantly more favourable distribution of NPI prognostic categories compared with symptomatic cancers (P breast cancers detected outside the organized screening programme were asymptomatic, with a prognostic profile comparable with screening-detected breast cancers in the NBCSP. Individual data regarding the detection method for all breast cancers are needed for a complete evaluation of the organized screening programme in Norway.

  16. Does routine symptom screening with ESAS decrease ED visits in breast cancer patients undergoing adjuvant chemotherapy?

    Science.gov (United States)

    Barbera, L; Sutradhar, R; Howell, D; Sussman, J; Seow, H; Dudgeon, D; Atzema, C; Earle, C; Husain, A; Liu, Y; Krzyzanowska, M K

    2015-10-01

    In 2007, the provincial cancer agency in Ontario, Canada initiated a wide-scale program to screen for symptoms in the cancer population using the Edmonton Symptom Assessment Scale (ESAS). The purpose of this study is to evaluate the impact of screening with ESAS on emergency department (ED) visit rates in women with breast cancer receiving adjuvant chemotherapy. This retrospective cohort study used linked administrative health care data from across the province of Ontario, Canada. The cohort included all women aged ≥18 who were diagnosed with stage I-III breast cancer between January 2007 and December 2009 and received adjuvant chemotherapy within 6 months of diagnosis. Using an adjusted recurrent event model, we examined the association of screening with ESAS at a clinic visit on the ED visit rate. The relative rate of ED visits was 0.57 when prior ESAS screening occurred compared to when it did not. The relative rate of ED visits was 0.83 when the prior number of ESAS screens was modeled as a continuous variable. Alternatively stated, the rate of ED visits was 43 % lower among patients previously screened with ESAS compared to those not previously screened. For each additional prior ESAS assessment, there was a 17 % decreased rate of ED visits. Our results demonstrate that screening with ESAS is associated with decreased ED visits. To our knowledge, this is the first report on the effectiveness of routinely documenting a patient reported outcome on ED visits, in a real-world setting.

  17. Breast cancer screening among women younger than age 50: a current assessment of the issues.

    Science.gov (United States)

    Smith, R A

    2000-01-01

    In the hope of resolving underlying policy questions related to the value of breast cancer screening with mammography for women younger than 50 years of age, the National Institutes of Health and the National Cancer Institute in 1997 jointly sponsored a consensus conference on the subject. While the panel concluded that the data were insufficient to endorse mammography for this age group apart from individual choice, the conclusion was not the "consensus" sought by many of those with strong opinions on both sides of this issue, and the debate raged on. Prior to the 1997 conference, and since, meta-analyses of trial data and assessments of service screening programs have indicated that breast cancer screening with mammography for women between 40 and 49 meets recommended levels of performance compared with performance in women 50 years and older, especially if programs achieve high quality and screen at 12-to-18 month intervals. Because the detectable preclinical phase is shorter in younger women who develop breast cancer compared with that in women 50 years of age or older, a key component of any screening program for those younger than 50 is an appropriate screening interval. Many of the screening programs that had historically been developed for women in their forties--and whose disappointing results contributed to the confusion and controversy about the efficacy of mammography in younger women--had a 24-month screening interval, which was not found to be of significant benefit for early detection of breast cancer in this age group. While a new emphasis of this controversy has focused on the balance of benefits and harms in women ages 40 to 49, women of all ages need to be fully informed about the benefits and limitations of breast cancer screening--more specifically, what to expect at the time of screening, and what to expect from screening. There are differences in the performance and effectiveness of mammography in different age groups of women aged 40 and

  18. A Mixed Methods Review of Education and Patient Navigation Interventions to Increase Breast and Cervical Cancer Screening for Rural Women.

    Science.gov (United States)

    Falk, Derek

    2018-02-07

    Reviews have assessed studies of breast and cervical cancer screening access and utilization for rural women, but none analyze interventions to increase screening rates. A mixed methods literature search identified studies of breast and/or cervical cancer prevention education and patient navigation interventions for rural women. Rural areas need greater implementation and evaluation of screening interventions as these services address the challenges of delivering patient-centered cancer care to un-/underserved communities. The lack of intervention studies on breast and cervical cancer education and patient navigation programs compared to urban studies highlights the need for validation of these programs among diverse, rural populations.

  19. Reliability and validity of the breast cancer screening belief scale among Turkish women.

    Science.gov (United States)

    Secginli, Selda; Nahcivan, Nursen O

    2004-01-01

    Breast cancer is the second leading cause of cancer deaths in Turkish women, and the use of breast self-examination (BSE) and mammography remains low in Turkey. Therefore, we need to identify the beliefs, influencing BSE and mammography, and a valid and reliable tool to measure constructs. The Champion's health belief model scale (CHBMS) is a valid and reliable tool to measure beliefs about breast cancer, BSE, and mammography in an English culture. The purpose of this study was to assess the psychometric characteristics of a Turkish version of the CHBMS related to breast cancer, BSE, and mammography. A convenience sample of 656 women was recruited from 3 health centers and 2 maternal and child health centers in Istanbul. The CHBMS was translated to Turkish, validated by professional judges, back translated, and tested. Factor analysis yielded 7 factors for BSE: confidence, seriousness, barriers-BSE, health motivation 1 and 2, susceptibility, and benefits-BSE. For mammography scale, 6 factors were identified: seriousness, benefits-mammography, barriers-mammography, health motivation 1 and 2, and susceptibility. All items on each factor were from the same construct. Cronbach alpha reliability coefficients ranged from.75 to.87 for the subscales. The Turkish version of the CHBMS showed adequate reliability and validity for use in Turkish women. It could easily be used to evaluate the health beliefs about breast cancer, BSE, and mammography. Further refinement is required to study Turkish women's health beliefs and breast cancer screening behaviors in various settings.

  20. Tumor cell migration screen identifies SRPK1 as breast cancer metastasis determinant.

    Science.gov (United States)

    van Roosmalen, Wies; Le Dévédec, Sylvia E; Golani, Ofra; Smid, Marcel; Pulyakhina, Irina; Timmermans, Annemieke M; Look, Maxime P; Zi, Di; Pont, Chantal; de Graauw, Marjo; Naffar-Abu-Amara, Suha; Kirsanova, Catherine; Rustici, Gabriella; Hoen, Peter A C 't; Martens, John W M; Foekens, John A; Geiger, Benjamin; van de Water, Bob

    2015-04-01

    Tumor cell migration is a key process for cancer cell dissemination and metastasis that is controlled by signal-mediated cytoskeletal and cell matrix adhesion remodeling. Using a phagokinetic track assay with migratory H1299 cells, we performed an siRNA screen of almost 1,500 genes encoding kinases/phosphatases and adhesome- and migration-related proteins to identify genes that affect tumor cell migration speed and persistence. Thirty candidate genes that altered cell migration were validated in live tumor cell migration assays. Eight were associated with metastasis-free survival in breast cancer patients, with integrin β3-binding protein (ITGB3BP), MAP3K8, NIMA-related kinase (NEK2), and SHC-transforming protein 1 (SHC1) being the most predictive. Examination of genes that modulate migration indicated that SRPK1, encoding the splicing factor kinase SRSF protein kinase 1, is relevant to breast cancer outcomes, as it was highly expressed in basal breast cancer. Furthermore, high SRPK1 expression correlated with poor breast cancer disease outcome and preferential metastasis to the lungs and brain. In 2 independent murine models of breast tumor metastasis, stable shRNA-based SRPK1 knockdown suppressed metastasis to distant organs, including lung, liver, and spleen, and inhibited focal adhesion reorganization. Our study provides comprehensive information on the molecular determinants of tumor cell migration and suggests that SRPK1 has potential as a drug target for limiting breast cancer metastasis.

  1. Cost-Effectiveness of Screening Women With Familial Risk for Breast Cancer With Magnetic Resonance Imaging

    NARCIS (Netherlands)

    Saadatmand, S.; Tilanus-Linthorst, M.M.; Rutgers, E.J.; Hoogerbrugge, N.; Oosterwijk, J.C.; Tollenaar, R.A.E.M.; Hooning, M.; Loo, C.E.; Obdeijn, I.M.; Heijnsdijk, E.A.; Koning, H.J. de

    2013-01-01

    BACKGROUND: To reduce mortality, women with a family history of breast cancer are often screened with mammography before age 50 years. Additional magnetic resonance imaging (MRI) improves sensitivity and is cost-effective for BRCA1/2 mutation carriers. However, for women with a family history

  2. Developing a Culturally Responsive Breast Cancer Screening Promotion with Native Hawaiian Women in Churches

    Science.gov (United States)

    Kaopua, Lana Sue

    2008-01-01

    This article presents findings from research to develop the promotional component of a breast cancer screening program for Native Hawaiian women associated with historically Hawaiian churches in medically underserved communities. The literature on adherence to health recommendations and health promotions marketing guided inquiry on screening…

  3. Effect of screening and adjuvant therapy on mortality from breast cancer

    NARCIS (Netherlands)

    D.A. Berry (Donald); K.A. Cronin (Kathleen); S.K. Plevritis (Sylvia); D.G. Fryback (Dennis); L. Clarke (Lauren); M. Zelen (Marvin); J.S. Mandelblatt (Jeanne); A.Y. Yakovlev (Andrei); J.D.F. Habbema (Dik); E. Feuer (Eric)

    2005-01-01

    textabstractBACKGROUND: We used modeling techniques to assess the relative and absolute contributions of screening mammography and adjuvant treatment to the reduction in breast-cancer mortality in the United States from 1975 to 2000. METHODS: A consortium of investigators developed seven independent

  4. Are All Latinas the Same?: Perceived Breast Cancer Screening Barriers and Facilitative Conditions

    Science.gov (United States)

    Buki, Lydia P.; Borrayo, Evelinn A.; Feigal, Benjamin M.; Carrillo, Iris Y.

    2004-01-01

    In this article, we examine perceived breast cancer screening barriers and facilitative conditions for immigrant women from Mexico, Puerto Rico, Cuba, El Salvador, and South America (N=58). Focus groups conducted separately with women of each ancestry were analyzed using grounded theory methods. Identified barriers comprise secrecy, lack of…

  5. Risk profile of breast cancer following atypical hyperplasia detected through organized screening.

    Science.gov (United States)

    Buckley, Elizabeth; Sullivan, Tom; Farshid, Gelareh; Hiller, Janet; Roder, David

    2015-06-01

    Few population-based data are available indicating the breast cancer risk following detection of atypia within a breast screening program. Prospectively collected data from the South Australian screening program were linked with the state cancer registry. Absolute and relative breast cancer risk estimates were calculated for ADH and ALH separately, and by age at diagnosis and time since diagnosis. Post-hoc analysis was undertaken of the effect of family history on breast cancer risk. Women with ADH and ALH had an increase in relative risk for malignancy (ADH HR 2.81 [95% CI 1.72, 4.59] and (ALH HR 4.14 [95% CI 1.97, 8.69], respectively. Differences in risk profile according to time since diagnosis and age at diagnosis were not statistically significant. Estimates of the relative risk of breast cancer are necessary to inform decisions regarding clinical management and/or treatment of women with ADH and ALH. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Developing a Culturally Responsive Breast Cancer Screening Promotion with Native Hawaiian Women in Churches

    OpenAIRE

    Ka’opua, Lana Sue

    2008-01-01

    This article presents findings from research to develop the promotional component of a breast cancer screening program for Native Hawaiian women associated with historically Hawaiian churches in medically underserved communities. The literature on adherence to health recommendations and health promotions marketing guided inquiry on screening influences. Focus groups and individual interviews patterned on the culturally familiar practice of talk story were conducted with 60 Hawaiian women recr...

  7. [Cost-effectiveness of breast cancer screening policies in Mexico].

    Science.gov (United States)

    Valencia-Mendoza, Atanacio; Sánchez-González, Gilberto; Bautista-Arredondo, Sergio; Torres-Mejía, Gabriela; Bertozzi, Stefano M

    2009-01-01

    Generate cost-effectiveness information to allow policy makers optimize breast cancer (BC) policy in Mexico. We constructed a Markov model that incorporates four interrelated processes of the disease: the natural history; detection using mammography; treatment; and other competing-causes mortality, according to which 13 different strategies were modeled. Strategies (starting age, % of coverage, frequency in years)= (48, 25, 2), (40, 50, 2) and (40, 50, 1) constituted the optimal method for expanding the BC program, yielding 75.3, 116.4 and 171.1 thousand pesos per life-year saved, respectively. The strategies included in the optimal method for expanding the program produce a cost per life-year saved of less than two times the GNP per capita and hence are cost-effective according to WHO Commission on Macroeconomics and Health criteria.

  8. Value analysis of digital breast tomosynthesis for breast cancer screening in a commercially-insured US population

    Directory of Open Access Journals (Sweden)

    Bonafede MM

    2015-01-01

    Full Text Available Machaon M Bonafede,1 Vivek B Kalra,2 Jeffrey D Miller,1 Laurie L Fajardo3 1Truven Health Analytics, Cambridge, MA, 2Yale University School of Medicine, New Haven, CT, 3Department of Radiology, University of Iowa College of Medicine, Iowa City, IA, USA Purpose: The objective of this study was to conduct a value analysis of digital breast tomosynthesis (DBT for breast cancer screening among women enrolled in US commercial health insurance plans to assess the potential budget impact associated with the clinical benefits of DBT. Methods: An economic model was developed to estimate the system-wide financial impact of DBT as a breast cancer screening modality within a hypothetical US managed care plan with one million members. Two scenarios were considered for women in the health plan who undergo annual screening mammography, ie, full field digital mammography (FFDM and combined FFDM + DBT. The model focused on two main drivers of DBT value, ie, the capacity for DBT to reduce the number of women recalled for additional follow-up imaging and diagnostic services and the capacity of DBT to facilitate earlier diagnosis of cancer at less invasive stages where treatment costs are lower. Model inputs were derived from published sources and from analyses of the Truven Health MarketScan® Research Databases (2010–2012. Comparative clinical and economic outcomes were simulated for one year following screening and compared on an incremental basis. Results: Base-case analysis results show that 4,523 women in the hypothetical million member health plan who are screened using DBT avoid the use of follow-up services. The overall benefit of DBT was calculated at $78.53 per woman screened. Adjusting for a hypothetical $50 incremental cost of the DBT examination, this translates to $28.53 savings per woman screened, or $0.20 savings per member per month across the plan population and an overall cost savings to the plan of $2.4 million per year. Conclusion: The

  9. Organizational change: a way to increase colon, breast and cervical cancer screening in primary care practices.

    Science.gov (United States)

    Arroyave, Ana Maria; Penaranda, Eribeth K; Lewis, Carmen L

    2011-04-01

    Screening tests for colon, cervical and breast cancer remain underutilized despite their proven effectiveness in reducing morbidity and mortality. Stone et al. concluded that cancer screening is most likely to improve when a health organization supports performance through organizational changes (OC) in staffing and clinical procedures. OC interventions include the use of separate clinics devoted to prevention, use of a planned care visit, designation of non-physician staff for specific prevention activities and continuous quality improvement interventions. To identify specific elements of OC interventions that increases the selected cancer screening rates. To determine to which extent practices bought into the interventions. Eleven randomized controlled trials from January 1990 to June 2010 that instituted OC to increase cancer screening completion were included. Qualitative data was analyzed by using a framework to facilitate abstraction of information. For quantitative data, an outcome of measure was determined by the change in the proportion of eligible individuals receiving cancer screening services between intervention and control practices. The health prevention clinic intervention demonstrated a large increase (47%) in the proportion of completed fecal occult blood test; having a non-physician staff demonstrated an increase in mammography (18.4%); and clinical breast examination (13.7%); the planned care visit for prevention intervention increased mammography (8.8%); continuous quality improvement interventions showed mixed results, from an increase in performance of mammography 19%, clinical breast examination (13%); Pap smear (15%) and fecal occult blood test (13%), to none or negative change in the proportion of cancer screening rates. To increase cancer screening completion goals, OC interventions should be implemented tailored to the primary care practice style. Interventions that circumvent the physicians were more effective. We could not conclude

  10. Determinants of breast cancer screening among inner-city Hispanic women in comparison with other inner-city women.

    Science.gov (United States)

    Fulton, J P; Rakowski, W; Jones, A C

    1995-01-01

    A telephone survey of a random sample of Rhode Island women ages 40 and older residing in minority low-income census tracts--census tracts in the lowest quartile of a variety of socioeconomic indicators in which at least 5 percent of the population was classified as Hispanic or non-Hispanic black--was conducted in 1991, focusing on breast cancer screening. Hispanic women were found to have about half the breast cancer screening rate (20 percent, according to current screening guidelines) of other respondents (37 percent). Determinants of screening were explored to suggest reasons for this difference. The Health Belief Model was used to identify and compare determinants of breast cancer screening (sociodemographics, health care utilization, perceived susceptibility to breast cancer, perceived seriousness of breast cancer, cues to screening such as a provider's recommendation, and the perceived benefits and costs of screening) among Hispanics, non-Hispanic whites, and non-Hispanic blacks. Hispanics were younger, less educated, and had lower family incomes than other women residing in minority low-income census tracts, were less likely to receive medical care, to perceive themselves as susceptible to breast cancer, and to perceive breast cancer as curable. Logistic regression analyses revealed the importance of use of health care, cues for screening, and perceptions of mammography to explain the screening behavior of Hispanics and non-Hispanics alike. Access to medical care is a significant problem in the Rhode Island Hispanic community, related to recent immigration, undocumented immigration, and low income characteristics of its members. Efforts to increase long-term screening for breast cancer in this community should focus on access while paying attention to its unique perceptions of breast cancer.

  11. Assessment of the contents related to screening on Portuguese language websites providing information on breast and prostate cancer

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira

    2013-11-01

    Full Text Available The objective of this study was to assess the quality of the contents related to screening in a sample of websites providing information on breast and prostate cancer in the Portuguese language. The first 200 results of each cancer-specific Google search were considered. The accuracy of the screening contents was defined in accordance with the state of the art, and its readability was assessed. Most websites mentioned mammography as a method for breast cancer screening (80%, although only 28% referred to it as the only recommended method. Almost all websites mentioned PSA evaluation as a possible screening test, but correct information regarding its effectiveness was given in less than 10%. For both breast and prostate cancer screening contents, the potential for overdiagnosis and false positive results was seldom addressed, and the median readability index was approximately 70. There is ample margin for improving the quality of websites providing information on breast and prostate cancer in Portuguese.

  12. Immediate and delayed effects of mammographic screening on breast cancer mortality and incidence in birth cohorts.

    Science.gov (United States)

    Ripping, T M; Verbeek, A L M; van der Waal, D; Otten, J D M; den Heeten, G J; Fracheboud, J; de Koning, H J; Broeders, M J M

    2013-10-29

    Trend studies investigating the impact of mammographic screening usually display age-specific mortality and incidence rates over time, resulting in an underestimate of the benefit of screening, that is, mortality reduction, and an overestimate of its major harmful effect, that is, overdiagnosis. This study proposes a more appropriate way of analysing trends. Breast cancer mortality (1950-2009) and incidence data (1975-2009) were obtained from Statistics Netherlands, 'Stg. Medische registratie' and the National Cancer Registry in the Netherlands for women aged 25-85 years. Data were visualised in age-birth cohort and age-period figures. Birth cohorts invited to participate in the mammographic screening programme showed a deflection in the breast cancer mortality rates within the first 5 years after invitation. Thereafter, the mortality rate increased, although less rapidly than in uninvited birth cohorts. Furthermore, invited birth cohorts showed a sharp increase in invasive breast cancer incidence rate during the first 5 years of invitation, followed by a moderate increase during the following screening years and a decline after passing the upper age limit. When applying a trend study to estimate the impact of mammographic screening, we recommend using a birth cohort approach.

  13. Appalachian women’s perspectives on breast and cervical cancer screening

    Science.gov (United States)

    Schoenberg, NE; Kruger, TM; Bardach, S; Howell, BM

    2016-01-01

    Introduction Although breast and cervical cancer screening rates have been increasing over the three past decades, many Appalachian women in the USA do not receive screening, leading to disproportionate mortality rates. The aims of this study were to: (1) better understand barriers to and facilitators of breast and cervical cancer screening among Appalachian women; and (2) identify strategies to increase cancer screening. Methods Eight focus groups and 19 key informant interviews were conducted with 79 participants. Tape-recorded session were transcribed and content analyzed. Results Findings consistent with screening determinants research include: inadequate personal and community resources, attitudinal and knowledge barriers, and competing demands. Less commonly described factors include family cancer history, personal health habits, and the multiple influences of healthcare providers. Conclusions Interpreting findings in terms of consumer information processing theory, healthcare providers and supports play a key role in educating and influencing the screening uptake among Appalachian Kentucky women. These findings have the potential to inform innovative and culturally consonant intervention approaches capable of increasing screening and decreasing mortality rates. PMID:24016336

  14. Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation.

    Science.gov (United States)

    Arrospide, Arantzazu; Rue, Montserrat; van Ravesteyn, Nicolien T; Comas, Merce; Larrañaga, Nerea; Sarriugarte, Garbiñe; Mar, Javier

    2015-10-12

    Since the breast cancer screening programme in the Basque Country (BCSPBC) was started in 1996, more than 400,000 women aged 50 to 69 years have been invited to participate. Based on epidemiological observations and simulation techniques it is possible to extend observed short term data into anticipated long term results. The aim of this study was to assess the effectiveness of the programme through 2011 by quantifying the outcomes in breast cancer mortality, life-years gained, false positive results, and overdiagnosis. A discrete event simulation model was constructed to reproduce the natural history of breast cancer (disease-free, pre-clinical, symptomatic, and disease-specific death) and the actual observed characteristics of the screening programme during the evaluated period in the Basque women population. Goodness-of-fit statistics were applied for model validation. The screening effects were measured as differences in benefits and harms between the screened and unscreened populations. Breast cancer mortality reduction and life-years gained were considered as screening benefits, whereas, overdiagnosis and false positive results were assessed as harms. Results for a single cohort were also obtained. The screening programme yielded a 16 % reduction in breast cancer mortality and a 10 % increase in the incidence of breast cancer through 2011. Almost 2 % of all the women in the programme had a false positive result during the evaluation period. When a single cohort was analysed, the number of deaths decreased by 13 %, and 4 % of screen-detected cancers were overdiagnosed. Each woman with BC detected by the screening programme gained 2.5 life years due to early detection corrected by lead time. Fifteen years after the screening programme started, this study supports an important decrease in breast cancer mortality due to the screening programme, with reasonable risk of overdiagnosis and false positive results, and sustains the continuation of the breast cancer

  15. Comparison of direct digital mammography, computed radiography, and film-screen in the French national breast cancer screening program.

    Science.gov (United States)

    Séradour, Brigitte; Heid, Patrice; Estève, Jacques

    2014-01-01

    The purpose of this article was to compare the performance of digital mammography using hardcopy image reading against film-screen mammography in a French national routine population-based screening program with a decentralized organization. The French context offered the opportunity to examine separately computed radiography and direct digital mammography performances in a large cohort. The study includes 23,423 direct digital mammography, 73,320 computed radiography, and 65,514 film-screen mammography examinations performed by 123 facilities in Bouches du Rhône, France, for women 50-74 years old between 2008 and 2010. We compared abnormal mammography findings rate, cancer detection rate, and tumor characteristics among the technologies. Abnormal finding rates were higher for direct digital mammography (7.78% vs 6.11% for film-screen mammography and 5.34% for computed radiography), particularly in younger women and in denser breasts. Cancer detection rates were also higher for direct digital mammography (0.71% vs 0.66% for film-screen mammography and 0.55% for computed radiography). The contrast between detection rates was stronger for ductal carcinoma in situ. Breast density was the main factor explaining the differences in detection rates. For direct digital mammography only, the detection rate was clearly higher in dense breasts whatever the age (odds ratio, 2.20). Except for grade, no differences were recorded concerning tumor characteristics in which the proportion of high-grade tumors was larger for direct digital mammography for invasive and in situ tumors. Direct digital mammography has a higher detection rate than film-screen mammography in dense breasts and for tumors of high grade. This latter association warrants further study to measure the impact of technology on efficacy of screening. The data indicate that computed radiography detects fewer tumors than film-screen mammography in most instances.

  16. Health beliefs related to breast cancer screening behaviours in women who applied to cancer early detection center

    Directory of Open Access Journals (Sweden)

    Melek Serpil Talas

    2015-06-01

    Full Text Available Background: Breast cancer is one of the most common malignancies affecting women in Turkey. The early detection methods for breast cancer have been associated with health belief variables. Objectives: The purpose of this study was to determine women's health beliefs related to breast cancer screening behaviours. Methods: This study was designed as descriptive and cross-sectional survey and was performed on 344 women who applied the Nigde Cancer Early Diagnosis, Screening and Education Center between May and October 2009. The data were collected using a questionnaire which consists of socio-demographic characteristics and breast cancer risk factors and Health Belief Model Scale. Data analysis was performed using frequency and Mann-Whitney U Test. All values of p0.05. According to study results, the rate of regular BSE performance rate for women was found low. Therefore, KETEM was planned to the training programs related to breast cancer screening methods. [TAF Prev Med Bull 2015; 14(3.000: 265-271

  17. [Cost-effectiveness of an organized breast cancer screening program in Southern Brazil].

    Science.gov (United States)

    Ribeiro, Rodrigo Antonini; Caleffi, Maira; Polanczyk, Carisi Anne

    2013-11-01

    The aim of this study was to evaluate the cost-effectiveness of an organized breast cancer mammographic screening program implemented in Porto Alegre (Núcleo Mama Porto Alegre - NMPOA), Rio Grande do Sul State, Brazil. A Markov model was constructed to estimate the incremental cost-effectiveness ratio of NMPOA compared to current BC diagnosis and care in the Brazilian public health system, in a hypothetical cohort of women aged 40-69 years at risk of developing breast cancer. Model parameters were collected from NMPOA and the national literature. In the NMPOA strategy, effectiveness was modeled taking into account the actual observed screening adherence. Effectiveness was measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio in the base case was R$ 13,426 per QALY. This result was not sensitive to variation in the main model parameters in sensitivity analyses. Considering the threshold usually suggested as highly attractive in Brazil, breast cancer screening as performed in NMPOA is cost-effective in cities with high incidence of breast cancer.

  18. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer

    NARCIS (Netherlands)

    Kriege, Mieke; Brekelmans, Cecile T. M.; Obdeijn, Inge Marie; Boetes, Carla; Zonderland, Harmine M.; Muller, Sara H.; Kok, Theo; Manoliu, Radu A.; Besnard, A. Peter E.; Tilanus-Linthorst, Madeleine M. A.; Seynaeve, Caroline; Bartels, Carina C. M.; Kaas, Reini; Meijer, Siebren; Oosterwijk, Jan C.; Hoogerbrugge, Nicoline; Tollenaar, Rob A. E. M.; Rutgers, Emiel J. T.; de Koning, Harry J.; Klijn, Jan G. M.

    2006-01-01

    Background The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the

  19. Overdiagnosis and overtreatment associated with breast cancer mammography screening: A simulation study with calibration to population-based data.

    Science.gov (United States)

    Seigneurin, Arnaud; Labarère, José; François, Olivier; Exbrayat, Catherine; Dupouy, Maylis; Filippi, Marc; Colonna, Marc

    2016-08-01

    The magnitude of overdiagnosis of breast cancer associated with mammography screening remains controversial because of methodological issues. The objective of this study was to quantify overdiagnosis and overtreatment associated with a population-based screening programme, taking into account lead time and uncertainty concerning baseline incidence of breast cancers. A simulation model was developed to replicate incidence and detection rates of breast cancer observed in the Isère Département, France. The parameters of the model were estimated using an approximate Bayesian computation method. For women aged 50-74 years during the 2007-2010 period, overdiagnosis of non-progressive breast cancers accounted for 17.0% (95% credibility interval (CI): 2.5%-35.5%) of all in situ cancers diagnosed, 5.5% (95% CI: 0.8%-9.8%) of all invasive cancers diagnosed, and 20.3% (95% CI: 3.0%-38.9%) of in situ and 13.0% (95% CI: 2.2%-23.3%) of invasive screen detected breast cancers. The estimates of overdiagnosis due to competitive causes of death were 1.0% (95% CI: 0.2%-%1.7) and 1.1% (95% CI: 0.6%-1.7%) for all in situ and invasive cancers diagnosed, respectively, and 1.3% (95% CI: 0.2%-2.0%) and 2.6% (95% CI: 1.4%-4.0%) of all in situ and invasive screen detected breast cancers, respectively. Among 1000 screen-detected cancers in 2010, 155 (95% CI: 27-284), 134 (95% CI: 10-242) and 140 (95% CI: 25-254) women underwent breast conserving surgery, lymph node dissection and radiation therapy for overdiagnosed cancers, respectively. Our estimates of overdiagnosis should be balanced against the reduction of breast cancer mortality to assess the value of breast cancer screening programme. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Factors that influence awareness of breast cancer screening among Arab women in Qatar: results from a cross sectional survey.

    Science.gov (United States)

    Donnelly, Tam Truong; Khater, Al-Hareth Al; Al-Bader, Salha Bujassoum; Al Kuwari, Mohammed Ghaith; Malik, Mariam; Al-Meer, Nabila; Singh, Rajvir; Fung, Tak

    2014-01-01

    Breast cancer is the most common cancer among women in the State of Qatar. Due to low participation in breast cancer screening (BCS) activities, women in Qatar are often diagnosed with breast cancer at advanced stages of the disease. Findings indicate that low participation rates in BCS activities are significantly related to women's low level of awareness of breast cancer screening. The objectives of this study were to: (1) determine the factors that influence Qatari women's awareness of breast cancer and its screening activities: and (2) to find ways to effectively promote breast cancer screening activities among Arabic speaking women in Qatar. A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) female Qatari citizens and non-Qatari Arabic-speaking residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Outcome measures included participant awareness levels of the most recent national recommended guidelines of BCS, participation rates in BCS activities, and factors related to awareness of BCS activities. While most participants (90.7%) were aware of breast cancer, less than half had awareness of BCS practices (28.9% were aware of breast self-examination and 41.8% of clinical breast exams, while 26.4% knew that mammography was recommended by national screening guidelines. Only 7.6% had knowledge of all three BCS activities). Regarding BCS practice, less than one-third practiced BCS appropriately (13.9% of participants performed breast self-examination (BSE) monthly, 31.3% had a clinical breast exam (CBE) once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogram once every year or two years). Awareness of BCS was significantly related to BCS practice, education level, and receipt of information about breast cancer and/or BCS from a variety of sources, particularly doctors and the media. The low levels of participation rates in BCS among Arab women in this study

  1. Modeling the impact of population screening on breast cancer mortality in the United States‡

    Science.gov (United States)

    Mandelblatt, Jeanne S.; Cronin, Kathleen A.; Berry, Donald A.; Chang, Yaojen; de Koning, Harry J.; Lee, Sandra J.; Plevritis, Sylvia K.; Schechter, Clyde B.; Stout, Natasha K.; van Ravesteyn, Nicolien T.; Zelen, Marvin; Feuer, Eric J.

    2012-01-01

    Summary Objective Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. Methods The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. Results The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50–74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Conclusion Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations. PMID:22015298

  2. Modeling the impact of population screening on breast cancer mortality in the United States.

    Science.gov (United States)

    Mandelblatt, Jeanne S; Cronin, Kathleen A; Berry, Donald A; Chang, Yaojen; de Koning, Harry J; Lee, Sandra J; Plevritis, Sylvia K; Schechter, Clyde B; Stout, Natasha K; van Ravesteyn, Nicolien T; Zelen, Marvin; Feuer, Eric J

    2011-10-01

    Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50-74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. The effect of breast cancer screening messages on knowledge, attitudes, perceived risk, and mammography screening of African American women in the rural South.

    Science.gov (United States)

    Grindel, Cecelia Gatson; Brown, Larry; Caplan, Lee; Blumenthal, Daniel

    2004-07-01

    To determine the effect of three types of breast cancer screening messages (positive/upbeat, neutral/cognitive, and negative/fear) on knowledge, attitudes, perceived risk for breast cancer, and mammography screening of African American women. Repeated measures intervention. Three rural counties in the South. 450 African American women aged 45-65 who had not received a mammogram in the past 12 months. Following completion of pretest knowledge and attitude surveys, the women participated in a 60-minute breast health intervention session that included watching one of three videos with varied affective tones (positive/upbeat, neutral/cognitive, negative/fear). Data on knowledge, attitudes, perceived risk for breast cancer, and mammography screening were collected before, after, and 12 months following the intervention. Knowledge, attitudes, perceived risk for breast cancer, and mammography screening. No significant difference was found among video groups on mammography screening and knowledge of and attitudes about breast cancer over the three measurement periods. The affective tone of the educational videos did not make a difference in mammogram screening, attitudes, and knowledge of breast cancer screening. More women received a mammogram 12 months postintervention than prior to the intervention; however, the influence of the intervention on this outcome is uncertain. Nurses and health communication experts should design interventions that foster positive attitudes, increase knowledge about breast cancer screening, and stimulate women to participate in breast cancer screening as outlined by the American Cancer Society. These interventions need to be done in the context of the cultural norms and the education levels of the target population.

  4. Women’s views on overdiagnosis in breast cancer screening: a qualitative study

    Science.gov (United States)

    Hersch, Jolyn; Jansen, Jesse; Barratt, Alexandra; Irwig, Les; Houssami, Nehmat; Howard, Kirsten; Dhillon, Haryana

    2013-01-01

    Objective To elicit women’s responses to information about the nature and extent of overdiagnosis in mammography screening (detecting disease that would not present clinically during the woman’s lifetime) and explore how awareness of overdiagnosis might influence attitudes and intentions about screening. Design Qualitative study using focus groups that included a presentation explaining overdiagnosis, incorporating different published estimates of its rate (1–10%, 30%, 50%) and information on the mortality benefit of screening, with guided group discussions Setting Sydney, Australia Participants Fifty women aged 40–79 years with no personal history of breast cancer and with varying levels of education and participation in screening. Results Prior awareness of breast cancer overdiagnosis was minimal. Women generally reacted with surprise, but most came to understand the issue. Responses to overdiagnosis and the different estimates of its magnitude were diverse. The highest estimate (50%) made some women perceive a need for more careful personal decision making about screening. In contrast, the lower and intermediate estimates (1–10% and 30%) had limited impact on attitudes and intentions, with many women remaining committed to screening. For some women, the information raised concerns, not about whether to screen but whether to treat a screen detected cancer or consider alternative approaches (such as watchful waiting). Information preferences varied: many women considered it important to take overdiagnosis into account and make informed choices about whether to have screening, but many wanted to be encouraged to be screened. Conclusions Women from a range of socioeconomic backgrounds could comprehend the issue of overdiagnosis in mammography screening, and they generally valued information about it. Effects on screening intentions may depend heavily on the rate of overdiagnosis. Overdiagnosis will be new and counterintuitive for many people and may

  5. Reliability and validity of Champion's Health Belief Model Scale for breast cancer screening among Malaysian women.

    Science.gov (United States)

    Parsa, P; Kandiah, M; Mohd Nasir, M T; Hejar, A R; Nor Afiah, M Z

    2008-11-01

    Breast cancer is the leading cause of cancer deaths in Malaysian women, and the use of breast self-examination (BSE), clinical breast examination (CBE) and mammography remain low in Malaysia. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence breast cancer screening practices. The Champion's Health Belief Model Scale (CHBMS) is a valid and reliable tool to measure beliefs about breast cancer and screening methods in the Western culture. The purpose of this study was to translate the use of CHBMS into the Malaysian context and validate the scale among Malaysian women. A random sample of 425 women teachers was taken from 24 secondary schools in Selangor state, Malaysia. The CHBMS was translated into the Malay language, validated by an expert's panel, back translated, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using factor analysis. The mean age of the respondents was 37.2 (standard deviation 7.1) years. Factor analysis yielded ten factors for BSE with eigenvalue greater than 1 (four factors more than the original): confidence 1 (ability to differentiate normal and abnormal changes in the breasts), barriers to BSE, susceptibility for breast cancer, benefits of BSE, health motivation 1 (general health), seriousness 1 (fear of breast cancer), confidence 2 (ability to detect size of lumps), seriousness 2 (fear of long-term effects of breast cancer), health motivation 2 (preventive health practice), and confidence 3 (ability to perform BSE correctly). For CBE and mammography scales, seven factors each were identified. Factors for CBE scale include susceptibility, health motivation 1, benefits of CBE, seriousness 1, barriers of CBE, seriousness 2 and health motivation 2. For mammography the scale includes benefits of mammography, susceptibility, health motivation 1, seriousness 1, barriers to mammography seriousness 2 and health

  6. A Comparison of Breast and Cervical Cancer Legislation and Screening in Georgia, North Carolina, and South Carolina

    OpenAIRE

    Miles-Richardson, Stephanie; Blumenthal, Daniel; Alema-Mensah, Ernest

    2012-01-01

    We identified legislation (1989–2005) relating to breast and cervical cancer in Georgia, North Carolina, and South Carolina and examined its impact on screening rates for these cancers and on Black-White disparities in screening rates. Legislation was identi-fied using the National Cancer Institute’s (NCI) State Cancer Legislative Database (SCLD) Program. Screening rates were identified using the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. Georgia ...

  7. The WISDOM Study: breaking the deadlock in the breast cancer screening debate.

    Science.gov (United States)

    Esserman, Laura J

    2017-01-01

    There are few medical issues that have generated as much controversy as screening for breast cancer. In science, controversy often stimulates innovation; however, the intensely divisive debate over mammographic screening has had the opposite effect and has stifled progress. The same two questions-whether it is better to screen annually or bi-annually, and whether women are best served by beginning screening at 40 or some later age-have been debated for 20 years, based on data generated three to four decades ago. The controversy has continued largely because our current approach to screening assumes all women have the same risk for the same type of breast cancer. In fact, we now know that cancers vary tremendously in terms of timing of onset, rate of growth, and probability of metastasis. In an era of personalized medicine, we have the opportunity to investigate tailored screening based on a woman's specific risk for a specific tumor type, generating new data that can inform best practices rather than to continue the rancorous debate. It is time to move from debate to wisdom by asking new questions and generating new knowledge. The WISDOM Study (Women Informed to Screen Depending On Measures of risk) is a pragmatic, adaptive, randomized clinical trial comparing a comprehensive risk-based, or personalized approach to traditional annual breast cancer screening. The multicenter trial will enroll 100,000 women, powered for a primary endpoint of non-inferiority with respect to the number of late stage cancers detected. The trial will determine whether screening based on personalized risk is as safe, less morbid, preferred by women, will facilitate prevention for those most likely to benefit, and adapt as we learn who is at risk for what kind of cancer. Funded by the Patient Centered Outcomes Research Institute, WISDOM is the product of a multi-year stakeholder engagement process that has brought together consumers, advocates, primary care physicians, specialists, policy

  8. Breast cancer screening among women in Namibia: explaining the effect of health insurance coverage and access to information on screening behaviours.

    Science.gov (United States)

    Kangmennaang, Joseph; Mkandawire, Paul; Luginaah, Isaac

    2017-09-01

    Breast cancer contributes substantially to morbidity and mortality in Namibia as is the case in most countries in Sub-Saharan Africa (SSA). However, there is a dearth of nationally representative studies that examine the odds of screening for breast cancer in Namibia and SSA at large. This paper aims to fill this gap by examining the determinants of breast cancer screening guided by the Health Belief Model. We applied hierarchical binary logit regression models to explore the determinants of breast cancer screening using the 2013 Namibia Demography and Health Survey (NDHS). We accounted for the effect of unobserved heterogeneity that may affect breast cancer, testing behaviours among women cluster level. The NDHS is a nationally representative dataset that has recently started to collect information on cancer screening. The results show that women who have health insurance coverage (odds ratio (OR) = 1.62, p ≤ 0.01), maintain contact with health professionals (OR = 1.47, p = 0.01), and who have secondary (OR = 1.38, p = 0.01) and higher (OR = 1.77, p ≤ 0.01) education were more likely to be screened for breast cancer. Factors that influence women's perception of their susceptibility to breast cancer such as birthing experience, age, region and place of residence were associated with screening in this context. Overall, the health belief model predicted women's testing behaviours and also revealed the absence of relevant risk factors in the NDHS data that might influence screening. Overall, our results show that strategies for early diagnosis of breast cancer should be given major priority by cancer control boards as well as ministries of health in SSA. These strategies should centre on early screening and may involve reducing or eliminating barriers to health care, access to relevant health information and encouraging breast self-examination.

  9. The Athena Breast Health Network: developing a rapid learning system in breast cancer prevention, screening, treatment, and care.

    Science.gov (United States)

    Elson, Sarah L; Hiatt, Robert A; Anton-Culver, Hoda; Howell, Lydia P; Naeim, Arash; Parker, Barbara A; Van't Veer, Laura J; Hogarth, Michael; Pierce, John P; Duwors, Robert J; Hajopoulos, Kathy; Esserman, Laura J

    2013-07-01

    The term breast cancer covers many different conditions, whose clinical course ranges from indolent to aggressive. However, current practice in breast cancer prevention and care, and in breast cancer epidemiology, does not take into account the heterogeneity of the disease. A comprehensive understanding of the etiology and progression of different breast cancer subtypes would enable a more patient-centered approach to breast health care: assessing an individual's risk of getting specific subtypes of the disease, providing risk-based screening and prevention recommendations, and, for those diagnosed with the disease, tailored treatment options based on risk and timing of progression and mortality. The Athena Breast Health Network is an initiative of the five University of California medical and cancer centers to prototype this approach and to enable the development of a rapid learning system-connecting risk and outcome information from a heterogeneous patient population in real time and using new knowledge from research to continuously improve the quality of care. The Network is based on integrating clinical and research processes to create a comprehensive approach to accelerating patient-centered breast health care. Since its inception in 2009, the Network has developed a multi-site, transdisciplinary collaboration that enables the learning system. The five-campus collaboration has implemented a shared informatics platform, standardized electronic patient intake questionnaires, and common biospecimen protocols, as well as new clinical programs and multi-center research projects. The Athena Breast Health Network can serve as a model of a rapid learning system that integrates epidemiologic, behavioral, and clinical research with clinical care improvements.

  10. The Psychosocial Distress Questionnaire-Breast Cancer (PDQ-BC) is a useful instrument to screen psychosocial problems

    NARCIS (Netherlands)

    Bogaarts, M.P.J.; den Oudsten, B.L.; Roukema, J.A.; van Riel, J.M.G.H.; Beerepoot, L.V.; de Vries, J.

    2012-01-01

    Purpose Recently, the Psychosocial Distress Questionnaire-Breast Cancer (PDQ-BC), a screening instrument specific for patients with early-stage breast cancer, was developed. The aim of this study was to further examine the psychometric properties of the PDQ-BC, in particular the subscales social

  11. Examining the Role of Electronic Medical Record Generated Provider Reminders on Provider Offering of Breast Cancer Screening Services

    Science.gov (United States)

    Beverley, Charles St. Clare, Jr.

    2013-01-01

    Introduction: Breast cancer affects the lives of millions of women each year in the United States. Early detection by mammography screening can reduce the risk for advanced stages of breast cancer and improve the probability of long-term survival in women. Electronic medical records (EMRs) have been identified as a successful approach for…

  12. Initiation of population-based mammography screening in Dutch municipalities and effect on breast-cancer mortality: a systematic review.

    NARCIS (Netherlands)

    Otto, S.J.; Fracheboud, J.; Looman, C.W.; Broeders, M.J.M.; Boer, R.; Hendriks, J.H.C.L.; Verbeek, A.L.M.; Koning, H.J. de

    2003-01-01

    BACKGROUND: More than a decade ago, a mammography screening programme for women aged 50-69 years was initiated in the Netherlands. Our aim was to assess the effect of this programme on breast-cancer mortality rates. METHODS: We examined data for 27948 women who died of breast-cancer aged 55-74 years

  13. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline

    Directory of Open Access Journals (Sweden)

    Brouwers Melissa C

    2011-09-01

    Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? Methods A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Results Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Conclusion Using established guideline development methodologies and the AGREE II as our methodological

  14. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline.

    Science.gov (United States)

    Brouwers, Melissa C; De Vito, Carol; Bahirathan, Lavannya; Carol, Angela; Carroll, June C; Cotterchio, Michelle; Dobbins, Maureen; Lent, Barbara; Levitt, Cheryl; Lewis, Nancy; McGregor, S Elizabeth; Paszat, Lawrence; Rand, Carol; Wathen, Nadine

    2011-09-29

    Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale) for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Using established guideline development methodologies and the AGREE II as our methodological frameworks, we developed an implementation guideline to advise on

  15. The efficacy of using CAD for detection of breast cancer in mammography screening A systematic review

    DEFF Research Database (Denmark)

    Henriksen, Emilie; Lauridsen, Carsten Ammitzbøl

    Abstract Purpose: The aim of this systematic review is to present an overview of the available studies concerning the use of computer-aided detection (CAD) systems in screening mammography for early detection of breast cancer and compare the diagnostic accuracy and recall rates of single reading...... with single reading + CAD and double reading with single reading + CAD. Materials and methods: PRISMA guidelines were used as a review protocol. Only articles on clinical trials concerning the efficacy of computer-aided detection systems to detect breast cancer for use in a screening population were included...... with CAD group indicate that the addition of CAD increases sensitivity and cancer detection rate (CDR). For the double reading vs. single reading with CAD group none of the studies reported significant differences in sensitivity and CDR. Adding CAD to single reading increased the recall rates and decreased...

  16. Survey of breast cancer mammography screening behaviors in Eastern Taiwan based on a health belief model

    Directory of Open Access Journals (Sweden)

    Wen-Li Wang

    2014-08-01

    Full Text Available Breast cancer is the main form of cancer affecting women and the fourth most common cause of cancer mortality in women. The aim of this study was to explore regular mammography screening in Hualien women and to identify the factors that influence its uptake based on a health belief model. This cross-sectional study was performed between July 2012 and December 2012. A total of 776 women aged 45–69 years were enrolled in the study. The results of crude and adjusted analyses showed that there were significant differences in the prevalence of regular mammography screening, which were related to different age groups, residence areas, educational levels, hormone replacement therapy status, and history of breast cancer. Women in the older age groups, with a higher educational level, in receipt of hormone replacement therapy, and with a personal history of breast cancer had significantly higher odds ratios for regular mammography screening (2.75, 1.68, 1.75, and 1.98, respectively; all p < 0.05.

  17. Clinicopathological differences between interval and screen-detected breast cancers diagnosed within a screening programme in Northern Portugal.

    Science.gov (United States)

    José Bento, Maria; Gonçalves, Guilherme; Aguiar, Ana; Antunes, Luis; Veloso, Vitor; Rodrigues, Vítor

    2014-06-01

    To evaluate clinicopathological differences between screen-detected (SD) and interval (IC) breast cancers diagnosed in women enrolled in an organized breast screening programme in 2000--2007. Breast Cancer Screening Programme of the north region of Portugal. Using data from the screening programme and from the population-based North Region Cancer Registry, SD and IC were identified. Information on screening history, age, date of diagnosis, tumour size, histological type and grade, lymph node status, tumour stage, biomarkers, and treatment was obtained from the cancer registry and from clinical and pathological reports. Association between mode of detection and these clinicopathological characteristics was estimated by unconditional logistic regression. A total of 442 SD and 112 IC were identified in women aged 50--69. Compared with SD, IC were diagnosed in younger women (60.0 ± 5.8 years and 58.4 ± 6.0 years, respectively), were larger (tumour size >20 mm: 60.2% versus 25.1%), lobular (6.3% versus 16.1%), with a higher differentiation grade (grade 3: 17.7% versus 38.9%), had more lymph node metastases, more advanced stage, and oestrogen receptor (ER) negative (12.9% versus 29.0%) and progesterone negative, and HER2 positive. After multivariable analysis, compared with SD, IC were more likely to be larger than 20 mm, lobular, of grade 3 and negative for ER. Our results are consistent with other studies. IC's have a more aggressive biology than SDs. Our findings did not show any unexpected pattern requiring changes to our screening procedures, but continuous identification and characterization of IC is advisable. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Cost-effectiveness of MRI for breast cancer screening in BRCA1/2 mutation carriers.

    Science.gov (United States)

    Pataky, Reka; Armstrong, Linlea; Chia, Stephen; Coldman, Andrew J; Kim-Sing, Charmaine; McGillivray, Barbara; Scott, Jenna; Wilson, Christine M; Peacock, Stuart

    2013-07-10

    Women with mutations in BRCA1 or BRCA2 are at high risk of developing breast cancer and, in British Columbia, Canada, are offered screening with both magnetic resonance imaging (MRI) and mammography to facilitate early detection. MRI is more sensitive than mammography but is more costly and produces more false positive results. The purpose of this study was to calculate the cost-effectiveness of MRI screening for breast cancer in BRCA1/2 mutation carriers in a Canadian setting. We constructed a Markov model of annual MRI and mammography screening for BRCA1/2 carriers, using local data and published values. We calculated cost-effectiveness as cost per quality-adjusted life-year gained (QALY), and conducted one-way and probabilistic sensitivity analysis. The incremental cost-effectiveness ratio (ICER) of annual mammography plus MRI screening, compared to annual mammography alone, was $50,900/QALY. After incorporating parameter uncertainty, MRI screening is expected to be a cost-effective option 86% of the time at a willingness-to-pay of $100,000/QALY, and 53% of the time at a willingness-to-pay of $50,000/QALY. The model is highly sensitive to the cost of MRI; as the cost is increased from $200 to $700 per scan, the ICER ranges from $37,100/QALY to $133,000/QALY. The cost-effectiveness of using MRI and mammography in combination to screen for breast cancer in BRCA1/2 mutation carriers is finely balanced. The sensitivity of the results to the cost of the MRI screen itself warrants consideration: in jurisdictions with higher MRI costs, screening may not be a cost-effective use of resources, but improving the efficiency of MRI screening will also improve cost-effectiveness.

  19. Turkish female academician self-esteem and health beliefs for breast cancer screening.

    Science.gov (United States)

    Avci, Ilknur Aydin; Kumcagiz, Hatice; Altinel, Busra; Caloglu, Ayse

    2014-01-01

    This study aimed to analyse female academician health beliefs for breast cancer screening and levels of self-esteem. This cross-sectional study was conducted between October 2010 and March 2011, covering female academicians working in all faculties and vocational schools at Ondokuz Mayis University, except for the ones in the field of health (n=141). Data was collected using a questionnaire developed by researchers in the light of the related literature, the Champion's Health Belief Model Scale for Breast Cancer, and the Coopersmith Self-Esteem Inventory. Descriptive statistics, the t-test, Mann-Whitney U and correlation analysis were used to analyze the data with the SPSS 13.0 statistical package. 53.8% of the participants were single, 58.6% did not have children, 80.7% had regular menstrual cycles, 28.3% was taking birth control pills, 17.9% were undergoing hormone therapy, 11% suffered breast problems, 8.3% had relatives with breast cancer, 78,6% knew about breast self-examination (BSE), 68.3% was performing BSE, 16.2% were performing BSE monthly, 17.9% had had mammograms, and 30.3% had undergone breast examinations conductedby physicians. The women who had breast physical examinations done by physicians had higher susceptibility, self-efficacy and health motivation, and fewer barriers to mammography than those who did not have breast physical examinations. There was a relationship between the female academician self-esteem and their perceived seriousness of breast cancer, perceived barriers to BSE and health motivation. Our Turksih female academicians had medium levels of self-esteem.

  20. Barriers to and factors facilitating breast cancer screening among Iranian women: a qualitative study.

    Science.gov (United States)

    Lamyian, M; Hydarnia, A; Ahmadi, F; Faghihzadeh, S; Aguilar-Vafaie, M E

    2007-01-01

    This study used qualitative methodology to understand Iranian women's views about barriers to and factors facilitating screening for early detection of breast cancer. Using grounded theory with in-depth interviews of 31 participants, themes emerged from the data in 2 main categories (internal and external) with 3 sub-categories: women's attitudes, feelings and beliefs; women's social network experiences; and accessibility. Facilitating factors for screening were self-care, fear, proactive coping, state of mind and advocacy. Barriers were negligence, cancer-related fear, low self-efficacy, fatalism, misinformation, ineffective health communication and competing priorities.

  1. Opportunistic screening actions for breast cancer performed by nurses working in primary health care

    Directory of Open Access Journals (Sweden)

    Débora Cherchiglia de Moraes

    2016-02-01

    Full Text Available Abstract OBJECTIVE To identify opportunistic screening actions for breast cancer performed by nurses working in primary health care units in Ribeirão Preto, São Paulo. METHOD Cross-sectional study with 60 nurses from 28 units, who had been working for at least one year in the public municipal health care network. Data were collected between December 2013 and March 2014, by means of a questionnaire, using descriptive analysis and the software IBM SPSS version 20 and Microsoft Excel 2010. RESULTS The results showed that 71.7% of the participants questioned their female patients as for risk factors for breast cancer, mainly during nursing consultation; 70.0% oriented users about the age to perform clinical breast exam, whereas 30.0% did not due to lack of knowledge and time; 60.0% explained about the age to perform mammogram; 73.3% did not refer patients with suspicious breast exam results to the referral department, citing scheduling as the main obstacle to referral. Educational activities were not performed by 78.3% of participants. CONCLUSION Investment is needed in professional training and management of breast cancer screening.

  2. Breast cancer knowledge, attitudes, and screening behaviors among African American women: the Black cosmetologists promoting health program.

    Science.gov (United States)

    Sadler, Georgia R; Ko, Celine M; Cohn, Jennifer A; White, Monique; Weldon, Rai-nesha; Wu, Phillis

    2007-04-17

    African American women have higher rates of breast cancer mortality than their white counterparts. Studies have suggested that this is partly caused by discovery of cancer at a later stage, highlighting the importance of encouraging early detection of breast cancer in this population. To guide the creation of a breast cancer education intervention and help focus other health educators' and clinicians' health promotion efforts, this study explored whether a cohort of African American women living in San Diego would demonstrate the possession of adequate baseline knowledge about breast cancer screening and adherence to widely recommended screening guidelines. African American women (N = 1,055) from San Diego, California participated in a beauty salon-based survey about breast cancer knowledge, attitudes, and screening practices. Women's ages ranged from 20 to 94 years, with average age of 42.20 (SD = 13.53) years. Thirty-four percent reported completing college and/or some graduate school training, and 52% reported having some college or post high school formal training. Seventy-five percent of the sample reported working outside their home. Participating cosmetologists and their salons were recruited to the study through word-of-mouth referral by highly respected African American community leaders. Salon clients reported low rates of adherence to recommended breast cancer screening guidelines. Of the 1,055 participants, 31% reporting performing breast self-exam every month. Of those participants 40 and older, 57% reported having had a clinical breast exam and 43% reported having had a mammogram in the past year. Knowledge of breast cancer was associated with adherence to screening guidelines. While women recognized the serious health threat that breast cancer poses and that early detection of breast cancer is important, only 30% of women reported feeling well informed about the disease. Many participants demonstrated a lack of basic knowledge about breast cancer

  3. Breast cancer knowledge, attitudes, and screening behaviors among African American women: the Black cosmetologists promoting health program

    Directory of Open Access Journals (Sweden)

    Weldon Rai-nesha

    2007-04-01

    Full Text Available Abstract Background African American women have higher rates of breast cancer mortality than their white counterparts. Studies have suggested that this is partly caused by discovery of cancer at a later stage, highlighting the importance of encouraging early detection of breast cancer in this population. To guide the creation of a breast cancer education intervention and help focus other health educators' and clinicians' health promotion efforts, this study explored whether a cohort of African American women living in San Diego would demonstrate the possession of adequate baseline knowledge about breast cancer screening and adherence to widely recommended screening guidelines. Methods African American women (N = 1,055 from San Diego, California participated in a beauty salon-based survey about breast cancer knowledge, attitudes, and screening practices. Women's ages ranged from 20 to 94 years, with average age of 42.20 (SD = 13.53 years. Thirty-four percent reported completing college and/or some graduate school training, and 52% reported having some college or post high school formal training. Seventy-five percent of the sample reported working outside their home. Participating cosmetologists and their salons were recruited to the study through word-of-mouth referral by highly respected African American community leaders. Results Salon clients reported low rates of adherence to recommended breast cancer screening guidelines. Of the 1,055 participants, 31% reporting performing breast self-exam every month. Of those participants 40 and older, 57% reported having had a clinical breast exam and 43% reported having had a mammogram in the past year. Knowledge of breast cancer was associated with adherence to screening guidelines. While women recognized the serious health threat that breast cancer poses and that early detection of breast cancer is important, only 30% of women reported feeling well informed about the disease. Many participants

  4. Factors affecting breast cancer screening behavior in Japan--assessment using the health belief model and conjoint analysis.

    Science.gov (United States)

    Tsunematsu, Miwako; Kawasaki, Hiromi; Masuoka, Yuko; Kakehashi, Masayuki

    2013-01-01

    Japanese women in their 40s or older have been encouraged to attend breast cancer screening. However, the breast cancer screening rate in Japan is not as high as in Europe and the United States. The aim of this study was to identify psychological and personal characteristics of women concerning their participation in breast cancer screening using the Health Belief Model (HBM). In addition, the attributes of screening more easily accepted by participants were analyzed by conjoint analysis. In this cross sectional study of 3,200 age 20-69 women, data were collected by an anonymous questionnaire. Questions were based on HBM and personal characteristics, and included attitudes on hypothetical screening attributes. Data of women aged 40-69 were analyzed by logistic regression and conjoint analysis to clarify the factors affecting their participation in breast cancer screening. Among responses collected from 1,280 women of age 20-69, the replies of 993 women of age 40-69 were used in the analysis. Regarding the psychological characteristics based on HBM, the odds ratios were significantly higher in "importance of cancer screening" (95%CI: 1.21-2.47) and "benefits of cancer screening" (95%CI: 1.09-2.49), whereas the odds ratio was significantly lower in "barriers to participation before cancer screening" (95%CI: 0.27-0.51). Conjoint analysis revealed that the respondents, overall, preferred screening to be low cost and by female staff members. Furthermore, it was also clarified that attributes of screening dominant in decision-making were influenced by the employment status and the type of medical insurance of the women. In order to increase participation in breast cancer screening, it is necessary to disseminate accurate knowledge on cancer screening and to reduce barriers to participation. In addition, the attributes of screening more easily accepted were inexpensive, provided by female staff, executed in a hospital and finished in a short time.

  5. Features of undiagnosed breast cancers at screening breast MR imaging and potential utility of computer-aided evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Mirinae; Cho, Nariya; Bea, Min Sun; Koo, Hye Ryoung; Kim, Won Hwa; Lee, Su Hyun; Chu, A Jung [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-02-15

    To retrospectively evaluate the features of undiagnosed breast cancers on prior screening breast magnetic resonance (MR) images in patients who were subsequently diagnosed with breast cancer, as well as the potential utility of MR-computer-aided evaluation (CAE). Between March 2004 and May 2013, of the 72 consecutive pairs of prior negative MR images and subsequent MR images with diagnosed cancers (median interval, 32.8 months; range, 5.4-104.6 months), 36 (50%) had visible findings (mean size, 1.0 cm; range, 0.3-5.2 cm). The visible findings were divided into either actionable or under threshold groups by the blinded review by 5 radiologists. MR imaging features, reasons for missed cancer, and MR-CAE features according to actionability were evaluated. Of the 36 visible findings on prior MR images, 33.3% (12 of 36) of the lesions were determined to be actionable and 66.7% (24 of 36) were underthreshold; 85.7% (6 of 7) of masses and 31.6% (6 of 19) of non-mass enhancements were classified as actionable lesions. Mimicking physiologic enhancements (27.8%, 10 of 36) and small lesion size (27.8%, 10 of 36) were the most common reasons for missed cancer. Actionable findings tended to show more washout or plateau kinetic patterns on MR-CAE than underthreshold findings, as the 100% of actionable findings and 46.7% of underthreshold findings showed washout or plateau (p = 0.008). MR-CAE has the potential for reducing the number of undiagnosed breast cancers on screening breast MR images, the majority of which are caused by mimicking physiologic enhancements or small lesion size.

  6. Impacts of the Finnish service screening programme on breast cancer rates

    Directory of Open Access Journals (Sweden)

    Hakulinen Timo

    2008-01-01

    Full Text Available Abstract Background The aim of the current study was to examine impacts of the Finnish breast cancer (BC screening programme on the population-based incidence and mortality rates. The programme has been historically targeted to a rather narrow age band, mainly women of ages 50–59 years. Methods The study was based on the information on breast cancer during 1971–2003 from the files of the Finnish Cancer Registry. Incidence, cause-specific mortality as well as incidence-based (refined mortality from BC were analysed with Poisson regression. Age-specific incidence and routine cause-specific mortality were estimated for the most recent five-year period available; incidence-based mortality, respectively, for the whole steady state of the programme, 1992–2003. Results There was excess BC incidence with actual screening ages; incidence in ages 50–69 was increased 8% (95 CI 2.9–13.4. There was an increasing temporal tendency in the incidence of localised BC; and, respectively, a decrease in that of non-localised BC. The latter was most consistent in age groups where screening had been on-going several years or eventually after the last screen. The refined mortality rate from BC diagnosed in ages 50–69 was decreased with -11.1% (95% CI -19.4, -2.1. Conclusions The current study demonstrates that BC screening in Finland is effective in reducing mortality rates from breast cancers, even though the impact on the population level is smaller than expected based on the results from randomised trials among women screened in age 50 to 69. This may be explained by the rather young age group targeted in our country. Consideration whether to targeted screening up to age 69 is warranted.

  7. The Yo me cuido® Program: Addressing Breast Cancer Screening and Prevention Among Hispanic Women.

    Science.gov (United States)

    Davis, Jenna L; Ramos, Roberto; Rivera-Colón, Venessa; Escobar, Myriam; Palencia, Jeannette; Grant, Cathy G; Green, B Lee

    2015-09-01

    Breast cancer is less likely to be diagnosed at the earliest stage in Hispanic/Latino (Hispanic) women compared to non-Hispanic White women, even after accounting for differences in age, socioeconomic status, and method of detection. Moffitt Cancer Center created a comprehensive health education program called Yo me cuido (®) (YMC) to address and reduce breast cancer disparities among Spanish- and English-speaking Hispanic women by providing breast cancer and healthy lifestyles awareness and education, and promoting breast cancer screenings, reminders, and referrals for women 40 years and older. The purpose of this paper is to showcase the innovative approaches and methods to cancer prevention and early detection of the YMC program, and to promote it as an effective tool for improving outcomes in community health education, outreach, and engagement activities with Hispanic populations. Key components of the program include educational workshops, mammogram referrals, and a multimedia campaign. The YMC program is unique because of its approaches in reaching the Hispanic population, such as delivering the program with compassionate services to empower participants to live a healthier lifestyle. Additionally, direct follow-up for mammography screenings is provided by program staff. From 2011 to 2013, YMC has educated 2,226 women and 165 men through 93 workshops. About 684 (52 %) women ages 40 and older have had a screening mammogram within their first year of participating in the program. The YMC program is an innovative cancer education and outreach program that has demonstrated a positive impact on the lives of the Hispanic community in the Tampa Bay region.

  8. Improving breast and colon cancer screening rates: a comparison of letters, automated phone calls, or both.

    Science.gov (United States)

    Phillips, Lindsay; Hendren, Samantha; Humiston, Sharon; Winters, Paul; Fiscella, Kevin

    2015-01-01

    Low-cost interventions to improve cancer screening among primary care patients are needed. The comparative effectiveness of personalized letters, automated telephone calls, and both on breast cancer (BC) and colorectal cancer (CRC) screening is not known. A pragmatic, randomized, controlled trial was conducted in 2011 to 2012. Eligible primary care patients were women ages 50 to 74 years who were past due for mammography and men or women who were past due for mammography or CRC screening of any kind (>12 months since last fecal occult blood test, >5 years since last sigmoidoscopy/double-contrast barium enema, or >10 years since last colonoscopy), respectively. Participants were randomized to 1 of 3 interventions: personalized mailed letters, automated telephone calls, or both. The primary outcome was medical record documentation of a completed mammogram or CRC screening within 36 weeks of randomization. We estimated the costs of each intervention and calculated the marginal cost-effectiveness per person screened. The crude screening rates for BC were 19%, 22%, and 37% and for CRC were 17%, 14%, and 24% for the letter, automated call, and combined (letter/automated call) groups, respectively. The combined intervention group had a statistically higher screening rate (P costs $5.11 per additional person screened for BC and $13.14 per additional person screened for CRC. In a primary care practice, letters plus automated telephone calls are better than either alone in increasing cancer screening rates among patients who are overdue for screening. These findings suggest the promise of a relatively inexpensive intervention to improve cancer screening. © Copyright 2015 by the American Board of Family Medicine.

  9. Las mujeres saludables: reaching Latinas for breast, cervical and colorectal cancer prevention and screening.

    Science.gov (United States)

    Larkey, Linda

    2006-02-01

    Community health advisors have effectively promoted breast and cervical cancer prevention and screening among low-income Latina women. Specific elements of such programs, such as enhanced social support, may explain successes. Promotion of colorectal cancer screening has been less studied. Promotoras de Salud (i.e., Latina health advisors) implemented a 12-week program among women recruited from community-based organizations. The program educated 366 Latinas in breast, cervical and colorectal cancer prevention and screening and emphasized social support among class members. Pre- and post-intervention assessments demonstrated significant increases for fruit and vegetable consumption (3.05 to 3.60 servings/day), and physical activity (65.15 to 122.40 minutes/week). Of women previously non-compliant, 39 percent, 31 percent and 4 percent received Pap tests, mammography, and fecal occult blood test (FOBT), respectively. A culturally aligned education program using community health advisors and emphasizing social support among participants may improve prevention and selected screening behaviors, but more intensive interventions may be required for colorectal cancer screening compliance.

  10. Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Lee, Hee; Ghebre, Rahel; Le, Chap; Jang, Yoo Jeong; Sharratt, Monica; Yee, Douglas

    2017-11-07

    Despite the increasing breast cancer incidence and mortality rates, Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States. Mobile health (mHealth), defined as the delivery of health care information or services through mobile communication devices, has been utilized to successfully improve a variety of health outcomes. This study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women, an underserved community. Using a randomized controlled trial design, 120 Korean American women aged 40 to 77 years were recruited and randomly assigned to either the mMammogram intervention group (n=60) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group (n=60) to receive a printed brochure. Outcome measures included knowledge, attitudes, and beliefs about breast cancer screening, readiness for mammography, and mammogram receipt. The feasibility and acceptability of the mMammogram intervention was also assessed. The intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines (P=.01). The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group. A significantly higher proportion of women who received the mMammogram intervention (75%, 45/60) completed mammograms by the 6-month follow-up compared with the control group (30%, 18/60; Phttps://clinicaltrials.gov/show/NCT01972048 (Archived by WebCite at https://clinicaltrials.gov/archive/NCT01972048/2013_10_29).

  11. Breast and cervical cancer screening among South Asian immigrants in the United States.

    Science.gov (United States)

    Menon, Usha; Szalacha, Laura A; Prabhughate, Abhijit

    2012-01-01

    South Asian (SA) immigrants (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) constitute the fastest growing of all Asian American immigrants to the United States, with a growth rate of 106% from 1990 to 2001. Data are lacking on health behaviors of this population subgroup, including cancer-related information. : The purpose of this study was to assess rates and correlates of breast and cervical cancer screening in a community sample of SAs. Participants were recruited from among attendees of 3 community-based agency programs. Data were collected in English, Hindi, and Gujarati from a convenience sample of 198 participants. Two-thirds of the sample (n = 127, 65.5%) had ever had a mammogram, whereas only a third (n = 65, 32.8%) had ever had a Papanicolaou smear or vaginal examination. Several predisposing factors (eg, country of birth, years in the United States, acculturation, age, and acknowledged barriers to screening) were significant predictors of breast and cervical screening, whereas the only enabling factor was past screening behavior. Additional study is warranted on cultural aspects of cancer screening behaviors. These data are formative on facilitators and barriers to mammogram and Papanicolaou test completion among these understudied minority women. Nurses who practice in primary care may begin to target health education based on sociodemographics of SA women and emphasize discussion of barriers to screening.

  12. Increased Identification of Candidates for High-Risk Breast Cancer Screening Through Expanded Genetic Testing.

    Science.gov (United States)

    Rosenthal, Eric T; Evans, Brent; Kidd, John; Brown, Krystal; Gorringe, Heidi; van Orman, Michael; Manley, Susan

    2017-04-01

    Breast MRI screening is recommended for women with a >20% lifetime risk for breast cancer on the basis of estimates derived from risk models dependent largely on family history. Alternatively, a >20% lifetime risk can be established through genetic testing of BRCA1 and BRCA2, as well as a growing selection of other genes associated with inherited breast cancer risk. The aim of this study was to quantify the impact of testing for genes other than BRCA1/2 and the extent to which mutation carriers in these genes would have been identified as candidates for enhanced screening on the basis of family history alone. Women were tested with a 25-gene hereditary cancer panel including BRCA1/2 and 7 additional genes known to be associated with a >20% lifetime risk for breast cancer (ATM, CHEK2, PALB2, TP53, PTEN, CDH1, and STK11). Women found to carry pathogenic variants (PVs) were evaluated with the Claus model to assess whether they would have been found to be at >20% lifetime risk on the basis of family history. In total, 9,751 PVs in the selected breast cancer risk genes were identified in 9,641 women. BRCA1/2 accounted for 59.1% of the PVs, and 38.8% were in ATM, CHEK2, or PALB2. Only 24.7% of all women with PVs found in any gene reached the >20% lifetime risk threshold using the Claus model. Expanding genetic testing beyond BRCA1/2 significantly increases the number of women who are candidates for breast MRI and other risk reduction measures, most of whom would not have been identified through family history assessment. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. Analysis of Cost-effectiveness of screening for breast cancer with conventional mammography, digital and magnetic resonance imaging

    National Research Council Canada - National Science Library

    Antonio Augusto deFreitas Peregrino; Cid Manso deMello Vianna; Carlos Eduardo Veloso de Almeida; Gabriela Bittencourt Gonzáles; Samara Cristina Ferreira Machado; Frances Valéria Costa e Silva; Marcus Paulo daSilva Rodrigues

    2012-01-01

      A cost-effectiveness analysis was conducted in screening for breast cancer. The use of conventional mammography, digital and magnetic resonance imaging were compared with natural disease history as a baseline...

  14. Autoantibody to tumor antigen, alpha 2-HS glycoprotein: a novel biomarker of breast cancer screening and diagnosis.

    Science.gov (United States)

    Yi, Jae Kyo; Chang, Jong Wook; Han, Wonshik; Lee, Jong Won; Ko, Eunyoung; Kim, Dong Hyun; Bae, Ji-Yeon; Yu, Jonghan; Lee, Cheolju; Yu, Myeong-Hee; Noh, Dong-Young

    2009-05-01

    We sought to identify a new serum biomarker for breast cancer screening and diagnosis using stepwise proteomic analysis of sera from breast cancer patients to detect the presence of autoantibodies that react with urinary protein. Two-dimensional immunoblotting was done for screening autoimmunogenic tumor antigens in the urine of breast cancer patients. Reactive spots were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Among urinary proteins separated by two-dimensional electrophoresis, 13 spots showed strong reactivity with pooled sera from breast cancer patients or control sera. By mass spectrometry, we identified alpha 2-HS glycoprotein (AHSG) as a tumor antigen. Peripheral blood was obtained from 81 women diagnosed with breast cancer before surgery and 73 female donors without evidence of any malignancy for the individual analysis. In one-dimensional Western blot analysis, AHSG autoantibody was detected in 64 of 81 breast cancer patients (79.1%) and in 7 of 73 controls (9.6%). The sensitivity of this test in breast cancer patients was 79.0%. Our results suggest that AHSG and anti-AHSG autoantibody may be useful serum biomarkers for breast cancer screening and diagnosis.

  15. Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme

    Energy Technology Data Exchange (ETDEWEB)

    Timmermans, Lore; Hauwere, An de; Bacher, Klaus; Thierens, Hubert [Ghent University, Department of Basic Medical Sciences, QCC-Gent, Ghent (Belgium); Bosmans, Hilde; Lemmens, Kim; Steen, Andre van [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Bleyen, Luc; Mortier, Griet; Herck, Koen van [Ghent University, Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Ghent (Belgium); Limbergen, Erik van [Leuvens Universitair Centrum voor Kankerpreventie, Leuven (Belgium); Martens, Patrick [Vroegtijdige Opsporing van Borstklierkanker vzw, Bruges (Belgium)

    2014-08-15

    To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30 % in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. (orig.)

  16. Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme.

    Science.gov (United States)

    Timmermans, Lore; De Hauwere, An; Bacher, Klaus; Bosmans, Hilde; Lemmens, Kim; Bleyen, Luc; Van Limbergen, Erik; Martens, Patrick; Van Steen, Andre; Mortier, Griet; Van Herck, Koen; Thierens, Hubert

    2014-08-01

    To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30% in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. • Performance parameters showed no major differences after digitalisation to CR or DR. • Transition from SFM to CR results in a higher mean glandular dose. • Transition from SFM to DR results in a lower mean glandular dose.

  17. Screening for Ataxia-Telangiectasia Mutations in a Population-Based Sample of Women with Early-Onset Breast Cancer

    Science.gov (United States)

    1999-09-01

    G, Itnyre J (1997) Prevalence and contribution of BRCA1 mutations in breast and ovarian cancer: results from three U.S. population-based case-control...GTTAAGAA two of these cases, AT1ILA and AT119LA, the families were consanguineous , and the mutations were homo- zygous, simplifying the interpretation...screening efficiency and expand significantly the number of cases to be screened. Assessment of the prevalence of ATM mutations in breast cancer

  18. Cultural Factors Associated with Breast and Cervical Cancer Screening in Korean American Women in the US: An Integrative Literature Review

    Directory of Open Access Journals (Sweden)

    Shin-Young Lee, PhD

    2015-06-01

    Conclusions: Theories focusing on interpersonal relationships and standardized, reliable, and valid instruments to measure cultural concepts are needed to breast and cervical cancer screening research in KA women. Traditional cultural factors associated with cancer screening should be considered for practical implications and future research with KA women.

  19. Are Cervical and Breast Cancer Screening Programmes Equitable? The Case of Women with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Cobigo, V.; Ouellette-Kuntz, H.; Balogh, R.; Leung, F.; Lin, E.; Lunsky, Y.

    2013-01-01

    Background: Effective cancer screening must be available for all eligible individuals without discrimination. Lower rates of cervical and breast cancer screening have been reported in certain groups compared with women from the general population, such as women with intellectual and developmental disabilities (IDD). Research on the factors…

  20. Women's participation in breast cancer screening in France--an ethical approach.

    Science.gov (United States)

    Moutel, Grégoire; Duchange, Nathalie; Darquy, Sylviane; de Montgolfier, Sandrine; Papin-Lefebvre, Frédérique; Jullian, Odile; Viguier, Jérôme; Sancho-Garnier, Hélène

    2014-08-16

    Breast cancer is a major public health challenge. Organized mammography screening (OS) is considered one way to reduce breast cancer mortality. EU recommendations prone mass deployment of OS, and back in 2004, France introduced a national OS programme for women aged 50-74 years. However, in 2012, participation rate was still just 52.7%, well short of the targeted 70% objective. In an effort to re-address the (in) efficiency of the programme, the French National Cancer Institute has drafted an expert-group review of the ethical issues surrounding breast cancer mammography screening. Prompted by emerging debate over the efficiency of the screening scheme and its allied public information provision, we keynote the experts' report based on analysis of epidemiological data and participation rate from the public health authorities. The low coverage of the OS scheme may be partly explained by the fact that a significant number of women undergo mammography outside OS and thus outside OS criteria. These findings call for further thinking on (i) the ethical principles of beneficence and non-malfeasance underpinning this public health initiative, (ii) the reasons behind women's and professionals' behavior, and (iii) the need to analyze how information provision to women and the doctor-patient relationship need to evolve in response to scientific controversy over the risks and benefits of conducting mammographic screening. This work calls for a reappraisal of the provision of screening programme information. We advocate a move to integrate the points sparking debate over the efficiency of the screening scheme to guarantee full transparency. The perspective is to strengthen the respect for autonomy allowing women to make an informed choice in their decision on whether or not to participate.

  1. The determinants of breast cancer screening behavior: a focus group study of women in the United Arab Emirates.

    Science.gov (United States)

    Bener, Abdulbari; Honein, Gladys; Carter, Anne O; Da'ar, Zahra; Miller, Campbell; Dunn, Earl V

    2002-10-01

    To explore perceptions, knowledge, attitudes, and beliefs about breast cancer and its screening among Emirati national women in Al Ain, United Arab Emirates. A qualitative study using focus group methods. Primary healthcare centers and a community-based women's association in the United Arab Emirates. 41 women, aged 25-45 years. Four 90-minute focus group discussions exploring perceptions, knowledge, attitudes, beliefs, and practices regarding breast cancer were audiotaped, transcribed, translated, and analyzed. Social and cultural themes related to breast cancer and its screening. Focus group methodology worked well in this setting. The women's perceptions, knowledge, attitudes, and beliefs regarding cancer and screening, together with aspects of the healthcare system and social milieu, appeared to strongly influence the women's preventive practices. Some of these factors had an encouraging effect on the women's practices, and others had a deterring effect. The encouraging factors included feelings of susceptibility, high levels of knowledge in some women, attitudes and beliefs about personal responsibility for health, and a supportive social milieu. Deterring factors included anxiety and fear leading to denial; lack of knowledge about cancer and the screening program; fear, embarrassment, and mistrust of health care; and belief in predestination. Health planners and healthcare providers must capitalize on encouraging factors and minimize deterring factors to optimize breast cancer screening practices among these women. Identifying and accounting for the factors that encourage or deter women in their breast cancer screening practices will help to optimize screening programs.

  2. Interval breast cancers: Absolute and proportional incidence and blinded review in a community mammographic screening program

    Energy Technology Data Exchange (ETDEWEB)

    Carbonaro, Luca A., E-mail: luca.carbonaro@gmail.com [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Azzarone, Antonio [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Paskeh, Bijan Babaei [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Brambilla, Giorgio [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Brunelli, Silvia [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Calori, Anna [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Caumo, Francesca [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Malerba, Paolo [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Menicagli, Laura [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Sconfienza, Luca M. [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano (Italy); Vadalà, Giuseppe [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Brambilla, Gelma; Fantini, Luigi [Servizio di Medicina Preventiva delle Comunità, ASL Milano 2, Via Friuli 2, Lacchiarella (Mi) 20084 (Italy); Ciatto, Stefano [Screening Program, ULSS 16, Padova (Italy); and others

    2014-02-15

    Purpose: To evaluate the performance of the first years since the beginning of a mammographic population-based screening program. Materials and methods: Women aged 49–69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records. The proportional incidence of IC was determined considering breast cancers expected without screening. Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis, randomly mixed with negative mammograms (1:2 ratio). Cases unrecalled at review were considered as true ICs, those recalled by only one reviewer as minimal signs, and those recalled by two or three reviewers as missed cancers. T and N stage of the reviewed ICs were evaluated and compared. Results: A total of 86,276 first level mammograms were performed. Mean recall rate was 6.8% at first and 4.6% at repeat screening. We had 476 screen-detected cancers and 145 ICs (10 of them ductal carcinomas in situ). Absolute incidence was 17 per 10,000 screening examinations. Invasive proportional incidence was 19% (44/234) in the first year, 39% (91/234) in the second year, and 29% (135/468) in the two-year interval. Of 145 ICs, 130 (90%) were reviewed mixed with 287 negative controls: 55% (71/130) resulted to be true ICs, 24% (31/130) minimal signs, and 22% (28/130) missed cancers. The rate of ICs diagnosed in the first year interval was 21% (15/71) for true ICs, 46% (13/28) for missed cancers, and 39% (12/31) for minimal signs, with a significant difference of true ICs rate compared to missed cancers rate (p = 0.012). A higher rate of T3 and T4 stages was found for missed cancers (18%, 5/28) compared to minimal signs (6%, 2/31) or true ICs (8%, 6/71), while the rate of N2 and N3 stage for both minimal signs (19%, 6/31) or missed cancers (25

  3. Interval breast cancers: absolute and proportional incidence and blinded review in a community mammographic screening program.

    Science.gov (United States)

    Carbonaro, Luca A; Azzarone, Antonio; Paskeh, Bijan Babaei; Brambilla, Giorgio; Brunelli, Silvia; Calori, Anna; Caumo, Francesca; Malerba, Paolo; Menicagli, Laura; Sconfienza, Luca M; Vadalà, Giuseppe; Brambilla, Gelma; Fantini, Luigi; Ciatto, Stefano; Sardanelli, Francesco

    2014-02-01

    To evaluate the performance of the first years since the beginning of a mammographic population-based screening program. Women aged 49-69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records. The proportional incidence of IC was determined considering breast cancers expected without screening. Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis, randomly mixed with negative mammograms (1:2 ratio). Cases unrecalled at review were considered as true ICs, those recalled by only one reviewer as minimal signs, and those recalled by two or three reviewers as missed cancers. T and N stage of the reviewed ICs were evaluated and compared. A total of 86,276 first level mammograms were performed. Mean recall rate was 6.8% at first and 4.6% at repeat screening. We had 476 screen-detected cancers and 145 ICs (10 of them ductal carcinomas in situ). Absolute incidence was 17 per 10,000 screening examinations. Invasive proportional incidence was 19% (44/234) in the first year, 39% (91/234) in the second year, and 29% (135/468) in the two-year interval. Of 145 ICs, 130 (90%) were reviewed mixed with 287 negative controls: 55% (71/130) resulted to be true ICs, 24% (31/130) minimal signs, and 22% (28/130) missed cancers. The rate of ICs diagnosed in the first year interval was 21% (15/71) for true ICs, 46% (13/28) for missed cancers, and 39% (12/31) for minimal signs, with a significant difference of true ICs rate compared to missed cancers rate (p=0.012). A higher rate of T3 and T4 stages was found for missed cancers (18%, 5/28) compared to minimal signs (6%, 2/31) or true ICs (8%, 6/71), while the rate of N2 and N3 stage for both minimal signs (19%, 6/31) or missed cancers (25%, 7/28) was higher than that for true ICs (10

  4. Promoting community practitioners' use of evidence-based approaches to increase breast cancer screening.

    Science.gov (United States)

    Leeman, Jennifer; Moore, Alexis; Teal, Randall; Barrett, Nadine; Leighton, Ashely; Steckler, Allan

    2013-07-01

    Many women do not get mammography screenings at the intervals recommended for early detection and treatment of breast cancer. The Guide to Community Preventive Services (Community Guide) recommends a range of evidence-based strategies to improve mammography rates. However, nurses and others working in community-based settings make only limited use of these strategies. We report on a dissemination intervention that partnered the University of North Carolina with the Susan G. Komen Triangle Affiliate to disseminate Community Guide breast cancer screening strategies to community organizations. The intervention was guided by social marketing and diffusion of innovation theory and was designed to provide evidence and support via Komen's existing relationships with grantee organizations. The present study reports the findings from a formative evaluation of the intervention, which included a content analysis of 46 grant applications pre- and post intervention and focus groups with 20 grant recipients. © 2013 Wiley Periodicals, Inc.

  5. [Population-based breast cancer screening: certainties, controversies, and future perspectives].

    Science.gov (United States)

    Apesteguía Ciriza, Luis; Pina Insausti, Luis Javier

    2014-01-01

    Population-based breast cancer screening programs based on mammography must maintain a high level of quality, so the results must be constantly monitored. Although most authors consider that these programs have decreased the mortality due to breast cancer by about 30%, others claim that the mortality has decreased by only about 12% due to errors in the randomization of patients, because the rate of advanced tumors has hardly decreased and because adjuvant treatment also improves survival. Other criticisms focus on overdiagnosis and overtreatment. We believe that despite the unquestionable value of mammographic screening, we should be open to certain changes such as the stratification of patients by their level of risk and the introduction of complementary techniques like tomosynthesis, ultrasonography, and magnetic resonance imaging in selected cases. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  6. A cluster randomized controlled trial to increase breast cancer screening among African American women: the black cosmetologists promoting health program.

    Science.gov (United States)

    Sadler, Georgia Robins; Ko, Celine M; Wu, Phillis; Alisangco, Jennifer; Castañeda, Sheila F; Kelly, Colleen

    2011-08-01

    African American women have disproportionately higher rates of breast cancer mortality than all other ethnic groups, thus highlighting the importance of promoting early detection. African American women (N = 984) from San Diego, California, participated in a randomized controlled trial testing the efficacy of breast cancer education sessions offered in beauty salons. Cosmetologists received ongoing support, training, and additional culturally aligned educational materials to help them engage their clients in dialogues about the importance of breast cancer early detection. Posters and literature about breast cancer early detection were displayed throughout the salons and cosmetologists used synthetic breast models to show their clients how breast cancer lumps might feel. Participants in the control group received a comparable diabetes education program. Baseline and 6-month follow-up surveys were administered to evaluate changes in women's breast cancer knowledge, attitudes, and screening behaviors. This intervention was well received by the participants and their cosmetologists and did not interfere with or prolong the client's salon visit. Women in the intervention group reported significantly higher rates of mammography compared to women in the control group. Training a single educator proved sufficient to permeate the entire salon with the health message, and salon clients agreed that cosmetologists could become effective health educators. Cosmetologists are in an ideal position to increase African American women's breast cancer knowledge and adherence to breast cancer screening guidelines.

  7. Cost-effectiveness of MRI compared to mammography for breast cancer screening in a high risk population

    Directory of Open Access Journals (Sweden)

    Tumeh John W

    2009-01-01

    Full Text Available Abstract Background Breast magnetic resonance imaging (MRI is a sensitive method of breast imaging virtually uninfluenced by breast density. Because of the improved sensitivity, breast MRI is increasingly being used for detection of breast cancer among high risk young women. However, the specificity of breast MRI is variable and costs are high. The purpose of this study was to determine if breast MRI is a cost-effective approach for the detection of breast cancer among young women at high risk. Methods A Markov model was created to compare annual breast cancer screening over 25 years with either breast MRI or mammography among young women at high risk. Data from published studies provided probabilities for the model including sensitivity and specificity of each screening strategy. Costs were based on Medicare reimbursement rates for hospital and physician services while medication costs were obtained from the Federal Supply Scale. Utilities from the literature were applied to each health outcome in the model including a disutility for the temporary health state following breast biopsy for a false positive test result. All costs and benefits were discounted at 5% per year. The analysis was performed from the payer perspective with results reported in 2006 U.S. dollars. Univariate and probabilistic sensitivity analyses addressed uncertainty in all model parameters. Results Breast MRI provided 14.1 discounted quality-adjusted life-years (QALYs at a discounted cost of $18,167 while mammography provided 14.0 QALYs at a cost of $4,760 over 25 years of screening. The incremental cost-effectiveness ratio of breast MRI compared to mammography was $179,599/QALY. In univariate analysis, breast MRI screening became $50,000/QALY in 34%, and inferior in 44% of trials. Conclusion Although breast MRI may provide health benefits when compared to mammographic screening for some high risk women, it does not appear to be cost-effective even at willingness to pay

  8. Abortion, Miscarriage, and Breast Cancer Risk

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Abortion, Miscarriage, and Breast Cancer Risk: 2003 Workshop In ... cancer risk, including studies of induced and spontaneous abortions. They concluded that having an abortion or miscarriage ...

  9. Screening of 1331 Danish breast and/or ovarian cancer families identified 40 novel BRCA1 and BRCA2 mutations

    DEFF Research Database (Denmark)

    Hansen, Thomas V O; Jønson, Lars; Steffensen, Ane Y

    2011-01-01

    and BRCA2 in high risk breast and/or ovarian cancer families. The mutations were detected via pre-screening using dHPLC or high-resolution melting and direct sequencing. We identified 16 variants in BRCA1, including 9 deleterious frame-shift mutations, 2 intronic variants, 4 missense mutations, and 1......Germ-line mutations in the tumour suppressor genes BRCA1 and BRCA2 predispose to breast and ovarian cancer. Since 1999 we have performed mutational screening of breast and/or ovarian cancer patients in East Denmark. During this period we have identified 40 novel sequence variations in BRCA1...

  10. [Breast cancer incidence related with a population-based screening program].

    Science.gov (United States)

    Natal, Carmen; Caicoya, Martín; Prieto, Miguel; Tardón, Adonina

    2015-02-20

    To compare breast cancer cumulative incidence, time evolution and stage at diagnosis between participants and non-participant women in a population-based screening program. Cohort study of breast cancer incidence in relation to participation in a population screening program. The study population included women from the target population of the screening program. The source of information for diagnostics and stages was the population-based cancer registry. The analysis period was 1999-2010. The Relative Risk for invasive, in situ, and total cancers diagnosed in participant women compared with non-participants were respectively 1.16 (0.94-1.43), 2.98 (1.16-7.62) and 1.22 (0.99-1.49). The Relative Risk for participants versus non-participants was 2.47 (1.55-3.96) for diagnosis at stagei, 2.58 (1.67-3.99) for T1 and 2.11 (1.38-3.23) for negative lymph node involvement. The cumulative incidence trend had two joint points in both arms, with an Annual Percent of Change of 92.3 (81.6-103.5) between 1999-2001, 18.2 (16.1-20.3) between 2001-2005 and 5.9 (4.0-7.8) for the last period in participants arm, and 72.6 (58.5-87.9) between 1999-2001, 12.6 (7.9-17.4) between 2001-2005, and 8.6 (6.5-10.6) in the last period in the non-participant arm. Participating in the breast cancer screening program analyzed increased the in situ cumulative cancer incidence, but not the invasive and total incidence. Diagnoses were earlier in the participant arm. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  11. Modelling mammography screening for breast cancer in the Canadian context: Modification and testing of a microsimulation model

    Science.gov (United States)

    Yaffe, Martin J.; Mittmann, Nicole; Lee, Pablo; Tosteson, Anna N.A.; Trentham-Dietz, Amy; AIagoz, Oguzhan; Stout, Natasha K.

    2016-01-01

    Background Modelling is a flexible and efficient approach to gaining insight into the trade-offs surrounding a complex process like breast screening, which involves more variables than can be controlled in an experimental study. Data and methods The University of Wisconsin CISNET breast cancer microsimulation model was adapted to simulate breast cancer incidence and screening performance in Canada. The model considered effects of breast density on the sensitivity and specificity of screening. The model’s ability to predict age-specific incidence of breast cancer was assessed. Results Predictions of age-adjusted incidence over calendar years and age-specific incidence of breast cancer in Canadian women are presented. Based on standard screening strategies, ratios of in situ to invasive disease and stage distribution of disease at diagnosis are compared with data from the British Columbia provincial screening program. Interpretation The adapted model performs well in predicting age-specific incidence and cross-sectional incidence in the absence of screening. The ratios of detection of in situ to invasive cancers and the overall stage distribution of detected cancers are in reasonable agreement with empirical data from British Columbia. PMID:26676233

  12. Development of a screening tool for the identification of psychooncological treatment need in breast cancer patients.

    Science.gov (United States)

    Meraner, Verena; Giesinger, Johannes; Kemmler, Georg; Taucher, Susanne; Hubalek, Michael; Weber, Barbara; Rumpold, Gerhard; Sperner-Unterweger, Barbara; Holzner, Bernhard

    2009-09-01

    In breast cancer patients the diagnosis, treatment and aftercare of the physical disease cause a large amount of psychosocial distress, which can have a variety of negative consequences on patients' physical and mental well-being. Although about one-third of the patients show heightened psychosocial distress that may require psychooncological interventions its detection in daily clinical routine is poor and referral to mental health professionals is insufficient. The aim of the study was to develop a short screening tool for the detection of need for psychooncological treatment (POT) in breast cancer patients. Over a period of six months, 115 breast cancer outpatients attending the Department of Gynaecology at Innsbruck Medical University were consecutively included in the study. Logistic regression analysis and ROC analyses were used to identify the most predictive item set from a set of questionnaires (EORTC-QLQ-C30, HADS and Hornheide Screening Instrument) and other additional questions. Data from 105 breast cancer patients (mean age 58.8, SD 12.3) were available for analysis. A logistic regression equation containing the EORTC-QLQ-C30 scales Emotional Functioning and Role Functioning as well as the yes-no question after psychiatric/psychological/psychotherapeutic treatment at any point in lifetime showed highest predictive power with regard to need of POT (AUC=0.88; CI 95% 0.82-0.95). A pilot study (n=20) investigating applicability of a computerized version of this screening tool in oncological routine showed high acceptance and feasibility. The developed PO-screening tool showed high diagnostic accuracy regarding POT needs. The short assessment time and good usability of its computerized version allowed easy implementation in daily oncological routine.

  13. Evaluation issues in the Swedish Two-County Trial of breast cancer screening: An historical review.

    Science.gov (United States)

    Tabar, Laszlo; Chen, Tony Hsiu-Hsi; Hsu, Chen-Yang; Wu, Wendy Yi-Ying; Yen, Amy Ming-Fang; Chen, Sam Li-Sheng; Chiu, Sherry Yueh-Hsia; Fann, Jean Ching-Yuan; Beckmann, Kerri; Smith, Robert A; Duffy, Stephen W

    2017-03-01

    Objectives To summarize debate and research in the Swedish Two-County Trial of mammographic screening on key issues of trial design, endpoint evaluation, and overdiagnosis, and from these to infer promising directions for the future. Methods A cluster-randomized controlled trial of the offer of breast cancer screening in Sweden, with a single screen of the control group at the end of the screening phase forms the setting for a historical review of investigations and debate on issues of design, analysis, and interpretation of results of the trial. Results There has been considerable commentary on the closure screen of the control group, ascertainment of cause of death, and cluster randomization. The issues raised were researched in detail and the main questions answered in publications between 1989 and 2003. Overdiagnosis issues still remain, but methods of estimation taking full account of lead time and of non-screening influences on incidence (taking place mainly before 2005) suggest that it is a minor phenomenon. Conclusion Despite resolution of issues relating to this trial in peer-reviewed publications dating from years, or even decades ago, issues that already have been addressed continue to be raised. We suggest that it would be more profitable to concentrate efforts on current research issues in breast cancer diagnosis, treatment, and prevention.

  14. Knowledge, Attitudes, and Beliefs Regarding Breast and Cervical Cancer Screening among Cambodian, Laotian, Thai, and Tongan Women

    OpenAIRE

    Dang, Jeff; Lee, Jessica; Tran, Jacqueline H.

    2010-01-01

    Asian American Pacific Islander (AAPI) groups have low rates of breast and cervical cancer screening. This study examined knowledge, attitudes, and beliefs (KABs) regarding breast and cervical cancer on AAPI women. A cross-sectional survey of 1,808 AAPI women was included. Descriptive statistics and chi-square tests were provided and 55.3%, 68.6%, and 71.9% had received mammograms, clinical breast exam, and Pap smears, respectively. KABs on breast and cervical cancer varied between the four e...

  15. The Impact of mHealth Interventions on Breast Cancer Awareness and Screening: Systematic Review Protocol.

    Science.gov (United States)

    Tokosi, Temitope O; Fortuin, Jill; Douglas, Tania S

    2017-12-21

    Mobile health (mHealth) is the use of mobile communication technologies to promote health by supporting health care practices (eg, health data collection, delivery of health care information). mHealth technologies (such as mobile phones) can be used effectively by health care practitioners in the distribution of health information and have the potential to improve access to and quality of health care, as well as reduce the cost of health services. Current literature shows limited scientific evidence related to the benefits of mHealth interventions for breast cancer, which is the leading cause of cancer deaths in women worldwide and contributes a large proportion of all cancer deaths, especially in developing countries. Women, especially in low- and middle-income countries (LMICs), are faced with low odds of surviving breast cancer. This finding is likely due to multiple factors related to health systems: low priority of women's health and cancer on national health agendas; lack of awareness that breast cancer can be effectively treated if detected early; and societal, cultural, and religious factors that are prevalent in LMICs. The proposed systematic review will examine the impact of mHealth interventions on breast cancer awareness and screening among women aged 18 years and older. The objectives of this study are to identify and describe the various mHealth intervention strategies that are used for breast cancer, and assess the impact of mHealth strategies on breast cancer awareness and screening. Literature from various databases such as MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials will be examined. Trial registers, reports, and unpublished theses will also be included. All mobile technologies such as cell phones, personal digital assistants, and tablets that have short message service, multimedia message service, video, and audio capabilities will be included. mHealth is the primary intervention. The search strategy will

  16. Does breast cancer screening level health inequalities out? A population-based study in an Italian region.

    Science.gov (United States)

    Pacelli, Barbara; Carretta, Elisa; Spadea, Teresa; Caranci, Nicola; Di Felice, Enza; Stivanello, Elisa; Cavuto, Silvio; Cisbani, Luca; Candela, Silvia; De Palma, Rossana; Fantini, Maria P

    2014-04-01

    Although population-based screening has the potential to reduce inequalities in breast cancer survival, evidence on this topic is controversial. The objective of this study was to evaluate whether the full implementation of a mammography screening programme in Emilia-Romagna in Italy had an impact on variations in breast cancer survival by educational level. A cohort study was performed, including all women breast cancer registered in 1997-2000 (transitional screening period) or 2001-03 (consolidation screening period). Cancer cases were retrieved from the regional Breast Cancer Registry and followed up for 5 years. Educational level was determined from census data and allocated to cancer cases by individual record linkage. Age at diagnosis was classified into two groups (30-49, 50-69: screening target population). A total of 9639 cases were analyzed. In the 1997-2000 period, low-educated women had significantly lower survival compared with high-educated women, both in the younger and in the older age-groups. After the full implementation of the screening programme, these differences decreased in both age-groups, until disappearing completely among women in the age-group invited to screening. Our findings suggest that a fee-free population-based organized mammography screening programme with active invitation of the whole target population could be effective in reducing differences in survival in the population targeted by the screening.

  17. Comparing Visually Assessed BI-RADS Breast Density and Automated Volumetric Breast Density Software: A Cross-Sectional Study in a Breast Cancer Screening Setting.

    Directory of Open Access Journals (Sweden)

    Daniëlle van der Waal

    Full Text Available The objective of this study is to compare different methods for measuring breast density, both visual assessments and automated volumetric density, in a breast cancer screening setting. These measures could potentially be implemented in future screening programmes, in the context of personalised screening or screening evaluation.Digital mammographic exams (N = 992 of women participating in the Dutch breast cancer screening programme (age 50-75y in 2013 were included. Breast density was measured in three different ways: BI-RADS density (5th edition and with two commercially available automated software programs (Quantra and Volpara volumetric density. BI-RADS density (ordinal scale was assessed by three radiologists. Quantra (v1.3 and Volpara (v1.5.0 provide continuous estimates. Different comparison methods were used, including Bland-Altman plots and correlation coefficients (e.g., intraclass correlation coefficient [ICC].Based on the BI-RADS classification, 40.8% of the women had 'heterogeneously or extremely dense' breasts. The median volumetric percent density was 12.1% (IQR: 9.6-16.5 for Quantra, which was higher than the Volpara estimate (median 6.6%, IQR: 4.4-10.9. The mean difference between Quantra and Volpara was 5.19% (95% CI: 5.04-5.34 (ICC: 0.64. There was a clear increase in volumetric percent dense volume as BI-RADS density increased. The highest accuracy for predicting the presence of BI-RADS c+d (heterogeneously or extremely dense was observed with a cut-off value of 8.0% for Volpara and 13.8% for Quantra.Although there was no perfect agreement, there appeared to be a strong association between all three measures. Both volumetric density measures seem to be usable in breast cancer screening programmes, provided that the required data flow can be realized.

  18. Cervical and Breast Cancer Screening After CARES: A Community Program for Immigrant and Marginalized Women.

    Science.gov (United States)

    Dunn, Sheila F; Lofters, Aisha K; Ginsburg, Ophira M; Meaney, Christopher A; Ahmad, Farah; Moravac, M Catherine; Nguyen, Cam Tu Janet; Arisz, Angela M

    2017-05-01

    Marginalized populations such as immigrants and refugees are less likely to receive cancer screening. Cancer Awareness: Ready for Education and Screening (CARES), a multifaceted community-based program in Toronto, Canada, aimed to improve breast and cervical screening among marginalized women. This matched cohort study assessed the impact of CARES on cervical and mammography screening among under-screened/never screened (UNS) attendees. Provincial administrative data collected from 1998 to 2014 and provided in 2015 were used to match CARES participants who were age eligible for screening to three controls matched for age, geography, and pre-education screening status. Dates of post-education Pap and mammography screening up to June 30, 2014 were determined. Analysis in 2016 compared screening uptake and time to screening for UNS participants and controls. From May 15, 2012 to October 31, 2013, a total of 1,993 women attended 145 educational sessions provided in 20 languages. Thirty-five percent (118/331) and 48% (99/206) of CARES participants who were age eligible for Pap and mammography, respectively, were UNS on the education date. Subsequently, 26% and 36% had Pap and mammography, respectively, versus 9% and 14% of UNS controls. ORs for screening within 8 months of follow-up among UNS CARES participants versus their matched controls were 5.1 (95% CI=2.4, 10.9) for Pap and 4.2 (95%=CI 2.3, 7.8) for mammography. Hazard ratios for Pap and mammography were 3.6 (95% CI=2.1, 6.1) and 3.2 (95% CI=2.0, 5.3), respectively. CARES' multifaceted intervention was successful in increasing Pap and mammography screening in this multiethnic under-screened population. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. [Breast cancer screening: have there been any changes during the last decade? A study in a Spanish unit].

    Science.gov (United States)

    Martínez-Ramos, David; Escrig-Sos, Javier; García-Redón, Teresa; Fortea-Sanchis, Carlos; Alcalde-Sánchez, Miguel; Salvador-Sanchis, José Luis

    2011-01-01

    Breast screening programs in Spain cover almost 100% of population. The objective of the present study was to analyze if there have been any changes during the last decade in our breast screening unit (Unidad de Prevención del Cáncer de Mama de Castellón) that can also be extrapolated to other breast screening units. We conducted a retrospective and descriptive analysis reviewing patients seen in our breast screening unit between January 1, 2000 and December 31, 2009. Patients with a final diagnosis of carcinoma, year of diagnosis, age, histological type, infiltration, surgical procedure and tumor extension were analyzed. A total of 311 breast cancers were diagnosed among 90,010 women who were seen at our breast screening unit. Mean age of the patients was 56 years. A progressive increase of the target population was seen (24,004 persons in 2000 and 31,950 in 2009). Histological type, percentage of infiltrative tumors and lymph node involvement did not show significant differences by year. Differences were observed for tumor size (pT category of TNM classification) and breast conservation surgery. Tumor stage in cancers diagnosed in breast screening units progressively decreased when the program was being implemented. There is a maximum level among which tumor characteristics remain constant. Changes in screening programs can modify these characteristics.

  20. Colorectal Cancer Screening

    Science.gov (United States)

    ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma Pancreatic Cancer Prostate Cancer Skin Cancer Thyroid Cancer Uterine Cancer All ...

  1. Esophageal Cancer Screening

    Science.gov (United States)

    ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma Pancreatic Cancer Prostate Cancer Skin Cancer Thyroid Cancer Uterine Cancer All ...

  2. Breast and cervical cancer screening specific effects of depression and obesity.

    Science.gov (United States)

    Ludman, Evette J; Ichikawa, Laura E; Simon, Gregory E; Rohde, Paul; Arterburn, David; Operskalski, Belinda H; Linde, Jennifer A; Jeffery, Robert W

    2010-03-01

    Obesity and depression may each be associated with lower rates of cervical and breast cancer screening. Studies have examined obesity or depression alone, but not together, despite the established link between them. This article aims to disentangle the effects of depression and obesity on receipt of breast and cervical cancer screening. A stratified sampling design was used to recruit women aged 40-65 years with information on BMI from an integrated health plan in Washington State in 2003-2005. A telephone survey included the Patient Health Questionnaire-9 for depression, weight, and height. Automated data assessed Paps for 3097 women over a 3-year period and screening mammograms over a 2-year period for 2163 women aged > or =51 years. Logistic regression models (conducted in 2008) examined the association between obesity and depression and receipt of screening tests. In univariate logistic regression models, women were less likely to receive a Pap if they were obese (OR=0.53, 95% CI=0.41, 0.69) or depressed (OR=0.60, 95% CI=0.42, 0.87). Further, women were less likely to receive a screening mammogram if they were depressed (OR=0.45, 95% CI=0.30, 0.67). In multivariable models, only obesity remained significantly associated with a lower likelihood of Pap screening (OR=0.67, 95% CI=0.0.49, 0.93), and only depression remained significantly associated with lower rates of screening mammography (OR=0.49, 95% CI=0.31, 0.76). Obesity and depression did not interact significantly in either model. Obesity and depression appear to have specific effects on receipt of different cancer-screening tests. Copyright (c) 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. CT Findings of Axillary Tuberculosis Lymphadenitis: A Case Detected by Breast Cancer Screening Examination

    Directory of Open Access Journals (Sweden)

    Hiroko Shojaku

    2016-01-01

    Full Text Available We report the first description of CT findings of axillary tuberculous lymphadenitis confirmed by the pathological specimen. The breast cancer screening examination is one of the prime methods of detection of axillary tuberculous lymphadenitis. The most common site of axillary tuberculous lymphadenitis is the deep axilla. Screening mammography often fails to cover the whole axilla. The presence on the contrast-enhanced CT of unilateral multiple circumscribed dense nodes, some of which have large and dotted calcifications, might suggest tuberculous lymphadenitis in axillary region.

  4. Breast Cancer

    Science.gov (United States)

    Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks that ... who have family members with breast or ovarian cancer may wish to be tested for the genes. ...

  5. CLINICAL BREAST CANCER SCREENING- A CAMP-BASED STUDY AMONG RURAL WOMEN IN NORTH KERALA

    Directory of Open Access Journals (Sweden)

    Usha Karunakaran

    2017-07-01

    Full Text Available BACKGROUND Early diagnosis of breast cancer is of extreme significance in improving the survival rates and quality of life. Unfortunately, studies have revealed that a major proportion of women from low-income countries are still not breast aware. MATERIALS AND METHODS In this study, Clinical Breast Examination (CBE was done. In addition, we assessed the knowledge, attitude and practice of Breast Self-Examination (BSE. A cross-sectional study with quantitative method of data collection was conducted in a village in North Kerala. The study population was all women aged 20 years and above and who resided in the village for 6 months and more and they were motivated to attend the camps by community health workers from the same village. RESULTS Out of the 319 women who attended the CBE camps, 301 (94% had heard of breast cancer and 113 (36% had heard of it from community workers during their survey. Around 63% of the women knew at least one symptom of breast cancer while 73% did not know any risk factor. Only 234 (73% had heard of BSE. Only 137 (43% knew the right technique of BSE. Out of the 184 women who did BSE, 124 (67.4% did it to examine breasts regularly, 5 (2.7% did it because they had a family history of breast cancer, 52 (28.3% following classes by community workers, 2 (1.1% because their friends had breast cancer and 1 (0.5% following a resected lump. Out of the 135 women who did not practice BSE, 36 (26.7% did not know the method, 85 (63% did not think it was important, 10 (7.4% had no symptoms and 4 (2.9% were scared of finding a lump. The women with either breast or axillary lumps (3.4% were referred for mammography. CONCLUSION Utilisation of the services of primary healthcare facilities for opportunistic screening and health awareness classes by trained nonmedical community personnel should become main activities in our future policies. They should be trained for providing BSE training to women at their doorstep. This simple approach

  6. Screening Mammography and Digital Breast Tomosynthesis: Controversies.

    Science.gov (United States)

    Funaro, Kimberly; Drukteinis, Jennifer; Falcon, Shannon

    2017-10-01

    Breast cancer screening with mammography reduces breast cancer mortality; however, diverging recommendations regarding screening have caused controversy. The emerging technology of digital breast tomosynthesis (DBT) may soon become the mainstay of breast cancer screening. We present recommendations for breast cancer screening based on guidelines. A PubMed literature review was performed and the results from five large clinical studies comparing the efficacy of digital mammography alone versus digital mammography with DBT are examined. We emphasize the importance of annual screening to reduce breast cancer mortality. Our review of the literature demonstrates that DBT increases cancer detection rates and reduces callbacks. Additional research is needed to determine whether the increased cancer detection rates are associated with a decrease in mortality.

  7. Quality appraisal of documents producing recommendations for breast, colorectal and cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Paolo Giorgi Rossi

    2014-01-01

    Full Text Available Background: Breast, cervical, and colorectal cancer screening are evidence-based interventions recommended by most governmental agencies and scientific societies. The aim of this review is to assess the quality of guidelines on screening and to describe differences according to the context in which they were produced.Methods: A literature search of the main databases, websites on health care, and guidelines, as well as the websites of several scientific societies was carried out in order to identify the most recent guidelines (since 2000 on cervical, breast, and colorectal cancer screening. Only documents written in Italian or English were included. Two investigators independently assessed quality by using the AGREE (Appraisal of Guidelines, Research and Evaluation in Europe instrument.Results: Thirty-three, 32, and 18 relevant documents for cervical, breast, and colorectal cancer, respectively, were identified. Only some documents (19, 12 and 13 for cervical, breast, and colorectal cancer, respectively could be evaluated with AGREE. Items included in the domain “scope and purpose” obtained the highest scores, followed by “clarity of presentation” domain, while “applicability”, “patient involvement,” and “conflict of interest disclosure” domains obtained the lowest scores. The quality did not improve in more recent documents. Documents produced by governmental agencies, on average, had higher scores than documents by scientific societies, particularly for “stakeholder involvement” and “applicability”.Conclusions: Documents from different countries and health systems differ in terms of the main recommendations given and in the quality of the documents. Those produced by governmental agencies have a more multidisciplinary authorship and pay more attention to applicability than do those produced by scientific societies. societies.

  8. Is the tide turning against breast screening?

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl

    2012-01-01

    ABSTRACT: Herein I argue that mammographic screening has not delivered on its fundamental premise: to reduce the incidence of advanced breast cancer. Indeed, achieving this goal is required if screening is to reduce breast cancer mortality or mastectomy use. Rather, screening has caused substanti...

  9. Breast cancer risk in young women in the national breast screening programme: implications for applying NICE guidelines for additional screening and chemoprevention.

    Science.gov (United States)

    Evans, D Gareth; Brentnall, Adam R; Harvie, Michelle; Dawe, Sarah; Sergeant, Jamie C; Stavrinos, Paula; Astley, Susan; Wilson, Mary; Ainsworth, John; Cuzick, Jack; Buchan, Iain; Donnelly, Louise S; Howell, Anthony

    2014-10-01

    In the United Kingdom, women at moderate and high risk of breast cancer between the ages of 40 and 49 years are eligible for annual mammographic screening and preventive therapy with tamoxifen. Here, we estimate the numbers of women in a population eligible for this service and the proportion of breast cancers detected in this group compared with the whole population. Women screening in the National Health Service Breast Screening Programme (NHSBSP) completed a risk questionnaire. The proportion at moderate and high risk according to National Institute of Health Care Excellence (NICE) guidelines was estimated. An estimate was also made using a different model of risk estimation (Tyrer-Cuzick). The numbers of cancers detected in the moderate/high risk groups were compared with numbers detected in the whole population. Completed questionnaires were available for 4,360 women between ages 46 and 49 years. Thirty women [0.7%; 95% confidence interval (CI), 0.5-1.0%] were at high risk and 130 (3.0%, 2.5-3.5%) were at moderate risk according to NICE guidelines. Thirty-seven cancers were detected by mammography in the whole group. Five of these were found in the moderate-/high-risk group giving a 3.2-fold increase in detection compared with the standard risk group. More women were assigned to the moderate- or high-risk group using the Tyrer-Cuzick model (N = 384), but the numbers of cancers in this group were not appreciably increased (N = 8). Systematic assessment of family history in primary care or through population-based screening will identify appreciable numbers of women in their forties, eligible for additional surveillance and chemoprevention. ©2014 American Association for Cancer Research.

  10. Cost effectiveness of breast cancer screening using mammography; a systematic review.

    Science.gov (United States)

    Rashidian, Arash; Barfar, Eshagh; Hosseini, Hamed; Nosratnejad, Shirin; Barooti, Esmat

    2013-01-01

    Breast cancer is the leading cause of malignancy among women. Screening using mammography is proposed as an effective intervention for reducing early deaths due to breast cancer. We conducted a systematic review to assess the cost-effectiveness of such screening programs. We searched Medline, Scopus and Google Scholar and complemented it by other searches using sensitive search terms from 1993-2010. We screened the titles and abstracts, assessed the full texts of the remaining studies, and extracted data to a pre-designed data extraction sheet. Studies were categorized according to the age groups of the target population. We used narrative synthesis approaches for analyzing the data. Twenty-eight articles met the minimum inclusion criteria, mostly from high income settings. All studies used secondary data, and a variety of modeling techniques, age groups, screening intervals and outcome measures. Cost per life year gained, ranging from $1,634 (once at the age of 50 in India) to $65,000 (extending the lower age limit of screening to 40 Australian study), was the most commonly used outcome measure. Biennial screening test for those aged 50-70 years seems to be the most cost-effective option ($2685). Biennial screening for aged 50-70 years is the most cost-effective option among alternative scenarios. Screening those aged less than 50 is not recommended. Further studies in low-income and middle-income countries, and cost effectiveness studies along with randomized trials are required. To improve the comparability of the findings, future studies should include biennial screening in 50-70 age groups as an alternative strategy.

  11. Initiators and promoters for the occurrence of screen-detected breast cancer and the progression to clinically-detected interval breast cancer.

    Science.gov (United States)

    Yen, Amy Ming-Fang; Wu, Wendy Yi-Ying; Tabar, Laszlo; Duffy, Stephen W; Smith, Robert A; Chen, Hsiu-Hsi

    2017-03-01

    The risk factors responsible for breast cancer have been well documented, but the roles of risk factors as initiators, causing the occurrence of screen-detected breast cancer, or promoters, responsible for the progression of the screen-detected to the clinically-detected breast cancer, have been scarcely evaluated. We used data from women in a cohort in Kopparberg (Dalarna), Sweden between 1977 and 2010. Conventional risk factors, breast density, and tumor-specific biomarkers are superimposed to the temporal course of the natural history of the disease. The results show that older age at first full-term pregnancy, dense breast, and a family history of breast cancer increased the risk of entering the preclinical screen-detectable phase of breast cancer by 23%, 41%, and 89%, respectively. Overweight/obesity (body mass index ≥25 kg/m 2 ) was a significant initiator (adjusted relative risk [aRR] 1.15; 95% confidence interval [CI], 0.99-1.33), but was inversely associated with the role of promoter (aRR 0.65; 95% CI, 0.51-0.82). Dense breast (aRR 1.46; 95% CI, 1.12-1.91), triple-negative (aRR 2.07; 95% CI, 1.37-3.15), and Ki-67 positivity (aRR 1.66; 95% CI, 1.19-2.30) were statistically significant promoters. When the molecular biomarkers were considered collectively as one classification, the basal-like subtype was the most influential subtype on promoters (aRR 4.24; 95% CI, 2.56-7.02) compared with the Luminal A subtype. We ascertained state-dependent covariates of initiators and promoters to classify the risk of the two-step progression of breast cancer. The results of the current study are useful for individually-tailored screening and personalized clinical surveillance of patients with breast cancer that was detected at an early stage. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  12. Turnaround times in breast cancer: From screening to diagnosis to treatment

    Directory of Open Access Journals (Sweden)

    Kaylene J Logan

    2013-01-01

    Discussion: The CCBCC ranks at the 75%ile in overall turnaround times; however, this turnaround time included an interval of MRI, not previously measured in NQMBC benchmark. Rate-limiting steps were identified as the time from screening mammogram to diagnostic mammogram, and biopsy to surgery-specifically, the sub-interval MRI to surgery. Since 2009, the CCBCC has already improved the process for obtaining insurance approval and preauthorization for MRIs; and has added an additional breast surgeon to share the burden of benign cases, and a nurse practitioner to see post-op and follow up patients, improving the accessibility to the primary breast surgeon specialist. Consideration should be given to future time interval studies that evaluate breast cancer turnaround time including MRI to help establish benchmarks.

  13. Successful Repatriation of Breast Cancer Surveillance for High-Risk Women to the UK National Health Service Breast Screening Programme.

    Science.gov (United States)

    McVeigh, Terri P; Wiggins, Jennifer; Ward, Simon; Kemp, Zoe; George, Angela J

    2017-10-28

    Since April 2013, the UK's National Health Service Breast Screening Programme (NHSBSP) centers have been obliged to provide services for women at the highest risk of breast cancer, including those carrying highly penetrant single gene mutations (BRCA1, BRCA2, TP53). Since then, such individuals previously undergoing surveillance in the Royal Marsden Hospital were referred to their local NHSBSP centers. We aimed to assess patient experience of surveillance provided by local NHSBSP services at 1 and 3 years after repatriation. High-risk gene mutation carriers referred to the NHSBSP for breast cancer surveillance were identified from a departmental database in the Cancer Genetics Unit and invited to complete questionnaires about their experience of surveillance under this new pathway, first in 2014 and again in 2016. Three hundred forty-six individuals were invited to participate in 2014, of whom 182 responded (53%). A total of 464 patients were invited in 2016, of whom 246 (53%) completed the second questionnaire. Ninety-four percent of patients with residual breast tissue received some screening at the first (n = 161) and second (n = 185) time points. Ninety-one percent of patients (n = 146) received at least recommended surveillance in the year preceding the initial survey, a proportion decreasing slightly by the second time point (n = 164, 87%). Seventeen percent of individuals required additional diagnostic investigations, with cancers detected in 2%. These proportions remained stable between surveys. Repatriation of high-risk individuals from Royal Marsden Hospital to NHSBSP centers has been successfully accomplished. Most individuals received appropriate recommended annual surveillance. Further improvements are required to ensure equal and timely provision of recommended surveillance. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Screening for Breast Cancer: #BeBrave: A Life-Saving Test

    Science.gov (United States)

    ... their lifetimes. She has confronted her diagnosis of breast cancer by speaking out in support of others facing the disease. You discovered your breast cancer in an unusually public way. Would you tell ...

  15. A Monte Carlo tool to simulate breast cancer screening programmes

    Science.gov (United States)

    Forastero, C.; Zamora, L. I.; Guirado, D.; Lallena, A. M.

    2010-09-01

    A Monte Carlo tool which permits the simulation of screening mammography programmes is developed. Various statistical distributions describing different parameters involved in the problem are used: the characteristics of the population under study, a tumour growth model and a model for tumour detection based on parameters such as sensitivity and specificity which depends on the woman's age. We reproduce results of different actual programmes. The model enables us to find out the configuration (the age of the women who attend the screening trials and screening frequency) which produces maximum benefits with minimum risks. In addition, the model has permitted us to validate some of the assumed hypothesis, such as the probability distribution of the tumour detection as a function of the tumour size, the frequency of the histological types and the transition probability between different histological types.

  16. Overdiagnosis of breast cancer at screening is clinically insignificant.

    Science.gov (United States)

    Feig, Stephen A

    2015-08-01

    Long-term follow-up of randomized trials provide the most accurate estimates of overdiagnosis. Estimates from follow-up of service screening studies are almost as accurate if there is sufficient adjustment for lead time and risk status. When properly analyzed data from both of these types of trials indicate that the rate of overdiagnosis at screening mammography is clinically negligible: 0-5%. Population trend studies are a potentially highly inaccurate means to estimate overdiagnosis. Most cases of DCIS detected at screening are medium and high grade with substantial potential to become an invasive disease. To avoid overtreatment, clinicians need to tailor their treatment of DCIS to the histologic and molecular characteristics of each case. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  17. Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

    Science.gov (United States)

    van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

    2015-07-01

    Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

  18. Clinical breast examination as the recommended breast cancer screening modality in a rural community in Malaysia; what are the factors that could enhance its uptake?

    Directory of Open Access Journals (Sweden)

    Nik Daliana Nik Farid

    Full Text Available Breast cancer is the most common cause of deaths and the most frequently diagnosed cancer among women worldwide. This study aimed to determine the prevalence of breast cancer screening, specifically on clinical breast examination, and the predictors of its uptake among women in Malaysia. A cross-sectional study was carried out in five selected districts whereby women aged between 20 to 64 years old, from a total of 1000 households were interviewed. A total of 1192 women responded to the survey of which 53.3% reported had ever done clinical breast examination. Significant associations with clinical breast examination were noted for income and distance from the hospital. These factors should be considered in developing interventions aimed at promoting clinical breast examination. In particular, healthcare providers should be proactive in raising awareness about clinical breast examination among women in Malaysia.

  19. An investigation into why two-view mammography is better than one-view in breast cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Hackshaw, A.K.; Wald, N.J.; Michell, M.J.; Field, S.; Wilson, A.R.M

    2000-06-01

    AIM: To determine why two-view mammography in screening for breast cancer is more effective than using a single medio-lateral oblique view. MATERIALS AND METHODS: In the United Kingdom Coordinating Committee on Cancer Research randomized trial of one- vs two-view mammography in breast cancer screening the oblique view was assessed by one radiologist and two views (oblique and cranio-caudal) assessed by another. For the present study the mammographic films were retrieved from the screening centres and assessed by three consultant radiologists. Mammographic films were available from 110 women; 87 had their breast cancer detected by both one and two views and in 23 it was missed by one view but detected using two views. Outcome measures were breast size, location and size of the cancer, mammographic features, presence of microcalcification and overall radiological assessment. RESULTS: Although 23 cancers were missed in the original trial when one view was used, only two were not visible on the oblique view. Cancers missed using a single oblique view (and only detected if the cranio-caudal view was available with the oblique) tended to be smaller by about 4 mm (P = 0.05), centrally located in the breast (P = 0.16), not spiculated or round, (P {<=} 0.001) and lacked microcalcification (P = 0.15). Breast size and breast radiographic density were not significantly associated with breast cancer detection. CONCLUSIONS: The results provide the basis for the observation that two-view mammographic screening is more effective than one-view mammographic screening. Hackshaw, A. (2000). Clinical Radiology 55, 454-458.

  20. Use of risk projection models to estimate mortality and incidence from radiation-induced breast cancer in screening programs

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, M [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Ferrer, S [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Villaescusa, J I [Radiation Protection Service, Hospital Universitario La Fe, Avda Campanar, 21 46009 Valencia (Spain); Verdu, G [Chemical and Nuclear Engineering Department, Polytechnic University of Valencia, Camino de Vera s/n 46022 Valencia (Spain); Salas, M D [Public Health General Direction, Conselleria de Sanitat de Valencia, C/Micer Masco, 31 46021 Valencia (Spain); Cuevas, M D [Assistential Service General Direction, Conselleria de Sanitat de Valencia, C/Micer Masco, 31 46021 Valencia (Spain)

    2005-02-07

    The authors report on a method to calculate radiological risks, applicable to breast screening programs and other controlled medical exposures to ionizing radiation. In particular, it has been applied to make a risk assessment in the Valencian Breast Cancer Early Detection Program (VBCEDP) in Spain. This method is based on a parametric approach, through Markov processes, of hazard functions for radio-induced breast cancer incidence and mortality, with mean glandular breast dose, attained age and age-at-exposure as covariates. Excess relative risk functions of breast cancer mortality have been obtained from two different case-control studies exposed to ionizing radiation, with different follow-up time: the Canadian Fluoroscopy Cohort Study (1950-1987) and the Life Span Study (1950-1985 and 1950-1990), whereas relative risk functions for incidence have been obtained from the Life Span Study (1958-1993), the Massachusetts tuberculosis cohorts (1926-1985 and 1970-1985), the New York post-partum mastitis patients (1930-1981) and the Swedish benign breast disease cohort (1958-1987). Relative risks from these cohorts have been transported to the target population undergoing screening in the Valencian Community, a region in Spain with about four and a half million inhabitants. The SCREENRISK software has been developed to estimate radiological detriments in breast screening. Some hypotheses corresponding to different screening conditions have been considered in order to estimate the total risk associated with a woman who takes part in all screening rounds. In the case of the VBCEDP, the total radio-induced risk probability for fatal breast cancer is in a range between [5 x 10{sup -6}, 6 x 10{sup -4}] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 x 10{sup -3}. The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs.

  1. Financial barriers to utilization of screening and treatment services for breast cancer: an equity analysis in Nigeria.

    Science.gov (United States)

    Okoronkwo, I L; Ejike-Okoye, P; Chinweuba, A U; Nwaneri, A C

    2015-01-01

    To determine financial barriers that impede the utilization of screening and treatment services for breast cancer among Nigerian women from different socioeconomic groups. A descriptive study was carried out in 2013 among women attending the oncology clinic of a tertiary institution in Enugu, Southeast Nigeria. Data were collected from 270 women using an interviewer-administered questionnaire. The links between the influence of socioeconomic factors on barriers to the utilization of breast cancer screening and treatment services were examined. A total of 270 women were studied. The mean age was 34.69 (Standard deviation = 5.07) years. Half of the study participants were single 141 (51.3%), while 105 (38.2%) were married. Cost of medical treatment and not having insurance coverage was major financial barriers to utilization of screening and treatment services. The least poor and poor socioeconomic status (SES) groups utilized screening services and treatment more frequently than the very poor and poorest SES groups ( P = 0.034). There was no significant difference in the utilization of the different treatment options among the different socioeconomic groups with the exception of surgery (χ² = 11.397; P = 0.000). Financial barriers limit the ability of women, especially the poorest SES group, to utilize screening and treatment services for early diagnosis and treatment of breast cancer. Interventions that will improve financial risk protection for women with breast cancer or at risk of breast cancer are needed to ensure equitable access to screening and treatment services.

  2. Proportional incidence and radiological review of large (T2+) breast cancers as surrogate indicators of screening programme performance

    Energy Technology Data Exchange (ETDEWEB)

    Ciatto, S.; Bernardi, D.; Pellegrini, M.; Borsato, G.; Peterlongo, P. [APSS, U.O. Senologia Clinica e Screening Mammografico, Dipartimento di Radiodiagnostica, Trento (Italy); Gentilini, M.A. [APSS, Servizio Osservatorio Epidemiologico, Direzione promozione ed educazione alla salute, Trento (Italy); Caumo, F. [Centro di Prevenzione Senologica, Verona (Italy); Frigerio, A. [CRR, Centro di Riferimento Regionale per lo Screening Mammografico, Torino (Italy); Houssami, N. [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney (Australia)

    2012-06-15

    Surrogate measures of screening performance [e.g. interval cancer (IC) proportional incidence] allow timely monitoring of sensitivity and quality. This study explored measures using large (T2+) breast cancers as potential indicators of screening performance. The proportional incidence of T2+ cancers (observed/expected cases) in a population-based screening programme (Trento, 2001-2009) was estimated. A parallel review of 'negative' preceding mammograms for screen-detected T2+ and for all ICs, using 'blinded' independent readings and case-mixes (54 T2+, 50 ICs, 170 controls) was also performed. T2+ cancers were observed in 168 screening participants: 48 at first screen, 67 at repeat screening and 53 ICs. The T2+ estimated proportional incidence was 68% (observed/expected = 168/247), corresponding to an estimated 32% reduction in the rate of T2+ cancers in screening participants relative to that expected without screening. Majority review classified 27.8% (15/54) of T2+ and 28% (14/50) of ICs as screening error (P = 0.84), with variable recall rates amongst radiologists (8.8-15.2%). T2+ review could be integrated as part of quality monitoring and potentially prove more feasible than IC review for some screening services. circle Interval breast cancers, assumed as screening failures, are monitored to estimate screening performance circle Large (T2+) cancers at screening may also represent failed prior screening detection circle Analysis of T2+ lesions may be more feasible than assessing interval cancers circle Analysis of T2+ cancers is a potential further measure of screening performance. (orig.)

  3. Intrinsic Factors of Non-adherence to Breast and Cervical Cancer Screenings Among Latinas.

    Science.gov (United States)

    Zorogastua, Karent; Erwin, Deborah; Thelemaque, Linda; Pulley, LeaVonne; Jandorf, Lina

    2016-12-01

    Although adhering to regular screenings can improve timely diagnosis and survivorship, Latinas continue to exhibit the lowest breast and cervical cancer screening rates in the country. Initiatives have generally addressed extrinsic factors to combat disparities. However, the answer to increasing screening adherence among Latina women might lie in equally addressing intrinsic factors as well extrinsic factors. Social Cognitive Theory provided the foundation for the design of Esperanza y Vida, a culturally tailored outreach program that educated Latinas on breast and cervical cancer. Non-adherent participants were offered navigation and followed-up to reassess screening behavior. The objective of this manuscript is to outline the salient culture-related intrinsic factors reported by a sample of Latina women from New York and Arkansas in response to open-ended questions asked at 8 months post-educational intervention and navigation services. In turn, the findings are incorporated in an effort to recommend future steps for effective interventions. Content analysis was used to guide the qualitative data analysis. The most salient barriers reported were related to Systems, Organization and Logistics, Time, being Decidedly Unscreened, and Contrary Beliefs or Confusion.

  4. [Breast cancer screening in Dakar: knowledge and practice of breast self examination among a female population in Senegal].

    Science.gov (United States)

    Gueye, S M K; Bawa, K D D; Ba, M G; Mendes, V; Toure, C T; Moreau, J C

    2009-01-01

    In front of the absence of a mammographic screening program and the late diagnosis of the breast cancers in Senegal, we wanted to evaluate the knowledge and the practice of the breast self examination (BSE) by feminine population in Senegal. During the period between July 10th to August 25th 2006, through five big hospitals in Dakar, we interviewed 300 patients coming from a medical or surgical consultation. For every patient we studied the social and demographic characteristics, the antecedents and arguments about the knowledge and practice of BSE. We found, in majority, a young population (the average age was 34 years), no sent to school (26.7%), without any financial income (58.7%), with a brief knowledge about BSE (42.7%) and a regular practice of BSE (29%). The information about BSE originated essentially from educational television (52.9%). This knowledge and practice were significantly influenced by the study level (p = 0.000) and the level of financial income (p = 0.02). Among these who presented certain factors of breast cancer risk, the knowledge and the practice of the BSE were however low. The authors insist on the need to encourage the women schooling and their socioprofessional insertion so to improve the knowledge and practice of the breast self-examination in our developing countries.

  5. An investigation of the apparent breast cancer epidemic in France: screening and incidence trends in birth cohorts

    Directory of Open Access Journals (Sweden)

    Olsen Jørn

    2011-09-01

    Full Text Available Abstract Background Official descriptive data from France showed a strong increase in breast-cancer incidence between 1980 to 2005 without a corresponding change in breast-cancer mortality. This study quantifies the part of incidence increase due to secular changes in risk factor exposure and in overdiagnosis due to organised or opportunistic screening. Overdiagnosis was defined as non progressive tumours diagnosed as cancer at histology or progressive cancer that would remain asymptomatic until time of death for another cause. Methods Comparison between age-matched cohorts from 1980 to 2005. All women residing in France and born 1911-1915, 1926-1930 and 1941-1945 are included. Sources are official data sets and published French reports on screening by mammography, age and time specific breast-cancer incidence and mortality, hormone replacement therapy, alcohol and obesity. Outcome measures include breast-cancer incidence differences adjusted for changes in risk factor distributions between pairs of age-matched cohorts who had experienced different levels of screening intensity. Results There was an 8-fold increase in the number of mammography machines operating in France between 1980 and 2000. Opportunistic and organised screening increased over time. In comparison to age-matched cohorts born 15 years earlier, recent cohorts had adjusted incidence proportion over 11 years that were 76% higher [95% confidence limits (CL 67%, 85%] for women aged 50 to 64 years and 23% higher [95% CL 15%, 31%] for women aged 65 to 79 years. Given that mortality did not change correspondingly, this increase in adjusted 11 year incidence proportion was considered as an estimate of overdiagnosis. Conclusions Breast cancer may be overdiagnosed because screening increases diagnosis of slowly progressing non-life threatening cancer and increases misdiagnosis among women without progressive cancer. We suggest that these effects could largely explain the reported

  6. A Study on the Knowledge, Perception, and Use of Breast Cancer Screening Methods and Quality of Care Among Women from Central Mexico.

    Science.gov (United States)

    Cruz-Castillo, Andrea B; Hernández-Valero, María A; Hovick, Shelly R; Campuzano-González, Martha Elva; Karam-Calderón, Miguel Angel; Bustamante-Montes, L Patricia

    2015-09-01

    Studies on health behaviors have observed several barriers to breast cancer screening, including lack of breast cancer knowledge, distrust of health care providers, and long waiting times to be screened or to receive screening results. We conducted a nested case-control study among a subsample of 200 women 21 years of age and older [100 patients (cases)], who had been diagnosed with breast cancer, and 100 controls, who were screened and found to be free of breast cancer), all residing in the Toluca metropolitan area in central Mexico. We examined how knowledge of breast cancer screening guidelines, perceptions of screening methods, and quality of health care influenced the use of breast cancer screening among study participants. Our study found that the most important factor associated with the decision to have breast cancer screenings was having a positive perception of the quality of care provided by the local health care centers, such as having competent clinic personnel, sufficient screening equipment, and reasonable waiting times to receive screening and to receive the screening results. Therefore, individual health care centers need to focus on the patients' perception of the services received by optimizing the care provided and, in so doing, increase the rates of early diagnosis and reduce the rate of mortality from breast cancer as well as its associated treatment costs.

  7. Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme.

    Science.gov (United States)

    Dibden, A; Offman, J; Parmar, D; Jenkins, J; Slater, J; Binysh, K; McSorley, J; Scorfield, S; Cumming, P; Liao, X-H; Ryan, M; Harker, D; Stevens, G; Rogers, N; Blanks, R; Sellars, S; Patnick, J; Duffy, S W

    2014-02-04

    The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50-64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1,000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15-20% reduction in interval cancer rates in the NHSBSP. The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens.

  8. Strategies to Increase Cancer Detection: Review of True-Positive and False-Negative Results at Digital Breast Tomosynthesis Screening.

    Science.gov (United States)

    Korhonen, Katrina E; Weinstein, Susan P; McDonald, Elizabeth S; Conant, Emily F

    2016-01-01

    Digital breast tomosynthesis (DBT) represents a valuable addition to breast cancer screening by decreasing recall rates while increasing cancer detection rates. The increased accuracy achieved with DBT is due to the quasi-three-dimensional format of the reconstructed images and the ability to "scroll through" breast tissue in the reconstructed images, thereby reducing the effect of tissue superimposition found with conventional planar digital mammography. The margins of both benign and malignant lesions are more conspicuous at DBT, which allows improved lesion characterization, increased reader confidence, and improved screening outcomes. However, even with the improvements in accuracy achieved with DBT, there remain differences in breast cancer conspicuity by mammographic view. Early data suggest that breast cancers may be more conspicuous on craniocaudal (CC) views than on mediolateral oblique (MLO) views. While some very laterally located breast cancers may be visualized on only the MLO view, the increased conspicuity of cancers on the CC view compared with the MLO view suggests that DBT screening should be performed with two-view imaging. Even with the improved conspicuity of lesions at DBT, there may still be false-negative studies. Subtle lesions seen on only one view may be discounted, and dense and/or complex tissue patterns may make some cancers occult or extremely difficult to detect. Therefore, radiologists should be cognizant of both perceptual and cognitive errors to avoid potential pitfalls in lesion detection and characterization. ©RSNA, 2016 Online supplemental material is available for this article.

  9. Empowering Factors Among Breast Cancer Screening Compliant Underserved Populations

    Science.gov (United States)

    2005-10-01

    are empow- controversies. J.Am Board Porn Pract. 2003; 1992z8:182-185. ered by the benefits of screening and 16:233-241. 19. Lee JR, Vogel VG. Who...University, Nashville, TN 37208. As adjunct faculty in Department of Psychology, responsibility was to teach child and adolescent development course to...and Biostatistics; research design, statistical and epidemiologic analysis, program evaluation. @Developing Web -based Biostatistics course

  10. Social support and non-participation in breast cancer screening

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit

    2015-01-01

    Social støtte har en positiv indflydelse på sundhedsadfærd, viser tidligere studier. Det er dog endnu ikke tilstrækkeligt belyst, om social støtte påvirker deltagelse i screening. I dette studie ses der nærmere på, om der er en sammenhæng mellem graden af social støtte (defineret som hyppigheden af...

  11. Patterns of non-participation in breast cancer screening

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær

    2015-01-01

    Screening for brystkræft blev introduceret i Region Midtjylland i 2008-2009 for kvinder i alderen 50-69 år for at øge overlevelsen ved at fange sygdommen tidligt. En høj deltagelse i screeningen er afgørende, hvis dødeligheden for brystkræft fremover skal reduceres. I første screeningsrunde deltog...... screeningsenheden har af betydning. Resultaterne viser, at de kvinder, der ikke kom til screening, hyppigst var at finde blandt kvinder med lav social position, kvinder med flere kroniske sygdomme og kvinder med bopæl langt væk fra screeningsenheden. Resultaterne viser dog også, at kvinder med høj uddannelse deltog...... drage fordel af ekstra støtte eller særlige interventioner, når de skal beslutte, om de vil deltage i screening. Derfor bør fremtidige tiltag, som har til formål at øge deltagelsen, tage højde for individuelle, sociale og organisatoriske barrierer....

  12. Perceptions of breast and cervical cancer risk and screening among Dominicans and Puerto Ricans in Rhode Island.

    Science.gov (United States)

    Goldman, Roberta E; Risica, Patricia Markham

    2004-01-01

    This study explored perceptions of cancer, risk, and screening among Dominicans and Puerto Ricans in Rhode Island. Qualitative interviews were conducted with a community-based sample of 147 adults. Perceived risks for breast cancer were predominantly associated with carelessness about health care, trauma to the breast, and breastfeeding. Cervical cancer risks were mostly attributed to carelessness about health care and sexual behaviors. A strong sense of fatalism and embarrassment coexisted with positive beliefs about check-ups and screening. Participants cited confianza (trust, confidence) in their doctor, and their doctor's provision of information and explanations, as important factors in decreasing embarrassment and increasing their likelihood of getting screened. While familiarity with mammography and Pap testing was great among participants, many did not practice sustained, regular screening, and held misconceptions about tests and screening guidelines. Respondents' perceptions of having sufficient information often did not correspond to their having the accurate information necessary to promote informed screening decisions.

  13. Influence of Study Features and Methods on Overdiagnosis Estimates in Breast and Prostate Cancer Screening

    Science.gov (United States)

    Etzioni, Ruth; Gulati, Roman; Mallinger, Leslie; Mandelblatt, Jeanne

    2013-01-01

    Knowledge of the likelihood that a screen-detected cancer case has been overdiagnosed is vitally important for treatment decision making and screening policy development. An overdiagnosed case is an excess case detected because of cancer screening. Estimates of the frequency of overdiagnosis in breast and prostate cancer screening are highly variable across studies. In this article we identify features of overdiagnosis studies that influence results and illustrate their impact using published studies. We first consider different ways to define and measure overdiagnosis. We then examine contextual features and how they affect overdiagnosis estimates. Finally, we discuss the effect of estimation approach. Many studies use excess incidence under screening as a proxy for overdiagnosis. Others use statistical models to make inferences about lead time or natural history and then derive the corresponding fraction of cases that are overdiagnosed. We conclude with a list of questions that readers of overdiagnosis studies can use to evaluate the validity and relevance of published estimates and recommend that authors of publications quantifying overdiagnosis provide information about these features of their studies. PMID:23732716

  14. Cytotoxicity Screening of Plants of Genus Piper in Breast Cancer ...

    African Journals Online (AJOL)

    pellitorine) or other compounds. Commercial piperine and pellitorine, major compound of P. nigrum, were used to test their cytotoxic effects and compared them with those curcumin, the active compound from turmeric, the cytotoxic effects of which on many cancer cells have been reported [7-9]. Our results revealed that both.

  15. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Cheryl Brunelle

    2015-05-01

    Full Text Available There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screenin