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Sample records for breast screening programme

  1. The breast screening programme and misinforming the public

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Jørgensen, Karsten Juhl

    2011-01-01

    The information provided to the public by the NHS Breast Screening Programme has been criticized for lack of balance, omission of information on harms and substantially exaggerated estimates of benefit. These shortcomings have been particularly evident in the various invitation leaflets for breas...... documents still downplay this most important harm of breast cancer screening.......The information provided to the public by the NHS Breast Screening Programme has been criticized for lack of balance, omission of information on harms and substantially exaggerated estimates of benefit. These shortcomings have been particularly evident in the various invitation leaflets for breast...... about breast screening has had any impact on the contents of the new 2010 leaflet and on the 2010 Annual Review. We conclude that spokespeople for the Programme have stuck to the beliefs about benefit that prevailed 25 years ago. Concerns about over-diagnosis have not been addressed either and official...

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

    NARCIS (Netherlands)

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

    2015-01-01

    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 uni

  3. 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...

  4. Mean glandular dose in a breast screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Galvan, H. A.; Perez-Badillo, M. P.; Villasenor, Y. [Instituto Nacional de Cancerologia, Av. San Fernando No. 22, Col Seccion XVI, Mexico, D. F., C. P. 14080 (Mexico)

    2012-10-23

    Breast density has an important role in early detection of breast cancer, because has been reported the strong association between breast density and invasive breast cancer risk. Mammography is the gold standard to early detection of breast cancer, despite of this require ionizing radiation that may increase radio-induced cancer risk. This maybe limited with a quality control programme of mammographic units, with the main goal of achieving high quality images with low radiation dose. International Atomic Energy Agency (IAEA) published in 2011 the {sup Q}uality assurance programme for digital mammography{sup ,} where glandular tissue quantity is an important parameter to compute mean glandular dose (MGD), which is necessary to reduce its associated risk. In this work we show the first results in our country applying this protocol and studying breast density in a small group. MGD complies with national and IAEA dose limits.

  5. 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 screeni...

  6. Information provided by Italian breast cancer screening programmes: a comparison between 2001 and 2014.

    Science.gov (United States)

    Castagno, Roberta; Canuti, Debora; Petrella, Marco; Bucchi, Lauro; Fedato, Chiara; Garena, Francesca; Giordano, Livia

    2015-01-01

    Debate on efficacy, benefits, and risks of breast cancer screening continues to rage, and scientific controversy surrounding overdiagnosis, false positives/false negatives, raises questions about communication to women attending screening programmes. The study compares information provided by invitation letters and leaflets of Italian breast screening programmes in 2001 (N=47) and 2014 (N=80). At both times, nearly all programmes provided adequate practical information and details about screening objectives and test procedures. Information regarding epidemiology/figures was scarce or absent in 2001, while in 2014 a number of programmes began to inform women about screening risks (false negative and positive results and overdiagnosis, 65%, 16%, and 21% respectively) although actual figures were rarely supplied. Despite this small improvement, Italian programmes are still far from giving balanced information. Further efforts should be addressed to providing accurate and transparent information, enabling women to make an informed choice. PMID:26405776

  7. Radial scars detected mammographically in a breast cancer screening programme

    International Nuclear Information System (INIS)

    Radial scars are getting more and more common since implementation of mammography as diagnostic tool in screening women for breast cancer. At Karolinska Hospital, 18987 asymptomatic women, aged 50-69, were screened for breast cancer through mammography during August 1989-May 1991. A total of 735 (3.87%) were recalled for additional views after initial mammograms and 463 (2.44%) were assessed with help of cytology. In all 175 women (0.92%) were selected for surgery and 146 (0.77%) had histologically verified cancers. The remaining 29 (0.15%) had non- malignant lesions of which 11 (0.06%) were radial scars. All radial scars were diagnosed on mammograms and later confirmed with histology. The radiologic characteristics were found to be a) rather thick and long radiating structures accompanied by radiolucent linear structures parallel to some of the spicules, b) absence of calcifications, c) radiolucent areas in the body of the lesion, d) an average mean size of 6 mm and e) changing image in different views. Most of the lesions, 73% (8/11), were in moderately dense breasts and there was no specific relation to the right or left breast. A majority of radial scars, 64% (7/11), were found in the upper outer quadrants, 3/11 in the lower outer quadrants and 1/11 in the lower inner quadrant. Literature shows that histology uses many synonyms for radial scars and therefore team work between radiologists and pathologists is suggested for better conformity of the diagnosis. (author). 32 refs.; 1 fig

  8. Study of radiological risk in breast cancer screening programme at Comunidad Valenciana

    International Nuclear Information System (INIS)

    It is demonstrated that screening mammography programmes reduce breast cancer mortality considerably. Nevertheless, radiology techniques have an intrinsic risk being the most important late somatic effect the induction of cancer. This study is made in order to evaluate the risk produced into the population by the Cimadon Valenciana Breast Screening Programme. All the calculations are carried out for two risk models, UNSCEAR 94 and NRPB 93. On the one hand, screening series detriment are investigated as a function of doses delivered and other parameters related to population structure and X-ray equipment. And on the other hand, radiation induced cancer probability for a woman who starts at 45 years and remains into the programme until 65 years old is calculated as a function of mammography unit's doses and average compression breast thickness. (author)

  9. 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...... 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....

  10. Studies of benefit and risk resulting from the UK Breast Screening Programme

    International Nuclear Information System (INIS)

    The use of mammography as a screening modality must be justified by comparison of the benefits and risks associated with the technique. The benefit risk ratio (BRR) associated with the National Health Service Breast Screening Programme (NHSBSP) is therefore an important quantity. In order that the BRR can be estimated accurately, it is important that the radiation risks and therefore the Mean Glandular Doses (MGD) received by women attending screening are quantified as precisely as possible. The Monte Carlo model used at present for MGD estimation makes no allowance for alterations in breast composition and is not applicable to women with augmented breasts, leading to significant errors in current MGD estimates. This model has been modified in order to allow for alterations in the proportion of glandular tissue contained within the female breast, and for the presence of a breast prosthesis. The modified models have been coupled with radiographic factors, and information regarding the breast composition of 1258 women, facilitating MGD estimation for these women and for a cohort of 80 women with augmented breasts. This information has in turn been used as a basis for mammography related radiation risk estimation. The associated beneficial effects of screening have been estimated using the results of an established computer simulation. It was found that the use of the conventional Monte Carlo model leads to overestimates of MGD for women with non-augmented breasts of up to 13% over the age range 35-79 years. This error range can be reduced to 1% when compressed breast thickness and age are used to estimate breast glandularity. At low breast thickness, little difference is found between composition dependent MGD-per-film estimates for women with augmented breasts and their non augmented counterparts. At high breast thickness however, the MGD's per film received by women with breast prostheses are considerably lower. In general, the BRR relating to the NHSBSP is

  11. 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.)

  12. Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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 < 0.0001). A similar trend was observed in the ROC curve. For conventional mammography, AUC was 0.779. With CESM, AUC increased to 0.976 (p < 0.0001). In addition, good agreement between tumour diameters measured using CESM, breast MRI and histopathology was observed. CESM increases diagnostic performance of conventional mammography, even in lower prevalence patient populations such as referrals from breast cancer screening. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Lobbes, Marc B.I.; Wildberger, Joachim E. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Lalji, Ulrich; Houwers, Janneke; Nijssen, Estelle C. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); Nelemans, Patty J. [Maastricht University, Department of Epidemiology, Maastricht (Netherlands); Roozendaal, Lori van; Heuts, Esther [Maastricht University Medical Center, Department of Surgical Oncology, Maastricht (Netherlands); Smidt, Marjolein L. [Maastricht University Medical Center, Department of Surgical Oncology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2014-07-15

    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 < 0.0001). A similar trend was observed in the ROC curve. For conventional mammography, AUC was 0.779. With CESM, AUC increased to 0.976 (p < 0.0001). In addition, good agreement between tumour diameters measured using CESM, breast MRI and histopathology was observed. CESM increases diagnostic performance of conventional mammography, even in lower prevalence patient populations such as referrals from breast cancer screening. (orig.)

  15. Typetesting of physical characteristics of digital mammography systems for screening within the Flemish breast cancer screening programme

    International Nuclear Information System (INIS)

    To investigate compliance with the acceptance criteria of the European guidelines for quality assurance in breast cancer screening, a typetesting programme of the physical characteristics of digital mammography systems based on direct readout (DR) technology or computed radiography (CR) was organised and executed within the Flemish breast cancer screening programme. While in general image quality/dose characteristics of flat panel DR systems passed the acceptance criteria more easily than CR systems, the slit-scanning direct photon counting system included in present study was outstanding in combining a very low dose with a good image quality. The data obtained up to now indicate the necessity of retuning the AEC for DR systems according to constant contrast to noise ratio (CNR) over the whole range of PMMA thicknesses (20-70 mm) to improve image quality in imaging breasts of large thickness at the cost of higher doses. For the two CR systems which passed the typetesting procedure dose levels do not allow a similar improvement of CNR for thick objects for these systems. The obtained results highlight the importance of the use of high Z target/filter combinations in X-ray generating systems for imaging thick objects to meet the image quality/dose criteria. With respect to image display aspects high-quality 3-megapixel LCD monitors succeeded also in the typetesting procedure in addition to 5-megapixel monitors. However, as zooming and scrolling are necessary for 3-megapixel monitors to get the full resolution capabilities of the image capture system, 5-megapixel monitors are preferred in a busy screening environment.

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

    Energy Technology Data Exchange (ETDEWEB)

    Toernberg, Sven; Kemetli, Levent [Karolinska Univ. Hospital, Stockholm (Sweden). Cancer Screening Unit, Oncologic Centre; Lynge, Elsebeth; Olsen, Anne Helene [Univ. of Copenhagen, (Denmark). Inst. of Public Health; Hofvind, Solveig; Wang, Hege [The Cancer Registry of Norway, Oslo (Norway); Anttila, Ahti [Finnish Cancer Registry, Helsinki (Finland); Hakama, Matti [Univ. of Tampere (Finland). School of Public Health; Nystroem, Lennarth [Umeaa Univ. (Sweden). Dept. of Public Health and Clinical Medicine

    2006-07-15

    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 the introduction of screening was visible after seven to 12 years of screening in any of the three capitals where significant effects of the screening on the breast cancer mortality had already been demonstrated by using other analytical methods for the evaluation. No visible effect on mortality reduction 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.

  17. Auditing Mammographic Dose and Image Quality in the UK Breast Screening Programme

    Energy Technology Data Exchange (ETDEWEB)

    Young, K.C.; Ramsdale, M.L.; Rust, A

    1998-07-01

    A national audit of image quality and dose has been conducted across 267 mammography X ray sets in the UK Breast Screening Programme, repeating a previous survey in 1991. The main parameters were film density, film contrast, mean glandular dose to the standard breast (MGD) and image quality (IQ) measured with a TOR(MAM) test object. Film density has increased from a mean of 1.33 in 1991 to a mean of 1.61 in 1996 as a result of national guidelines. Over the same period the average MGD has increased from 1.28 to 1.36 mGy. Average film gradient ranged from 2.2 to 3.9 with a mean of 3.2. IQ ranged from 48 to 86 with a mean of 69. Causes of reduced IQ were low film densities, medium screens and older designs of mammography X ray set. Although film density and MGD were generally satisfactory, there appears to be room for further optimisation of film contrast and IQ. (author)

  18. Auditing Mammographic Dose and Image Quality in the UK Breast Screening Programme

    International Nuclear Information System (INIS)

    A national audit of image quality and dose has been conducted across 267 mammography X ray sets in the UK Breast Screening Programme, repeating a previous survey in 1991. The main parameters were film density, film contrast, mean glandular dose to the standard breast (MGD) and image quality (IQ) measured with a TOR(MAM) test object. Film density has increased from a mean of 1.33 in 1991 to a mean of 1.61 in 1996 as a result of national guidelines. Over the same period the average MGD has increased from 1.28 to 1.36 mGy. Average film gradient ranged from 2.2 to 3.9 with a mean of 3.2. IQ ranged from 48 to 86 with a mean of 69. Causes of reduced IQ were low film densities, medium screens and older designs of mammography X ray set. Although film density and MGD were generally satisfactory, there appears to be room for further optimisation of film contrast and IQ. (author)

  19. Non-operative diagnosis - effect on repeat-operation rates in the UK breast screening programme

    International Nuclear Information System (INIS)

    Non-operative diagnosis rates in the UK breast screening programme have improved dramatically from 48.8% in 1994/95 (only nine units achieved the then minimum standard of 70%) to 94% in 2005/06 (only seven units failed to achieve the target of 90%). Preoperative and operative history of all 120,550 women diagnosed with screen-detected breast cancer in the UK between April 1994 and March 2006 was derived from different national databases. In 2005/06, 2,790 (17.8%) of the 15,688 women having surgery needed two or more operations. In 2001/02 (non-operative diagnosis rate 87%), the re-operation rate was 23.8% (2,377 of 9,969). Extrapolation backwards to 1994/95 (non-operative diagnosis rate 48.8%) suggests a re-operation rate of 62%. Analysis over the 4 years from April 2002 (n=34,198) demonstrates that 4,089 (12%) women with a correct non-operative diagnosis of invasive disease required additional surgery compared to 1,166 (48%) of women who were under-staged (diagnosed as non-invasive based on core biopsy, but actually suffering from invasive disease). Failure to achieve a non-operative diagnosis of invasive disease (n=1,542) or non-invasive disease (n=2,247) resulted in re-operation rates of 65 and 43% respectively. Given the impact of not having a diagnosis pre-operatively, or of under-staging invasive carcinoma, it seems timely to introduce more sophisticated standards. (orig.)

  20. Two-view versus single-view mammography at subsequent screening in a region of the Dutch breast screening programme.

    NARCIS (Netherlands)

    Smallenburg, V.v.; Duijm, L.E.M.; Heeten, G.J. den; Groenewoud, J.H.; Jansen, F.H.M.; Fracheboud, J.; Plaisier, M.L.; Doorne-Nagtegaal, H.J. van; Broeders, M.J.M.

    2012-01-01

    We retrospectively determined the effect of analogue two-view mammography versus single-view mammography at subsequent screens on breast cancer detection and determined financial consequences for a current digital mammography setting. Two screening radiologists reviewed the mammograms of 536 screen

  1. Cost effectiveness of shortening screening interval or extending age range of NHS breast screening programme: computer simulation study

    NARCIS (Netherlands)

    R. Boer (Rob); A. Threlfall; P. Warmerdam (Peter); A. Street (Andrew); E. Friedman (Eitan); C. Woodman; H.J. de Koning (Harry)

    1998-01-01

    markdownabstract__OBJECTIVE__: To compare the cost effectiveness of two possible modifications to the current UK screening programme: shortening the screening interval from three to two years and extending the age of invitation to a final screen from 64 to 69. __DESIG

  2. Studies of benefit and risk resulting from the UK Breast Screening Programme

    CERN Document Server

    Beckett, J

    2000-01-01

    13% over the age range 35-79 years. This error range can be reduced to 1% when compressed breast thickness and age are used to estimate breast glandularity. At low breast thickness, little difference is found between composition dependent MGD-per-film estimates for women with augmented breasts and their non augmented counterparts. At high breast thickness however, the MGD's per film received by women with breast prostheses are considerably lower. In general, the BRR relating to the NHSBSP is favourable, even for subgroups of women who are thought to be at high risk or to obtain low benefit from the examination. The overall breast cancer mortality reduction for the NHSBSP at steady state was found to be in agreement with the Health of the Nation target of 25% in the age range 55-69 years. The use of mammography as a screening modality must be justified by comparison of the benefits and risks associated with the technique. The benefit risk ratio (BRR) associated with the National Health Service Breast Screening...

  3. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    Energy Technology Data Exchange (ETDEWEB)

    Ascunce, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Instituto de Salud Publica, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Ederra, Maria; Delfrade, Josu; Erdozain, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Baroja, Araceli [Fundacion Rioja Salud, Logrono (Spain); Zubizarreta, Raquel [Public Health and Planning Directorate, Health Office, Galician Breast Cancer Screening Programme, Galicia (Spain); Salas, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Castells, Xavier [Mar Teaching Hospital, CIBERESP, Department of Clinical Epidemiology, Barcelona (Spain)

    2012-02-15

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  4. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    International Nuclear Information System (INIS)

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  5. Two-view versus single-view mammography at subsequent screening in a region of the Dutch breast screening programme

    International Nuclear Information System (INIS)

    We retrospectively determined the effect of analogue two-view mammography versus single-view mammography at subsequent screens on breast cancer detection and determined financial consequences for a current digital mammography setting. Two screening radiologists reviewed the mammograms of 536 screen detected cancers (SDCs) and 171 interval cancers (ICs) with single-view mammography (medio-lateral-oblique view) at the last but one screen (SDCs) or latest screen (ICs). They determined whether two-view mammography at the last (but one) screen could have increased the cancer detection rate at that screening round. For subsequent screens, the radiologists also assessed the percentage of SDCs and ICs that had been missed at previous two-view screening mammography (SDC) or latest two-view screening (IC), respectively. Additional personnel and digital storage costs for standard two-view mammography at subsequent screening were calculated for digital screening. Two-view mammography could have facilitated earlier cancer detection in 40.9% (219/536) of SDCs and 39.8% (68/171) of ICs. For two-view screens, 24.4% of SDCs (213/871) were missed at previous two-view screening and 29.3% of ICs (110/375) were missed at the latest screen. Overall costs increase € 1.03/screen after implementation of digital two-view mammography. Standard two-view mammography at subsequent screening may modestly increase cancer detection at an earlier stage, whereas additional screening costs are limited

  6. 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

    interval cancer subtypes. This information could be useful to improve effectiveness of breast cancer screening programmes and to better classify subgroups of women with different risks of developing cancer.

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

    International Nuclear Information System (INIS)

    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, age, final diagnosis and final TNM classification were available from the screening registry. Interval cancers were obtained through linkage with the cancer registry. BI-RADS was introduced as a pilot in the Amsterdam region before the nationwide introduction of digital mammography (2009-2010). A total of 1,559 women were referred to hospital (referral rate 1.7 %). Breast cancer was diagnosed in 485 women (detection rate 0.52 %); 253 interval cancers were reported, yielding a programme sensitivity of 66 % and specificity of 99 %. BI-RADS 0 had a lower positive predictive value (PPV, 14.1 %) than BI-RADS 4 (39.1 %) and BI-RADS 5 (92.9 %; P < 0.0001). The number of invasive procedures and tumour size also differed significantly between BI-RADS categories (P < 0.0001). The significant differences in PPV, invasive procedures and tumour size match with stratification into BI-RADS categories. It revealed inter-observer variability between screening radiologists and can thus be used as a quality assessment tool in screening and as a stratification tool in diagnostic work-up. (orig.)

  8. Health professionals' agreement on density judgements and successful abnormality identification within the UK Breast Screening Programme

    Science.gov (United States)

    Darker, Iain T.; Chen, Yan; Gale, Alastair G.

    2011-03-01

    Higher breast density is associated with a greater chance of developing breast cancer. Additionally, it is well known that higher mammographic breast density is associated with increased difficulty in accurately identifying breast cancer. However, comparatively little is known of the reliability of breast density judgements. All UK breast screeners (primarily radiologists and technologists) annually participate in the PERFORMS self-assessment scheme where they make several judgements about series of challenging recent screening cases of known outcomes. As part of this process, for each case, they provide a radiological assessment of the likelihood of cancer on a confidence scale, alongside an assessment of case density using a three point scale. Analysis of the data from two years of the scheme found that the degree of agreement on case density was significantly greater than no agreement (p < .001). However, only a moderate degree of inter-rater reliability was exhibited (κ = .44) with significant differences between the occupational groups. The reasons for differences between the occupational groups and the relationship between agreement on density rating and case reading ability are explored.

  9. Fine-needle aspiration cytology in nonpalpable mammographic abnormalities in breast cancer screening: results from the breast cancer screening programme in Oslo 1996-2001.

    Science.gov (United States)

    Sauer, Torin; Myrvold, Kristina; Lømo, Jon; Anderssen, Karin Yvonne; Skaane, Per

    2003-10-01

    Fine-needle aspiration cytology (FNAC) of nonpalpable mammographic lesions has been under attack from two sides for some years. There has been much discussion and controversy as to the ability to differentiate between in situ and invasive carcinomas in cytological material. A further issue is that of optimal sampling to obtain adequate cell material in sufficient quantity. We present the results of FNAC from 832 nonpalpable mammographic abnormalities detected in the course of the breast cancer screening programme in Oslo during 1996-2001. In 11.6% of cases the smears were inadequate, and there were 7% false negatives (FN) and 1.3% false positives. Of the FN, 64% represented microcalcifications and 86% were due to sampling errors. Absolute sensitivity was 74%, complete sensitivity 88% and specificity 88%. In 255 carcinomas a cytological diagnosis of them as in situ or invasive was made. In 93% of the invasive cases (190/205) these had been correctly identified as invasive on FNAC. In 78% of cases proper follow-up could be resolved by cytology/radiology alone. Suboptimal sampling and localization remains the main cause of FN FNAC results. Problems in differentiating between in situ and invasive breast carcinomas can be significantly reduced by applying strict criteria for in situ lesions. PMID:14659146

  10. Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme.

    Directory of Open Access Journals (Sweden)

    Margarita Posso

    Full Text Available The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme.Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1 double reading; 2 double reading for women in their first participation and single reading for women in their subsequent participations; and 3 single reading. We calculated the incremental cost-effectiveness ratio (ICER, which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER.The detection rate of double reading (5.17‰ was similar to that of single reading (4.78‰; P = .768. The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance.From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs.

  11. Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme

    Science.gov (United States)

    Posso, Margarita; Carles, Misericòrdia; Rué, Montserrat; Puig, Teresa; Bonfill, Xavier

    2016-01-01

    Objectives The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme. Methods Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1) double reading; 2) double reading for women in their first participation and single reading for women in their subsequent participations; and 3) single reading. We calculated the incremental cost-effectiveness ratio (ICER), which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER. Results The detection rate of double reading (5.17‰) was similar to that of single reading (4.78‰; P = .768). The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance. Conclusions From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs). PMID:27459663

  12. Evaluation by Markov chain models of a non-randomised breast cancer screening programme in women aged under 50 years in Sweden

    OpenAIRE

    Chen, H.H; Thurfjell, E.; Duffy, S W; Tabar, L

    1998-01-01

    STUDY OBJECTIVE: To apply Markov chain models that have previously been used on data in randomised trials of breast cancer screening to data from an uncontrolled service screening programme; to compare results with those from a randomised trial. DESIGN: A service screening programme in Uppsala county, Sweden, inviting 25,660 women aged 39-49 to mammographic screening every 20 months, and the Swedish Two-County Trial inviting 19,844 women aged 40-49 to two yearly screening, compared with...

  13. Film reading in the East Midlands Breast Screening Programme – Are we missing opportunities for earlier diagnosis?

    International Nuclear Information System (INIS)

    Aim: To assess whether there are any significant differences in the film-reading histories of interval or screen-detected cancers, and whether this affects stage at diagnosis. Materials and methods: The rates of screen-detected and interval cancers (overall and by radiological categorization) were observed from 268,067 women screened in the East Midlands Breast Screening Programme over 2004–2007 to assess whether there were differences in incidence based on previous film-reading history. Cancers detected at the subsequent screen and film-reading history were analysed to assess whether this affected stage at diagnosis. Analysis undertaken involved cancer detection rates, confidence intervals, and chi-square tests with Monte Carlo simulation. Results: Rates of interval cancers were similar in all groups where at least one reader had indicated recall to assessment (6.1–7.7/1000) and were significantly higher in comparison to women whose previous film-reading outcome was unanimous routine rescreen (2.9/1000; p < 0.001). Four point one percent of interval cancers with no previous recall outcomes were false negatives, which was significantly lower compared to the groups where at least one reader had indicated recall (10.9%; p = 0.005). Cancers detected at the subsequent screen demonstrated no significant difference in prognosis dependent on previous film-reading history (p = 0.503). Conclusion: The prognosis of screen-detected cancers was similar and few cancers were false negatives regardless of film-reading history at the previous screen

  14. Breast cancer screenings

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000837.htm Breast cancer screenings To use the sharing features on this page, please enable JavaScript. Breast cancer screenings can help find breast cancer early, before ...

  15. 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

    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...

  16. Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Domingo, Laia; Sala, Maria [IMIM-Hospital del Mar, Department of Epidemiology and Evaluation, Barcelona (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona (Spain); Universitat Autonoma de Barcelona (UAB), EHEA Doctoral Program in Public Health. Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Barcelona (Spain); Romero, Anabel; Belvis, Francesc; Macia, Francesc; Castells, Xavier [IMIM-Hospital del Mar, Department of Epidemiology and Evaluation, Barcelona (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona (Spain); Sanchez, Mar [Government of Cantabria, General Directorate of Public Health, Department of Health, Santander (Spain); Ferrer, Joana [Radiology Unit. Hospital Santa Caterina, Girona (Spain); Salas, Dolores; Ibanez, Josefa [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Vega, Alfonso [Hospital Universitario Marques de Valdecilla, Radiology Unit, Santander (Spain); Ferrer, Francesc [Hospital del Mar, Radiology and Nuclear Medicine Service, Barcelona (Spain); Laso, M.S. [Breast Cancer Screening Unit Burjassot, Valencia (Spain)

    2011-09-15

    To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women. 242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45-69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated. The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08-1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060). PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses. (orig.)

  17. Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain

    International Nuclear Information System (INIS)

    To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women. 242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45-69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated. The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08-1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060). PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses. (orig.)

  18. The influence of HRT on technical recall in the UK Breast Screening Programme: are pain, compression force, and compressed breast thickness contributing factors?

    Energy Technology Data Exchange (ETDEWEB)

    Nimmo, L.J. [Division of Radiography, School of Health and Social Care, Glasgow Caledonian University, Glasgow (United Kingdom)]. E-mail: l.nimmo@gcal.ac.uk; Alston, L.A.C. [Division of Radiography, School of Health and Social Care, Glasgow Caledonian University, Glasgow (United Kingdom); McFadyen, A.K. [Division of Radiography, School of Health and Social Care, Glasgow Caledonian University, Glasgow (United Kingdom)

    2007-05-15

    Aim: To investigate recall for technical reasons within the UK Breast Screening Programme, and to determine whether differences exist in those women using hormone replacement therapy (HRT), considering potential associations with reported pain, compression force used and compressed breast thickness (CBT) obtained. Materials and method: A prospective cohort study of 2765 women attending for incident round breast screening appointments who were either HRT users, with a minimum of 1 year duration (n = 1077), or had never used HRT (n = 1688). Data were collected using technical recall records, a radiographer data-collection sheet, and a self-administered participant questionnaire. Results: Sixty-eight (2.5%) participants were recalled for technical reasons of whom 28 (2.6%) were HRT and 40 (2.4%) non-HRT users. This difference was not statistically significant (p = 0.80). Significant differences were found for CBT between those HRT users who were and were not recalled for technical reasons (p < 0.01) and for the similar categories of non-HRT users (p = 0.03). No significant differences were found for force between those HRT users who were recalled or not (p = 0.73) and for the similar categories of non-HRT users (p = 0.07). Similarly no significant differences were found for pain between those HRT users who were recalled or not (p = 0.75) and for the similar categories of non-HRT users (p = 0.73). Conclusion: CBT was the only variable to have both a statistically and a clinically significant relationship with technical recall.

  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. Evaluation of screening programmes: Stud ies on breast cancer and prostate cancer

    NARCIS (Netherlands)

    P.M.M. Beemsterboer (Petra)

    1999-01-01

    textabstractIn the past century treatment and primary prevention of disease has focussed on decreasing mortality rates (Wolleswinkel-van den Bosch, 1998). The current challenge is directed towards secondary prevention. Screening for disease is becoming increasingly part of medical practice in the We

  1. Factors influencing participation in breast cancer screening.

    Science.gov (United States)

    Edgar, Lynne; Glackin, Marie; Hughes, Caroline; Rogers, Katherine Mary Ann

    Despite the efficacy of mammography and the widespread promotion of screening programmes, a significant number of eligible women still do not attend for regular breast screening. An integrative review methodology was considered the most appropriate means to critically analyse the available literature pertaining to factors which influence participation in breast cancer screening. From the extensive literature search, 12 selected core research papers met the inclusion criteria and were incorporated in the literature review. Four themes emerged from the literature which impact on participation in mammography screening: psychological and practical issues, ethnicity issues, influence of socioeconomic status and issues related to screening programmes. The recent Independent Review Panel on Breast Cancer Screening endorsed the importance of access to information which clearly communicates the harms and benefits of breast screening to enable women to make informed decisions about their health. The recommendations from the panel and others have been included in this review. PMID:24067312

  2. Frequency of asymptomatic choroidal metastasis in patients with disseminated breast cancer: results of a prospective screening programme

    OpenAIRE

    Wiegel, T.; Kreusel, K. M.; Bornfeld, N; Bottke, D.; M. Stange; Foerster, M.; Hinkelbein, W.

    1998-01-01

    AIM—To determine the frequency of visually asymptomatic choroidal metastasis in patients with disseminated breast cancer and its dependence on the incidence of metastasis by number and site of other organ metastases.
METHODS—From January 1995 until April 1997 120 patients irradiated for disseminated breast cancer underwent ophthalmological screening for choroidal metastasis. No patient was symptomatic for ocular disease. 68 out of 120 patients were found to have metastases in one organ and 52...

  3. Health workforce planning and service expansion during an economic crisis: A case study of the national breast screening programme in Ireland.

    Science.gov (United States)

    McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C

    2015-12-01

    This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency.

  4. A comparison of mean glandular dose diagnostic reference levels within the all-digital Irish National Breast Screening Programme and the Irish Symptomatic Breast Services.

    Science.gov (United States)

    O'Leary, Desiree; Rainford, Louise

    2013-03-01

    Data on image quality, compression and radiation dose were collected from symptomatic breast units within the Republic of Ireland. Quantitative and qualitative data were analysed using SPSS. Recommendations of mean glandular dose (MGD) diagnostic reference levels were made at various levels for film-screen and full field digital mammography units to match levels published worldwide. MGDs received by symptomatic breast patients within Ireland are higher than those received in the all-digital Irish Breast Screening service; 55-65 mm breast: 1.75 mGy (screening) vs. 2.4 mGy (symptomatic) at the 95th percentile; various reasons are proposed for the differences. MGDs achieved in the screening service may be lower because of the exacting requirements for radiographer training, characteristics of the patients and equipment quality assurance levels. More precise imaging guidelines, standards and training of symptomatic radiographers performing mammography are suggested to remediate MGDs delivered to the breasts of Irish women attending the symptomatic breast services. PMID:22740646

  5. Breast cancer screening

    OpenAIRE

    Skrabanek, P

    1988-01-01

    Consensus is still lacking on guidelines for breast-cancer screening with mammography: who should be screened, how frequently at what age, to what benefits and at what risks. American, Dutch, Swedish and Italian studies spanning the 1960s to the 1980s reveal a benefit from screening (reduced mortality from breast cancer) that occurs unambiguously only in women 50 years of age and over. Physicians who choose to screen mammographically their over-49-year-old female patients must do so with the ...

  6. Breast screening and ethnic minorities.

    Science.gov (United States)

    Hoare, T

    1996-09-01

    The concern for minority ethnic women is whether they are disadvantaged either in terms of the incidence of breast cancer or because of a lower uptake of screening. There are considerable worldwide variations in the incidence of breast cancer. The lowest rates are found in Chinese, Japanese and Arabic populations and women from the Indian subcontinent, and are 2-3 times lower than that of the UK. This may change in future generations. Although minority ethnic women are not a high risk group for the breast screening programme, in absolute terms breast cancer is a major health problem. Very few studies have measured ethnic differences in the uptake of screening, and they may be confounded by such factors as socio-economic group. When this is accounted for, uptake by Asian women may not necessarily be lower than by other women in the same area and can be higher for black than white women. One of the most important reasons for non-attendance is inaccurate screening registers, compounded for Asian women by their return, or extended visits, to the Indian subcontinent. A further organisational issue concerns poor awareness of minority ethnic naming systems, causing confusion over the receipt of invitations. Comprehension of the concept of screening may be difficult for minority ethnic women yet there has been little evaluation of strategies to promote understanding. However a randomised controlled trial of a linkworker intervention, designed to be feasible for implementation on a population basis, showed no increase in the uptake of breast screening by Asian women. This does not undermine linkworkers' role but suggests that their efforts should be used in other ways. It is essential to assess the relative importance of reasons for low uptake and evaluate measures to meet any unmet need, so that resources can be directed in the most effective way. PMID:8782797

  7. 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....

  8. Breast density and outcome of mammography screening: a cohort study

    DEFF Research Database (Denmark)

    Olsen, A H; Bihrmann, K; Jensen, M-B;

    2009-01-01

    The purpose of this study was to investigate the effect of breast density on breast cancer (BC) mortality in a mammography screening programme. The cohort included 48 052 women participating in mammography screening in Copenhagen, Denmark, where biennial screening is offered to women aged 50...

  9. Avoidable surgical consultations in women with a positive screening mammogram: Experience from a southern region of the Dutch breast screening programme

    International Nuclear Information System (INIS)

    Introduction: According to current Dutch guidelines, all women with a positive screening mammogram are referred for a full hospital assessment, which includes surgical consultation and radiological assessment. Surgical consultation may be unnecessary for many patients. Our objective was to determine how often surgical consultations can be avoided by radiological pre-assessment. Materials and methods: All women with a positive screening mammogram, referred to our radiology department between 2002 and 2007, were included (n = 1014). Percentage of women that was downstaged to BI-RADS category 1 or 2 by radiological pre-assessment was calculated. Negative predictive value (NPV) for malignancy was estimated from the in-hospital follow-up, which was available up to September 2012. Results: 423 of 1014 women (42%) were downstaged to BI-RADS category 1 or 2 by radiological pre-assessment. During follow-up, 8 of these 423 women (2%) developed a malignancy in the same breast. At least 6 of these malignancies were located at a different location as the original screening findings which led to the initial referral. The estimated NPV for malignancy was 99.5% (95%CI, 98.3–99.9). Conclusion: By referring women with a positive screening mammogram to the radiology department for pre-assessment, a surgical consultation was avoided in 42%, with an estimated NPV of 99.5% for malignancy

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

    NARCIS (Netherlands)

    ScafKlomp, W; VanSonderen, E; VandenHeuvel, W

    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 screening programme in 1975 and who were invited to each subsequent screening round until 1992. Three compliance groups were compared: 'attended all rounds'

  11. The patient's subjective attitude towards screening for breast cancer. Should screening be extended to other forms of cancer?

    OpenAIRE

    Taylor, T V; Rimmer, S.; Forrest, A P

    1980-01-01

    A sample of 500 consecutive women without symptoms of breast disease attending a breast screening clinic were investigated regarding their attitude to breast screening and to the extension of the screening programme to other forms of cancer. Attendance at the screening clinic was found to be reassuring by 94.2%, and 96.4% felt that the screening programme should be extended to include other forms of malignancy. There was a history of either respiratory or alimentary tract symptoms, and of smo...

  12. Screening for Breast Problems

    Science.gov (United States)

    ... a clinical breast exam done? • What is breast self-awareness? • How is breast self-awareness different from the traditional breast self-exam? •Glossary ... problems includes mammography , clinical breast exams, and breast self-awareness. What is mammography? Mammography is an X-ray ...

  13. 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.

  14. Mammographic screening for breast cancer: A review

    OpenAIRE

    Lee, Warwick; Peters, Gudrun

    2013-01-01

    In 2011, BreastScreen Australia celebrated 20 years of mammographic screening for breast cancer in Australia. There has been a reduction in mortality from breast cancer over the last two decades, coincident with mammographic screening. However, there are concerns that mammographic screening may result in overdiagnosis of breast cancer and that the reduction in mortality from breast cancer is the result of better treatment rather than screening. This article reviews the evidence on which mammo...

  15. Measuring the burden of interval cancers in long-standing screening mammography programmes

    DEFF Research Database (Denmark)

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

    2015-01-01

    OBJECTIVES: Mammography screening programme sensitivity is evaluated by comparing the interval cancer rate (ICR) with the expected breast cancer incidence without screening, ie. the proportional interval cancer rate (PICR). The PICR is usually found by extrapolating pre-screening incidence rates......, whereas ICR is calculated from data available in the screening programmes. As there is no consensus regarding estimation of background incidence, we seek to validate the ICR measure against the PICR. METHODS: Screening data from the three mammography screening programmes of Stockholm, Copenhagen, and...

  16. A population screening programme for atrial fibrillation

    DEFF Research Database (Denmark)

    Proietti, Marco; Mairesse, Georges H; Goethals, Peter;

    2016-01-01

    general population using an ECG handheld machine and its feasibility to identify new AF cases. METHODS AND RESULTS: We analysed data obtained from 5 years of the 'Belgian Heart Rhythm Week' screening programme. All subjects were screened using a one-lead ECG handheld machine. Among 65 747 subjects...

  17. 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…

  18. 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....

  19. 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

    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.......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...

  20. Determinants of successful implementation of population-based cancer screening programmes

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Törnberg, Sven; von Karsa, Lawrence;

    2012-01-01

    consider when planning, implementing and running population based cancer screening programmes. The list is general and is applicable to breast, cervical and colorectal cancer screening. It is based on evidence presented in the three European Union guidelines on quality assurance in cancer screening......) piloting or trial implementation, (5) scaling up from pilot to service, (6) running of full-scale programme, and (7) sustainability. For each phase, a substantial number of specified conditions have to be met. Successful implementation of a cancer screening programme requires societal acceptance and local...

  1. Attendance in cancer screening programmes in Italy

    Directory of Open Access Journals (Sweden)

    Grazia Grazzini

    2008-06-01

    Full Text Available

    Background: The European Community recommends mammography, cervical and colorectal cancer screening programmes. In Italy, cancer screening programmes have been included in the Basic Healthcare Parameters (Livelli Essenziali di Assistenza since 2001. Full national coverage of a population-based organized screening programme has been planned for in Italy and is being implemented. Since 2005, the Ministry of Health - Department of Prevention has formally charged The National Centre for Screening Monitoring (Osservatorio Nazionale Screening –ONS- with monitoring and promoting screening programmes nationwide. Participation of target populations is a key indicator of the impact and efficacy of a screening programme in reducing cancer mortality.

    Methods: Attendance of invitees is one of the indicators calculated every year in the quality control of Italian screening programmes. Data collection is organized by means of a structured questionnaire, sent by ONS to the referent for data collection in each Region, who then returns the completed questionnaires to the Regional Centre. Questionnaires are then sent to the National Centre. Logical and epidemiologic checks are performed at both levels. Every year ONS publishes reports on the results of the surveys. A feasibility study for a National data warehouse based on individual records is in progress. The national survey “Multiscopo sulle famiglie” and the Passi Study (Progetti delle Aziende Sanitarie per la Salute in Italia provided additional information regarding spontaneous preventive health care activities in the Italian population.

    Results: Mammography screening: In 2006, 78.2% of Italian women aged 50-69 lived in areas where organised screening was in place (theoretical extension, however, the distribution of the screening activity is not uniform (higher in Northern/Central Italy compared with Southern

  2. 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%.

  3. Comparison of various characteristics of women who do and do not attend for breast cancer screening

    OpenAIRE

    Banks, Emily; Beral, Valerie; Cameron, Rebecca; Hogg, Ann; Langley, Nicola; Barnes, Isobel; Bull, Diana; Reeves, Gillian; English, Ruth; Taylor, Sarah; Elliman, Jon; Lole Harris, Carole

    2001-01-01

    Background Information regarding the characteristics and health of women who do and do not attend for breast cancer screening is limited and representative data are difficult to obtain. Methods Information on age, deprivation and prescriptions for various medications was obtained for all women at two UK general practices who were invited to breast cancer screening through the National Health Service Breast Screening Programme. The characteristics of women who attended and did not attend scree...

  4. Screening in breast cancer: a view from the front line

    International Nuclear Information System (INIS)

    Mammography screning presents the only real breakthrough in breast cancer in this century. Twenty-five percent of all cancer in women is breast cancer. About 50 percent of these women die from their disease. It has not been possible to reduce breast cancer mortality more than marginally by any mode of treatment. Single view mammography screening can do so, however, at the rate of 30 to 40 percent. Screening has many detractors, especially in the treatment camp. These detractors do not always act in the patients' best interests. Considering the vast resources used up until now in trying to improve on breast cancer treatment, and to little avail, it is time to divert some of these efforts to set up screening programmes wherever possible. Well handled, these are able to reduce suffering and health care costs and save lines

  5. 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 substantial...

  6. Breast cancer screening; cost-effective in practice?

    International Nuclear Information System (INIS)

    The main aim of national breast screening is a reduction in breast cancer mortality. The data on the reduction in breast cancer mortality from three (of the five) Swedish trials in particular gave rise to the expectation that the Dutch programme of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. In all likelihood, many of the years of life gained as a result of screening are enjoyed in good health. According to its critics the actual benefit that can be achieved from the national breast cancer screening programmes is overstated. Considerable benefits have recently been demonstrated in England and Wales. However, the fall was so considerable in such a relatively short space of time that screening (started in 1987) was thought to only have played a small part. As far as the Dutch screening programme is concerned it is still too early to reach any conclusions about a possible reduction in mortality. The first short-term results of the screening are favourable and as good as (or better than) expectations. In Swedish regions where mammographic screening was introduced, a 19% reduction in breast cancer mortality can be estimated at population level, and recently a 20% reduction was presented in the UK. In countries where women are expected to make appointments for screening themselves, the attendance figures are significantly lower and the quality of the process as a whole is sometimes poorer. The benefits of breast cancer screening need to be carefully balanced against the burden to women and to the health care system. Mass breast screening requires many resources and will be a costly service. Cost-effectiveness of a breast cancer screening programme can be estimated using a computer model. Published cost-effectiveness ratios may differ tremendously, but are often the result of different types of calculation, time periods considered, including or excluding downstream cost. The approach of simulation and estimation is here

  7. Patient-initiated breast cancer screening

    International Nuclear Information System (INIS)

    This paper reviews the results of a breast cancer screening program sponsored by organizations at workplace or community locations. A comprehensive mobile breast cancer screening program, including education, breast physical examination, and mammography, was provided to 89 local organizations at $50.00 per examination over an 18-month period. The examination was patient initiated, following the ACS screening guidelines. Estimates of eligible women were provided by each organization. A total of 5,030 women at 89 organizations were screened for breast cancer. Approximately 25,727 women were eligible

  8. 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...

  9. 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.

  10. 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.

  11. 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....

  12. Population screening for breast cancer in the European Community

    International Nuclear Information System (INIS)

    Although our understanding of the causes of breast cancer is increasing, it is as yet not possible to recommend measures to decrease its occurrence. Therefore we have to resort to a substitute called secondary prevention which aims at preventing the occurrence of metastatic breast cancer and death by detecting the primary cancer in the breast at an earlier point in its natural history. The question whether this can be achieved can only be answered by scientific study. Such studies are being called: population-based screening programmes. Screening requires one or more tests by which one can partition a population in those who probably have a cancer and those who have not. Since an early breast cancer does not produce symptoms like pain the test has to be some sort of objective assessment. In the field of detecting breast cancer we have been greatly helped by the development of a radiologic technique called mammography. Mammography basically is not an easy technique since there is little contrast between structures in the breast compared with e.g. bone. The quality of mammograms, therefore, was not very high in the pioneering era during the nineteen-fifties and -sixties. This presentation discusses a move of a few doctors in New York city: a radiologist, a surgeon and epidemiologist, to design a scientific study which could answer the question whether mammography, added to a standard clinical examination of the breast would decrease mortality from breast cancer

  13. Screening for breast cancer post reduction mammoplasty

    International Nuclear Information System (INIS)

    Aim: To investigate whether remodelling of the breast after breast reduction surgery has an effect on mammographic cancer detection. Methods and materials: For women who attended population-based screening between January 1998 to December 2007, data were extracted on their age, history of previous breast reduction, and the result of screening (recall for further assessment, cancer, or no cancer). The number of cancers detected, recalls per 1000 screens and the characteristics of the cancers detected in the two groups was compared. Results: In total 244,147 women with 736,219 screening episodes were reviewed. In the 4743 women who had a breast reduction, 51 breast cancers were detected [age standardized rate (ASR) of 4.28 per 1000 screening episodes; 95% CI 3.11-5.46], compared with 4342 breast cancers in 239 404 women screened in the non-reduction group (ASR of 5.99 per 1000 screening episodes; 95% CI 5.81-6.16). There were fewer cancers in the breast reduction group with a relative risk of 0.71. There was no significant difference in the rate of recall between the two groups, with a crude recall rate of 46.1 per 1000 screening episodes post-breast reduction compared with 50.7 per 1000 screening episodes for women without breast reduction. There was no significant difference in the pathological type or location of the cancer between the two groups of women. Conclusion: Postoperative breast changes following reduction mammoplasty do not significantly hinder analysis of the screening mammogram.

  14. Distressed or relieved? Psychological side effects of breast cancer screening in the Netherlands

    NARCIS (Netherlands)

    Scaf-Klomp, W; Sanderman, R; van de Wiel, HBM; Otter, R; van den Heuvel, WJA

    1997-01-01

    Study objectives-To assess the psychological impact of mammographic screening on women with non-malignant outcomes after attending the Netherlands' National Breast Cancer Screening Programme. Design-During one year all women with false positive test results (95) in a screening area were invited for

  15. Overview of guidelines on breast screening

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl; Kalager, Mette; Barratt, Alexandra;

    2016-01-01

    Updated guidelines on breast cancer screening have been published by several major organisations over the past five years. Recommendations vary regarding both age range, screening interval, and even on whether breast screening should be offered at all. The variation between recommendations reflects...... substantial differences in estimates of the major benefit (breast cancer mortality reduction) and the major harm (overdiagnosis). Estimates vary considerably among randomised trials, as well as observational studies: from no benefit to large reductions, and from no overdiagnosis to substantial levels......, such as small effects in absolute terms. There is a need for agreement on a hierarchy of observational study designs to quantify the major benefit and harm of cancer screening. This review provides a summary of recent guidelines on breast cancer screening and their major strengths and weaknesses, as well...

  16. Ethnic disparities in knowledge of cancer screening programmes in the UK

    OpenAIRE

    Robb, K; Wardle, J.; Stubbings, S.; Ramirez, A.; Austoker, J.; Macleod, U; Hiom, S; Waller, J.

    2010-01-01

    Objective The aim of the study was to examine awareness of the three National Cancer Screening Programmes (breast, cervical, bowel) among white and ethnic minority groups in the UK.Setting Data were from two surveys in which the screening questions were added: (i) the Office of National Statistics (ONS) Opinions Survey, carried out in September and October 2008; and (ii) the Ethnibus (TM) survey of the main ethnic minority groups in England, conducted in October and November 2008.Methods The ...

  17. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Nielsen, Margrethe

    2009-01-01

    BACKGROUND: A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary. OBJECTIVES: To assess the effect of screening for breast cancer with mammography on mortality and morbidity. SEARCH STRATEGY: We searched Pub...... excluded a biased trial and included 600,000 women in the analyses. Three trials with adequate randomisation did not show a significant reduction in breast cancer mortality at 13 years (relative risk (RR) 0.90, 95% confidence interval (CI) 0.79 to 1.02); four trials with suboptimal randomisation showed...... a significant reduction in breast cancer mortality with an RR of 0.75 (95% CI 0.67 to 0.83). The RR for all seven trials combined was 0.81 (95% CI 0.74 to 0.87). We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential...

  18. Knowledge of Breast Cancer and Screening Practices

    Science.gov (United States)

    Vahabi, Mandana

    2005-01-01

    Objective: To assess young women's breast health knowledge and explore its relation to the use of screening mammography. Methods: A convenience sample of 180 women aged 25-45 residing in Toronto, Canada, with no history of breast cancer and mammography received an information brochure and four questionnaires which assessed their knowledge of…

  19. Screening for breast cancer with mammography

    International Nuclear Information System (INIS)

    Mammography is generally accepted as a useful problem-solving clinical tool in characterizing known breast lesions, so that appropriate and timely treatment can be given. However, it remains grossly underutilized at what it does best: screening. The major strengths of mammography are (a) its ability to detect breast cancer at a smaller, potentially more curable stage than any other examination, and (b) its proved efficacy in reducing breast cancer mortality in asymptomatic women aged 40-74. If, as has recently been estimated, screening with mammography and physical examination can be expected to lower breast cancer deaths by 40%-50% among those actually examined (13), then the lives of almost 20,000 U.S. women might be saved each year if screening were to become very widely used. The challenges of the next decade are clear, to mount much more effective campaigns to educate physicians and lay women about the life-saving benefits of breast cancer screening, to devise increasingly effective and lower cost screening strategies, to further improve the current high quality of mammographic imaging despite its increasing proliferation, and to train large numbers of breast imaging specialists to guarantee that the growing case load of screening and problem-solving mammograms is interpreted with a very high level of skill

  20. Breast cancer screening controversies: who, when, why, and how?

    Science.gov (United States)

    Chetlen, Alison; Mack, Julie; Chan, Tiffany

    2016-01-01

    Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening.

  1. Nipple discharge in a screening programme: Imaging findings with pathological correlation

    International Nuclear Information System (INIS)

    BreastScreen Australia provides free mammographic screening for asymptomatic women over the age of 40, targeting women aged 50–69. Occasionally women will present to screening programmes with a history of nipple discharge, which is uncommonly associated with significant underlying breast disease. Seventy-six women with a history of nipple discharge were recalled to BreastScreen Western Australia assessment centres from 2004 to 2008, of whom 72 were recalled primarily for their symptoms. Thirty-six of these patients had pathology investigations, including 18 nipple discharge smears, 17 fine needle aspirations, 11 core biopsies and eight surgical biopsies or therapeutic resections. The biopsies found 11 intraduct papillomas and one invasive ductal carcinoma with ductal carcinoma in situ. Fourteen patients had imaging findings consistent with benign mammary duct ectasia. Our findings confirm that the presentation of nipple discharge in a screening programme is uncommonly associated with significant breast disease, and present representative cases of the radiological findings with pathological correlation of benign and malignant causes including mammary duct ectasia, intraduct papillomas, multiple papillomas, invasive ductal carcinoma and ductal carcinoma in situ.

  2. 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...

  3. Using hair to screen for breast cancer

    Science.gov (United States)

    James, Veronica; Kearsley, John; Irving, Tom; Amemiya, Yoshiyuki; Cookson, David

    1999-03-01

    We have studied hair using fibre X-ray diffraction studies with synchrotron radiation and find that hair from breast-cancer patients has a different intermolecular structure to hair from healthy subjects. These changes are seen in all samples of scalp and pubic hair taken from women diagnosed with breast cancer. All the hair samples from women who tested positive for a mutation of the BRCA1 gene, which is associated with a higher risk of breast cancer, also show these changes. Because our results are so consistent, we propose that such hair analyses may be used as a simple, non-invasive screening method for breast cancer.

  4. Breast cancer screening implementation and reassurance

    DEFF Research Database (Denmark)

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

    2013-01-01

    difference in reported psychosocial aspects had disappeared or been reduced because of the nationwide screening implementation. METHODS: The 1000 women included in the previous survey were posted part I of the questionnaire Consequences of Screening in Breast Cancer (COS-BC1) in August 2011, nearly 5 years...

  5. To nudge or not to nudge: cancer screening programmes and the limits of libertarian paternalism

    DEFF Research Database (Denmark)

    Ploug, T.; Holm, S.; Brodersen, J.

    2012-01-01

    exerted upon women's choices of participation cannot be justified within a welfare-enhancing libertarian paternalistic framework. The article suggests that screening programmes alternatively adopt a liberty-enhancing approach and considers the practical implications of this alternative......'Nudging-and the underlying idea 'libertarian paternalism'-to an increasing degree influences policy thinking in the healthcare sector. This article discusses the influence exerted upon a woman's choice of participation in the Danish breast screening programme in light of 'libertarian paternalism......'. The basic tenet of 'libertarian paternalism' is outlined and the relationship between 'libertarian paternalism' and informed consent investigated. Key elements in the process of enrolling women into the Danish mammography screening programme are introduced. It is shown that for several reasons the influence...

  6. To nudge or not to nudge: cancer screening programmes and the limits of libertarian paternalism.

    Science.gov (United States)

    Ploug, Thomas; Holm, Søren; Brodersen, John

    2012-12-01

    'Nudging--and the underlying idea 'libertarian paternalism'--to an increasing degree influences policy thinking in the healthcare sector. This article discusses the influence exerted upon a woman's choice of participation in the Danish breast screening programme in light of 'libertarian paternalism'. The basic tenet of 'libertarian paternalism' is outlined and the relationship between 'libertarian paternalism' and informed consent investigated. Key elements in the process of enrolling women into the Danish mammography screening programme are introduced. It is shown that for several reasons the influence exerted upon women's choices of participation cannot be justified within a welfare-enhancing libertarian paternalistic framework. The article suggests that screening programmes alternatively adopt a liberty-enhancing approach and considers the practical implications of this alternative.

  7. Breast cancer screening in Canada: a review

    International Nuclear Information System (INIS)

    Organized screening for breast cancer in Canada began in 1988 and has been implemented in all provinces and 2 of the 3 territories. Quality initiatives are promoted through national guidelines which detail best practices in various areas, including achieving quality through a client-service approach, recruitment and capacity, retention, quality of mammography, reporting, communication of results, follow-up and diagnostic workup, and program evaluation; it also offers detailed guidelines for the pathological examination and reporting of breast specimens. The Canadian Breast Cancer Data Base is a national breast cancer screening surveillance system whose objective is to collect information from provincial-screening programs. These data are used to monitor and evaluate the performance of programs and allow comparison with national and international results. A series of standardized performance indicators and targets for the evaluation of performance and quality of organized breast cancer screening programs have been developed from the data base. Although health care is a provincial responsibility in Canada, the collective reporting and comparison of results both nationally and internationally is beneficial in evaluating and refining both screening programs and individual radiologist performance. The results of Canadian performance indicators compare favourably with those of other well-established international screening programs. There are variations in performance indicators across the provinces and territories, but these differences are not extreme. (author)

  8. Screening of newborns for congenital hypothyroidism. Guidance for developing programmes

    International Nuclear Information System (INIS)

    Congenital hypothyroidism is a condition that, if left untreated, can cause lifelong human suffering as a result of severe mental retardation and deficiency of growth. With the involvement of the IAEA, screening programmes to detect congenital hypothyroidism in newborn infants have been introduced successfully in a large number of countries. The cornerstone of these programmes is accurate and reliable screening methods involving isotope techniques and simple medical treatment. The suffering - and heavy social and economic burden - caused by congenital hypothyroidism prompted many countries to institute a formalized screening programme directed at newborns, just as a vaccination programme has become an integral part of child health care. In many other countries however, this type of formalized service has not yet been established. For these countries, the implementation of a neonatal screening programme will bring about a considerable improvement in child health care. It is hoped that the guidance in this publication will be especially useful to the signatories of the United Nations Convention on the Rights of the Child. Several factors that prevail in a country - the climate, political environment, economic development, level of health care and the transportation system - have an influence on the overall operational systems, design and implementation of a screening programme. As such, the design of such a programme will differ greatly from country to country. Nevertheless, neonatal screening programmes have many elements in common. This book draws on the IAEA's experience in this area over more than a decade, and on the results of a regional technical cooperation programme on neonatal screening for congenital hypothyroidism in East Asia (IAEA Project RAS6032). This publication provides guidance aimed specifically at implementing and sustaining programmes for the screening of newborn infants

  9. Screen-detected mucinous breast carcinoma: Potential for delayed diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Dhillon, R. [Department of Diagnostic and Interventional Imaging, Royal Perth Hospital, Perth, WA (Australia)]. E-mail: ravinder.dhillon@health.wa.gov.au; Depree, P. [Department of Diagnostic and Interventional Imaging, Royal Perth Hospital, Perth, WA (Australia); Metcalf, C. [Department of Anatomical Pathology, Royal Perth Hospital, Perth, WA (Australia); Wylie, E. [Department of Diagnostic and Interventional Imaging, Royal Perth Hospital, Perth, WA (Australia)

    2006-05-15

    AIM: To describe the imaging features of 34 screen-detected mucinous carcinomas lesions. MATERIALS AND METHODS: The BreastScreen Western Australia (WA) database between January 1991 and December 2003 was searched. During this period, 214,507 women were screened and 2745 cases of invasive carcinoma and 45 cases of mucinous carcinoma were recorded. Case notes, radiology films and pathology reports of patients with mucinous carcinoma were reviewed. Thirty-four radiologically detected pure mucinous carcinomas are described. RESULTS: Of the pure mucinous carcinomas, the average age at diagnosis was 65 years (range 48-82 years), which was higher than that of other women with breast cancer (average age 60 years) screened at BreastScreen WA. Characteristic mammographic features of mucinous carcinoma are well-circumscribed masses with lobulated margins (26/34). Only 39% (11/28) of tumours were detected at ultrasound, as the smaller lesions less than 15 mm in diameter were often isoechoic with normal fat. Where histological grade was reported at excision, most (25/26) were low to medium-grade tumours (Bloom, Richardson and Elston grade I and II). A significant number of lesions (13/34) were evident on the previous screening examination where they were misinterpreted as benign lesions. However, none of these cases had positive axillary lymph nodes at final diagnosis. CONCLUSION: Although mammographically benign appearances of mucinous carcinoma caused a delay in diagnosis in 38% of the present cases, mucinous breast carcinomas have a favourable prognosis, as they are often low-grade tumours and rarely metastasize. Delay in diagnosis for these tumours in a screening programme may not lead to a significant adverse outcome for most women.

  10. Breast and cervical cancer screening in Great Britain: Dynamic interrelated processes.

    Science.gov (United States)

    Labeit, Alexander; Peinemann, Frank

    2015-12-01

    No previous analysis has investigated the determinants of screening uptake for breast and cervical cancer screening for possible spillover effects from one type of screening examination to the other type of screening examination with a dynamic bivariate panel probit model. For our analysis, we used a dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) and dependent variables were the participation of breast and cervical cancer screening in the recent year. The balanced panel sample consisted of 844 women from the British Household Panel Survey (BHPS) from the time period 1992 to 2008. Our analysis showed the high relevance of past screening behaviour and the importance of state dependency for the same and the other type of cancer screening examinations even after controlling for covariates and unobserved heterogeneity. The uptake for breast and cervical cancer screening was higher when the same screening examination was done one or three years earlier. This result is in accordance with the medical screening programmes in Great Britain. With regard to breast and cervical cancer screening positive spillover effects existed between screening examinations in the third order lags. Women with a previous visit to a general practitioner and individuals in the recommended age groups had a higher uptake for breast and cervical cancer screening. Other socioeconomic and health related variables had non-uniform results in both screening examinations. Promoting the uptake of one female prevention activity could also enhance the uptake of the other prevention activity. PMID:26487452

  11. Does computer-aided detection have a role in the arbitration of discordant double-reading opinions in a breast-screening programme?

    Energy Technology Data Exchange (ETDEWEB)

    James, J.J. [Nottingham Breast Institute, Nottingham City Hospital, Nottingham (United Kingdom)], E-mail: jonathan.james@nuh.nhs.uk; Cornford, E.J. [Nottingham Breast Institute, Nottingham City Hospital, Nottingham (United Kingdom)

    2009-01-15

    Aims: To investigate whether a computer-aided detection (CAD) system could act as an arbitrator of discordant double-reading opinions, replacing the need for an independent third film reader. Methods: The mammograms of the 240 women that underwent arbitration by an independent third reader were identified from the 16,629 women attending our screening centre between July 2003 and April 2004. Mammograms of the arbitration cases were digitized and analysed by a CAD system. To assess the ability of CAD to act as the arbitrator, the site of the CAD prompts was retrospectively compared to the site of any abnormality noted by the original film readers. If a CAD prompt was placed on a region marked by one of the film readers then the decision of CAD as the arbitrator was that the women should be recalled for further assessment. If no mark was placed then the region was considered low risk and the decision was not to recall. The decision of CAD as the arbitrator was retrospectively compared with the original recall decision of the independent third reader. Results: There were 21 cancer cases in the group of women undergoing arbitration, diagnosed both at the original screening episode and subsequently. The independent third reader recalled 15/18 (83%) of the cancers that corresponded with the arbitrated lesion. CAD as the arbitrator would have recalled 16/18 (89%) of the cancers that corresponded to the arbitrated lesion. CAD acting as the arbitrator would have resulted in a significant increase in normal women being recalled to assessment in the arbitration group (P < 0.001). The extra 50 recalls would have potentially increased the overall recall rate to assessment from 3.1 to 3.4%; a relative increase of 10%. Conclusions: The main effect of CAD acting as an arbitrator of discordant double-reading opinions is to increase the recall rate, significantly above what is found when arbitration is performed by an independent third reader. Using CAD as an arbitrator may be an

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

    International Nuclear Information System (INIS)

    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

  13. 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

  14. Reducing Barriers to Use of Breast Cancer Screening

    Science.gov (United States)

    Investigation to determine whether a telephone counseling intervention aimed at women who are known to underuse breast cancer screening can with, or without, an accompanying educational intervention for their physicians, increase use of breast cancer screening.

  15. Intervention trial of previous nonattender invitation for breast screening.

    Science.gov (United States)

    Fleming, Padraic; Mooney, Therese; Wilson, Linda; Fitzpatrick, Patricia

    2016-11-01

    BreastCheck, the National Breast Screening Programme in the Republic of Ireland, invites women aged between 50 and 64 years biennially. A pilot intervention trial of invitation for screening of women not attending the previous appointment [previous nonattender (PNA)] was carried out that aimed at maximizing the efficiency of resources in terms of radiographer workload and scheduled appointment slots. The trial was conducted during screening round 5 at two of the regional units. The intervention arm implemented an alternative process for inviting PNA women, in which they were sent a letter inviting them to phone their screening unit to make an appointment at a convenient date/time. The control arm continued usual practice - that is, all PNA women were sent a single invitation letter with a scheduled appointment slot at a predetermined date/time. In the intervention arm, fewer PNAs took up their appointments (15.5%) compared with the control arm (18.3%; P<0.001). Uptake among PNAs fell in both arms between screening rounds 4 and 5 (intervention arm: 22.0% OSR 4, 15.5% OSR 5; control arm: 21.4% OSR 4, 18.3% OSR 5). There was a significant increase in mobile unit screening days saved because of the intervention and a significant improvement in the percentage of women reinvited for screening within 27 months in the intervention arm (85.5%). PNA recall and cancer detection rates were significantly higher compared with the general screened population. This trial showed an improvement in the efficiency of resource use. However, there was a higher cancer detection rate in PNA women. This trial provides important evidence for invitation policy for screening. PMID:26642321

  16. Round one of the Adelaide and Meath Hospital/Trinity College Colorectal Cancer Screening Programme: programme report and analysis based on established international key performance indices.

    LENUS (Irish Health Repository)

    McNamara, D

    2012-02-01

    BACKGROUND: In Ireland, colorectal cancer (CRC) is the second most frequently diagnosed cancer in men, after prostate cancer, and the second most frequently diagnosed cancer in women, after breast cancer. By 2020, the number of new cases diagnosed annually in Ireland is projected to have increased by 79% in men and 56% in women. Organised screening for CRC is already underway or is in the process of being rolled out in several European countries, either at a regional or national level. The Adelaide and Meath Hospital\\/ Trinity College Dublin Colorectal Cancer Screening Programme (TTC-CRC-SP) is Ireland\\'s first pilot population based bowel screening programme. METHOD: Based on a biennial test model the pilot aimed to assess the accuracy of FIT and to evaluate the whole programme based on established international key performance indices. RESULTS: To date 9,993 individuals aged 50-74 years have been invited to participate in the TTC-CRC-SP with over 5,000 FIT\\'s analysed. Overall uptake was 51% and FIT positivity was 10%. The programme has undertaken over 400 screening colonoscopies and detected 154 precancerous adenomas and 38 cancerous lesions. CONCLUSIONS: The first round of The Adelaide and Meath Hospital Tallaght\\/Trinity College Dublin Colorectal Cancer Screening Programme has been highly successful and confirmed that there is an advantage for FIT based two stage bowel cancer screening programmes.

  17. Modelling the healthcare costs of an opportunistic chlamydia screening programme

    OpenAIRE

    Adams, E; Lamontagne, D; Johnston, A; Pimenta, J; Fenton, K; Edmunds, W.

    2004-01-01

    Objectives: To estimate the average cost per screening offer, cost per testing episode and cost per chlamydia positive episode for an opportunistic chlamydia screening programme (including partner management), and to explore the uncertainty of parameter assumptions, based on the costs to the healthcare system.

  18. Colorectal cancer screening: a global overview of existing programmes.

    Science.gov (United States)

    Schreuders, Eline H; Ruco, Arlinda; Rabeneck, Linda; Schoen, Robert E; Sung, Joseph J Y; Young, Graeme P; Kuipers, Ernst J

    2015-10-01

    Colorectal cancer (CRC) ranks third among the most commonly diagnosed cancers worldwide, with wide geographical variation in incidence and mortality across the world. Despite proof that screening can decrease CRC incidence and mortality, CRC screening is only offered to a small proportion of the target population worldwide. Throughout the world there are widespread differences in CRC screening implementation status and strategy. Differences can be attributed to geographical variation in CRC incidence, economic resources, healthcare structure and infrastructure to support screening such as the ability to identify the target population at risk and cancer registry availability. This review highlights issues to consider when implementing a CRC screening programme and gives a worldwide overview of CRC burden and the current status of screening programmes, with focus on international differences.

  19. National industry's interest in colorectal cancer screening programmes.

    OpenAIRE

    Hart, A R; Barone, T L; Wicks, A C; Mayberry, J F

    1994-01-01

    The interest of the largest 200 British industries in developing and financing colorectal screening services for employees was determined. A standard questionnaire asked if the company would advertise screening supply names of employees to local hospitals and finance faecal occult blood testing. The reasons for rejection were noted. Eighty-six companies returned the questionnaire (43% response rate) of which 78 firms (39% of the total mailed) were prepared to advertise screening programmes at...

  20. Surgical outcomes of borderline breast lesions detected by needle biopsy in a breast screening program

    OpenAIRE

    Flegg Karen M; Flaherty Jeffrey J; Bicknell Anne M; Jain Sanjiv

    2010-01-01

    Abstract Background The Australian Capital Territory and South East New South Wales branch of BreastScreen Australia (BreastScreen ACT&SENSW) performs over 20,000 screening mammograms annually. This study describes the outcome of surgical biopsies of the breast performed as a result of a borderline lesion being identified after screening mammography and subsequent workup. A secondary aim was to identify any parameters, such as a family history of breast cancer, or radiological findings that m...

  1. 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 to...... screening....

  2. Experience with the European quality assurance guidelines for digital mammography systems in a national screening programme.

    Science.gov (United States)

    McCullagh, J; Keavey, E; Egan, G; Phelan, N

    2013-02-01

    The transition to a fully digital breast screening programme, utilising three different full-field digital mammography (FFDM) systems has presented many challenges to the implementation of the European guidelines for physico-technical quality assurance (QA) testing. An analysis of the QA results collected from the FFDM systems in the screening programme over a 2-y period indicates that the three different systems have similar QA performances. Generally, the same tests were failed by all systems and failure rates were low. The findings provide some assurance that the QA guidelines are being correctly implemented. They also suggest that there is more scope for the development of the relevance of the guidelines with respect to modern FFDM systems. This study has also shown that a summary review of the QA data can be achieved by simple organisation of the QA data storage and by automation of data query and retrieval using commonly available software.

  3. Cervical screening programme: HPV triage and test of cure protocol

    OpenAIRE

    Public Health Agency

    2013-01-01

    Testing for high-risk human papillomavirus (HR-HPV) as triage and test of cure was introduced into the Northern Ireland Cervical Screening Programme on Monday 28 January 2013. This policy change will significantly alter the screening pathway for women with a mild dyskaryosis or borderline smear result. The link between HR-HPV infection and the development of cervical cancer has now been clearly established, with almost 100% of cervical cancers containing HPV DNA. Women with no evidence of HR-...

  4. Arab women's breast cancer screening practices: a literature review.

    Science.gov (United States)

    Donnelly, Tam Truong; Khater, Al-Hareth Al; Al-Bader, Salha Bujassoum; Al Kuwari, Mohammed Ghaith; Al-Meer, Nabila; Malik, Mariam; Singh, Rajvir; Jong, Floor Christie-de

    2013-01-01

    Breast cancer incidence and mortality rates are increasing in the Arab world and the involved women are often diagnosed at advanced stages of breast cancer. This literature review explores factors influencing Arab women's breast cancer screening behavior. Searched databases were: Medline, PubMed, Cochrane Database of Systematic Reviews, CINAHL Plus, Google Scholar, Index Medicus for WHO Eastern Mediterranean, and Asian Pacific Journal of Cancer Prevention. Breast cancer screening participation rates are low. Screening programs are opportunistic and relatively new to the region. Knowledge amongst women and health care providers, professional recommendation, socio-demographic factors, cultural traditions, beliefs, religious, social support, accessibility and perceived effectiveness of screening influence screening behavior.

  5. Initial results from the newborn hearing screening programme in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, A

    2013-03-02

    INTRODUCTION: Hearing screening programmes aim to detect hearing loss in the neonate. The Health Service Executive (HSE) South was the first phase of a national roll-out of a neonatal hearing screening programme in Ireland, going live on 28 April 2011. RESULTS: Over 11,738 babies have been screened for permanent childhood hearing impairment (PCHI) during the first 12 months. The percentage of eligible babies offered hearing screening was 99.2 %. Only 0.2 % (n = 25) of those offered screening declined. 493 (4 %) were referred for immediate diagnostic audiological assessment. The average time between screen and diagnostic audiology appointment was 2 weeks. 15 (1.3\\/1,000) babies have been identified with a PCHI over the 12-month period. 946 (4 %) babies screened were admitted to the neonatal intensive care unit (NICU) for >48 h. The prevalance of PCHI is 7.3\\/1,000 in the NICU population compared to 0.6\\/1000 in the well baby population. 214 (1.8 % of total babies screened) had a clear response in the screening programmes, but were deemed to be at risk of an acquired childhood hearing impairment. These babies will be reassessed with a diagnostic audiology appointment at 8-9 months of age. To date, there is one case of acquired hearing impairment through this targeted follow-up screen. Of the 15 cases of PCHI identified, 8 (53 %) of these had one or more risk factors for hearing loss and 7 (37 %) were admitted to the NICU for >48 h. Four babies were referred for assessment at the National Cochlear Implant Centre.

  6. Interventions for increasing uptake in screening programmes

    Directory of Open Access Journals (Sweden)

    Droste, Sigrid

    2006-08-01

    Full Text Available Introduction: Opportunities for the early detection of disease are not sufficiently being taken advantage of. Specific interventions could increase the uptake of prevention programmes. A comprehensive analysis of effectiveness and cost-effectiveness of these interventions with reference to Germany is still needed. Objectives: This report aimed to describe and assess interventions to increase uptake in primary and secondary prevention and to explore the assessment of their cost-effectiveness. Methods: 29 scientific databases were systematically searched in a wide strategy. Additional references were located from bibliographies. All published systematic reviews and primary studies were assessed for inclusion without language restrictions. Teams of two reviewers identified the literature, extracted data and assessed the quality of the publications independently. Results: Four HTA reports and 22 systematic reviews were identified for the medical evaluation covering a variety of interventions. The economic evaluation was based on two HTA-reports, one meta-analysis and 15 studies. The evidence was consistent for the effectiveness of invitations and reminders aimed at users, and for prompts aimed at health care professionals. These interventions were the most commonly analysed. (Financial Incentives for users and professionals were identified in a small number of studies. Limited evidence was available for cost-effectiveness showing incremental costs for follow-up reminders and invitations by telephone. Evidence for ethical, social and legal aspects pointed to needs in vulnerable populations. Discussion: The material was heterogeneous regarding interventions used, study populations and settings. The majority of references originated from the United States and focused on secondary prevention. Approaching all target groups by invitations and reminders was recommended to increase uptake in prevention programmes in general. Conclusions: Further research

  7. Recording of hormone therapy and breast density in breast screening programs: summary and recommendations of the International Cancer Screening Network.

    NARCIS (Netherlands)

    Cox, B.; Ballard-Barbash, R.; Broeders, M.J.M.; Dowling, E.; Malila, N.; Shumak, R.; Taplin, S.; Buist, D.; Miglioretti, D.

    2010-01-01

    Breast density and the use of hormone therapy (HT) for menopausal symptoms alter the risk of breast cancer and both factors influence screening mammography performance. The International Cancer Screening Network (ICSN) surveyed its 29 member countries and found that few programs record breast densit

  8. Improving regional universal newborn hearing screening programmes in Italy.

    Science.gov (United States)

    Molini, E; Cristi, M C; Lapenna, R; Calzolaro, L; Muzzi, E; Ciciriello, E; Della Volpe, A; Orzan, E; Ricci, G

    2016-02-01

    The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion. PMID:27054385

  9. Improving regional universal newborn hearing screening programmes in Italy.

    Science.gov (United States)

    Molini, E; Cristi, M C; Lapenna, R; Calzolaro, L; Muzzi, E; Ciciriello, E; Della Volpe, A; Orzan, E; Ricci, G

    2016-02-01

    The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion.

  10. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates.

    NARCIS (Netherlands)

    Bluekens, A.M.; Karssemeijer, N.; Beijerinck, D.; Deurenberg, J.J.; Engen, R.E. van; Broeders, M.J.M.; Heeten, G.J. den

    2010-01-01

    OBJECTIVES: To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. METHODS: Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection

  11. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    NARCIS (Netherlands)

    A.M.J. Bluekens; N. Karssemeijer; D. Beijerinck; J.J.M. Deurenberg; R.E. van Engen; M.J.M. Broeders; G.J. den Heeten

    2010-01-01

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates f

  12. Conspicuity of breast cancer according to histopathological type and breast density when imaged by full-field digital mammography compared with screen-film mammography

    International Nuclear Information System (INIS)

    To compare the conspicuity of different histopathological types of breast cancer according to breast density and mammographic imaging in patients with screen-detected breast cancers undergoing both full-field digital mammography (FFDM) and screen-film mammography (SFM) in the United Kingdom National Health Service Breast Screening Programme (NHSBSP). 185 patients underwent routine screening with SFM followed by further imaging using FFDM with consequent diagnosis of breast cancer. All SFM and soft-copy FFDM images were evaluated by two readers in an independent, retrospective review. The visualisation and conspicuity of the mammographic abnormality were recorded and graded using a four-level scale. Conspicuity of breast cancer was qualitatively evaluated. Breast density and conspicuity were correlated with histopathological diagnosis and inter-observer correlation was calculated. Mixed Model ANOVA demonstrated significant differences between FFDM and SFM (p < 0.001) and breast densities (p = 0.009): conspicuity of the mammographic abnormality (p < 0.001) and visualisation of the dominant mammographic feature (p < 0.001) were significantly greater with FFDM than SFM. This held true for both readers and for all histopathological tumour types with no significant differences between each tumour type. FFDM is significantly superior to SFM for conspicuity of screen-detected breast cancers for all histopathological types and breast densities. (orig.)

  13. 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.

  14. 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…

  15. Mammography in breast screening and in the evaluation and management of breast cancer

    International Nuclear Information System (INIS)

    This paper aims to discuss the importance of breast screening most especially amongst women above the age of 40 years.the limitation of the screening procedure is due to lack of special machines and power awareness campaigns. the application of Mammography and ultrasound in the examination of the breast and other breast imaging techniques will be considered in this paper. The paper will look at the indications for mammography, indications for breast ultrasound, signs of breast carcinoma on mammography, breast enlargement and also the need for breast ultrasound in cases of discrete Mammography

  16. Most Breast Cancer Screening Trials Have a Flawed Design

    OpenAIRE

    Gurnani, Nishant; Srivastava, Anurag

    2011-01-01

    In the present article, we discuss that why most breast cancer screening trials have a flawed origin. We suggest some solutions to correct these flaws so that more valid and reliable screening trials can be conducted in the future.

  17. Sickle cell disease: time for a targeted neonatal screening programme.

    LENUS (Irish Health Repository)

    Gibbons, C

    2015-02-01

    Ireland has seen a steady increase in paediatric sickle cell disease (SCD). In 2005, only 25% of children with SCD were referred to the haemoglobinopathy service in their first year. A non-funded screening programme was implemented. This review aimed to assess the impact screening has had. All children referred to the haemoglobinopathy service born in Ireland after 2005 were identified. Data was collected from the medical chart and laboratory system. Information was analysed using Microsoft Excel. 77 children with SCD were identified. The median age at antibiotic commencement in the screened group was 56 days compared with 447 days in the unscreened group, p = < 0.0003. 22 (28%) of infants were born in centre\\'s that do not screen and 17 (81%) were over 6 months old at referral, compared with 14 (21%) in the screened group. 6 (27%) of those in the unscreened group presented in acute crisis compared with 2 (3%) in the screened population. The point prevalence of SCD in Ireland is 0.2% in children under 15 yr of African and Asian descent. We identified delays in referral and treatment, which reflect the lack of government funded support and policy. We suggest all maternity units commence screening for newborns at risk of SCD. It is a cost effective intervention with a number needed to screen of just 4 to prevent a potentially fatal crisis.

  18. Process performance of cervical screening programmes in Europe

    DEFF Research Database (Denmark)

    Ronco, Guglielmo; Ballegooijen, Marjolein van; Becker, Nikolaus;

    2009-01-01

    . These comparisons may be useful for improving the performance of cervical screening in general and more so if new screening technologies and vaccination for Human Papillomavirus are introduced. Overall, quality was better in countries that have operated organised programmes for a longer time, plausibly as a result...... of long-lasting monitoring and quality assurance activities. Therefore, the availability of these data, the first comparing European countries, and the increased number of countries that can provide such data (only five in 2004) represent progress. Nevertheless, there is a clear need to standardise...

  19. The Impact of Breast Cancer Screening on Population Health

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien)

    2013-01-01

    textabstractBreast cancer is an important public health problem with an estimated number of 1.38 million breast cancer cases and 458,000 deaths from the disease yearly worldwide. Randomized trials have shown that mammography screening significantly reduces breast cancer mortality. Besides the benefi

  20. A Social Marketing Approach To Increasing Breast Cancer Screening Rates.

    Science.gov (United States)

    Bryant, Carol A.; Forthofer, Melinda S.; McCormack Brown, Kelli; Alfonso, Moya Lynn; Quinn, Gwen

    2000-01-01

    Used social marketing to identify factors influencing women's breast cancer screening behaviors. Data from focus groups and interviews with diverse women highlighted women's attitudes, knowledge, and barriers regarding screening. Results were used to develop a comprehensive social marketing plan to motivate irregular users of breast cancer…

  1. 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....

  2. Analysis of a hepatitis C screening programme for US veterans.

    Science.gov (United States)

    Zuniga, I A; Chen, J J; Lane, D S; Allmer, J; Jimenez-Lucho, V E

    2006-04-01

    This study analyses a screening programme for hepatitis C virus (HCV) infection among US veterans in a suburban Veterans Affairs Medical Center, in New York. This is the first study examining all 11 potential risk factors listed in the 2001 National U.S. Veterans Health Administration Screening Guidelines. A retrospective study was conducted of 5400 veterans 'at risk' of HCV, identified through a questionnaire in this institution's primary-care outpatient departments between 1 October 2001 and 31 December 2003. Multivariate logistic regression models were built to identify independent predictors of infection. Of 2282 veterans tested for HCV, 4.6% were confirmed by HCV PCR to be HCV infected. In the multivariate model developed, injection drug use, blood transfusion before 1992, service during the Vietnam era, tattoo, and a history of abnormal liver function tests were independent predictors of HCV infection. Our data support considering a more targeted screening approach that includes five of the 11 risk factors. PMID:16490127

  3. Effectiveness of ultrasound for breast cancer screening

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of ultrasound (US) for breast cancer screening, we conducted a retrospective survey of 856 breast cancer patients who were preoperatively examined by mammography (MMG) and US. Their average age was 54.7 years, with a range of 24 to 92 years. MMG revealed positive findings in 771 patients (90.1%), and negative findings in the remaining 85 patients (9.9%). Likewise, US revealed positive findings in 835 patients (97.5%), and negative findings in the remaining 21 patients (2.5%). Accordingly, the proportion of positive finding in US was significantly higher than that in MMG (chi-square test, p<0.0001). The incidence of negative findings with MMG was inversely related to age: 5.8% for patients in their 70s, 5.7% for those in their 60s, 8.3% for those in their 50s, 11.1% for those in their 40s, and 26.2% for those in their 30s or younger, because of the higher breast density in younger women (chi-square test, p<0.0001). The incidence of positive findings was 99.4% for tumors 2.1 to 3.0 cm in size, 96.3% for those measuring 1.6 to 2.0 cm, 94.3% for those measuring 1.1 to 1.5 cm, and 75.4% for those less than or equal to 1.0 cm (chi-square test, p<0.0001). Among the 85 patients with negative findings by MMG, 70(82.4%) were positive and 15 (17.6%) were negative by US. As findings of calcification by US, high echo spots plus a tumor lesion were observed in 59 patients (71.1%), high echo spots only were noted in 22 patients (26.5%), and high echo spots were not seen in 2 patients (2.4%). In conclusion, parallel use of MMG and US is recommended for breast cancer screening, especially for women in their 50s or younger, to reduce the incidence of misdiagnosis. (author)

  4. Regional trends in breast cancer incidence and mortality in Denmark prior to mammographic screening

    DEFF Research Database (Denmark)

    Andreasen, A H; Andersen, K W; Madsen, Mette;

    1994-01-01

    To provide a basis for the evaluation of mammographic screening programmes in Denmark, a study was undertaken of the regional differences in breast cancer incidence and mortality. All 16 regions were followed for the 20 year period, 1970-89, before the start of the first population...... among women below age 60. The mortality was more stable, changing only from 24 to 28 (per 100,000 standardised WSP), but a significant increase occurred in the late 1980s. The study showed regional differences in both incidence and mortality of breast cancer in Denmark. Both the incidence......-based mammographic screening programme in the Copenhagen municipality in 1991. Multiplicative Poisson models were used for the analysis. In general, the incidence increased during this period from 55 to 70 [per 100,000 standardised world standard population (WSP)], and the analysis shows this to be most pronounced...

  5. Radiation doses to screened women in the Norwegian Breast Cancer Screening Program in 2005 and 2006

    International Nuclear Information System (INIS)

    The radiographers report exposure data for approximately 50 women annually to the Norwegian Radiation Protection Authority. Based on reported data from all laboratories involved in the Norwegian Breast Cancer Screening Program average glandular dose (AGD) to the screened. (author)

  6. Screening for breast cancer in a high-risk series

    International Nuclear Information System (INIS)

    A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer Institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammography was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, use of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening

  7. Breast Cancer Screening in Black and Hispanic Subpopulations

    Directory of Open Access Journals (Sweden)

    Sarah J. Miller

    2014-03-01

    Full Text Available Background: The primary objective was to examine and compare the breast cancer screening adherence rates between black (African American and Afro-Caribbean and Hispanic (foreign born Hispanic and US-born Hispanic subpopulations. Methods: Study data was collected in community settings in New York City between the years of 2011-2012. Participants (N=592 were black and Hispanic individuals who attended a breast cancer screening community outreach program. Breast cancer screening rates as well as demographic data were collected. Results: Results revealed that Afro-Caribbean and foreign-born Hispanics are at a greater risk for non-adherence in breast cancer screening compared with African Americans and US-born Hispanics. Conclusions: The majority of breast screening research and community outreach programs categorize people into broad racial and ethnic groups (e.g., black and Hispanic. The results revealed significant variability within these broader racial/ethnic categories with regard to breast cancer screening. Community outreach programs and future research efforts should target the subpopulations that are at particular risk for breast cancer screening non-adherence.

  8. Social support and non-participation in breast cancer screening

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: Social support may have an impact on screening participation. We studied the association between social support in 2006, defined as frequencies of contacts, instrumental support and emotional support and participation in breast cancer screening in 2008-09. METHODS: This population...... likely not to participate in screening in 2008-09 [prevalence ratio (PR) 1.69, 95% confidence interval (CI) 1.26-2.26, P-value time...... with non-participation in breast cancer screening in 2008-09. Targeted social interventions may, therefore, have an impact on future screening behaviour, which calls for further research....

  9. Guidelines for Follow-Up of Women at High Risk for Inherited Breast Cancer: Consensus Statement from the Biomed 2 Demonstration Programme on Inherited Breast Cancer

    Directory of Open Access Journals (Sweden)

    P. Møller

    1999-01-01

    Full Text Available Protocols for activity aiming at early diagnosis and treatment of inherited breast or breast-ovarian cancer have been reported. Available reports on outcome of such programmes are considered here. It is concluded that the ongoing activities should continue with minor modifications. Direct evidence of a survival benefit from breast and ovarian screening is not yet available. On the basis of expert opinion and preliminary results from intervention programmes indicating good detection rates for early breast cancers and 5-year survival concordant with early diagnosis, we propose that women at high risk for inherited breast cancer be offered genetic counselling, education in ‘breast awareness’ and annual mammography and clinical expert examination from around 30 years of age. Mammography every second year may be sufficient from 60 years on. BRCA1 mutation carriers may benefit from more frequent examinations and cancer risk may be reduced by oophorectomy before 40–50 years of age. We strongly advocate that all activities should be organized as multicentre studies subjected to continuous evaluation to measure the effects of the interventions on long-term mortality, to match management options more precisely to individual risks and to prepare the ground for studies on chemoprevention.

  10. 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...

  11. 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.

  12. [Breast cancer screening in Austria: Key figures, age limits, screening intervals and evidence].

    Science.gov (United States)

    Jeitler, Klaus; Semlitsch, Thomas; Posch, Nicole; Siebenhofer, Andrea; Horvath, Karl

    2015-01-01

    In January 2014, the first nationwide quality-assured breast cancer screening program addressing women aged ≥ 40 years was introduced in Austria. As part of the process of developing a patient information leaflet, the Evidence Based Medicine (EBM) Review Center of the Medical University of Graz was charged with the task of assessing the potential benefits and harms of breast cancer screening from the available evidence. Based on these results, key figures were derived for mortality, false-positive and false-negative mammography results, and overdiagnosis, considering Austria-specific incidence rates for breast cancer and breast cancer mortality. Furthermore, the current evidence regarding age limits and screening interval, which were the subjects of controversial public discussions, was analyzed. A systematic search for primary and secondary literature was performed and additional evidence was screened, e. g., evaluation reports of European breast cancer screening programs. On the basis of the available evidence and of the Austrian breast cancer mortality and incidence rates, it can be assumed that - depending on the age group - 1 to 4 breast cancer deaths can be avoided per 1,000 women screened in a structured breast cancer screening program, while the overall mortality remains unchanged. On the other hand, 150 to 200 of these 1,000 women will be affected by false-positive results and 1 to 9 women by overdiagnosis due to the structured breast cancer screening. Therefore, the overall benefit-harm balance is uncertain. If women from 40 to 44 or above 70 years of age are considered, who can also participate in the Austrian screening program, even a negative benefit-harm balance seems possible. However, with the implementation of quality standards in breast cancer screening and the dissemination of a patient information leaflet, an improvement in the medical treatment situation, specifically in terms of informed decision-making, can be expected.

  13. [Breast cancer screening in Austria: Key figures, age limits, screening intervals and evidence].

    Science.gov (United States)

    Jeitler, Klaus; Semlitsch, Thomas; Posch, Nicole; Siebenhofer, Andrea; Horvath, Karl

    2015-01-01

    In January 2014, the first nationwide quality-assured breast cancer screening program addressing women aged ≥ 40 years was introduced in Austria. As part of the process of developing a patient information leaflet, the Evidence Based Medicine (EBM) Review Center of the Medical University of Graz was charged with the task of assessing the potential benefits and harms of breast cancer screening from the available evidence. Based on these results, key figures were derived for mortality, false-positive and false-negative mammography results, and overdiagnosis, considering Austria-specific incidence rates for breast cancer and breast cancer mortality. Furthermore, the current evidence regarding age limits and screening interval, which were the subjects of controversial public discussions, was analyzed. A systematic search for primary and secondary literature was performed and additional evidence was screened, e. g., evaluation reports of European breast cancer screening programs. On the basis of the available evidence and of the Austrian breast cancer mortality and incidence rates, it can be assumed that - depending on the age group - 1 to 4 breast cancer deaths can be avoided per 1,000 women screened in a structured breast cancer screening program, while the overall mortality remains unchanged. On the other hand, 150 to 200 of these 1,000 women will be affected by false-positive results and 1 to 9 women by overdiagnosis due to the structured breast cancer screening. Therefore, the overall benefit-harm balance is uncertain. If women from 40 to 44 or above 70 years of age are considered, who can also participate in the Austrian screening program, even a negative benefit-harm balance seems possible. However, with the implementation of quality standards in breast cancer screening and the dissemination of a patient information leaflet, an improvement in the medical treatment situation, specifically in terms of informed decision-making, can be expected. PMID:26354136

  14. Transillumination in breast cancer detection: screening failures and potential

    International Nuclear Information System (INIS)

    This prospective study of 1265 women referred to a multimodality breast diagnostic center compares the sensitivity for breast cancer detection of state-of-the-art transillumination light scanning and film-screen mammography. Of 33 biopsy-proven cancers, transillumination light scanning detected 58%, while mammography detected 97% of the cancers. Light scanning did detect 55% of the nonpalpable breast cancers, and 30% of those tumors smaller than 1 cm. Detection of breast cancer by light scanning was affected by breast size, but not architecture, and was directly related to tumor size. Although transillumination light scanning can detect some small curable breast cancers (smaller than 1 cm), it does not do so at a sensitivity adequate for screening

  15. Predicting the risk of a false-positive test for women following a mammography screening programme

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Olsen, Anne Helene; Schwartz, Walter;

    2007-01-01

    OBJECTIVES: The objectives of this study was to provide a simple estimate of the cumulative risk of a false-positive test for women participating in mammography screening. To test the method, we used data from two well-established, organized mammography screening programmes offering biennial...... be calculated in a simple way relatively early after the start of a mammography screening programme....

  16. Breast cancer screening in British Columbia: implications of diagnostic trajectories

    OpenAIRE

    McKay, Rachel

    2008-01-01

    Despite reductions in mortality rates, breast cancer remains the most common cancer and the second most common cause of cancer death in Canadian women. Organized screening programs have contributed to the decrease in breast cancer mortality by allowing for early diagnosis and treatment. The diagnostic phase following an abnormal screen has implications for patient well-being, clinical practice, and resource management in health care. We present data from British Columbia that show that improv...

  17. False-positive findings in mammography screening induces short-term distress - breast cancer-specific concern prevails longer

    DEFF Research Database (Denmark)

    Aro, A R; Pilvikki Absetz, S; van Elderen, T M;

    2000-01-01

    -ups at 2 and 12 months postscreening. At 2 months, there was a moderate multivariate effect of group on distress; and intrusive thinking and worry about breast cancer, in particular, were most frequent amongst the false positives. Intrusive thinking still prevailed at 12 months, in addition to a higher...... perceived breast cancer risk and susceptibility. Distress related to screening and false-positive findings seems to be moderate, but prevailing cancer-specific concerns call for improvements in screening programmes....... findings (n=1407), false-positive findings (n=492) and referents from outside the screening programme (n=1718, age 48-49 years). Distress was measured as illness worry, anxiety, depression, cancer beliefs and early detection behaviour. Measurements were one month before screening invitation with follow...

  18. 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

  19. 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.

  20. 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 Nijme

  1. User acceptability of an alpha-fetoprotein screening programme

    DEFF Research Database (Denmark)

    Jørgensen, Finn Stener

    1995-01-01

    The objective of the study was to determine user acceptability among women who were classified as false positives or test negatives in an alpha-fetoprotein screening programme. The study was performed as a questionnaire study over a one-year period from October 1, 1988 to September 30, 1989 at...... Hvidovre University Hospital, Copenhagen, and the county hospitals of Sønderjylland, Denmark. The participating subjects were 4104 pregnant women who had had an alpha-fetoprotein test and had completed 30 weeks of gestation, when the questionnaire was delivered. Main outcome measures were degree and...... duration of anxiety, influence on daily life and whether the woman wanted the alpha-fetoprotein test again in a new pregnancy. Three thousand, three hundred and thirty-one questionnaires were analyzed. The participation rate was 81.2%. For 219 women (6.6%), the first alpha-fetoprotein test was abnormal...

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

    International Nuclear Information System (INIS)

    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)

  3. Mammography - importance, possibilities, current screening situation of the breast cancer and further expansion possibilities

    International Nuclear Information System (INIS)

    Breast cancer still remains the most frequent cancer in women population. Incidence of breast cancer is increasing, but mortality is decreasing. The most important for decreasing of breast cancer mortality is early diagnostic, especially screening. Screening is a form of secondary prevention. Although many screening studies have shown that mammography decreases of the breast cancer death, there are still many controversies. The published recommendations for the breast screening are sometimes very different. (author)

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

    Science.gov (United States)

    Williams, Alex C.; Hitt, Austin; Voisin, Sophie; Tourassi, Georgia

    2013-03-01

    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.

  5. 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.

  6. Supplementary Screening Sonography in Mammographically Dense Breast: Pros and Cons

    Energy Technology Data Exchange (ETDEWEB)

    Youk, Ji Hyun; Kim, Eun Kyung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-12-15

    Sonography is an attractive supplement to mammography in breast cancer screening because it is relatively inexpensive, requires no contrast-medium injection, is well tolerated by patients, and is widely available for equipment as compared with MRI. Sonography has been especially valuable for women with mammographically dense breast because it has consistently been able to detect a substantial number of cancers at an early stage. Despite these findings, breast sonography has known limitations as a screening tool; operator-dependence, the shortage of skilled operators, the inability to detect microcalcifications, and substantially higher false-positive rates than mammography. Further study of screening sonography is still ongoing and is expected to help establish the role of screening sonography

  7. Improved detection of breast cancer on FDG-PET cancer screening using breast positioning device

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the detection rate of breast cancer by positron emission tomography cancer screening using a breast positioning device. Between January 2004 and January 2006, 1,498 healthy asymptomatic individuals underwent cancer screening by fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) at our institution; 660 of 1498 asymptomatic healthy women underwent breast PET imaging in the prone position using the breast positioning device to examine the mammary glands in addition to whole-body PET imaging. All subjects that showed abnormal 18F-FDG uptake in the mammary glands were referred for further examination or surgery at our institution or a local hospital. Our data were compared with the histopathological findings or findings of other imaging modalities in our institution and replies from the doctors at another hospital. Of the 660 participants, 7 (1.06%) were found to have breast cancers at a curable stage. All the seven cancers were detected by breast PET imaging, but only five of these were detected by whole-body PET imaging; the other two were detected by breast PET imaging using the breast positioning device. In cancer screening, prone breast imaging using a positioning device may help to improve the detection rate of breast cancer. However, overall cancer including mammography and ultrasonography screening should be performed to investigate the false-negative cases and reduce false-positive cases. The effectiveness of prone breast PET imaging in cancer screening should be investigated using a much larger number of cases in the near future. (author)

  8. 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

    -positive result, or live more years as a patient with breast cancer. Systematic reviews of the randomized trials have shown that for every 2000 women invited for mammography screening throughout 10 years, only 1 will have her life prolonged. In addition, 10 healthy women will be overdiagnosed with breast cancer...

  9. Assessment of Breast Cancer Risk and Belief in Breast Cancer Screening Among the Primary Healthcare Nurses.

    Science.gov (United States)

    İz, Fatma Başalan; Tümer, Adile

    2016-09-01

    Breast cancer is the most frequently diagnosed cancer in women. Early detection of breast cancer is known to increase survival rates significantly after diagnosis. This research was carried out to determine the level of breast cancer risk among primary healthcare nurses and their belief in breast cancer screening. In this descriptive research, the data were collected in face-to-face interviews with the participants. The researchers contacted all primary healthcare nurses currently working in the province. The data collection tools included a questionnaire form on sociodemographic characteristics, breast cancer risk assessment form, and Champion's Health Belief Model Scale (CHBMS) for breast cancer screening. In data analysis, descriptive statistics, t test, and analysis of variance (ANOVA) were used. The mean age of nurses was 35 ± 3.6. The mean score for the breast cancer risk assessment form was calculated as 82.9 ± 18.7. The subscale scores for the CHBMS for breast cancer screening were as follows: susceptibility 7.3 ± 1.8, seriousness 19.5 ± 4.1, benefits of breast self-exam 15.5 ± 2.6, barriers to breast self-exam 15.1 ± 2.8, self-efficacy 40.3 ± 7.0, and motivation 19.5 ± 4.1. The risk of breast cancer was found to be low in the study group. The analysis of the subscale scores for the CHBMS for breast cancer screening revealed that nurses had a below-average susceptibility perception, a somewhat lower perception of seriousness, an above-average mean score for perceived benefits, a moderate barrier perception, a relatively high perceived self-efficacy, and motivation above average. PMID:26758047

  10. Assessment of Breast Cancer Risk and Belief in Breast Cancer Screening Among the Primary Healthcare Nurses.

    Science.gov (United States)

    İz, Fatma Başalan; Tümer, Adile

    2016-09-01

    Breast cancer is the most frequently diagnosed cancer in women. Early detection of breast cancer is known to increase survival rates significantly after diagnosis. This research was carried out to determine the level of breast cancer risk among primary healthcare nurses and their belief in breast cancer screening. In this descriptive research, the data were collected in face-to-face interviews with the participants. The researchers contacted all primary healthcare nurses currently working in the province. The data collection tools included a questionnaire form on sociodemographic characteristics, breast cancer risk assessment form, and Champion's Health Belief Model Scale (CHBMS) for breast cancer screening. In data analysis, descriptive statistics, t test, and analysis of variance (ANOVA) were used. The mean age of nurses was 35 ± 3.6. The mean score for the breast cancer risk assessment form was calculated as 82.9 ± 18.7. The subscale scores for the CHBMS for breast cancer screening were as follows: susceptibility 7.3 ± 1.8, seriousness 19.5 ± 4.1, benefits of breast self-exam 15.5 ± 2.6, barriers to breast self-exam 15.1 ± 2.8, self-efficacy 40.3 ± 7.0, and motivation 19.5 ± 4.1. The risk of breast cancer was found to be low in the study group. The analysis of the subscale scores for the CHBMS for breast cancer screening revealed that nurses had a below-average susceptibility perception, a somewhat lower perception of seriousness, an above-average mean score for perceived benefits, a moderate barrier perception, a relatively high perceived self-efficacy, and motivation above average.

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

    OpenAIRE

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

    2013-01-01

    Background: 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. Methods: 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 o...

  12. An audit to investigate the impact of false positive breast screening results and diagnostic work-up on re-engagement with subsequent routine screening

    International Nuclear Information System (INIS)

    Introduction: Women attending breast screening may have suspicious mammographic findings that are subsequently found at assessment clinic to be normal (false positive, FP). A false positive diagnosis is not harmless, with short and long term negative psychosocial consequences reported. Women are at increased relative risk of breast cancer therefore their attendance at subsequent screening is essential. Aims: To assess the impact of FP breast screening diagnosis and diagnostic work-up on re-attendance rates across four consecutive screening rounds at a typical breast screening centre. Method: Diagnostic interventions and screening re-attendance rates at one prior and two consecutive rounds were analysed for women receiving an FP diagnosis between 2004 and 2006. Results: 397 women (5.57%) were referred for further assessment, including 228 (57.43%) false positives. 34 eligible women failed to re-attend routine screening (+3 years), with 17 failing to re-attend subsequently (+6 years). 70.6% (24/34) of non-attenders had attended at least two screening rounds prior to FP assessment. 75% of FP women had an imaging-only assessment with 17.5% (30/171) failing to re-attend, and 25% received a biopsy, with 7% (4/57) failing to re-attend subsequently. Conclusion: This study is unique as it follows FP women through four consecutive screening rounds. FP non-attendance rates were considerably lower compared to the general screening population, with diagnostic work-up having limited influence. FP non-attendance may appear insignificant in comparison to total screened population, but these women are at greater risk of subsequent cancer so should be actively encouraged to re-engage with the screening programme

  13. Analysis of previous screening examinations for patients with breast cancer

    International Nuclear Information System (INIS)

    We wanted to improve the quality of subsequent screening by reviewing the previous screening of breast cancer patients. Twenty-four breast cancer patients who underwent previous screening were enrolled. All 24 took mammograms and 15 patients also took sonograms. We reviewed the screening retrospectively according to the BI-RADS criteria and we categorized the results into false negative, true negative, true positive and occult cancers. We also categorized the causes of false negative cancers into misperception, misinterpretation and technical factors and then we analyzed the attributing factors. Review of the previous screening revealed 66.7% (16/24) false negative, 25.0% (6/24) true negative, and 8.3% (2/24) true positive cancers. False negative cancers were caused by the mammogram in 56.3% (9/16) and by the sonogram in 43.7% (7/16). For the false negative cases, all of misperception were related with mammograms and this was attributed to dense breast, a lesion located at the edge of glandular tissue or the image, and findings seen on one view only. Almost all misinterpretations were related with sonograms and attributed to loose application of the final assessment. To improve the quality of breast screening, it is essential to overcome the main causes of false negative examinations, including misperception and misinterpretation. We need systematic education and strict application of final assessment categories of BI-RADS. For effective communication among physicians, it is also necessary to properly educate them about BI-RADS

  14. Filipina American women's breast cancer knowledge, attitudes, and screening behaviors

    OpenAIRE

    Ryujin Lisa; Sadler Georgia; Ko Celine M; Dong Adam

    2003-01-01

    Abstract Background Filipino Americans are the fastest growing Asian minority group in the United States. There is limited knowledge about their breast cancer knowledge, screening practices and attitudes. Methods As part of the evaluation of the Asian Grocery Store-Based Cancer Education Program, 248 Filipino American women completed baseline and follow-up surveys, while an additional 58 took part in focus groups. Results Compliance with annual clinical breast exam guidelines among women 40 t...

  15. Imaging screening of breast cancer: primary results in 5307 cases

    International Nuclear Information System (INIS)

    Objective: To discuss the values of three screening methods for the detection of early breast cancer, and to analyze the features of the screening cancer. Methods: The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years. The three screening methods included physical examination with ultrasound and mammography, physical examination with mammography and mammography only. The rate of recall, biopsy, cancer detection of three methods were analyzed and the mammographic findings were reviewed. Chi-square test or Fisher's exact test were used for the statistics. Results: The recall rates were 4.90% (49/1001), 6.90% (166/2407) and 4. 48% (85/1899) in three methods respectively, the biopsy rates were 1.60% (16/1001), 1.04% (25/2407) and 0.63% (12/1899), the cancer detection rates were 0.50% (5/1001), 0.17% (4/2407) and 0 (0/1899). There were statistical differences among the three groups (χ2=12.99,6.264,8.764, P<0.05). Physical examination with ultrasound and mammography had the highest cancer detection rate, ten breast cancers were detected and 8 were early stage breast cancer. Of seven cancers detected by mammography, only two were found by ultrasound. A cluster of calcifications were found in 2 cases, linear calcifications in 2 cases. One case presented as a asymmetric density, one as a asymmetric density with calcifications, one as multiple nodules with a cluster of calcifications. Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review. Conclusion: Physical examination with ultrasound and mammography is the best method for breast cancer screening. The breast cancer can be detected by mammography earlier than other methods. (authors)

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

    LENUS (Irish Health Repository)

    Feeley, Linda

    2011-03-01

    Most studies comparing full-field digital mammography (FFDM) with conventional screen-film mammography (SFM) have been radiology-based. The pathological implications of FFDM have received little attention in the literature, especially in the context of screening programmes. The primary objective of this retrospective study is to compare FFDM with SFM in a population-based screening programme with regard to a number of pathological parameters.

  17. Decision aid for women considering breast cancer screening

    DEFF Research Database (Denmark)

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

    2011-01-01

    OBJECTIVES: The aim of this study was to describe the process and challenges of developing a decision aid for the national public breast cancer screening program in Finland. METHODS: An expert team with stakeholder representation used European guidelines and other literature as basis for selecting...... 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...

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

    OpenAIRE

    Z Heidari; 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...

  19. Breast cancer correlates in a cohort of breast screening program participants in Riyadh, KSA

    OpenAIRE

    Fahad A. Al-Amri; Mohammed Y. Saeedi; Fatina M. Al-Tahan; Ali, Arwa M.; Shaker A. Alomary; Mostafa Arafa; Ibrahim, Ahmed K.; Kassim A. Kassim

    2015-01-01

    Background: Breast cancer is the first cancer among females in the Kingdom of Saudi Arabia, accounting for 27.4% of all newly diagnosed female cancers in 2010. There are several risk factors affecting the incidence of breast cancer where some factors influence the risk more than the others. Aim: We aimed to identify the different risk factors related to breast cancer among females participating in the breast-screening program in Riyadh, KSA. Methods: Based on data from phase-I of the br...

  20. Joint breast and colorectal cancer screenings in medically underserved women

    Science.gov (United States)

    Davis, Terry C; Arnold, Connie L; Wolf, Michael S; Bennett, Charles L; Liu, Dachao; Rademaker, Alfred

    2016-01-01

    Background Breast and colon cancer screening in rural community clinics is underused. Objective To evaluate the effectiveness and cost-effectiveness of alternative interventions designed to promote simultaneous screening for breast and colon cancer in community clinics. Methods A 3-arm, quasi-experimental evaluation was conducted during May 2008-August 2011 in 8 federally qualifed health clinics in predominately rural Louisiana. Baseline screening rates reported by the clinics was <10% for breast cancer (using mammography) and 1%-2% for colon cancer (using the fecal occult blood test [FOBT]). 744 women aged 50 years or older who were eligible for routine mammography and an FOBT were recruited. The combined screening efforts included: enhanced care; health literacy-informed education (education alone), or health literacy-informed education with nurse support (nurse support). Results Postintervention screening rates for completing both tests were 28.1% with enhanced care, 23.7% with education alone, and 38.7% with nurse support. After adjusting for age, race, and literacy, patients who received nurse support were 2.21 times more likely to complete both screenings than were those who received the education alone (95% confidence interval [CI], 1.12-4.38; P = .023). The incremental cost per additional woman completing both screenings was $3,987 for education with nurse support over education alone, and $5,987 over enhanced care. Limitations There were differences between the 3 arms in sociodemographic characteristics, literacy, and previous screening history. Not all variables that were significantly different between arms were adjusted for, therefore adjustments for key variables (age, race, literacy) were made in statistical analyses. Other limitations related generalizability of results. Conclusions Although joint breast and colon cancer screening rates were increased substantially over existing baseline rates in all 3 arms, the completion rate for both tests was

  1. Factors Influencing Breast Density in Japanese Women Aged 40-49 in Breast Cancer Screening Mammography

    Directory of Open Access Journals (Sweden)

    Hori,Keisuke

    2013-08-01

    Full Text Available A relatively large number of women in their 40s with high-density breasts, in which it can be difficult to detect lesions, are encountered in mammography cancer screenings in Japan. Here, we retrospectively investigated factors related to breast density. Two hundred women (40-49 years old were examined at the screening center in our hospital. Multivariate analysis showed that factors such as small abdominal circumference, high HDL cholesterol, and no history of childbirth were related to high breast density in women in their 40s undergoing mammography. Other non-mammographic screening methods should be considered in women with abdominal circumferences <76cm, HDL-C >53mg/dl, and no history of childbirth, as there is a strong possibility of these women having high-density breasts that can make lesion detection difficult.

  2. Study of mammography in mass screening for breast cancer

    International Nuclear Information System (INIS)

    In order to examine the rate of correct diagnosis by mammography at initial mass screening for breast cancer, we carried out a retrospective study of mammography findings in 267 cases of breast cancer detected at Asahikawa Cancer Screening Center. The screening was performed by physical examination, and in cases where disease was suspected, mammography, ultrasonography, and needle biopsy were done. Mammographically, 172 cases (64.4%) were cancer-positive, 58 cases (21.7%) were suspicious for cancer, and 37 cases (13.9%) were cancer-negative. Patients below 50 years of age and those with tumors of small diameter (<20 mm) showed a significantly lower rate of cancer positivity than patients aged 50 years or more and those with tumors 20 mm or more in diameter. Mammographic abnormalities were not specific, since these changes were also found in normal subjects and patients with benign diseases. Therefore, we concluded that mammography without physical examination at initial mass screening has a high risk of missing breast cancer. Mass screening for breast cancer should be performed by physical examination involving inspection and palpation at the first instance. If any suspicious findings are obtained, mammography, ultrasonography, and needle biopsy should be done. (author)

  3. Psychological effects of a cosmetic education programme in patients with breast cancer.

    Science.gov (United States)

    Park, H Y; Kim, J H; Choi, S; Kang, E; Oh, S; Kim, J Y; Kim, S W

    2015-07-01

    Treatments for breast cancer often include interventions related to psychosocial issues such as negative body image, loss of femininity, and low self-esteem. We identified the psychological effects of a cosmetics education programme in patients with breast cancer. Cosmetic programme is a specific care designed to help patients handle appearance-related side effects. Thirty-one women with breast cancer at a university hospital in South Korea who received a cosmetics education programme were compared with 29 subjects in a control group who received the treatment as usual. Psychological factors including distress, self-esteem, and sexual functioning were assessed three times (before and after the programme, and at the 1-month follow-up). After the programme, patients in the treatment group were significantly less likely than those in the control group to rely on distress (P = 0.038) and avoidance coping (P self-esteem. The mean scores in the treatment group for sexual functioning were higher than those in the control group after the treatment. Our results suggest the potential usefulness of a brief cosmetics education programme for reducing distress and reliance on negative coping strategies. Implementing a cosmetics programme for patients with breast cancer may encourage patients to control negative psychological factors. PMID:25651297

  4. Radiologic aspects of breast cancers detected through a breast cancer screening program

    International Nuclear Information System (INIS)

    Early detection in breast cancer and reduced mortality in women with this disease is today attributed to widespread use of mammography. High-quality performance is essential in all steps of breast cancer screening programs in order to avoid unnecessary anxiety and surgery in the women concerned. This report presents radiologic aspects of screening cancers. A total of 8370 asymptomatic women aged 50-69 years were screened with 2-view mammography, of which only 70 (0.84 percent) were selected for surgery after a thorough work-up. Cancers were verified histologically in 61 women and 9 showed non-malignant histology, giving a cancer detection rate of 7.3 cancers per thousand screened asymptomatic women. The benign/malignant ratio in the operated cases is thus approximately 1:7. The cancers detected showed all existing types of mammographic features where 77 percent (47 cases) showed rather typical findings, such as spiculated densities both with and without microcalcifications. The results indicate that surgery can be minimized without impairing the breast cancer detection rate. Radiologists in screening programs should be aware that a large proportion of non-palpable breast cancers present in rather unconventional forms. This point is important in order to maintain a high cancer detection rate and thereby justify the widespread use of mammography as a screening tool for breast cancer in asymptomatic women. (author). 20 refs.; 1 tab

  5. Nation-wide breast cancer screening in the Netherlands: Support for breast-cancer mortality reduction

    NARCIS (Netherlands)

    H.J. de Koning (Harry); J. Fracheboud (Jacques); R. Boer (Rob); A.L.M. Verbeek (Andre); H.J.A. Collette (H. J A); J.H.C.L. Hendriks (J. H C L); B.M. van Ineveld (Martin); A.E. de Bruyn (A.); P.J. van der Maas (Paul)

    1995-01-01

    textabstractThe nationwide 2-yearly breastcancer screening programme in The Netherlands, for women aged 50-69, started around 1988, and was predicted to result eventually in a 16% reduction in breastcancer mortality in the total female population. We present the results of screening up to January 1,

  6. Breast cancer screening controversy: too much or not enough?

    Science.gov (United States)

    Pivot, Xavier; Viguier, Jérôme; Touboul, Chantal; Morère, Jean-François; Blay, Jean-Yves; Coscas, Yvan; Lhomel, Christine; Eisinger, François

    2015-06-01

    The Cochrane analysis exploring the risk/benefit ratio of breast cancer screening resulted in a controversy worldwide spread by the mass media. Our survey sought to assess the impact of this controversy in terms of breast cancer screening awareness and attendance. A nationwide observational study, recorded in the EDIFICE iterative surveys, with a representative sample of 451 women aged 40-75 years, living in France, was carried out in the 3 months after the start of the controversy in January 2013. Of the 405 women with no personal history of cancer, 69 (17%) declared having heard of the controversy (aware group). Women remembering the controversy were more likely to belong to higher socioprofessional categories and to have a higher level of education. The most frequently remembered issues were overdiagnosis (38%), unreliability (16%) and radiation risk (9%). Compared with women who were unaware of the controversy, the aware group knew more about the limits of breast cancer screening (undiagnosed cancers, 20 vs. 7%, Pmass media debate (8.7 vs. 1.2%, P<0.05). Nevertheless, only 1% of the aware-group declared their intention to subsequently undergo screening less frequently. The low impact of the controversy on the behaviour of women with respect to screening suggests that it should not be seen as a threat to screening attendance rates, but more as an opportunity to improve awareness. PMID:26016791

  7. Breast cancer correlates in a cohort of breast screening program participants in Riyadh, KSA

    International Nuclear Information System (INIS)

    Background: Breast cancer is the first cancer among females in the Kingdom of Saudi Arabia, accounting for 27.4% of all newly diagnosed female cancers in 2010. There are several risk factors affecting the incidence of breast cancer where some factors influence the risk more than the others. Aim: We aimed to identify the different risk factors related to breast cancer among females participating in the breast-screening program in Riyadh, KSA. Methods: Based on data from phase-I of the breast-screening program, a case-control study was conducted on women living in Riyadh, KSA. A sample of 349 women (58 cases and 290 controls) was recruited to examine the different breast cancer correlates. Multivariate regression model was built to investigate the most important risk factors. Results: The mean age of cases was 48.5 ± 7.1 years. Age at marriage, number of pregnancy, age at menopause, oral contraceptive pills, breast feeding and family history of breast cancer in first-degree relative were identified as the most important correlates among the studied cohort. Conclusions: The findings of the current work suggested that age at marriage, age at menopause ≥50 years, and 1st degree family history of breast cancer were risk factors for breast cancer, while, age at menopause<50 years, number of pregnancies and practicing breast feeding were protective factors against breast cancer. There was no effect of body mass index or physical inactivity. Further studies are needed to explore the hereditary, familial and genetic background risk factors in Saudi population.

  8. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    International Nuclear Information System (INIS)

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  9. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    Energy Technology Data Exchange (ETDEWEB)

    Bluekens, Adriana M.J. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Karssemeijer, Nico [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Preventicon Screening Centre/Mid-West, Utrecht (Netherlands); Engen, Ruben E. van [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Broeders, Mireille J.M. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Epidemiology, Biostatistics and HTA, Nijmegen (Netherlands); Heeten, Gerard J. den [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Academic Medical Centre (AMC), Department of Radiology, Amsterdam (Netherlands)

    2010-09-15

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  10. Results and analysis of screening for breast cancer

    International Nuclear Information System (INIS)

    Breast cancer is the most frequent cause of death in most countries of the world. Screening of asymptomatic women can detect a large percentage of cancers at an early stage. This is the basis for a possible cure or at least a prolongation of the survival time. The percentage of minimal cancers (smaller than 1 cm without dissemination) may be as high as 48% depending on the screening modality (10% without screening), axillary lymph node involvement can be reduced to 20% (40% without screening), and the percentage of stage II to IV cancers can be reduced to 8-20% (60% without screening). Mortality in the study group over age 50 years was reduced by 30%. Disadvantages of screening are: high cost; biopsies prompted by false positive results; psychological stress for the patients; radiation hazards which have, however, become almost negligible thanks to improved technique (2 cancers in 1 million mammographies and year). (Author)

  11. 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.

  12. Communicating the balance sheet in breast cancer screening.

    NARCIS (Netherlands)

    Giordano, L.; Cogo, C.; Patnick, J.; Paci, E.; Broeders, M.J.M.

    2012-01-01

    OBJECTIVE: Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening. METHODS: In this paper we review the issues in communication of benefits and harms of medical interventions and discuss these in terms

  13. 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 Dep

  14. Breast Cancer Screening: Cultural Beliefs and Diverse Populations

    Science.gov (United States)

    Simon, Cassandra E.

    2006-01-01

    This article addresses the role of culture in breast cancer screening behavior among African American, American Indian/Alaskan Native, Asian American/Pacific Islander, and Hispanic/Latina women. It reviews cultural beliefs, attitudes, and knowledge and their relative influence on women's decisions regarding health tests. The article explores how…

  15. Socioeconomic factors related to attendance at a Type 2 diabetes screening programme

    DEFF Research Database (Denmark)

    Dalsgaard, E.M.; Lauritzen, T.; Christiansen, T.;

    2009-01-01

    AIMS: The prevalence of diabetes is increasing, and screening of high-risk populations is recommended. A low attendance rate has been observed in many Type 2 diabetes screening programmes, so that an analysis of factors related to attendance is therefore relevant. This paper analyses the...... association between socioeconomic factors and attendance for Type 2 diabetes screening. METHODS: Persons aged 40-69 years (n = 4603) were invited to participate in a stepwise diabetes screening programme performed in general practitioners' offices in the county of Aarhus, Denmark in 2001. The study was...... population-based and cross-sectional with follow-up. The association between screening attendance in the high-risk population and socioeconomic factors was analysed by odds ratio. RESULTS: Forty-four percent of the estimated high-risk population attended the screening programme. In those with known risk for...

  16.   Personal invitations for population-based breast cancer screening

    DEFF Research Database (Denmark)

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

    2010-01-01

    , leaflets) the units sent to women was collected. Results from 2005 were sent as feedback to the units. Data were analyzed descriptively, and results from the 2 years were compared. RESULTS: Screening units sent personal invitation letters usually providing fixed appointment times. Most units informed about......RATIONALE AND OBJECTIVES: Women who are invited for breast cancer screening should get enough information about the benefits and harms of screening to make an informed decision on participation. Personal invitations are an important source of information, because all invited women receive them...

  17. Breast Cancer Screening Interventions in Selected Counties Across US Regions

    Science.gov (United States)

    Austin, Shamly; Martin, Michelle Y; Levine, Robert S.; Pisu, Maria

    2010-01-01

    Objectives To determine the types of, and the populations targeted by interventions implemented to increase breast cancer screening rates in counties with large African American populations across different US regions. Methods A brief questionnaire was administered by e-mail to county representatives from 33 states from October 2008 through March 2009. Responses were obtained from 33% of 203 targeted counties. Results Most counties (>80%) reported interventions for African American women and for women with low income. Women were exposed to different kinds of interventions depending on where they lived. Most counties in the Northeast (93%), Southwest (82%) and Midwest (100%) implemented interventions that provided free or low cost mammograms. Counties in the Southeast (83%) were more likely to report education interventions. Counties from the Southwest reported using a variety of interventions to encourage breast cancer screening. Conclusion In this selected group of counties, different types of interventions were used to increase breast cancer screening in minority and disadvantaged women. Interventions implemented were similar to those shown in the literature to be effective in increasing screening rates in specific populations. Future research should examine the use of screening interventions in a larger sample of US counties. PMID:20820899

  18. 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...... normal mammograms. Experience and PS did not influence responses to different screening findings. Of the finding groups, false positives experienced most adverse effects: their risk perception increased and they reported most post-screening breast cancer-specific concerns. Furthermore, they became more...

  19. An infrared image based methodology for breast lesions screening

    Science.gov (United States)

    Morais, K. C. C.; Vargas, J. V. C.; Reisemberger, G. G.; Freitas, F. N. P.; Oliari, S. H.; Brioschi, M. L.; Louveira, M. H.; Spautz, C.; Dias, F. G.; Gasperin, P.; Budel, V. M.; Cordeiro, R. A. G.; Schittini, A. P. P.; Neto, C. D.

    2016-05-01

    The objective of this paper is to evaluate the potential of utilizing a structured methodology for breast lesions screening, based on infrared imaging temperature measurements of a healthy control group to establish expected normality ranges, and of breast cancer patients, previously diagnosed through biopsies of the affected regions. An analysis of the systematic error of the infrared camera skin temperature measurements was conducted in several different regions of the body, by direct comparison to high precision thermistor temperature measurements, showing that infrared camera temperatures are consistently around 2 °C above the thermistor temperatures. Therefore, a method of conjugated gradients is proposed to eliminate the infrared camera direct temperature measurement imprecision, by calculating the temperature difference between two points to cancel out the error. The method takes into account the human body approximate bilateral symmetry, and compares measured dimensionless temperature difference values (Δ θ bar) between two symmetric regions of the patient's breast, that takes into account the breast region, the surrounding ambient and the individual core temperatures, and doing so, the results interpretation for different individuals become simple and non subjective. The range of normal whole breast average dimensionless temperature differences for 101 healthy individuals was determined, and admitting that the breasts temperatures exhibit a unimodal normal distribution, the healthy normal range for each region was considered to be the dimensionless temperature difference plus/minus twice the standard deviation of the measurements, Δ θ bar ‾ + 2σ Δ θ bar ‾ , in order to represent 95% of the population. Forty-seven patients with previously diagnosed breast cancer through biopsies were examined with the method, which was capable of detecting breast abnormalities in 45 cases (96%). Therefore, the conjugated gradients method was considered effective

  20. Simulation of reduced breast cancer mortality in breast cancer screening programs

    International Nuclear Information System (INIS)

    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.

  1. An ongoing case–control study to evaluate the NHS Bowel Cancer Screening Programme

    OpenAIRE

    Massat, Nathalie J; Sasieni, Peter D; Parmar, Dharmishta; Duffy, Stephen W

    2014-01-01

    Background Colorectal cancer is the third most common cause of cancer death in both males and females in England. A national bowel cancer screening programme was rolled out in England between 2006 and 2010. In the post-randomised controlled trials epoch, assessment of the impact of the programme using observational studies is needed. This study protocol was set up at the request of the UK Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis to evaluate the effect of the cur...

  2. Effects of HPV detection in population-based screening programmes for cervical cancer; a Dutch moment.

    NARCIS (Netherlands)

    Bekkers, R.L.M.; Meijer, C.J.M.; Massuger, L.F.A.G.; Snijders, P.J.L.M.; Melchers, W.J.G.

    2006-01-01

    Presently, large randomised studies are investigating the value of incorporating HPV detection in population-based cervical screening programmes to improve the effectiveness of these programmes. None of these studies, however, has assessed the effect of HPV detection on the participation rate of wom

  3. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  4. Sociodemographic Characteristics, Distance to the Clinic, and Breast Cancer Screening Results

    OpenAIRE

    Kim, Seijeoung; Chukwudozie, Beverly; Calhoun, Elizabeth

    2013-01-01

    Timely detection and follow-up of abnormal cellular changes can aid in early diagnosis of breast cancer, thus leading to better treatment outcomes. However, despite substantial breast cancer screening initiatives, the proportion of female breast cancer cases diagnosed at late stages remains high. Distance to screening clinics may affect access to care, particularly for women living in impoverished areas with limited means of reliable transportation. Utilizing breast cancer screening data coll...

  5. 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

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

    International Nuclear Information System (INIS)

    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

  7. Diagnostic Workup and Costs of a Single Supplemental Molecular Breast Imaging Screen of Mammographically Dense Breasts

    Science.gov (United States)

    Hruska, Carrie B.; Conners, Amy Lynn; Jones, Katie N.; O’Connor, Michael K.; Moriarty, James P.; Boughey, Judy C.; Rhodes, Deborah J.

    2016-01-01

    OBJECTIVE The purpose of this study was to examine additional diagnostic workup and costs generated by addition of a single molecular breast imaging (MBI) examination to screening mammography for women with dense breasts. SUBJECTS AND METHODS Women with mammographically dense breasts presenting for screening mammography underwent adjunct MBI performed with 300 MBq 99mTc-sestamibi and a direct-conversion cadmium-zinc-telluride dual-head gamma camera. All subsequent imaging tests and biopsies were tracked for a minimum of 1 year. The positive predictive value of biopsies performed (PPV3), benign biopsy rate, cost per patient screened, and cost per cancer detected were determined. RESULTS A total of 1651 women enrolled in the study. Among the 1585 participants with complete reference standard, screening mammography alone prompted diagnostic workup of 175 (11.0%) patients and biopsy of 20 (1.3%) and yielded five malignancies (PPV3, 25%). Results of combined screening mammography plus MBI prompted diagnostic workup of 279 patients (17.6%) and biopsy of 67 (4.2%) and yielded 19 malignancies (PPV3, 28.4%). The benign biopsy rates were 0.9% (15 of 1585) for screening mammography alone and 3.0% (48 of 1585) for the combination (p cost per patient screened from $176 for mammography alone to $571 for the combination. However, cost per cancer detected was lower for the combination ($47,597) than for mammography alone ($55,851). CONCLUSION The addition of MBI to screening mammography of women with dense breasts increased the overall costs and benign biopsy rate but also increased the cancer detection rate, which resulted in a lower cost per cancer detected than with screening mammography alone. PMID:26001247

  8. The results of screening examinations of breast cancer conducted from 2004 to 2005 in Sierpc poviat

    International Nuclear Information System (INIS)

    Background: Breast cancer is one of the most common malignant neoplasms among women in Poland. 11733 new cases were registered in 2003. Well organized screening examinations are the most effective method of fighting against breast cancer. Aim of study: The main objective of this work was a preliminary analysis of a prophylactic examination programme for breast cancer in Sierpc district performed by the Independent Unit of Public Health Care Centres in Sierpc during the period of 2004 to 2005. Material and methods: The research was performed based on retrospective analysis of files obtained from the Department of Radiology of the Independent Unit of Public Health Care Centres in Sierpc. Prophylactic examination for detection of breast cancer includes physical examination of the breast as well as mammography. Results: The research includes 1291 women, most of them at age 50-55 years (57.1 years on average). City residents represent the biggest group of women. Nearly half of women had their first menstruation at the age of 14 to 15 years. The last menstruation occurred at age between 46 and 50 years old most frequently. The average number of labours was 2.3 and 2.5 during the analyzed period. The first labour occurred most frequently in women at the age of 21 to 25 years old. Most of the women never took previously and still do not take hormonal medicines. 80% of women have done breast self examination but over half of them (60.8%) did it occasionally. Breast examination done by a gynaecologist was performed in 22% of women during the last year. Breast cancer did not occur among family members in most of the analyzed women. Breast pain was the most frequent complaint. Over half of women (64.6%) previously underwent mammography. The biggest group among them (31.1%) includes women who had mammography between 2003 and 2004. Adipose glandular breast texture was detected in near half of women (43.5%). The result of mammography was normal in most analyzed women (87.1%). A

  9. Breast cancer mortality in organised mammography screening in Denmark: comparative study

    DEFF Research Database (Denmark)

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

    2010-01-01

    To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up....

  10. False-positive results in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

    Hofvind, Solveig; Ponti, Antonio; Patnick, Julietta;

    2012-01-01

    To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment.......To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment....

  11. Breast cancer mortality in organised mammography screening in Denmark: comparative study

    DEFF Research Database (Denmark)

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

    2010-01-01

    To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up.......To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up....

  12. A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes.

    Science.gov (United States)

    Fortnum, Heather; Ukoumunne, Obioha C; Hyde, Chris; Taylor, Rod S; Ozolins, Mara; Errington, Sam; Zhelev, Zhivko; Pritchard, Clive; Benton, Claire; Moody, Joanne; Cocking, Laura; Watson, Julian; Roberts, Sarah

    2016-01-01

    BACKGROUND Identification of permanent hearing impairment at the earliest possible age is crucial to maximise the development of speech and language. Universal newborn hearing screening identifies the majority of the 1 in 1000 children born with a hearing impairment, but later onset can occur at any time and there is no optimum time for further screening. A universal but non-standardised school entry screening (SES) programme is in place in many parts of the UK but its value is questioned. OBJECTIVES To evaluate the diagnostic accuracy of hearing screening tests and the cost-effectiveness of the SES programme in the UK. DESIGN Systematic review, case-control diagnostic accuracy study, comparison of routinely collected data for services with and without a SES programme, parental questionnaires, observation of practical implementation and cost-effectiveness modelling. SETTING Second- and third-tier audiology services; community. PARTICIPANTS Children aged 4-6 years and their parents. MAIN OUTCOME MEASURES Diagnostic accuracy of two hearing screening devices, referral rate and source, yield, age at referral and cost per quality-adjusted life-year. RESULTS The review of diagnostic accuracy studies concluded that research to date demonstrates marked variability in the design, methodological quality and results. The pure-tone screen (PTS) (Amplivox, Eynsham, UK) and HearCheck (HC) screener (Siemens, Frimley, UK) devices had high sensitivity (PTS ≥ 89%, HC ≥ 83%) and specificity (PTS ≥ 78%, HC ≥ 83%) for identifying hearing impairment. The rate of referral for hearing problems was 36% lower with SES (Nottingham) relative to no SES (Cambridge) [rate ratio 0.64, 95% confidence interval (CI) 0.59 to 0.69; p < 0.001]. The yield of confirmed cases did not differ between areas with and without SES (rate ratio 0.82, 95% CI 0.63 to 1.06; p = 0.12). The mean age of referral did not differ between areas with and without SES for all referrals but children

  13. Community Screening for Preschool Child Inhibition to Offer the "Cool Little Kids" Anxiety Prevention Programme

    Science.gov (United States)

    Beatson, Ruth M.; Bayer, Jordana K.; Perry, Alexandra; Mathers, Megan; Hiscock, Harriet; Wake, Melissa; Beesley, Kate; Rapee, Ronald M.

    2014-01-01

    Temperamental inhibition has been identified as a key risk factor for childhood anxiety and internalizing problems. An efficacious early prevention programme for shy/inhibited children has been developed; however, accurate, efficient and acceptable screening is needed to support wider implementation. We explore community screening options in the…

  14. Using record linkage to monitor equity and variation in screening programmes

    Directory of Open Access Journals (Sweden)

    O’Reilly Dermot

    2012-04-01

    Full Text Available Abstract Background Ecological or survey based methods to investigate screening uptake rates are fraught with many limitations which can be circumvented by record linkage between Census and health services datasets using variations in breast screening attendance as an exemplar. The aim of this current study is to identify the demographic, socio-economic factors associated with uptake of breast screening. Methods Record linkage study: combining 2001 Census data within the Northern Ireland Longitudinal Study (NILS with data relating to validated breast screening histories from the National Breast Screening System. A cohort was identified of 37,059 women aged 48-64 at the Census who were invited for routine breast screening in the three years following the Census. All cohort attributes were as recorded on the Census form. Results The record linkage methodology enabled the records of almost 40,000 of those invited for screening to be analysed at an individual level, exceeding the largest published survey by a factor of ten. This produced a more robust analysis and demonstrated (in fully adjusted models the lower uptake amongst non-married women and those in the lowest social class (OR 0.74; 95%CI 0.66, 0.82, factors that had not been reported earlier in the UK. In addition, with the availability of both individual and area information it was possible to show that the much lower screening uptake in urban areas is not due to differences in population composition suggesting unrecognised organisational problems. Conclusions Linkage of screening data to Census-based longitudinal studies is an efficient and powerful way to increase the evidence base on sources of variation in screening uptake within the UK.

  15. 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

  16. Vision screening in children with developmental delay can be improved: analysis of a screening programme outside the ophthalmic clinic.

    Science.gov (United States)

    Nielsen, Lisbeth Sandfeld; Skov, Liselotte; Jensen, Hanne

    2007-07-01

    The purpose of the present study was to evaluate the effectiveness of a new vision-screening programme in detecting ophthalmic disorders in children with developmental delay (DD; IQIQ. A group of 467 children with an IQIQ>80 (85 males, 38 females; age range 3-16y; mean age 10y 5mo [SD 3y 2mo]) had an examination that included new vision-screening items: distance and near visual acuity and stereopsis for near objects (Lang stereo test II). A full ophthalmological examination was also conducted to determine the effectiveness of the new screening items. The previous screening programme consisted of only monocular visual acuity at distance. Sensitivity, specificity, the positive predictive value (PPV), and negative predictive value (NPV) of the tests were calculated with regard to the following ophthalmic disorders: hyperopia, myopia, astigmatism, anistometropia, amblyopia, low vision, and strabismus. Overall, the prevalence of ophthalmic disorders was 33.4% in children with DD and 11.4% in typically developing children. With the use of the new programme, the effectiveness of vision screening in both groups of children was improved. In children with DD, sensitivity increased from 49.4 to 80.1%, specificity decreased from 98.1 to 83.3%, PPV decreased from 92.8 to 70.6%, and NPV increased from 79.4 to 89.3%. In typically developing children, sensitivity improved from 50.0 to 85.7%, specificity declined from 98.2 to 87.2%, PPV decreased from 77.8 to 46.2%, and NPV increased from 93.9 to 97.9%. We conclude that the currently used vision-screening programme can be significantly improved. The speed and simplicity of the proposed screening programme makes it suitable for use by school nurses. The improvements were most prominent in children with DD. PMID:17593122

  17. Acceptability and effectiveness of a breast health awareness programme for rural women in India

    Directory of Open Access Journals (Sweden)

    Rao R

    2005-09-01

    Full Text Available Background: Breast cancer being one of the leading cancers among women in developing countries, prevention or identification of the disease at an early stage is of paramount importance in saving as well as improving the quality of life. Breast health awareness appears to be a pragmatic method for this. Objective: To determine the acceptability and effectiveness of an educational intervention programme on breast health awareness for rural women by trained female health workers. Settings and Design: Community based nonrandomised educational intervention study carried out over a period of 1 year. Three hundred and sixty rural women in the age group 30-59 years were randomly selected (and age-wise stratified, from a coastal village in Southern India. Methods: Women were educated on breast health and breast self-examination by specifically trained health workers and their awareness and proficiency levels were evaluated at the end of 1 and 3 months postintervention. Statistical analysis: This was done using the Statistical Package for Social Sciences Version 10. Results: Following the educational intervention, a significant increase in overall awareness regarding breast cancer (z=-15.807; P<0.001 as well as in the performance of self-examination of the breast 321/342 (93% was observed. Forgetfulness or being too busy appeared to be the two most frequently perceived barriers. Conclusion: This study clearly shows that a community oriented educational intervention programme emphasizing on proper technique can bring about the desirable behavioural change among women.

  18. Ethical aspects of the expansion of neonatal screening programme due to technological advances.

    Science.gov (United States)

    Elliman, David

    2012-06-01

    Many countries are considering the expansion of their newborn bloodspot screening programmes. Whereas some countries screen for very few conditions, others are planning to screen for dozens. While advances in technology may facilitate this expansion, they must not lead it at the expense of considerations of the possible harms of this expansion. This article reviews some of the potential disbenefits of this expansion and outlines the ethical issues that should be considered.

  19. The relationship between real life breast screening and an annual self assessment scheme

    Science.gov (United States)

    Scott, Hazel J.; Evans, Andrew; Gale, Alastair G.; Murphy, Alison; Reed, Jacquie

    2009-02-01

    Incidence of cancer in the UK NHS Breast Screening Programme (NHSBSP) is relatively low (approximately 7% per 1,000 cases screened). As such, feedback from cancers missed or interval cancers can be a relatively lengthy process (whereby a woman will not present for corroborating imaging for a further three years). Therefore in order to monitor their radiological skill, all breast screening radiologists and technologists read a self-assessed, standard set of challenging mammographic images bi-yearly. This scheme, 'PERFORMS' (Personal Performance in Mammographic Screening) has been running since near the inception of the NHSBSP in 1991. Although PERFORMS has functioned as an educational tool for film-readers on the UKBSP for decades, its relation to real life screening in past years has proven to be somewhat equivocal (Cowley & Gale, 1999). The present study investigated the relationship between performance measures in real life and their equivalent on the PERFORMS self assessment scheme namely: Miss Rate (FN), Cases Arbitrated and Returned to Routine screening and Incorrect recall (FP), Specificity (TN) and Cancer Detection (TP). Over 40 individuals from one NHS region in the UK submitted their real life data for comparison with PERFORMS results from the same time frame. Data from this initial study were taken from the year 2005-2006 and compared with the relevant PERFORMS set of cases. Results indicated a significant positive correlation between PERFORMS performance measures and performance measures for real life. These results are discussed in the light of the legitimacy of self-assessment comparative to film-reading skill (during real life clinical practice).

  20. Value of breast imaging reporting and data system in Chinese breast cancer screening

    International Nuclear Information System (INIS)

    Objective: To study the value of breast imaging reporting and data system (BI-RADS) in Chinese breast cancer screening. Methods: A total number of 3483 women participated in breast cancer screening with mammography in Hexi district in Tianjin from August to December 2009, which was organized by ministry of public health. BI-RADS assessment categories and recommendations were compared with histological findings. The precision, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: Among 3483 screening mammography cases, 267 were almost entirely fat breast, 1245 were scattered fibroglandular, 1890 were dense and 81 extremely dense. There were 1011 patients (29.0%) with category 1, 1741 (50.0%) with category 2, 383 (11.0%) with category 3, 59 patients (1.7%) with category 4 and 16 (0.5%) with category 5 according to BI-RADS assessment categories. Totally, 71 women with 77 lesions were confirmed by histological examinations. There were 29 malignant and 48 benign lesions. The diagnostic precision, sensitivity, specificity of' BI-RADS were 63.6% (49/77), 93.1% (27/29) and 45.8% (22/48). The general PPV of BI-RADS was 50.9% (27/53). The PPV of categories 0.4, 5 were 25.0% (1/4), 36.4% (12/33) and 87.5% (14/16). The NPV of categories 2 and 3 were 90.9% (10/11), 100.0% (12/12). Conclusions: BI-RADS is of much value in assessing the breast malignancy. It is applicable in Chinese breast cancer screening. (authors)

  1. Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

    OpenAIRE

    Samantha Garbers; Karen Schmitt; Anne Marie Rappa; Mary Ann Chiasson

    2010-01-01

    Samantha Garbers1, Karen Schmitt2, Anne Marie Rappa2, Mary Ann Chiasson11Public Health Solutions, New York, NY, USA; 2Columbia University Breast Cancer Screening Program, New York, NY, USABackground: This analysis examines the association between functional health literacy and follow-up after mammography among women receiving breast cancer screening at a National Breast and Cervical Cancer Early Detection Program site in New York City that provides universal bilingual case management.Methods:...

  2. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    OpenAIRE

    Schenberg, Tess; Mitchell, Gillian; Taylor, Donna; Saunders, Christobel

    2015-01-01

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australi...

  3. Predictors of Breast Cancer Screening in Asian and Latina University Students

    Science.gov (United States)

    Regan, Pamela C.; Durvasula, Ramani S.

    2008-01-01

    Preventative screening in the form of clinical breast examinations remains among the best protections against breast cancer. Despite the benefits that regular examinations confer, many women fail to obtain screening tests. Because ethnic minority women are particularly unlikely to undergo regular screening, and experience increased mortality and…

  4. The first national public breast cancer screening program in Saudi Arabia

    OpenAIRE

    Abulkhair, Omalkhair A.; Al Tahan, Fatina M.; Young, Susan E.; Musaad, Salma MA.; Jazieh, Abdul-Rahman M.

    2010-01-01

    BACKGROUND AND OBJECTIVES: Despite its relatively low incidence in Saudi Arabia, breast cancer has been the most common cancer among Saudi females for the past 12 consecutive years. The objective of this study was to report the results of the first national public breast cancer screening program in Saudi Arabia. METHODS: Women 40 years of age or older underwent breast cancer screening. Mammograms were scored using the Breast Imaging-Reporting and Data System (BI-RADS). Correlations between im...

  5. Implementing a screening programme for post-traumatic stress disorder following violent crime

    Directory of Open Access Journals (Sweden)

    Jonathan I. Bisson

    2010-12-01

    Full Text Available Background: The emergence of validated means to determine which individuals will develop post-traumatic stress disorder (PTSD following a traumatic event has raised the possibility of designing and implementing effective screening programmes following traumatic events. Objective: This study aimed to study the usefulness and implementation of a PTSD screening programme for victims of violent crime presenting to an emergency unit. Design: 3,349 individuals who presented to an emergency unit following a violent crime were asked to complete the Trauma Screening Questionnaire 2 weeks later. Those who scored above a standard cut-off were invited to attend a mental health assessment and subsequently offered treatment according to their needs. Results: Of the 3,349 individuals contacted, 572 (17.1% responded, 338 (10.1% screened positive, 26 (0.78% attended for assessment, and 9 (0.27% received treatment for PTSD. Conclusions: This simple screening programme was not as useful as was hoped raising questions regarding how best to develop screening programmes for PTSD following violent crime and other traumatic events.

  6. Problems, solutions, and perspectives in the evaluation of interval cancers in Italian mammography screening programmes: a position paper from the Italian group for mammography screening (GISMa).

    Science.gov (United States)

    Bucchi, Lauro; Frigerio, Alfonso; Zorzi, Manuel; Fedato, Chiara; Angiolucci, Giovanni; Bernardi, Daniela; Campari, Cinzia; Crocetti, Emanuele; Ferretti, Stefano; Giorgi, Daniela; Marchisio, Francesca; Morrone, Doralba; Naldoni, Carlo; Petrella, Marco; Ponti, Antonio; Ravaioli, Alessandra; Saguatti, Gianni; Santini, Dolores; Sassoli de Bianchi, Priscilla; Serafini, Monica; Vergini, Viviana; Giordano, Livia

    2015-01-01

    In this position paper, a self-convened team of experts from the Italian Group for Mammography Screening (Gruppo italiano screening mammografico, GISMa) pointed out the problems that increasingly hamper the feasibility and validity of the estimate of the proportional incidence of interval breast cancer (IBC) in Italy, suggested potential solutions and an agenda for research, and proposed that the question of the sensitivity of mammography be viewed in a larger perspective, with a greater attention to radiological review activities and breast radiology quality assurance programmes. The main problems are as follows: the coverage of cancer registration is incomplete; the robustness of using the pre-screening incidence rates as underlying rates decreases with time since the start of screening; the intermediate mammograms performed for early detection purposes may cause an overrepresentation of IBCs; the classification of many borderline screening histories is prone to subjectivity; and, finally, the composition of cohorts of women with negative screening results is uncertain, because several mammography reports are neither clearly negative nor clearly positive, and because of the limitations and instability of the electronic mammography records. Several possibilities can be considered to cope with these issues: standard methods for using the hospital discharge records in the identification of IBCs should be established; for the calculation of regional estimates of the underlying incidence, a suitable mathematical model should be identified; the definition of IBC according to the 2008 GISMa guidelines needs to be updated, especially with respect to in situ cancers and to invasive cancers with borderline screening histories; a closer adherence to standard screening protocols, with a simplified patient management, would make it easier to objectively identify IBCs; alternative methods for estimating the sensitivity of mammography should be taken into consideration; and

  7. Vision screening programme among school children--evaluation of the outcome in a selected urban locality.

    Science.gov (United States)

    Bagchi, Ketaki; Sarkar, Subhra Nag; Chattopadhyaya, Tutul; Dan, Amit

    2008-05-01

    To determine the profile of the visual acuity status, refractive error and other ocular morbidities and to asses the performance at different stages following a vision screening programme in school a retrospective analysis of the data obtained from the programme register for school vision screening programme conducted from April 2003 to March 2006 was done. The data was plotted age and genderwise. Statistical analysis was done to find out disease prevalence with 95% confidence Interval and Z-test was applied for comparison. There were 45,087 students for 239 primary and secondary schools who were examined; 1856 students (4.11%) found having visual acuity .5 or less in either or both eyes. Refractive error was evident in 4.03% students and was the aetiology of compromised vision in 98%. Myopia topped the list with the prevalence of 2.85%; 1733 students (3.84%) were provided with spectacles. Correction of refractive error improved the visual disability in 3.93% of students while amblyopia was found in 0.10%. Average student load per teacher for initial screening was 229. The vision screening programme in school helps to detect refractive error and other causes of compromised vision among large section of children between 5 and 15 years age group. Use of correct spectacles prevents amblyopia considerably. Constraints arising in the programme can be removed by proper planning. PMID:18839632

  8. Mammographic density and histopathologic characteristics of screen-detected tumors in the Norwegian Breast Cancer Screening Program

    International Nuclear Information System (INIS)

    High mammographic density might mask breast tumors, resulting in delayed diagnosis or missed cancers. To investigate the association between mammographic density and histopathologic tumor characteristics (histologic type, size, grade, and lymph node status) among women screened in the Norwegian Breast Cancer Screening Program. Information about 1760 screen-detected ductal carcinoma in situ (DCIS) and 7366 invasive breast cancers diagnosed among women aged 50–69 years, 1996–2010, was analyzed. The screening mammograms were classified subjectively according to the amount of fibroglandular tissue into fatty, medium dense, and dense by breast radiologists. Chi-square test was used to compare the distribution of tumor characteristics by mammographic density. Odds ratio (OR) of tumor characteristics by density was estimated by means of logistic regression, adjusting for screening mode (screen-film and full-field digital mammography), and age. Mean and median tumor size of invasive breast cancers was 13.8 and 12 mm, respectively, for women with fatty breasts, and 16.2 and 14 mm for those with dense breasts. Lymph node positive tumors were identified among 20.6% of women with fatty breasts compared with 27.2% of those with dense breasts (P < 0.001). The proportion of DCIS was significantly lower for women with fatty (15.8%) compared with dense breasts (22.0%). Women with dense breasts had an increased risk of large (OR, 1.44; 95% CI, 1.18–1.73) and lymph node positive tumors (OR, 1.26; 95% CI, 1.05–1.51) compared with women with fatty and medium dense breasts. High mammographic density was positively associated with tumor size and lymph node positive tumors

  9. Balancing sensitivity and specificity: sixteen year's of experience from the mammography screening programme in Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Utzon-Frank, Nicolai; Vejborg, Ilse; von Euler-Chelpin, My Catarina;

    2011-01-01

    To report on sensitivity and specificity from 7 invitation rounds of the organised, population-based mammography screening programme started in Copenhagen, Denmark, in 1991, and offered biennially to women aged 50-69. Changes over time were related to organisation and technology.......To report on sensitivity and specificity from 7 invitation rounds of the organised, population-based mammography screening programme started in Copenhagen, Denmark, in 1991, and offered biennially to women aged 50-69. Changes over time were related to organisation and technology....

  10. Effects of repeated mammographic screening on breast cancer stage distribution

    International Nuclear Information System (INIS)

    A randomised controlled trial of mass screening for breast cancer by single-view mammography was begun in Sweden in 1977. All women aged 40 and older and resident in the counties of Koppaberg and Oestergoetland were enrolled. The present report is confined to the Oestergoetland study, which started in 1978 and comprised 92934 women. After randomisation, which was done on the basis of communities rather than individuals, 47001 women were allocated to the study group and offered repeated mammographic screening; 45933 were allocated to the control group. As compliance among women over 74 years of age was poor these were excluded from the present report. The yearly incidence of stage II or more advanced breast cancers after the initial screening round up to and including the second was reduced by 40 per cent in the study group compared with the controls. This effect was less marked in the age group 40-49. After 5.5 years average from the date of entry the absolute number of women with stage II-IV disease in the control group exceeded that for the study group by 44, whereas there was a large excess of cancer in situ and stage I cancer in the study group. (orig.)

  11. Premarital screening programmes for haemoglobinopathies, HIV and hepatitis viruses: review and factors affecting their success.

    Science.gov (United States)

    Alswaidi, Fahad M; O'Brien, Sarah J

    2009-01-01

    This literature review is a comprehensive summary of premarital (prenuptial) screening programmes for the most prevalent hereditary haemoglobinopathies, namely thalassaemia and sickle cell disease, and the important infections HIV (human immunodeficiency virus) and hepatitis viruses B and C (HBV and HCV). It describes the background to premarital screening programmes and their value in countries where these diseases are endemic. The use of premarital screening worldwide is critically evaluated, including recent experiences in Saudi Arabia, followed by discussion of the outcomes of such programmes. Despite its many benefits, premarital testing is not acceptable in some communities for various legal and religious reasons, and other educational and cultural factors may prevent some married couples following the advice given by counsellors. The success of these programmes therefore depends on adequate religious support, government policy, education and counselling. In contrast to premarital screening for haemoglobinopathies, premarital screening for HIV and the hepatitis viruses is still highly controversial, both in terms of ethics and cost-effectiveness. In wealthy countries, premarital hepatitis and HIV testing could become mandatory if at-risk, high-prevalence populations are clearly identified and all ethical issues are adequately addressed. PMID:19349527

  12. Radiation-Induced Breast Cancer Incidence and Mortality from Digital Mammography Screening: A Modeling Study

    Science.gov (United States)

    Miglioretti, Diana L.; Lange, Jane; van den Broek, Jeroen J.; Lee, Christoph I.; van Ravesteyn, Nicolien T.; Ritley, Dominique; Kerlikowske, Karla; Fenton, Joshua J.; Melnikow, Joy; de Koning, Harry J.; Hubbard, Rebecca A.

    2016-01-01

    Background Estimates of radiation-induced breast cancer risk from mammography screening have not previously considered dose exposure variation or diagnostic work-up after abnormal screening. Objective To estimate distributions of radiation-induced breast cancer incidence and mortality from digital mammography screening, considering exposure from screening and diagnostic mammography and dose variation across women. Design Two simulation-modeling approaches using common data on screening mammography from the Breast Cancer Surveillance Consortium and radiation dose from mammography from the Digital Mammographic Imaging Screening Trial. Setting U.S. population. Patients Women aged 40–74 years. Interventions Annual or biennial digital mammography screening from age 40, 45, or 50 until 74. Measurements Lifetime breast cancer deaths averted (benefits) and radiation-induced breast cancer incidence and mortality per 100,000 women screened (harms). Results On average, annual screening of 100,000 women aged 40 to 74 years was projected to induce 125 breast cancers (95% confidence interval [CI]=88–178) leading to 16 deaths (95% CI=11–23) relative to 968 breast cancer deaths averted by early detection from screening. Women exposed at the 95th percentile were projected to develop 246 radiation-induced breast cancers leading to 32 deaths per 100,000 women. Women with large breasts requiring extra views for complete breast examination (8% of population) were projected to have higher radiation-induced breast cancer incidence and mortality (266 cancers, 35 deaths per 100,000 women), compared to women with small or average breasts (113 cancers, 15 deaths per 100,000 women). Biennial screening starting at age 50 reduced risk of radiation-induced cancers 5-fold. Limitations We were unable to estimate years of life lost from radiation-induced breast cancer. Conclusions Radiation-induced breast cancer incidence and mortality from digital mammography screening are impacted by dose

  13. Impact of second reminder invitation on uptake of screening and cancer detection in BreastCheck.

    LENUS (Irish Health Repository)

    Fleming, P

    2012-01-01

    This research aims to quantify the impact of reminder invitations on uptake and cancer detection in Ireland. Examination of BreastCheck\\'s clinical database (2000-2010) to determine number of women screened following first invitation and after reminder; comparison by age group and screening phase with outcomes of recall rate, cancer detection and true positive rates. Of 819,182 first invitations sent 448,974 (54.8%) women attended. 245,157 (66.2%) women attended after reminder invitations, increasing uptake by 29.9% to 694,131 (84.7%) and cancers detected by 1,550 (35%). Women awaiting a reminder were less likely recalled for assessment 9,555 (3.9%) than respondents to first invitation 2,887 (4.04%) (p=0.004). Younger, mainly initial women were more likely recalled for assessment after first invitation. There was no difference between cohorts for cancer detection rate or true positive rate. Reminders increased uptake, supporting international evidence. For programme efficiency attendance at first invitation is optimal. For maximum programme effectiveness attendance must be encouraged with reminders.

  14. 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 med

  15. Screening for Breast Cancer: #BeBrave: A Life-Saving Test

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Screening For Breast Cancer #BeBrave: A Life-Saving Test ... cancer survivor, you may not have gotten your screening mammogram. What is your message to other women ...

  16. Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl; Gøtzsche, Peter C

    2009-01-01

    . DATA SOURCES: PubMed (April 2007), reference lists, and authors. Review methods One author extracted data on incidence of breast cancer (including carcinoma in situ), population size, screening uptake, time periods, and age groups, which were checked independently by the other author. Linear regression...

  17. 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...

  18. Development and Validation of the Assessment of Health Literacy in Breast and Cervical Cancer Screening

    OpenAIRE

    Han, Hae-Ra; Huh, Boyun; Kim, Miyong T.; Kim, Jiyun; Nguyen, Tam

    2014-01-01

    For many people limited health literacy is a major barrier to effective preventive health behavior such as cancer screening, yet a comprehensive health literacy measure that is specific to breast and cervical cancer screening is not readily available. The purpose of this paper is to describe the development and testing of a new instrument to measure health literacy in the context of breast and cervical cancer screening, the Assessment of Health Literacy in Cancer Screening (AHL-C). The AHL-C ...

  19. CJS debate: Is mammography useful in average-risk screening for breast cancer?

    Science.gov (United States)

    Brackstone, Muriel; Latosinsky, Steven; Saettler, Elizabeth; George, Ralph

    2016-01-01

    Summary Given the recent debate over breast cancer screening that was reignited by the 25-year follow-up data from the Canadian National Breast Screening Study, the Canadian Journal of Surgery commissioned a group of Canadian experts to debate the value of screening mammography. We discuss the Canadian study and summarize the arguments in favour of and against screening mammography for average-risk patients. We also provide summary recommendations for the use of mammography. PMID:26574707

  20. Positive diagnostic values and histological detection ratios from the Rotterdam cervical cancer screening programme

    NARCIS (Netherlands)

    F.A. Kreuger; H. Beerman (Henk); H.G. Nijs (Huub); M. van Ballegooijen (Marjolein)

    1998-01-01

    textabstractBACKGROUND: In organized screening programmes for cervical cancer, pre-cancerous lesions are detected by cervical smears. However, during follow-up after a positive smear these pre-cancerous lesions are not always found. The purpose of the study is to analys

  1. Feasibility of a rubella screening and vaccination programme for unvaccinated young women.

    NARCIS (Netherlands)

    Ruijs, W.L.M.; Hulscher, M.E.J.L.; Hahne, S.J.; Binnendijk, R.S. van; Velden, J. van der

    2009-01-01

    The feasibility of a rubella screening and vaccination programme for unvaccinated young women was assessed after the 2004/2005 epidemic in The Netherlands. All 640 young women in two villages with low vaccination coverage were invited for a rubella seroprevalence test. Information on vaccination sta

  2. Explaining low uptake for Down syndrome screening in the Netherlands : (and predicting utilisation of other programmes)

    NARCIS (Netherlands)

    Crombag, NMTH

    2016-01-01

    In the Netherlands, only a quarter of all pregnant women take part in the current Down syndrome screening(DSS) programme. Compared to other Northern European countries, Dutch uptake rates are very low. This thesis concentrates on the test-utilisation of DSS, in particular the factors impeding or ena

  3. Filipina American women's breast cancer knowledge, attitudes, and screening behaviors

    Directory of Open Access Journals (Sweden)

    Ryujin Lisa

    2003-08-01

    Full Text Available Abstract Background Filipino Americans are the fastest growing Asian minority group in the United States. There is limited knowledge about their breast cancer knowledge, screening practices and attitudes. Methods As part of the evaluation of the Asian Grocery Store-Based Cancer Education Program, 248 Filipino American women completed baseline and follow-up surveys, while an additional 58 took part in focus groups. Results Compliance with annual clinical breast exam guidelines among women 40 to 49 years old was 43%, and annual mammography use among women 50 and over was 56%. The Asian Grocery Store-Based Cancer Education Program and complementary focus group study identified multiple barriers that hindered women from attending education programs, with time as the most frequently reported barrier. Conclusion The Asian Grocery Store-Based Cancer Education Program was reported to be a culturally acceptable and effective way of disseminating breast cancer information and one that addressed the women's most frequently reported barrier, lack of time.

  4. Implementation of a nation-wide automated auditory brainstem response hearing screening programme in neonatal intensive care units

    NARCIS (Netherlands)

    Straaten, H.L.M. van; Hille, E.T.M.; Kok, J.H.; Verkerk, P.H.; Baerts, W.; Bunkers, C.M.; Smink, E.W.A.; Elburg, R.M. van; Kleine, M.J.K. de; Ilsen, A.; Maingay-Visser, A.P.G.F.; Vries, L.S. de; Weisglas-Kuperus, N.

    2003-01-01

    Aim: As part of a future national neonatal hearing screening programme in the Netherlands, automated auditory brainstem response (AABR) hearing screening was implemented in seven neonatal intensive care units (NICUs). The objective was to evaluate key outcomes of this programme: participation rate,

  5. Screening for Breast Cancer : US Preventive Services Task Force Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen J.; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne M.; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Update of the 2002 U. S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population. Methods: The USPSTF examined the evidence on the efficacy of 5 screening modalities in reducing mortality from breast cancer: film mammogra

  6. 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…

  7. 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....

  8. 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

    , the influx of newcomers, and variations in the data. Women who had undergone previous screening were found to have the same incidence of breast cancer as women who were never screened. CONCLUSIONS: The data from the current study do not provide evidence of overdiagnosis of invasive breast cancer in the 2...

  9. Breast cancer screening with mammography as part of our comprehensive medical check-up

    International Nuclear Information System (INIS)

    In the breast cancer screening program adopted by our hospital's Health Care Center as part of a comprehensive medical check-up, mammography (MMG) is performed in addition to a clinical breast examination to provide better screening quality. The clinical breast examination is performed by our surgeons. Two-view MMG is performed for women in their 40's and one-view MMG for the others. If any abnormality is detected in the clinical breast examination, or if MMG reveals abnormalities of category 3 or over, a more thorough diagnostic work-up is recommended. Each year, 1,400 or more women undergo breast cancer screening at the center, with an average recall rate of 12% and an average breast cancer detection rate of 0.14%. The high recall rate indicates the need for improvement of screening accuracy. Although the breast cancer detection rate and positive predictive value are somewhat low, the majority of the detected cases are early-stage breast cancer, thus demonstrating the efficacy of the screening. Herein, we describe the current state of MMG screening in our comprehensive medical check-up, along with a discussion of the screening procedure. However, further efforts are needed to improve screening accuracy. (author)

  10. Systematic review of 3D mammography for breast cancer screening.

    Science.gov (United States)

    Hodgson, Robert; Heywang-Köbrunner, Sylvia H; Harvey, Susan C; Edwards, Mary; Shaikh, Javed; Arber, Mick; Glanville, Julie

    2016-06-01

    This review investigated the relative performance of digital breast tomosynthesis (DBT) (alone or with full field digital mammography (FFDM) or synthetic digital mammography) compared with FFDM alone for detecting breast cancer lesions in asymptomatic women. A systematic review was carried out according to systematic reviewing principles provided in the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. A protocol was developed a priori. The review was registered with PROSPERO (number CRD42014013949). Searches were undertaken in October 2014. Following selection, five studies were eligible. Higher cancer detection rates were observed when comparing DBT + FFDM with FFDM in two European studies: the summary difference per 1000 screens was 2.43 (95% CI: 1.8 to 3.1). Both European studies found lower false positive rates for individual readers. One found a lower recall rate based on conditional recall. The second study was not designed to compare post-arbitration recall rates between FFDM and DBT + FFDM. One European study presented data on interval cancer rates; sensitivity and specificity for DBT + FFDM were both higher compared to FFDM. One large multicentre US study showed a higher cancer detection rate for DBT + FFDM, while two smaller US studies did not find statistically significant differences. Reductions in recall and false positive rates were observed in the US studies in favour of DBT + FFDM. In comparison to FFDM, DBT, as an adjunct to FFDM, has a higher cancer detection rate, increasing the effectiveness of breast cancer screening. Additional benefits of DBT may also include reduced recalls and, consequently, reduced costs and distress caused to women who would have been recalled. PMID:27212700

  11. The many unanswered questions related to the German skin cancer screening programme.

    Science.gov (United States)

    Stang, Andreas; Garbe, Claus; Autier, Philippe; Jöckel, Karl-Heinz

    2016-09-01

    In 2008, the first nationwide skin cancer screening (SCS) programme in the world was established in Germany. The main reason to implement the SCS programme in Germany was the expected reduction of costs of care due to earlier detection of skin cancer. The aim of this commentary is to raise and discuss several unanswered questions related to the German SCS programme. The evidence of a temporary mortality decline of skin melanoma after SCS in Schleswig-Holstein is lower than previously assumed and the temporary decline may have been caused by other factors than screening (e.g. awareness effects, selection bias, data artifact, and random fluctuation). The evaluation of the nationwide effect of SCS on skin cancer mortality is hampered by birth cohort effects and low quality of the routine cause-of-death statistics. The nationwide skin melanoma mortality did not decrease from 2007 through 2014. The time interval between screenings after a screening without pathological findings is unclear. Appropriate research designs are needed that monitor and evaluate the effect of SCS not only on skin cancer mortality but also on other factors that may help to judge the potential benefits and harms of SCS including aggressiveness of therapy, costs of care, quality of life, and stage-specific incidence rates of skin cancer. Furthermore, SCS may profit from a high-risk strategy instead of population-wide screening and from newer technologies for early detection of skin cancer (e.g. dermoscopy). PMID:27371911

  12. A comparative study of breast cancer mass screening using ultrasonography and mammography at a single institution

    International Nuclear Information System (INIS)

    In order to evaluate the effectiveness of ultrasonic screening for breast cancer (US group) in comparison with mammographic screening (MMG group), we analyzed 78,214 breast screening examinees presenting between 2007 and 2008 at our institution. The cancer detection rate in the US group was lower than that in the MMG group. However, the average age in the US group was significantly younger than that in the MMG group, and the rate of annual screening was significantly higher in the former than in the latter. In the US subgroup who underwent annual screening, the recall rate and the cancer detection rate were significantly lower, and the rate of detection of early breast cancers was significantly higher than that in the subgroup who underwent screening biennially or at longer intervals, and there was no significant inter-group difference in the cancer detection rate between women in their 40s and those aged 50 or above who underwent annual screening. The proportion of early breast cancers detected was almost the same in the both groups. In summary, US screening as well as MMG screening seems to be useful for detection of early breast cancer. Although a high recall rate for US screening has been reported previously, annual screening and sufficient quality control based on the guidelines proposed by the Japan Association of Breast and Thyroid Sonology (JABTS) are considered to reduce the recall rate. (author)

  13. 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.

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

    OpenAIRE

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

    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...

  15. Comparison of standard mammography with digital mammography and digital infrared thermal imaging for breast cancer screening

    OpenAIRE

    2010-01-01

    Breast cancer is the most common malignancy in women. Screen-film mammography (SFM) has been considered the gold standard for breast cancer screening and detection. Despite its recognized value in detecting and characterizing breast disease, mammography has important limitations and its false-negative rate ranges from 4% to 34%. Given these limitations, development of imaging modalities that would enhance, complement, or replace mammography has been a priority. Digital mammography (FFDM) and ...

  16. 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

  17. An evaluation of two guidance programmes to promote breast-feeding

    Directory of Open Access Journals (Sweden)

    M. Steyn

    1989-09-01

    Full Text Available During the past ten years a comprehensive research project has been undertaken to develop a guidance programme in three adjacent communities in the South- Western Cape with the aim o f lowering the high incidence o f coronary heart disease. The purpose o f this substudy was to determine whether the guidance provided in the different communities had any influence on the knowledge o f and attitudes towards the nutrition o f pregnant women, babies and infants as well as breast-feeding practices o f the women who gave birth during the period 1980 to 1986. In the first community guidance was provided by means o f small mass media and interpersonal communication whereas only the small mass media were employed in the second. The third served as the control community. The findings suggest that the combined interpersonal and mass media programme was more successful than the mass media programme alone.

  18. Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

    International Nuclear Information System (INIS)

    To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p 14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

  19. A history of breast cancer screening and future problems in Japan

    International Nuclear Information System (INIS)

    In Europe and the United States, mortality due to breast cancer is decreasing. There are various reasons for this trend, including an increase in the detection of early-stage breast cancers due to the increased use of mammographic screening, and the establishment of standardized systemic treatments derived from evidence-based medicine (EBM). On the other hand, in Japanese women, both morbidity and mortality due to breast cancer are increasing. This paper describes the process of breast cancer screening in the past, its current status, and the quality control system for mammographic screening in Japan, as well as the status of breast cancer screening in Europe and the United States. Furthermore, problems of breast cancer screening in Japan discussed, together with the need for practical measures such as implementation of quality control systems aimed at improving the cancer screening rate (with a target of 50%), financial support, and population-based screening (organized screening), based on the Cancer Control Act. Current measures for screening of dense breast tissue in women in their 40s in Japan are also described. (author)

  20. 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.

  1. Risk factors for breast cancer with applications to selection for the prevalence screen.

    OpenAIRE

    Alexander, F. E.; Roberts, M. M.; Huggins, A

    1987-01-01

    There have been many studies of individual risk factors for breast cancer; most of the factors concerned may be broadly grouped into demographic and dietary, reproductive history, endocrine related, family history of breast cancer, and previous history of breast disease. Some of these studies have examined the combined effect of these factors. The present case-control study does this in the context of a randomised controlled trial of breast cancer screening. The relative risks that we have ob...

  2. Fertility drug use and mammographic breast density in a mammography screening cohort of premenopausal women

    OpenAIRE

    Sprague, Brian L.; Trentham-Dietz, Amy; Terry, Mary Beth; Nichols, Hazel B.; Bersch, Andy J.; Buist, Diana S. M.

    2008-01-01

    The widespread use of ovulation-inducing drugs to enhance fertility has raised concerns regarding potential effects on breast cancer risk, as ovarian stimulation is associated with increases in estrogen and progesterone levels. We investigated the short-term relation between fertility drug use and mammographic breast density, a strong marker of breast cancer risk, among participants in the Group Health Breast Cancer Screening Program. Data linkage with Group Health’s automated pharmacy record...

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

    OpenAIRE

    Li Rita Zhang; Chiarelli, Anna M; Gord Glendon; Lucia Mirea; Knight, Julia A.; Andrulis, Irene L.; Paul Ritvo

    2012-01-01

    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 canc...

  4. Questionnaire survey of current status and reserve for breast cancer screening in Mie prefecture. Achievement of a 50% participation rate

    International Nuclear Information System (INIS)

    Mie Medical Network of Breast Cancer Screening, a NPO, was assigned the task of breast cancer screening in Mie prefecture in April, 2010. For breast cancer screening in Mie prefecture in 2009, a questionnaire survey was performed toward both consigner and consignee. Consigners were local public offices managing breast cancer screening for local inhabitants, and consignees were facilities offering breast cancer screening. The number of breast cancer screening was investigated toward all 29 of consigners in Mie prefecture. The questionnaire survey was conducted toward all 52 of the facilities possessing mammography systems (breast cancer screening being performed at 48 of them) in Mie prefecture in 2009. We investigated the predictive additional number of breast cancer screening and also investigated the requisite number of staff to achieve the predictive maximum number of breast cancer screening. As a result, the total number of breast cancer screenings was 93,525, and the participation rate was 27.5% which was calculated by reduction of continuator in Mie prefecture in 2009. The continuator accounted for over 30% of all breast cancer screenings. The predictive additional number was 126,950, this indicates that a possible participation rate of 75.2% after 2011. To achieve this high participation rate, active support is essential for short-handed facilities, and about 20% increase of medical staff is necessary. To achieve a participation rate of over 50% as a goal, new screenees should be recruited and breast cancer screening of every other year should be enlightened. (author)

  5. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    International Nuclear Information System (INIS)

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening

  6. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    Science.gov (United States)

    Schenberg, Tess; Mitchell, Gillian; Taylor, Donna; Saunders, Christobel

    2015-09-01

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening. PMID:26451244

  7. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Schenberg, Tess [Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mitchell, Gillian [Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria (Australia); Taylor, Donna [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of Radiology, Royal Perth Hospital, Perth, Western Australia (Australia); BreastScreen Western Australia, Adelaide Terrace, Perth, Western Australia (Australia); Saunders, Christobel [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of General Surgery, St John of God Hospital, Perth, Western Australia (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)

    2015-09-15

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening.

  8. Screen-detected vs symptomatic breast cancer: is improved survival due to stage migration alone?

    OpenAIRE

    Wishart, G. C.; Greenberg, D. C.; Britton, P D; Chou, P; Brown, C.H.; Purushotham, A. D.; Duffy, S W

    2008-01-01

    This paper examines whether screen-detected breast cancer confers additional prognostic benefit to the patient, over and above that expected by any shift in stage at presentation. In all, 5604 women (aged 50–70 years) diagnosed with invasive breast cancer between 1998 and 2003 were identified by the Eastern Cancer Registration and Information Centre (ECRIC) and mammographic screening status was determined. Using proportional hazards regression, we estimated the effect of screen detection comp...

  9. 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.

  10. Breast cancer screening among females in Iran and recommendations for improved practice: a review.

    Science.gov (United States)

    Babu, Giridhara R; Samari, Goleen; Cohen, Sharon Phoebe; Mahapatra, Tanmay; Wahbe, Randa May; Mermash, Sherin; Galal, Osman M

    2011-01-01

    Breast cancer is the second most common cancer amongst women, in Iran comprising 21.4% of female cancers. There are several screening modalities for breast cancer including breast self-examination, clinical breast examination and mammography. This research reviews the literature surrounding the implementation of these screening approaches in the Islamic Republic of Iran. After initial results produced approximately 208 articles, a total of 96 articles were included because they specifically addressed epidemiological characteristics of breast cancer, culture, religion, health seeking behavior, screening programs and the health system in Iran. Literature showed that breast self-examination and clinical breast examination were most common as there is no population-based mammography screening program in Iran. Additionally, most women appear to obtain information through the mass media. Results also indicate that Islamic beliefs and preventative medicine are very much aligned and can be used to promote breast cancer screening in Iran. These results highlight that there is a need for aggressive preventative measures focusing on breast self examination and gradually moving towards national mammography programs in Iran ideally disseminated through the media with government support.

  11. Breast cancer screening in the working population. Current status and future issues in Tokyo

    International Nuclear Information System (INIS)

    We conducted a comparative study of breast cancer mass screening by the Tokyo Health Service Association for the regional and working population. The mammographic screening rate has been over 90% for all examinees since 2004, and the rate of inspection and palpation has been almost 0% in the regional population, although the rate was still 24% of all screenings among the working population even in 2006. In the working population the average age at which breast cancer screening was done was younger than in the regional population. The proportion of the population under 40 was 38.4% in 2003 and 35.7% in 2006, and in this population the rates of mammography, ultrasonography, and inspection and palpation were almost the same. This suggests a degree of confusion about breast cancer screening among younger women. The breast cancer detection rate was significantly better in the regional than in the working population. However, there was no significant difference in the rate between the two populations in the 40- to 59- year age range. In conclusion, the breast cancer screening system for the regional population has been improved as a result of the official notices of the Ministry of Health, Labour and Welfare. On the other hand, the data for the working population have not been favorable because of age-related factors and the methods used for screening. It will be necessary to refine the screening system for the working population to improve not only screening efficacy but also the breast cancer mortality rate. (author)

  12. Breast cancer screening: cultural beliefs and diverse populations.

    Science.gov (United States)

    Simon, Cassandra E

    2006-02-01

    This article addresses the role of culture in breast cancer screening behavior among African American, American Indian/Alaskan Native, Asian American/Pacific Islander, and Hispanic/ Latina women. It reviews cultural beliefs, attitudes, and knowledge and their relative influence on women's decisions regarding health tests. The article explores how to build on these cultural values, simultaneously mediating their barrier effects. Building on cultural explanatory models of health behavior, suggestions for incorporating culture into early detection strategies for ethnically and racially diverse, underserved women are provided. In addition, the article offers four practice principles that can be used with all of the groups: inclusion and use of indigenous support; cross-application of approaches for diverse populations; honor and incorporation of culture; and attention to language, literacy, and cultural information.

  13. Interventions to Enhance Breast Cancer Screening, Diagnosis, and Treatment among Racial and Ethnic Minority Women

    Science.gov (United States)

    Masi, Christopher M.; Blackman, Dionne J.; Peek, Monica E.

    2009-01-01

    The authors conduct a systematic review of the literature to identify interventions designed to enhance breast cancer screening, diagnosis, and treatment among minority women. Most trials in this area have focused on breast cancer screening, while relatively few have addressed diagnostic testing or breast cancer treatment. Among patient-targeted screening interventions, those that are culturally tailored or addressed financial or logistical barriers are generally more effective than reminder-based interventions, especially among women with fewer financial resources and those without previous mammography. Chart-based reminders increase physician adherence to mammography guidelines but are less effective at increasing clinical breast examination. Several trials demonstrate that case management is an effective strategy for expediting diagnostic testing after screening abnormalities have been found. Additional support for these and other proven health care organization-based interventions appears justified and may be necessary to eliminate racial and ethnic breast cancer disparities. PMID:17881627

  14. Breast dose variability in a bi-racial population undergoing screening mammography

    International Nuclear Information System (INIS)

    This study evaluated individual and population dose variability during screening mammography among 570 white and black women in South Carolina, USA. Aspects of dosimetry that were considered include compressed breast thickness (CBT), number of films per screening session, and dose in previous or subsequent sessions. Breast dose was log-normally distributed in the population, with a geometric mean of 6.6 mGy per session. Doses were significantly higher for black women, for women with high CBT or who receive more than two views per breast, and for the mediolateral oblique, compared to the craniocaudal view. No relationship was observed between age and dose. Total dose per breast varied by a factor of 20 across the study population, but the individual's dose varied little among repeat screening sessions, especially after adjusting for the number of films received per session. These results may inform assessments of the projected risks of inducing breast cancer from screening mammography. (author)

  15. Eleven cases of breast scirrhous carcinoma with a diameter of one centimeter or less detected by breast cancer screening

    International Nuclear Information System (INIS)

    Clinical, imaging, and histopathological characteristics were examined for breast scirrhous carcinoma with diameters of 1 cm or less detected by breast cancer screening. At our institution, screening includes palpation and mammography as well as ultrasound examinations of all patients. Single lesions were discovered by mammography in 3 patients and by ultrasound in 8 patients. None of the lesions were palpable. Lesions were detected by mammography in 3 patients. However, lesions were detected by ultrasound in all patients. On ultrasound, 82% of findings showed a mass. MRI was performed for 7 patients and demonstructed all of the lesions. In these patient so diagnoses by fine needle aspiration cytology were malignant lesions or lesions suspicious of malignancy in 55% of the patients. Histopathologically, 91% were nuclear grade 1, positive for hormone receptors, and negative for HER2. Breast scirrhous carcinoma with diameters of 1 cm or less detected by breast cancer screening were mostly detected by ultrasound and showed good prognosis. (author)

  16. Integrated screening concept in women with genetic predisposition for breast cancer

    International Nuclear Information System (INIS)

    Breast cancer is in 5% of cases due to a genetic disposition. BRCA1 and BRCA2 are by far the most common breast cancer susceptibility genes. For a woman with a genetic predisposition, the individual risk of developing breast cancer sometime in her life is between 70 and 90%. Compared to the spontaneous forms of breast cancer, woman with a genetic predisposition often develop breast cancer at a much younger age. This is why conventional screening programs on the basis of mammography alone cannot be applied without modification to this high-risk group. In this article, an integrated screening concept for women with genetic prodisposition for breast cancer using breast self-examination, clinical examination, ultrasound, mammography and magnetic resonance imaging is introduced. (orig.)

  17. Die Effektivität des Telepathologie-Konsultationsservice im Rahmen des Mamma-Screening-Programms

    OpenAIRE

    Rubach, Katharina

    2012-01-01

    Aims: With the decision of the Lower House of the German Parliament on July 28th in 2002 a German screening program was started for identifying breast cancer in the population of women fifty and above. The order was issued to the federal medical insurance alliance and the high associations of the health insurance company. For the first time German and European guidelines were established in this program to guarantee the high quality and the special standards: All given statements of the radio...

  18. Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.

    Science.gov (United States)

    Houssami, Nehmat; Lång, Kristina; Bernardi, Daniela; Tagliafico, Alberto; Zackrisson, Sophia; Skaane, Per

    2016-04-01

    This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening. PMID:27017251

  19. Breast cancer screening for severely disabled patients. Present status and future problems

    International Nuclear Information System (INIS)

    Recently, the attendance rate for breast screening has been increasing in Japan. However, little is known about how to conduct effective breast cancer screening, especially for patients with mental disability. The purpose of this study was to clarify the present status of breast cancer screening for severely disabled patients. Breast screening was performed for 160 disabled patients by physical examination and ultrasound from 2002 to 2005. The patients included 158 women and two men, with an average age of 59 years old. Ten disabled patients (10/160; 6.3%) showed abnormal findings on physical examination and four (4/160; 2.5%) showed probably benign findings by ultrasound examination. Mammography (MMG) screening was performed for only 33 patients (33/160; 21%), one of whom needed further examination. One lesion was diagnosed as breast cancer (1/160; 0.63%). Breast ultrasound is useful for severely disabled patients because it is painless, easy and rapid to perform. On the other hand, it is sometimes difficult for such patients to participate in MMG screening because of their inability to adapt to the examination. Therefore, some psychological method, for example operant conditioning, will be necessary for breast screening of patients with severe mental disability. (author)

  20. Breast cancer screening: emerging role of new imaging techniques as adjuncts to mammography.

    Science.gov (United States)

    Houssami, Nehmat; Lord, Sarah J; Ciatto, Stefano

    2009-05-01

    Early detection of breast cancer has been shown to reduce breast cancer deaths in randomised controlled trials (RCTs) of mammography in women aged 50-69 years, with weaker evidence of benefit in those aged 40-49 or 70 years and older. Magnetic resonance imaging (MRI) and ultrasonography have been evaluated in breast cancer screening, relative to, or in addition to, mammography, in selected populations; neither test has been examined in an RCT, and thus evidence of associated screening benefit is uncertain. MRI is more sensitive than mammography in screening women with suspected or proven inherited mutations of the breast cancer genes. The addition of MRI in screening this population detects 8-24 additional cancers per 1000 screens, but also significantly increases a woman's risk of being recalled for investigation or surgical biopsy for false-positive findings. In Australia, Medicare funding for MRI screening of women in specific risk groups was announced in February 2009. Ultrasonography can detect cancers not identified on mammography in asymptomatic women with dense breast tissue. Incremental ultrasound cancer detection is reported in 0.27%-0.46% of women with mammography-negative dense breasts; evidence varies on its association with false-positive findings. Computer-aided detection (CAD) is a complementary tool to mammography, prompting the reader to consider lesions on the mammogram that may represent cancer. Emerging evidence and improved CAD technology are likely to help define its role in breast screening. PMID:19413520

  1. Supplementary methods in breast cancer screening: ultrasonography and magnetic resonance tomography of the breast

    International Nuclear Information System (INIS)

    Ultrasonography and magnetic resonance (MR) tomography are helpful tools to evaluate unclear lesions found at screening mammography. Ultrasound is particularly useful to prove the presence of a cyst or to further examine unclear, asymmetrical densities. With MR mammography, carcinomas can be found even when X-ray mammography or ultrasonography are limited due to diffuse, benign, proliferative changes. Ultrasound guidance has greatly facilitated core needle biopsy for suspicious lesions. Additionally, approved devices for MR-guided biopsy are commercially available. As a primary screening tool, ultrasound or MR mammography may be used only in women who are positive for BRCA-1 or BRCA-2 mutations or who are otherwise at high risk for breast cancer. (orig.)

  2. Socio-economic inequalities in breast and cervical cancer screening practices in Europe: influence of the type of screening program

    NARCIS (Netherlands)

    L. Palència; A. Espelt; M. Rodríguez-Sanz; R. Puigpinós; M. Pons-Vigués; M.I. Pasarín; T. Spadea; A.E. Kunst; C. Borrell

    2010-01-01

    Methods A cross-sectional study was performed using individual-level data from the WHO World Health Survey (2002) and data regarding the implementation of cancer screening programmes. The study population consisted of women from 22 European countries, aged 25-69 years for cervical cancer screening (

  3. Mammographic breast cancer screening for women previously treated with high breast doses for diseases such as Hodgkin's

    International Nuclear Information System (INIS)

    In screening of a general population for breast cancer, benefit/risk ratios are of the order of 100/1. For the very small subgroup of women treated by radiotherapy for Hodgkin's disease below age 35, calculations of this type require different considerations, an overview of which is given in this text. It is concluded that although such previous exposures will increase their radiation risk, their increased risk of carrying an undetected breast cancer means that the potential benefit for them of screening is increased even more. In the United Kingdom, the Dept. of Health has recommended annual screening for these women. (authors)

  4. Take your blood pressure to heart! Screening programme 24-27 March

    CERN Multimedia

    2015-01-01

    In Switzerland, one person in four suffers from high blood pressure without knowing it. This silent killer can only be detected by carrying out regular blood pressure tests.     Following our last campaign in October 2014, 30% of participants were found to have previously undetected hypertension. This year, the nurses of the Medical Service are once again organising a blood pressure screening programme. See the flyer for more information. CERN Medical Service

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

    International Nuclear Information System (INIS)

    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.)

  6. 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 is un...

  7. Surface impedance based microwave imaging method for breast cancer screening: contrast-enhanced scenario

    Science.gov (United States)

    Güren, Onan; Çayören, Mehmet; Tükenmez Ergene, Lale; Akduman, Ibrahim

    2014-10-01

    A new microwave imaging method that uses microwave contrast agents is presented for the detection and localization of breast tumours. The method is based on the reconstruction of breast surface impedance through a measured scattered field. The surface impedance modelling allows for representing the electrical properties of the breasts in terms of impedance boundary conditions, which enable us to map the inner structure of the breasts into surface impedance functions. Later a simple quantitative method is proposed to screen breasts against malignant tumours where the detection procedure is based on weighted cross correlations among impedance functions. Numerical results demonstrate that the method is capable of detecting small malignancies and provides reasonable localization.

  8. Surface impedance based microwave imaging method for breast cancer screening: contrast-enhanced scenario.

    Science.gov (United States)

    Güren, Onan; Çayören, Mehmet; Ergene, Lale Tükenmez; Akduman, Ibrahim

    2014-10-01

    A new microwave imaging method that uses microwave contrast agents is presented for the detection and localization of breast tumours. The method is based on the reconstruction of breast surface impedance through a measured scattered field. The surface impedance modelling allows for representing the electrical properties of the breasts in terms of impedance boundary conditions, which enable us to map the inner structure of the breasts into surface impedance functions. Later a simple quantitative method is proposed to screen breasts against malignant tumours where the detection procedure is based on weighted cross correlations among impedance functions. Numerical results demonstrate that the method is capable of detecting small malignancies and provides reasonable localization.

  9. International variation in management of screen-detected ductal carcinoma in situ of the breast

    NARCIS (Netherlands)

    A. Ponti (Antonio); E. Lynge (Elsebeth); T. James (Ted); O. Májek (Ondřej); M. Von Euler-Chelpin (My); A. Anttila (Ahti); P. Fitzpatrick (Patricia); M.P. Mano (Maria Piera); M. Kawai (Masaaki); A. Scharpantgen (A.); J. Fracheboud (Jacques); S. Hofvind (Solveig); C. Vidal (Carmen); N. Ascunce (Nieves); D. Salas (Dolores); J.L. Bulliard; N. Segnan (N.); K. Kerlikowske (Karla); S. Taplin (Stephen)

    2014-01-01

    textabstractResults Twelve countries contributed data from a total of 15 screening programmes, all from Europe except the United States of America and Japan. Among women aged 50-69 years, 7,176,050 screening tests and 5324 screen-detected DCIS were reported. From 21% to 93% of DCIS had a pre-operati

  10. Ultrasonographic screening for breast cancer using the recall criteria established by the Japan Association of Breast and Thyroid Sonology (JABTS)

    International Nuclear Information System (INIS)

    As is the case in many other countries, mammography is currently used in Japan for breast cancer screening. However, as it cannot detect lesions in dense breasts such as those of young women, ultrasound (US) imaging is used for this purpose. Although there have been numerous reports of US screening, the results obtained using the recall criteria stipulated by the Japan Association of Breast and Thyroid Sonology (JABTS) has not yet been reported. We have performed US screening based on the JABTS guidelines for three years. Technologists perform the examinations, and physicians select recall cases on the basis of these criteria. So far there have been 17,089 attendees, of whom 90% were less than 50 years old. The recall rate was 3.6% (616/17,089). The results of further examinations were confirmed in 452 of these 616 recalled women, and breast cancer was detected in 48 (0.28%) of them. Cancer was detected early in 37 (80.5%) of these 48 cases. Mammography was unable to detect cancer in 16 (43%) of the cases. Although the high recall rate of US screening has been mentioned previously, we wish to emphasize that US breast cancer screening is effective, particularly in younger women. Furthermore, the reasonable recall rate ensures that a high quality of detection is maintained. (author)

  11. 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

  12. 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%....

  13. 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...

  14. 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

    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...... 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...... counties without screening. No difference in extent of disease or survival was observed between screening areas regardless of country. However, there were significant differences in stage distribution and survival between screening populations and Danish non-screening populations, to the benefit of...

  15. Changes in equipment and image quality. Impact of one year Austrian breast cancer early detection programme; Aenderungen in der Geraetelandschaft und Bildqualitaet. Auswirkungen nach einem Jahr Oesterreichischem Brustkrebsfrueherkennungsprogramm

    Energy Technology Data Exchange (ETDEWEB)

    Menhart, S.; Osanna-Elliott, A.; Semturs, F.; Schloegl, C.; Wildner, S.; Zwettler, G. [AGES, Wien (Austria). Referenzzentrum fuer technische Qualitaetssicherung im Brustkrebsfrueherkennungsprogramm

    2015-07-01

    The nationwide Austrian Breast Cancer Early Detection Programme (''BKFP'') started in January 2014. The Austrian Agency for Health and Food Safety Ltd. was entrusted with running the reference center for technical quality control (''RefZQS'') on April 1, 2014. The quality of the radiologists' equipment is evaluated against the standards described in the EUREF-Oeprotocol, which is based on the European guidelines for quality assurance in breast cancer screening and diagnosis (EPQC V4, 2006) and has been optimized for Austrian requirements. In its first year of operation the RefZQS has controlled the entire equipment (mammography, periphery and ultrasound system) of all participating radiologists. A significant number of systems had to be adjusted to meet the EUREF-Oecriteria. Some of the systems could not be adjusted accordingly, and had to be replaced. In the wake of the start of the screening programme, several sites switched from CR to more modern DR systems, yielding a significant benefit by reduction of radiation burden. The most important data after one year of RefZQS, especially according to adjustments and replacements, are presented.

  16. The Effects of New Screening Tests in the Dutch Cervical Cancer Screening Programme

    NARCIS (Netherlands)

    K. Rozemeijer (Kirsten)

    2016-01-01

    markdownabstractCervical cancer is the fourth most common cancer in women all over the world, mainly affecting young women. As cervical cancer is easy to prevent by early detection and treatment of the disease, screening was introduced in the Netherlands in the 1970s. The number of cervical cancer c

  17. Maximising the efficiency of clinical screening programmes: balancing predictive genetic testing with a right not to know.

    Science.gov (United States)

    Schuurman, Agnes G; van der Kolk, Dorina M; Verkerk, Marian A; Birnie, Erwin; Ranchor, Adelita V; Plantinga, Mirjam; van Langen, Irene M

    2015-09-01

    We explored the dilemma between patients' right not to know their genetic status and the efficient use of health-care resources in the form of clinical cancer screening programmes. Currently, in the Netherlands, 50% risk carriers of heritable cancer syndromes who choose not to know their genetic status have access to the same screening programmes as proven mutation carriers. This implies an inefficient use of health-care resources, because half of this group will not carry the familial mutation. At the moment, only a small number of patients are involved; however, the expanding possibilities for genetic risk profiling means this issue must be addressed because of potentially adverse societal and financial impact. The trade-off between patients' right not to know their genetic status and efficient use of health-care resources was discussed in six focus groups with health-care professionals and patients from three Dutch university hospitals. Professionals prefer patients to undergo a predictive DNA test as a prerequisite for entering cancer screening programmes. Professionals prioritise treating sick patients or proven mutation carriers over screening untested individuals. Participation in cancer screening programmes without prior DNA testing is, however, supported by most professionals, as testing is usually delayed and relatively few patients are involved at present. Reducing the number of 50% risk carriers undergoing screening is expected to be achieved by: offering more psychosocial support, explaining the iatrogenic risks of cancer screening, increasing out-of-pocket costs, and offering a less stringent screening programme for 50% risk carriers. PMID:25564039

  18. Maximising the efficiency of clinical screening programmes: balancing predictive genetic testing with a right not to know

    Science.gov (United States)

    Schuurman, Agnes G; van der Kolk, Dorina M; Verkerk, Marian A; Birnie, Erwin; Ranchor, Adelita V; Plantinga, Mirjam; van Langen, Irene M

    2015-01-01

    We explored the dilemma between patients' right not to know their genetic status and the efficient use of health-care resources in the form of clinical cancer screening programmes. Currently, in the Netherlands, 50% risk carriers of heritable cancer syndromes who choose not to know their genetic status have access to the same screening programmes as proven mutation carriers. This implies an inefficient use of health-care resources, because half of this group will not carry the familial mutation. At the moment, only a small number of patients are involved; however, the expanding possibilities for genetic risk profiling means this issue must be addressed because of potentially adverse societal and financial impact. The trade-off between patients' right not to know their genetic status and efficient use of health-care resources was discussed in six focus groups with health-care professionals and patients from three Dutch university hospitals. Professionals prefer patients to undergo a predictive DNA test as a prerequisite for entering cancer screening programmes. Professionals prioritise treating sick patients or proven mutation carriers over screening untested individuals. Participation in cancer screening programmes without prior DNA testing is, however, supported by most professionals, as testing is usually delayed and relatively few patients are involved at present. Reducing the number of 50% risk carriers undergoing screening is expected to be achieved by: offering more psychosocial support, explaining the iatrogenic risks of cancer screening, increasing out-of-pocket costs, and offering a less stringent screening programme for 50% risk carriers. PMID:25564039

  19. The relative effect of mammographic screening on breast cancer mortality by socioeconomic status

    Science.gov (United States)

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

    2016-01-01

    Abstract Breast cancer incidence and mortality are higher in women with a high socioeconomic status (SES). The potential to prevent death from breast cancer is therefore greater in the high SES group. This does, however, require that the effectiveness of screening in the high SES group is equal to or greater than the effectiveness in the low SES group. The aim of this study is to assess the relative effectiveness of mammographic screening on breast cancer mortality by SES. In Nijmegen, the Netherlands, women are invited to participate in biennial mammographic screening since 1975. Postal code is collected at each round and is used to calculate the SES of each woman based on the SES indicator of the Netherlands Institute for Social Research. The Dutch average was used to classify the SES score of each woman as either high or low. We designed a case-control study to investigate the effect of mammographic screening in women aged 50 to 75, 40 to 75, and 50 to 69 years, and calculated the odds ratios (ORs) and 95% confidence intervals (CIs). Among the women invited to the mammographic screening program in Nijmegen, 10% had a high SES. In women aged 50 to 75 years, the breast cancer death rate was 38% lower in screened women than in unscreened women. The ORs for women with high SES (OR 0.82, 95% CI 0.31–2.19) and low SES did not differ significantly (OR 0.61, 95% CI 0.47–0.78). Mammographic screening reduces breast cancer mortality, but we did not observe a significant difference in the relative effectiveness of screening by SES. If the effectiveness of mammographic screening is indeed not dependent on SES status, the absolute number of breast cancer deaths prevented by mammographic screening will be greater in the high SES than low SES group, because women with a high SES have a greater risk of breast cancer death. PMID:27495038

  20. Approaches to improving breast screening uptake: evidence and experience from Tower Hamlets.

    Science.gov (United States)

    Eilbert, K W; Carroll, K; Peach, J; Khatoon, S; Basnett, I; McCulloch, N

    2009-12-01

    This paper reports on an innovative whole-systems approach to improving uptake of breast screening in Tower Hamlets, a deprived borough in the East End of London with a large minority ethnic population. The approach, developed by the public health team at NHS Tower Hamlets, draws on analysis of needs and existing literature about effective interventions to promote breast screening. Social marketing research led to a campaign targeted at Bangladeshi women, together with a range of initiatives to promote breast screening through primary care services and community outreach through local well-known organisations. The breast screening service itself was upgraded and a new service specification is being introduced from April 2009. PMID:19956166

  1. Breast Cancer Screening in Saudi Arabia: Free but Almost No Takers

    OpenAIRE

    Charbel El Bcheraoui; Mohammed Basulaiman; Shelley Wilson; Farah Daoud; Marwa Tuffaha; AlMazroa, Mohammad A.; Memish, Ziad A.; Mohammed Al Saeedi; Mokdad, Ali H

    2015-01-01

    Introduction 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. Materials and Methods The Saudi Health Interview Survey is a national multistage survey of individuals aged 15 years or older. The survey included questions on socio-demographic ch...

  2. An effective programme to systematic diabetic retinopathy screening in order to reduce diabetic retinopathy blindness.

    Science.gov (United States)

    Papavasileiou, Evangelia; Dereklis, Dimitrios; Oikonomidis, Panayiotis; Grixti, Andre; Vineeth Kumar, Balakrishna; Prasad, Som

    2014-01-01

    The number of people identified with diabetes in England increased by nearly 5% during 2011-2012 to well over 2.5 million. During 2011-2012 the NHS Diabetic Eye Screening Programme screened more than 1.9 million people. In general, the UK is doing very well with its DR screening targets. It is a world leader in diabetic retinopathy screening, having offered 85.7% of eligible diabetic patients the screening programme. However, the target is 100% and efforts are still being made to improve screening locally. Our aim is to evaluate the prevalence of sight-threatening diabetic retinopathy (STDR) (proliferative retinopathy or maculopathy), the number of patients needing laser treatment or vitrectomy and registered blind in the last 12 months in a defined population. We did a twelve-month retrospective database review at the Systematic Diabetic Retinopathy Screening Service at Wirral University Hospital Trust, United Kingdom. The effectiveness of different screening modalities has been widely investigated. UK studies show sensitivity levels for the detection of sight-threatening diabetic retinopathy of 41%-67% for general practitioners, 48%-82% for optometrists, 65% for ophthalmologists, and 27%-67% for diabetologists and hospital physicians using direct ophthalmoscopy. Sensitivity for the detection of referable retinopathy by optometrists have been found to be 77%-100%, with specificity of 94%-100%. Photographic methods currently use digital images with subsequent grading by trained individuals. Sensitivity for the detection of sight-threatening diabetic retinopathy have been found 87%-100% for a variety of trained personnel reading mydriatic 45° retinal photographs, with specificities of 83%-96%. The British Diabetic Association (Diabetes UK) has established standard values for any diabetic retinopathy screening programme of at least 80% sensitivity and 95% specificity. We used descriptive analyses to characterise the study population and patterns of diabetic

  3. 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 differen

  4. Value analysis of digital breast tomosynthesis for breast cancer screening in a commercially-insured US population

    OpenAIRE

    Bonafede MM; Kalra VB; Miller JD; Fajardo LL

    2015-01-01

    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...

  5. Prospective study of predictors of attendance for breast screening in inner London.

    OpenAIRE

    Sutton, S; Bickler, G.; Sancho-Aldridge, J; Saidi, G

    1994-01-01

    OBJECTIVE--To investigate the predictors of first-round attendance for breast screening in an inner city area. DESIGN--Prospective design in which women were interviewed or completed a postal questionnaire before being sent their invitation for breast screening. Sociodemographic factors, health behaviours, and attitudes, beliefs, and intentions were used as predictors of subsequent attendance. A randomised control group was included to assess the effect of being interviewed on attendance. SET...

  6. 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

  7. Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment

    Science.gov (United States)

    2016-01-01

    Background Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Ultrasound has been suggested as a safe adjunct screening tool that can detect breast cancers missed on mammography. We investigated the benefits, harms, cost-effectiveness, and cost burden of ultrasound as an adjunct to mammography compared with mammography alone for screening women at average risk and at high risk for breast cancer. Methods We searched Ovid MEDLINE, Ovid Embase, EBM Reviews, and the NHS Economic Evaluation Database, from January 1998 to June 2015, for evidence of effectiveness, harms, diagnostic accuracy, and cost-effectiveness. Only studies evaluating the use of ultrasound as an adjunct to mammography in the specified populations were included. We also conducted a cost analysis to estimate the costs in Ontario over the next 5 years to fund ultrasound as an adjunct to mammography in breast cancer screening for high-risk women who are contraindicated for MRI, the current standard of care to supplement mammography. Results No studies in average-risk women met the inclusion criteria of the clinical review. We included 5 prospective, paired cohort studies in high-risk women, 4 of which were relevant to the Ontario context. Adjunct ultrasound identified between 2.3 and 5.9 additional breast cancers per 1,000 screens. The average pooled sensitivity of mammography and ultrasound was 53%, a statistically significant increase relative to mammography alone (absolute increase 13%; P mammography screening alone. The GRADE for this body of evidence was low. Additional annual costs of using breast ultrasound as an adjunct to mammography for high-risk women in Ontario contraindicated for MRI would range from $15,500 to $30,250 in the next 5 years. Conclusions We found no evidence that evaluated the comparative effectiveness or diagnostic accuracy of screening breast ultrasound as an

  8. 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 th

  9. Rationale, design, and results of the first screening round of a comprehensive, register-based, Chlamydia screening implementation programme in the Netherlands

    Directory of Open Access Journals (Sweden)

    Koekenbier Rik H

    2010-10-01

    Full Text Available Abstract Background Implementing Chlamydia trachomatis screening in the Netherlands has been a point of debate for several years. The National Health Council advised against implementing nationwide screening until additional data collected from a pilot project in 2003 suggested that screening by risk profiles could be effective. A continuous increase in infections recorded in the national surveillance database affirmed the need for a more active approach. Here, we describe the rationale, design, and implementation of a Chlamydia screening demonstration programme. Methods A systematic, selective, internet-based Chlamydia screening programme started in April 2008. Letters are sent annually to all 16 to 29-year-old residents of Amsterdam, Rotterdam, and selected municipalities of South Limburg. The letters invite sexually active persons to login to http://www.chlamydiatest.nl with a personal code and to request a test kit. In the lower prevalence area of South Limburg, test kits can only be requested if the internet-based risk assessment exceeds a predefined value. Results We sent invitations to 261,025 people in the first round. One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing. The overall positivity rate was 4.2%. Conclusions This programme advances Chlamydia control activities in the Netherlands. Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.

  10. [Screening for breast cancer on basis of individual risk assessment for women ineligible for the national population screening program].

    Science.gov (United States)

    van Asperen, C J; de Bock, G H; van der Horst, F; de Koning, H J; Rutgers, E J

    2001-01-20

    For healthy women, without malignancies in their personal histories, a positive family history for breast cancer is the single indication for individual breast surveillance outside the population screening. Management of women is based on individual risk assessment. A cumulative risk of 20% and more, as a result of a positive family history, will in practice be an indication for breast surveillance. This threshold is not evidence-based yet, nor are data available on the benefits of this surveillance efficacy. When a personal cumulative risk of more than 30% exists to develop breast cancer, a consultation with a clinical geneticist involved in a family cancer clinic should be offered. Surveillance of women with a high-risk cumulative risk should preferably be included in a prospective study design. Only in this way will data about compliance and the estimates of different ways of surveillance become available. There is no convincing evidence that population screening for women aged 40-49 years does lead to important mortality reduction in combination with a good balance between pros and cons for the women involved. Women in the age category 50-75 years, with breast cancer in their personal histories, who are not followed anymore, should be informed by their specialist about participating (again) in the population breast screening. There is no evidence of mortality reduction as a result of breast self-examination nor of palpation performed by a physician. However, awareness of the own body can be useful for early recognition of breast abnormalities; it may reduce the delay between the first recognizable symptom and the subsequently initiated therapy.

  11. Overestimation of complication rates in evaluations of Chlamydia trachomatis screening programmes--implications for cost-effectiveness analyses.

    NARCIS (Netherlands)

    Valkengoed, van IG; Morre, S.A.; Brule, van den AJ; Meijer, C.J.L.M.; Bouter, L.M.; Boeke, AJ

    2004-01-01

    BACKGROUND: Cost-effectiveness analyses of screening programmes for asymptomatic Chlamydia trachomatis infection suggest that screening at low prevalences in the population is cost-effective. However, the decision models in these studies are based on assumptions about the risk of complications, whic

  12. Take your blood pressure to heart! Screening programme 13-17 October

    CERN Multimedia

    2014-01-01

    The silent health threat, high blood pressure, can only be detected by regular blood pressure tests. In Switzerland, one in four people suffer from high blood pressure without being aware of it.  A screening programme will take place from 13 to 17 October 2014 at the Medical Service Infirmary, Building 57, from 9 a.m. to 12 p.m. and from 1.30 to 4.30 p.m. Blood pressure tests, advice and general information on high blood pressure will be available to everyone working at CERN. Medical Service

  13. Screening for Stromal and Matrix Effects in 3D Microenvironments of Breast Cancer Cells

    Science.gov (United States)

    Montanez-Sauri, Sara I.

    Breast cancer progression ensures through the acquisition of genetic mutations, the uncontrollable growth of cells, and their progression to invasion. Studies have shown that the surrounding three-dimensional (3D) microenvironment can also influence breast cancer cell progression by controlling the morphology, differentiation, proliferation, and migration of cells. However, most of the currently available in vitro screening platforms are based on the two-dimensional (2D) culture of cells, and do not provide cells with the complex 3D microenvironment that exists in vivo. Therefore, there is a need for more biologically relevant in vitro platforms to help decipher the complexity of the microenvironment and its influence in breast cancer. In this dissertation we present an automated microfluidic platform that allows to efficiently screen for the effect of multiple matrix and stromal microenvironment in 3D cultures of breast cancer cells. Several extracellular matrix (ECM) compositions and stromal cells are included in the 3D microenvironments to examine their influence on breast cancer cell behavior. The screening results suggest that collagen gels with fibronectin might be influencing paracrine signals between breast cancer cells and stromal cells. The ability of the platform to culture and treat cells in 3D microenvironments offers a powerful screening tool for the identification of compounds and interactions using more in vivo-like 3D microenvironments. The identification of these mechanisms will increase our current understanding of breast cancer, and will aid in the identification of potential therapeutics.

  14. Using lessons from breast, cervical, and colorectal cancer screening to inform the development of lung cancer screening programs.

    Science.gov (United States)

    Armstrong, Katrina; Kim, Jane J; Halm, Ethan A; Ballard, Rachel M; Schnall, Mitchell D

    2016-05-01

    Multiple advisory groups now recommend that high-risk smokers be screened for lung cancer by low-dose computed tomography. Given that the development of lung cancer screening programs will face many of the same issues that have challenged other cancer screening programs, the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium was used to identify lessons learned from the implementation of breast, cervical, and colorectal cancer screening that should inform the introduction of lung cancer screening. These lessons include the importance of developing systems for identifying and recruiting eligible individuals in primary care, ensuring that screening centers are qualified and performance is monitored, creating clear communication standards for reporting screening results to referring physicians and patients, ensuring follow-up is available for individuals with abnormal test results, avoiding overscreening, remembering primary prevention, and leveraging advances in cancer genetics and immunology. Overall, this experience emphasizes that effective cancer screening is a multistep activity that requires robust strategies to initiate, report, follow up, and track each step as well as a dynamic and ongoing oversight process to revise current screening practices as new evidence regarding screening is created, new screening technologies are developed, new biological markers are identified, and new approaches to health care delivery are disseminated. Cancer 2016;122:1338-1342. © 2016 American Cancer Society. PMID:26929386

  15. Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

    Energy Technology Data Exchange (ETDEWEB)

    Zubizarreta Alberdi, Raquel [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Edificio Administrativo da Conselleria de Sanidade, Servicio de Programas Poboacionais de Cribado, Direccion Xeral de Saude Publica e Planificacion, Santiago de Compostela, Galicia (Spain); Llanes, Ana B.F.; Ortega, Raquel Almazan [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Exposito, Ruben Roman; Collado, Jose M.V.; Oliveres, Xavier Castells [Department of Epidemiology and Evaluation, Institut Municipal d' Investigacio Medica-Parc de Salut Mar. CIBERESP, Barcelona (Spain); Queiro Verdes, Teresa [Galician Agency for Health Technology Assessment, Public Health and Planning Directorate, Health Office, Galicia (Spain); Natal Ramos, Carmen [Principality of Asturias Breast Cancer Screening Programme, Principality of Asturias (Spain); Sanz, Maria Ederra [Public Health Institute, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Salas Trejo, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia Breast Cancer Screening Programme, Valencia (Spain)

    2011-10-15

    To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p < 0.001) with greater reading volume in the previous year: OR 0.77 and OR 0.78, respectively, for a reading volume 500-1,999 mammograms and OR 0.59 and OR 0.60 for a reading volume of >14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

  16. Incidence of register-based diabetes 10 years after a stepwise diabetes screening programme

    DEFF Research Database (Denmark)

    Rasmussen, Signe S; Johansen, Nanna B; Witte, Daniel R;

    2016-01-01

    analyses. RESULTS: After 10 years of follow-up 1,164 new diabetes cases were registered. Incidence rates were 1.0, 4.2, 14.5, 28.8 and 52.6 per 1,000 person-years in individuals at low risk and in those with normal glucose tolerance, impaired fasting glucose, impaired glucose tolerance and one diabetic...... criteria. Seven incremental levels of diabetes risk were defined and followed for incident diabetes recorded in the Danish National Diabetes Register until December 2012. For each group, cumulative diabetes incidence was calculated. Incidence rates and rate ratios were estimated by Poisson regression......AIMS/HYPOTHESIS: Screening programmes for type 2 diabetes inevitably find more people at high risk of developing diabetes than people with undiagnosed prevalent diabetes. We describe the incidence of diabetes for risk groups according to advancement in a screening process. METHODS: In 2001...

  17. Breast Cancer Screening among Older Hispanic Women: Knowledge, Attitudes, and Practices.

    Science.gov (United States)

    Saint-Germain, Michelle A.; Longman, Alice J.

    1993-01-01

    Data from 409 Hispanic-American and 138 Anglo older women in Tucson identified few differences in their use of breast cancer screening and low levels of risk knowledge. Both groups fell well below recommended frequency of screening. Clinical examination and self-examination were used more than mammography. (SK)

  18. 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:…

  19. Comprehensive Diagnostic Program for Medically Underserved Women With Abnormal Breast Screening Evaluations in an Urban Population

    OpenAIRE

    Palmieri, Frances M.; Deperi, Elizabeth R.; Mincey, Betty A.; Smith, Judith A.; Wen, Lonnie K.; Chewar, Deborah M.; Abaya, Reza; Colon-Otero, Gerardo; Perez, Edith A.

    2009-01-01

    OBJECTIVE: To institute a patient navigator program for underinsured women to eliminate delays in diagnostic resolution of abnormal screening mammograms, provide services for abnormalities noted during breast cancer screening, describe demographic and clinical characteristics of enrollees, and assess postscreening follow-up care.

  20. Adjuvant therapy, not mammographic screening, accounts for most of the observed breast cancer specific mortality reductions in Australian women since the national screening program began in 1991.

    Science.gov (United States)

    Burton, Robert C; Bell, Robin J; Thiagarajah, Geetha; Stevenson, Christopher

    2012-02-01

    There has been a 28% reduction in age-standardised breast cancer mortality in Australia since 1991 when the free national mammographic program (BreastScreen) began. Therefore, a comparative study between BreastScreen participation and breast cancer age specific mortality trends in Australia was undertaken for two time periods between 1991 and 2007, where women aged 50-59 and 60-69 years, who were invited to screen, were compared to women aged 40-49 and 70-79 years who were not invited, but who did have access to the program. There were mortality reductions in all four age groups between 1991-1992 and 2007, resulting in 5,849 (95% CI 4,979 to 6,718) fewer women dying of breast cancer than would have otherwise been the case. Women aged 40-49 years, who had the lowest BreastScreen participation (approximately 20%), had the largest mortality reduction: 44% (95% CI 34.8-51.2). Women aged 60-69 years, who had the highest BreastScreen participation (approximately 60%), had the smallest mortality reduction: 19% (95% CI 10.5-26.9). As BreastScreen participation by invited women aged 50-69 years only reached a maximum of about 55-60% in 1998-1999, a decline in mortality in Australian women cannot be attributed to BreastScreen prior to this time. Thus, almost 60% of the Australian decline in breast cancer mortality since 1991 cannot be attributed to BreastScreen. Therefore, mammographic screening cannot account for most of the reductions in breast cancer mortality that have occurred in Australian women since 1991 and may have contributed to over-diagnosis. Most, if not all, of the reductions can be attributed to the adjuvant hormonal and chemotherapy, which Australian women have increasingly received since 1986.

  1. Cost-effective mammography screening in Korea. High incidence of breast cancer in young women

    International Nuclear Information System (INIS)

    The epidemiological characteristics of breast cancer in Korean women are different from the characteristics reported in Western women. The highest incidence rate occurs in Korean women in their 40s. The purpose of this study was to determine the most cost-effective screening interval and target age range for Korean women from the perspective of the national healthcare system. A stochastic model was used to simulate breast cancer screenings by varying both the screening intervals and the age ranges. The effectiveness of mammography screening was defined as the probability of detecting breast cancer in the preclinical state and the cost was based on the direct cost of mammography screening and the confirmative tests. The age-specific mean sojourn times and the sensitivity of the mammography were applied in the stochastic model. An optimal cost-effectiveness was determined by the incremental cost-effectiveness ratio and lifetime schedule sensitivity. Sensitivity analyses were undertaken to assess parameter uncertainty. The selected cost-effective strategies were: the current biennial mammography screenings for women who are at least 40 years old; biennial screening for women between the ages of 35 and 75 years; and a combination strategy consisting of biennial screening for women aged between 45 and 54 years, and 3-year interval screening for women aged between 40 and 44 years and 55 and 65 years. Further studies should follow to investigate the effectiveness of mammography screening in women younger than 40 years in Asia as well as in Korea. (author)

  2. A trial for improving the rate of participation in breast cancer screening

    International Nuclear Information System (INIS)

    In order to search for a good method of increasing the rate of participation in breast cancer screening, we reviewed our previous records of breast cancer screening carried out by inspection and palpation during the preceding 32-year period. Screening by mammography was started in 2004, and in the following year became employed in all districts of Kochi Prefecture. When mammography screening began, we hoped that the participation rate would be at least 20%, which was the level when breast cancer screening was performed by inspection and palpation. In fact, the participation rate was as high as 27.6% in the period 2004-2005, and the breast cancer detection rate was 0.38%. We think that this high participation rate was achieved through complete transition from screening by inspection and palpation to that by mammography, offering guidance to district health nurses and local government administrative staff, education of the public about the importance of breast self-palpation, and other informative activities. (author)

  3. Breast Cancer Screening Coverage with clinical examination and Mammography Among insured women in Bogota

    International Nuclear Information System (INIS)

    The objective is to determine the coverage of clinical breast examination (CBE) and mammography for screening of breast cancer among a group of insured women in Bogota. Methods: A telephone survey was carried out with 4,526 women between the ages of 50 and 69, residing in Bogota or its suburbs, who were insured by one of three commercial health plans. Women with a history of breast cancer were excluded. Screening coverage was estimated as the proportion of women who had had a mammography or CBE. Estimates were established for lifetime frequency, two years prior the survey, and one year prior the survey. Factors associated with screening procedures were analyzed with calculations based on adjusted OR. Results: Lifetime frequency of CBE was 59.3% and 79.8% for mammography; and 49.7% and 65.6% of women respectively underwent the tests for screening purposes; the remainder, for diagnostic purposes (breast symptoms). CBE reported a 34.2% one year coverage and mammography reported a 54% two years coverage. Screening was associated to cancer education and family history of breast cancer. Conclusion: Coverage of CBE for screening purposes is low. Mammography coverage is above that required by the Colombian Health Ministry, but below that reported by developed countries.

  4. 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

  5. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

    OpenAIRE

    Brunelle, Cheryl; Skolny, Melissa; Ferguson, Chantal; Swaroop, Meyha; O’Toole, Jean; Taghian, Alphonse G.

    2015-01-01

    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 screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within ...

  6. Screening a Novel Human Breast Cancer-Associated Antigen from a cDNA Expression Library of Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Shuhua Yang; Lin Zhang; Ruifang Niu; Defa Wang; Yurong Shi; Xiyin Wei; Yi Yang

    2005-01-01

    OBJECTIVE The aim of this research was to clone and express the antigen of the previously prepared monoclonal antibody named M4G3.METHODS Western blots were used to screen a breast cancer cell line that overexpresses the M4G3-associated antigen. A λ zap cDNA expression library of breast cancer cells was constructed and screened using M4G3 as a probe to clone the antigen. The positive clones were subcloned and identified by homologous comparison using BLAST.RESULTS The λ zap cDNA expression library had 1.0x106 independent clones. Fifteen positive clones were isolated following 3 rounds of immunoscreening and identified as being from Mycoplasma pulmonis.CONCLUSION The specific antigen that matched the monoclonal M4G3 antibody is an unknown protein of M. pulmonis. This work is helpful for the further study of the association of M. pulmonis infection with breast cancer.

  7. Neonatal Hearing Screening Programme (NHSP): At A Rural Based Tertiary Care Centre.

    Science.gov (United States)

    Sharma, Yojana; Mishra, Girish; Bhatt, Sushen H; Nimbalkar, Somashekhar

    2015-12-01

    Deafness is the most common curable childhood handicap. It is a well recognised fact that unidentified hearing impairment can adversely affect optimal speech and language development and therefore academic, social and emotional development. Universal neonatal hearing screening programmes are implemented in many developed countries. However it is still in its early stage in India. The incidence of hearing impairment in India is 1-6 per thousand newborns screened (Paediatrics 19:155-165, 1998; Indian J Paediatr 74(6):545-549, 2007; Status of Disability in India, pp 172-185 2000). To determine the incidence of permanent hearing loss of moderate to evere variety in neonates taking care in a tertiary care rural based hospital in Gujarat. It was a non randomised observational study done for duration of 3 years. All neonates born in Shri Krishna Hospital underwent screening using two stage protocols with DPOAE test and final confirmation done with BERA. Total 2534 neonates were screened out of them 52 failed and 2482 (97.94 %) neonates passed in the 1st DPOAE test with 2.05 % refer rate. Total 7 (2 per 1000) neonates were detected with hearing impairment. 10 % neonates had one or other high risk factor. Out of high risk neonates, 1.8 % were diagnosed with hearing impairment in high risk group. Overall the follow-up rate was 72.7 %. Hospital based universal hearing screening of new born before discharge is feasible at a rural based tertiary care centre. Non specialist staff is invaluable in achieving a satisfactory referral rate with two stage hearing screening protocol. However, more efficacious tracking and follow up system is needed to improve the follow up rate for diagnosis.

  8. Neonatal Hearing Screening Programme (NHSP): At A Rural Based Tertiary Care Centre.

    Science.gov (United States)

    Sharma, Yojana; Mishra, Girish; Bhatt, Sushen H; Nimbalkar, Somashekhar

    2015-12-01

    Deafness is the most common curable childhood handicap. It is a well recognised fact that unidentified hearing impairment can adversely affect optimal speech and language development and therefore academic, social and emotional development. Universal neonatal hearing screening programmes are implemented in many developed countries. However it is still in its early stage in India. The incidence of hearing impairment in India is 1-6 per thousand newborns screened (Paediatrics 19:155-165, 1998; Indian J Paediatr 74(6):545-549, 2007; Status of Disability in India, pp 172-185 2000). To determine the incidence of permanent hearing loss of moderate to evere variety in neonates taking care in a tertiary care rural based hospital in Gujarat. It was a non randomised observational study done for duration of 3 years. All neonates born in Shri Krishna Hospital underwent screening using two stage protocols with DPOAE test and final confirmation done with BERA. Total 2534 neonates were screened out of them 52 failed and 2482 (97.94 %) neonates passed in the 1st DPOAE test with 2.05 % refer rate. Total 7 (2 per 1000) neonates were detected with hearing impairment. 10 % neonates had one or other high risk factor. Out of high risk neonates, 1.8 % were diagnosed with hearing impairment in high risk group. Overall the follow-up rate was 72.7 %. Hospital based universal hearing screening of new born before discharge is feasible at a rural based tertiary care centre. Non specialist staff is invaluable in achieving a satisfactory referral rate with two stage hearing screening protocol. However, more efficacious tracking and follow up system is needed to improve the follow up rate for diagnosis. PMID:26693457

  9. Profiling β Thalassemia Mutations in Consanguinity and Nonconsanguinity for Prenatal Screening and Awareness Programme

    Directory of Open Access Journals (Sweden)

    Ravindra Kumar

    2015-01-01

    Full Text Available Mutation spectrum varies significantly in different parts and different ethnic groups of India. Social factors such as preference to marry within the community and among 1st degree relatives (consanguinity play an important role in impeding the gene pool of the disease within the community and so in society by and large. The present paper discusses the role of consanguinity in profiling of beta thalassemia mutation, and thus the approach for prenatal screening and prevention based awareness programme. Clinically diagnosed 516 cases of beta thalassemia were screened at molecular level. A detailed clinical Proforma was recorded with the information of origin of the family, ethnicity, and consanguinity. The present study reports that subjects originating from Uttar Pradesh, Uttarakhand, Bihar, and Jharkhand have c.92+5G>C and c.124_127delTTCT mutation as the commonest mutation compared to the subjects hailing from Madhya Pradesh and Chhattisgarh and Nepal where sickle mutation was found more common. In 40 consanguineous unions more common and specific beta mutations with higher rate of homozygosity have been reported. This consanguinity-based data helps not only in deciding target oriented prenatal diagnostic strategies but also in objective based awareness programmes in prevention of thalassemia major birth.

  10. Incorporating genomics into breast and prostate cancer screening: assessing the implications

    OpenAIRE

    Chowdhury, Susmita; Dent, Tom; Pashayan, Nora; Hall, Alison; Lyratzopoulos, Georgios; Hallowell, Nina; Hall, Per; Pharoah, Paul; Burton, Hilary

    2013-01-01

    Individual risk prediction and stratification based on polygenic profiling may be useful in disease prevention. Risk-stratified population screening based on multiple factors including a polygenic risk profile has the potential to be more efficient than age-stratified screening. In this article, we summarize the implications of personalized screening for breast and prostate cancers. We report the opinions of multidisciplinary international experts who have explored the scientific, ethical, an...

  11. Breast cancer screening: evidence of benefit depends on the method used

    Directory of Open Access Journals (Sweden)

    Autier Philippe

    2012-12-01

    Full Text Available Abstract In this article, we discuss the most common epidemiological methods used for evaluating the ability of mammography screening to decrease the risk of breast cancer death in general populations (effectiveness. Case-control studies usually find substantial effectiveness. However when breast cancer mortality decreases for reasons unrelated to screening, the case-control design may attribute to screening mortality reductions due to other causes. Studies based on incidence-based mortality have obtained contrasted results compatible with modest to considerable effectiveness, probably because of differences in study design and statistical analysis. In areas where screening has been widespread for a long time, the incidence of advanced breast cancer should be decreasing, which in turn would translate into reduced mortality. However, no or modest declines in the incidence of advanced breast cancer has been observed in these areas. Breast cancer mortality should decrease more rapidly in areas with early introduction of screening than in areas with late introduction of screening. Nonetheless, no difference in breast mortality trends has been observed between areas with early or late screening start. When effectiveness is assessed using incidence-based mortality studies, or the monitoring of advanced cancer incidence, or trends in mortality, the ecological bias is an inherent limitation that is not easy to control. Minimization of this bias requires data over long periods of time, careful selection of populations being compared and availability of data on major confounding factors. If case-control studies seem apparently more adequate for evaluating screening effectiveness, this design has its own limitations and results must be viewed with caution. See related Opinion article: http://www.biomedcentral.com/1741-7015/10/106 and Commentary http://www.biomedcentral.com/1741-7015/10/164

  12. Uptake of breast screening is influenced by current religion and religion of upbringing.

    Science.gov (United States)

    O'Reilly, Dermot; Kinnear, Heather; Rosato, Michael; Mairs, Adrian; Hall, Clare

    2013-12-01

    Research has shown that individuals with a current religious affiliation are more likely to use preventive health services. The aim of this study was to determine whether breast screening uptake in Northern Ireland is higher amongst women with a current affiliation to an organised religion and, for those with no current affiliation, to examine whether their religion of upbringing is associated with uptake of breast screening. The Northern Ireland Longitudinal Study (NILS) was used to link Census and national breast screening data for 37,211 women invited for routine breast screening between 2001 and 2004. Current religious affiliation, religion of upbringing and other demographic and socio-economic characteristics were as defined on the Census form. Multivariate logistic regression was used to determine the relationship between religion affiliation and attendance. Uptake of breast screening is about 25% lower for those without a current religious affiliation. There are modest differences between Catholics and Protestants, with the latter about 11% more likely to attend for screening. For those with no current religion, the religion of upbringing appears to positively influence attendance rates. These differences remain after adjustment for all of the socio-demographic and socio-economic factors that have been shown to influence uptake rates of breast screening in the UK to date. Record linkage is an efficient way to examine equity across demographic characteristics that are not routinely available. The lower uptake amongst those with no religious affiliation may mean that screening services may find it difficult to maintain or improve uptake rate in an increasingly secularised society.

  13. A Review on Family History of Breast Cancer: Screening and Counseling Proposals for Women with Familial (Non-Hereditary) Breast Cancer.

    Science.gov (United States)

    Unic, Ivana; Stalmeier, Peep F. M.; Peer, Petronella G. M.; van Daal, Willem A. J.

    1997-01-01

    Studies of variables predicting familial breast cancer (N=59) were analyzed to develop screening recommendations for women with nonhereditary familial breast cancer present. The pooled relative risk (RR) and cumulative probability were used to estimate risk. Data and conclusions are presented. Recommendations for screening and counseling are…

  14. Sensitivity of ultrasonographic breast cancer screening in relation to partipant age

    International Nuclear Information System (INIS)

    In order to reduce death due to breast cancer, which has recently been increasing in Japan, we must develop a high-quality screening system and ensure it is widely employed. Of course, promotion of mammographic screening is important, but since breast cancer frequently occurs in Japanese women their 5th and 6th decades, when breast tissue is dense, introduction of ultrasonography screening for women in this age brackets should also be urgently be considered. We performed both mammography and ultrasonography on all breast cancer screening participants during a 5-year period from 2000 through 2004. In this period, 69,220 women participated and breast cancers were detected in 170 of them (cancer detection rate 0.25%, recall rate 9.5%, and proportion of early cancers 76.2%). Based on an analysis of breast cancer detection rates according to age, the comparative sensitivity of each modality was studied. In women in their 5th decade, the sensitivity of ultrasonography was 82.5% and that of mammography was also 82.5%. In women in their 6th decade, the corresponding sensitivities were 75.9% and 70.7%, respectively. These results imply that if we perform either ultrasonography or mammography alone, then the cancer detection rate would be lowered to between 29% and 17%. We think that both mammography and ultrasonography must be used for breast cancer screening in women of these age brackets. We assume that breast cancers detected only by ultrasound were mostly small invasive cancers, whereas those detected only by mammography were mostly noninvasive ductal carcinomas revealed by microcalcifications. Thus, adoption of both modalities appears to be reasonable for raising the cancer detection rate in women in their 5th and 6th decades. (author)

  15. Screening of Breast Mass in Iraqi Females: Al-Kindy Hospital Breast Clinic

    Directory of Open Access Journals (Sweden)

    Wijdan Akram

    2009-01-01

    Full Text Available Problem statement: The aim of this study is to present the findings of a retrospective analysis in females with breast mass, the character of the women and the risk factors of breast cancer at Al-Kindy Breast Clinic Center. Approach: Data were collected during 2 months period using special form of questioner. The total number of studied sample was 60, which includes female patients living in Baghdad. Results: The highest prevalence of developing breast mass at age group 36-45 years, the majority of these women are housewives (81.7%, about (31.7% of the included sample were illiterate and only 10% graduated from college. (58.3% of the studied sample did not use contraception, while (30% of patients with breast mass had breast feeding on the other hand (70% did not had breast feeding, by self examination, (11.7% could not found the mass by themselves, (28.3% had a mass in the right breast, (50% had a mass in the left breast while (10% had the mass in both breasts. Conclusion: The study showed a high level of practice of breast-self examination among women in the sample under consideration, breast masses were more occurring at the third and fourth decades of life, the number of children may affect the development of breast mass and combined oral contraceptive has small increased risk of breast mass.

  16. Screening and prevention in women at increased breast cancer risk

    NARCIS (Netherlands)

    Groot, J.S. de

    2015-01-01

    The most frequent cancer among women in the Western world arises in the breast accounting for over 1.7 million new cases in 2012, a number which is still rising. Much attention is paid to the discovery of new ways to prevent breast cancer, as is the search for new treatment modalities with a minimum

  17. Breast Cancer Screening in Women with Hereditary or Familial Risk

    NARCIS (Netherlands)

    S. Saadatmand (Sepideh)

    2015-01-01

    markdownabstract__Abstract__ We estimated influence of tumor size and number of positive lymph nodes at breast cancer detection on survival in the current era of new system (neo) adjuvant therapies. We showed that early breast cancer detection remains of great influence. Relative 5-year survival wa

  18. 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.

  19. Evaluation of a mass screening of breast cancer with mammography in personnel of regional public schools

    International Nuclear Information System (INIS)

    We have examined a total of 15,224 women in our hospital aiming at a mass screening of breast cancer with mammography (MMG) during the last 8 years. Subjected women were teachers or staffs of public schools in six prefectures in the Tohoku area. More than 90% of them were under 50 years old and women younger than 49 accounted for about half of them. A recall rate was 3.8%, and breast cancer was found in 55 women (0.36%) and the ratio of cancers diagnosed among recalled women was 9.5%. Twenty-one point eight percent of detected cancers were associated with calcification. The average diameter of the detected tumors in the screening group was 1.6 cm, whereas that of outpatients (controls) was 2.5 cm. Stage 0 and I cancer cases in the screening group accounted for 82.0%, whereas those in the outpatient group, 49.6%, indicating a significant increase in detection rate of early breast cancer in the screening compared to the outpatients group. However, detection rate of breast masses was 76.7% of all cases of breast tumor by means of MMG, versus 86.0% by means of physical examination. These results suggest that the mass screening by using physical examination and MMG, as well as ultrasonography, may provide a better clinical application for precise diagnosis, when it is done for working women in the regional public schools who are younger. (author)

  20. 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.

  1. Screening prior to Breast Cancer Diagnosis: The More Things Change, the More They Stay the Same

    Directory of Open Access Journals (Sweden)

    Erica B. Friedman

    2013-01-01

    Full Text Available Purpose. In November 2009, the U.S. Preventative Service Task Force (USPSTF revised their breast cancer screening guidelines. We evaluated the pattern of screening subsequent to the altered guidelines in a cohort of women. Methods. Our database was queried for the following variables: age, race, method of diagnosis, mass palpability, screening frequency, histology, and stage. Statistical analyses were performed using Pearson’s chi-square and Fisher’s exact tests. Results. 1112 women were diagnosed with breast cancer from January 2010 to 2012. The median age at diagnosis was 60 years. Most cancers were detected on mammography (61%. The majority of patients had invasive ductal carcinoma (59%, stage 0 (23%, and stage 1 (50% cancers. The frequency of screening did not change significantly over time (P=0.30. However, nonregular screeners had an increased risk of being diagnosed with later stage breast cancer (P<0.001 and were more likely to present with a palpable mass compared to regular screeners (56% versus 21%; P<0.001. Conclusions. In our study, screening behavior did not significantly change in the years following the USPSTF guidelines. These results suggest that women who are not screened annually are at increased risk of a delay in breast cancer diagnosis, which may impact treatment options and outcomes.

  2. Studies Comparing Screen-Film Mammography and Full-Field Digital Mammography in Breast Cancer Screening: Updated Review

    International Nuclear Information System (INIS)

    Full-field digital mammography (FFDM) has several potential benefits as compared with screen-film mammography (SFM) in mammography screening. Digital technology also opens for implementation of advanced applications, including computer-aided detection (CAD) and tomosynthesis. Phantom studies and experimental clinical studies have shown that FFDM is equal or slightly superior to SFM for detection and characterization of mammographic abnormalities. Despite obvious advantages, the conversion to digital mammography has been slower than anticipated, and not only due to higher costs. Until very recently, some countries did not even permit the use of digital mammography in breast cancer screening. The reason for this reluctant attitude was concern about lower spatial resolution and about using soft-copy reading. Furthermore, there was a lack of data supporting improved diagnostic accuracy using FFDM in a screening setting, since two pioneer trials both showed nonsignificantly lower cancer detection rate at FFDM. The 10 studies comparing FFDM and SFM in mammography screening published so far have shown divergent and rather conflicting results. Nevertheless, there is a rapid conversion to digital mammography in breast cancer screening in many western countries. The aim of this article is to give an updated review of these studies, discuss the conflicting findings, and draw some conclusions from the results

  3. 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.

  4. Normal parenchymal enhancement patterns in women undergoing MR screening of the breast

    International Nuclear Information System (INIS)

    To characterize the kinetic and morphological presentation of normal breast tissue on DCE-MRI in a large cohort of asymptomatic women, and to relate these characteristics to breast tissue density. 335 consecutive breast MR examinations in 229 asymptomatic women undergoing high-risk screening evaluations based on recommendations from the American Cancer Society including strong family history and genetic predisposition were selected for IRB-approved review (average age 49.2 ± 10.5 years). Breast tissue density was assessed on precontrast T2-weighted images. Parenchymal enhancement pattern (PEP) was qualitatively classified as minimal, homogeneous, heterogeneous or nodular. Quantitative analysis of parenchymal enhancement kinetics (PEK) was performed, including calculation of initial and peak enhancement percentages (E1, Epeak), the time to peak enhancement (Tpeak) and the signal enhancement ratio (SER). 41.8% of examinations were classified as minimal, 13.7% homogeneous, 23.9% heterogeneous and 21.2% nodular PEP. Women with heterogeneously or extremely dense breasts exhibited a higher proportion of nodular PEP (44.2% (27/61)) and significantly higher E1, and Epeak (p < 0.003) compared with those with less dense breasts. Qualitative and quantitative parenchymal enhancement characteristics vary by breast tissue density. In future work, the association between image-derived MR features of the normal breast and breast cancer risk should be explored. (orig.)

  5. Normal parenchymal enhancement patterns in women undergoing MR screening of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, Sanaz A.; Lin, Vicky C.; Giger, Maryellen L.; Li, Hui; Karczmar, Gregory S.; Newstead, Gillian M. [University of Chicago, Department of Radiology, Chicago, IL (United States)

    2011-07-15

    To characterize the kinetic and morphological presentation of normal breast tissue on DCE-MRI in a large cohort of asymptomatic women, and to relate these characteristics to breast tissue density. 335 consecutive breast MR examinations in 229 asymptomatic women undergoing high-risk screening evaluations based on recommendations from the American Cancer Society including strong family history and genetic predisposition were selected for IRB-approved review (average age 49.2 {+-} 10.5 years). Breast tissue density was assessed on precontrast T{sub 2}-weighted images. Parenchymal enhancement pattern (PEP) was qualitatively classified as minimal, homogeneous, heterogeneous or nodular. Quantitative analysis of parenchymal enhancement kinetics (PEK) was performed, including calculation of initial and peak enhancement percentages (E{sub 1}, E{sub peak}), the time to peak enhancement (T{sub peak}) and the signal enhancement ratio (SER). 41.8% of examinations were classified as minimal, 13.7% homogeneous, 23.9% heterogeneous and 21.2% nodular PEP. Women with heterogeneously or extremely dense breasts exhibited a higher proportion of nodular PEP (44.2% (27/61)) and significantly higher E{sub 1}, and E{sub peak} (p < 0.003) compared with those with less dense breasts. Qualitative and quantitative parenchymal enhancement characteristics vary by breast tissue density. In future work, the association between image-derived MR features of the normal breast and breast cancer risk should be explored. (orig.)

  6. Changes in cerebral blood flow and anxiety associated with an 8-week mindfulness programme in women with breast cancer.

    Science.gov (United States)

    Monti, Daniel A; Kash, Kathryn M; Kunkel, Elisabeth J S; Brainard, George; Wintering, Nancy; Moss, Aleezé S; Rao, Hengyi; Zhu, Senhua; Newberg, Andrew B

    2012-12-01

    This study employed functional magnetic resonance imaging to evaluate changes in cerebral blood flow (CBF) associated with the Mindfulness-based Art Therapy (MBAT) programme and correlate such changes to stress and anxiety in women with breast cancer. Eighteen breast cancer patients were randomized to the MBAT or education control group. The patients received the diagnosis of breast cancer between 6 months and 3 years prior to enrollment and were not in active treatment. The age of participants ranged from 52 to 77 years. A voxel-based analysis was performed to assess differences at rest, during meditation and during a stress task. The anxiety sub-scale of the Symptoms Checklist-90-Revised was compared with changes in resting CBF before and after the programmes. Subjects in the MBAT arm demonstrated significant increases in CBF at rest and during meditation in multiple limbic regions, including the left insula, right amygdala, right hippocampus and bilateral caudate. Patients in the MBAT programme also had a significant correlation between increased CBF in the left caudate and decreased anxiety scores. In the MBAT group, responses to a stressful cue resulted in reduced activation of the posterior cingulate. The results demonstrate that the MBAT programme was associated with significant changes in CBF, which correlated with decreased anxiety over an 8-week period.

  7. First breast cancer mammography screening program in Mexico: initial results 2005-2006.

    Science.gov (United States)

    Rodríguez-Cuevas, Sergio; Guisa-Hohenstein, Fernando; Labastida-Almendaro, Sonia

    2009-01-01

    Breast cancer is the most frequent malignant neoplasia worldwide. In emergent countries as Mexico, an increase has been shown in frequency and mortality, unfortunately, most cases in advanced loco-regional stages developed in young women. The success of breast screening in mortality reduction has been observed since 1995 in Western Europe and the United States, where as many as 40% mortality reduction has been achieved. Most countries guidelines recommends an annual or biannual mammography for all women >40 years of age. In 2005, FUCAM, a nonlucrative civil foundation in Mexico join with Mexico City government, initiated the first voluntary mammography screening program for women >40 years of age residing in Mexico City's Federal District. Mammographies were carried out with analogical mammographs in specially designed mobile units and were performed in the area of women's domiciles. This report includes data from the first 96,828 mammographies performed between March 2005 and December 2006. There were 1% of mammographies in Breast Imaging Reporting and Data System 0, 4, or 5 and 208 out of 949 women with abnormal mammographies (27.7%) had breast cancer, a rate of 2.1 per thousand, most of them in situ or stage I (29.4%) or stage II (42.2%) nevertheless 21% of those women with abnormal mammography did not present for further clinical and radiologic evaluation despite being personally notified at their home addresses. The breast cancer rate of Mexican women submitted to screening mammography is lower than in European or North American women. Family history of breast cancer, nulliparity, absence of breast feeding, and increasing age are factors that increase the risk of breast cancer. Most cancers were diagnosed in women's age below 60 years (68.5%) with a mean age of 53.55 corroborating previous data published. It is mandatory to sensitize and educate our population with regard to accepting to visit the Specialized Breast Centers.

  8. A closer look at cervical smear uptake and results pre- and post- introduction of the national screening programme.

    LENUS (Irish Health Repository)

    Gallagher, F

    2012-02-01

    Prior to the introduction of a national cervical screening programme, death rates from cervical cancer in the Republic of Ireland were greater than the death rates in all other regions in Britain and Northern Ireland. The following audit compares the impact of the national cervical screening programme, established on 1 September \\'08, on uptake and results per age group screened before and after its implementation. This retrospective audit was carried out in a four-doctor practice with approximately 1554 GMS and 5000 private patients. Data over a ten month period in \\'08\\/\\'09 was collected from the practice record of cervical smears and compared to the same period in \\'07\\/\\'08. A cohort of 534 Irish urban women was included. A total number of 148 women were screened between October 2007 and July 2008 compared with 386 women screened over the same months in 2008\\/2009. Increase in uptake was most marked in the 25-44 years age group, 100 (\\'07-\\'08) vs. 303 (\\'08-\\'09). The majority of results for both time periods were negative (85% 07\\/08, 81% 08\\/09). There was a higher number of HSIL in \\'08-\\'09 (an increase from 1% to 3.37% of the total screened). This audit clearly supports the introduction of the national cervical screening programme showing both an increase in uptake and a increased pick-up of high grade lesions.

  9. Mathematical simulation for estimating reduction of breast cancer mortality in mass screening using mammography

    International Nuclear Information System (INIS)

    In Japan it is considered that mammography should be introduced with physical examination for the mass screening of breast cancer instead of physical examination alone, which is performed at present. Before the introduction of mammography, a mathematical simulation should be performed to show the reduction in breast cancer mortality by mass screening compared with an unscreened population. A mathematical model of cancer screening devised by the authors was used to estimate the number of deaths due to breast cancer (A) in the screened group and those (B) in the unscreened group within the same population. Then the relative risk (RR) and attributable risk (RD) were calculated as (A/B) and (B-A) respectively. Three methods of mass screening were compared: (1) physical examination (1-year interval), (2) mammography with physical examination (1-year interval), (3) mammography with physical examination (2-year interval). The calculated RR values were 0.85 for (1), 0.60 for (2) and 0.69 for (3). Assuming that the incidence of breast cancer was 100/105 person-years, the calculated RD values were 3.0, 8.1 and 6.2 persons/105 person-years for (1), (2) and (3), respectively. The 95% confidence interval of RR for three methods was over 1.0, and thus the reduction of breast cancer mortality was not statistically significant in the present population. In conclusion, mammography with physical examination may reduce breast cancer mortality in comparison with physical examination alone, but a larger number of women must be screened in order to obtain a significant RR value. (author)

  10. The current status and future prospects of breast cancer screening using ultrasonography at our facility

    International Nuclear Information System (INIS)

    We report the results obtained by breast cancer screening of the general population using both ultrasonography and mammography conducted by the Tochigi Public Health Service Association. An investigation of breast cancer screening carried out on approximately 140,000 participants between 2000 and 2007 showed that ultrasonography and mammography are remarkably complementary for detection of breast cancer, particularly for women in their 40s and 50s, and that each modality improves the sensitivity of breast cancer detection by approximately 20%. The following issues are pivotal for establishing a breast cancer ultrasonography screening system that is able to maintain high precision and adequate efficiency: technical training of sonographers and physicians who must interpret the sonographic images, quality control of equipment, and an interpretation system that allows previous sonographs to be used as a reference. In independent combined screening systems using ultrasonography and mammography, the high recall rate becomes an issue. Comparative interpretation of sonographic images with previous sonographs is effective for resolving this. However, hopes abound for a comprehensive assessment system that allows simultaneous imaging and interpretation of both ultrasonography and mammography. (author)

  11. An analysis of the duplicate testing strategy of an Irish immunochemical FOBT colorectal cancer screening programme.

    LENUS (Irish Health Repository)

    Kelley, Leanne

    2013-06-10

    AIM: This study examined the relevance of using a two sample quantitative immunochemical faecal occult blood test (iFOBT or FIT) at a high cut off stringency by the first population-based colorectal cancer (CRC) pilot screening programme in Ireland. METHOD: Approximately ten thousand individuals between the ages of 50-74 years were invited to perform two consecutive FITs. These were analysed in tandem using the OC-Sensor and participants with at least one positive result with a haemoglobin cut off for positivity at 100 ng\\/ml were offered colonoscopy. RESULTS: A total of 5023 (52%) (2177 (43%) male; 2846 (57%) female) individuals with a median age of 64 years participated. At least one positive FIT test was detected from 514 (10%) individuals. From the 419 (82%) patients who proceeded to colonoscopy 17 (4%) had CRC and 132(33%) had an advanced adenoma. The detection rate for these screen relevant lesions was 3% (95% CIs = 2.5% - 3.5%) and the FIT positive + colonoscopy detection rate was 36% (95% CI = 31% - 40%). The numbers needed to colonoscope to find an advanced lesion was 2.8. The two test system detected four (23.5%) additional patients with CRC and 37 (28%) with an advanced adenoma compared with a single test. CONCLUSION: The CRC miss rate estimated for a single test (23.5%) was unacceptably high when the goal was to maximize the discovery of advanced lesions in the initial screening round. We conclude that the two test protocol at a high cut off threshold is suitable to optimize FIT screening in Ireland. This article is protected by copyright. All rights reserved.

  12. Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    Samantha Garbers

    2009-03-01

    Full Text Available Samantha Garbers1, Karen Schmitt2, Anne Marie Rappa2, Mary Ann Chiasson11Public Health Solutions, New York, NY, USA; 2Columbia University Breast Cancer Screening Program, New York, NY, USABackground: This analysis examines the association between functional health literacy and follow-up after mammography among women receiving breast cancer screening at a National Breast and Cervical Cancer Early Detection Program site in New York City that provides universal bilingual case management.Methods: A total of 707 Latinas who spoke Spanish as their primary language completed a survey of health and demographic characteristics and the Test of Functional Health Literacy in Spanish (TOFHLA-S. Survey results were matched with clinical outcome data.Results: Among the survey participants, 98% were foreign-born and 99% had no health insurance. While the study found significant differences in access to health information and past screening behavior, women without adequate health literacy in Spanish were no less likely to receive clinical resolution of abnormal mammograms within 60 days (81.8% overall; n = 110 or to return for a repeat mammogram within 18 months (57.2% overall; n = 697. In fact, among those referred for a Pap test (n = 310, women without adequate health literacy were more likely to receive a Pap test within 60 days of their mammogram than those with adequate health literacy (82% compared to 71%, OR: 1.83, 95% CI: 1.04–3.22.Discussion: The lack of significantly lower follow-up outcomes among women with inadequate and marginal functional health literacy in this population of primary Spanish-speaking Latinas suggests that, once women have accessed screening services, programmatic approaches may exist to mitigate barriers to follow-up and to ensure optimal cancer screening outcomes for women of all literacy levels.Keywords: health literacy, mammography, Latinas, case management, cancer screening

  13. Experiences of low dose exposure mammography on the cancer mass screening of breast

    International Nuclear Information System (INIS)

    This paper summarizes experiences in the use of the mammograph for the mass screening of breast cancer. The exposure dose per experience was only 1/8.4 (0.21 mSv) that of conventional mammography. Application to 243 persons resulted in 95.6% (43/45 patients) of TPR, 57.1% (113/198 patients) of TNR and 1.7% (2/115 patients) of false negative. Although the authors consider that the mammograph has a bright future, a few points for improvement follow herein. To increase the accuracy of mass screening of breast cancer, photography techniques and decipherment of X-rays should be considered. (author)

  14. Tailored Lay Health Worker Intervention Improves Breast Cancer Screening Outcomes in Non-Adherent Korean-American Women

    Science.gov (United States)

    Han, Hae-Ra; Lee, H.; Kim, M. T.; Kim, K. B.

    2009-01-01

    Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an…

  15. 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.

    2011-01-01

    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 reduc

  16. 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.

  17. A self-directed home yoga programme for women with breast cancer during chemotherapy: A feasibility study.

    Science.gov (United States)

    Komatsu, Hiroko; Yagasaki, Kaori; Yamauchi, Hideko; Yamauchi, Teruo; Takebayashi, Toru

    2016-06-01

    Recent studies suggest yoga as a promising approach for improving the cognitive function of cancer survivors. We studied whether a self-directed home yoga programme was feasible for patients with breast cancer who were undergoing chemotherapy. Participants' preferences for the type of yoga course and the clinical effects of the programme were also assessed. In this study, 18 women (mean age, 43.9 years) were enrolled (44.7% recruitment rate). Of the participants, 63.6% had stage II cancer and 71.4% received adjuvant chemotherapy. Favourable retention (86%), adherence (94.4%) and acceptability (96.5%) rates were determined. Most (94.4%) of the women practiced the home programme more than twice a week on average. The participants preferred to gradually increase the intensity of the exercises. We only observed improvements in the cognitive aspects of fatigue. No serious adverse events were encountered during the programme. This self-directed home yoga programme was safe and feasible for patients with breast cancer undergoing chemotherapy. PMID:26643264

  18. Comparative effectiveness of breast MRI and mammography in screening young women with elevated risk of developing breast cancer: a retrospective cohort study.

    Science.gov (United States)

    Narayan, Anand K; Visvanathan, Kala; Harvey, Susan C

    2016-08-01

    Screening guidelines recommend that women with 20 % or greater lifetime risk of breast cancer undergo annual breast MRI screening to supplement mammography, irrespective of age. In patients less than 40 years, mammography is often avoided due to concerns about radiation and decreased performance. However, prior studies have been limited by large percentages of women above 40 with decreased breast density. Our purpose was to test whether adding mammography to breast MRI screening compared to breast MRI screening alone in women below 40 increases cancer detection rates. After obtaining IRB approval, chart review identified patients aged 25-40 years undergoing breast MR screening (2005-2014). Demographics, risk factors, BI-RADS assessments, background parenchymal enhancement, and mammographic breast tissue density were recorded. Cancer detection rates, short-term follow-up (BIRADS 3), image-guided biopsy (BIRADS 4,5), and PPV1-3 were calculated. 342 breast MRI exams were identified (average age was 33, 37 % were nulliparous, and 64 % had prior benign biopsy), 226 (66 %) of which underwent concurrent mammography. Risk factors included 64 % with breast cancer in first-degree relative(s), 90 % had heterogeneous or extremely dense breast tissue on mammography, and 16 % were BRCA carriers. Four invasive cancers were detected by MRI (11.7 cancers/1000 examinations, 95 % CI 8.3, 15.1). None of these was detected by mammography, and no cancers were independently identified by mammography. Breast MRI screening in high-risk women under 40 yielded elevated cancer detection rates (11.7/1000). The cancer detection rate for mammography was 0 %, suggesting that MRI alone may be useful in screening high-risk women under 40. PMID:27444927

  19. 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

  20. Screening for breast cancer with MRI: recent experience from the Australian Capital Territory

    International Nuclear Information System (INIS)

    Full text: The American Cancer Society now recommends annual MRI screening for women at 20-25% or greater lifetime risk of breast cancer. The role of MRI screening in other risk subgroups is unproved because of insufficient data. Our study comprised 209 breast MRI scans carried out in 171 asymptomatic patients (age range 22-67 years, mean 46 years), referred between January 2005 and June 2008. Targeted ultrasound was carried out in 32 episodes (15%) and biopsies were taken in 23 patients (13%). In four patients, MR-guided procedures were required to establish a diagnosis, two using hook-wire localization and two by means of vacuum-assisted biopsy. Seven cancers were detected by MRI in the 171 patients, with a yield of 4.1%. Only one of the seven cancers was also shown by x-ray mammography. Four patients had invasive ductal cancer (all axillary node negative) and three had high-grade ductal carcinoma in situ or pleomorphic lobular carcinoma in situ. The three women with in situ disease were all potentially high risk, based on the National Breast and Ovarian Cancer Centre (NBOCC) criteria. Three women with invasive breast cancer were at only average risk based on NBOCC criteria, but two of these had extremely dense breasts. A fourth patient, found to have multifocal invasive cancer, had a personal history of contralateral breast cancer, but no relevant family history. Our findings suggest that breast MRI could be used to screen a larger Australian population at increased risk of developing breast cancer.

  1. Characteristics of breast cancers detected by ultrasound screening in women with negative mammograms

    International Nuclear Information System (INIS)

    Screening ultrasound (US) can increase the detection of breast cancer. However, little is known about the clinicopathologic characteristics of breast cancers detected by screening US. A search of the database for patients with breast cancer yielded a dataset in 6837 women who underwent breast surgery at Seoul National University Hospital (Korea). Of 6837 women, 1047 were asymptomatic and had a non-palpable cancer. Two hundred fifty-four women with 256 cancers detected by US (US-detected cancer) and 793 women with 807 cancers detected by mammography (MG-detected cancer) were identified. The imaging, clinicopathologic, and molecular data were reviewed. Univariate and multivariate analyses were carried out. Women with US-detected cancer were younger and were more likely to undergo breast-conserving surgery and to have node-negative invasive cancer (P2 cm in size, tumors that were ≤1 cm in size were 2.2-fold more likely to be US-detected cancers (P=0.02). Compared to the luminal A subtype tumors (estrogen receptor [ER]+, PR+, HER2-), luminal B subtype tumors (ER+, PR+, HER2+) were less likely to be in the US-detected cancer group (P<0.01). Women with dense breasts were more likely to have US-detected cancer (P<0.01) versus those with non-dense breasts. Screening US-detected cancers were less likely to be diagnosed as category 5 instead of category 4 (P<0.01). In conclusion, women with US-detected breast cancer are more likely to have small-sized invasive cancer and more likely associated with the luminal A subtype. (author)

  2. Advances in breast cancer screening program%乳腺癌筛查研究进展

    Institute of Scientific and Technical Information of China (English)

    莫淼; 柳光宇; 吕力琅; 徐望红

    2012-01-01

    Breast cancer is the most common malignancy in women around the world. Breast cancer screening has been recognized as the primary approach to effectively improve the survival of female breast cancer. The most commonly used methods for breast cancer screening in China and other countries include mammography (MAM), ultrasonography (US), clinical breast examination (CBE) and magnetic resonance imaging (MRI). This paper summarizes the advantages and disadvantages of these screening techniques and reviewes the economic efficiency in health care of different screening techniques based on these examination approaches to provide some evidence for developing a breast cancer screening strategy with optimal cost-effectiveness for Chinese women.%乳腺癌是危害全世界女性健康最常见的恶性肿瘤.乳腺癌筛查是公认的能够有效提高女性乳腺癌生存率的主要方法.目前国内外常用的乳腺癌筛查手段包括乳房X线摄影术(钼靶X线摄影)、超声成像、临床乳腺检查和磁共振成像等.本文对这些筛查手段的优缺点进行了比较,并对基于这些手段建立的不同筛查方案在人群中的应用效果和卫生经济学评价进行综述,以期为建立符合中国国情的具有成本-效果的女性乳腺癌筛查策略提供参考和依据.

  3. Rubella serology by solid-phase radioimmunoassay: its potential for screening programmes

    International Nuclear Information System (INIS)

    Sera from 269 adult females who had experienced naturally acquired or vaccine-induced infection by rubella virus, including immune persons challenged intranasally with rubella vaccine (RA27/3) as well as sera from 100 patients attending antenatal clinics, were tested for rubella antibodies by the conventional haemagglutination inhibition tests (HAI), as well as a newly developed solid-phase radioimmunoassay (RIA) for rubella immunoglobulin G(IgG) antibodies. Following both naturally acquired and vaccine-induced infection, titres by RIA were approximately ten-fold higher than by HAI. The RIA test was particularly useful in assessing the true immune status of those with apparently low levels of HAI antibody and has the added advantage that pretreatment of sera to remove inhibitors of haemagglutination and red cell agglutinins is unnecessary. The RIA test has potential for the large-scale screening programmes which need to be carried out if the Department of Health and Social Security recommendation, that women attending antenatal and family planning clinics be screened for rubella antibodies, is to be effectively met. (author)

  4. Value of Sonography in Screening Women with Dense Breasts in Mammography

    Directory of Open Access Journals (Sweden)

    Esmaeel Shokrollahi

    2010-05-01

    Full Text Available Breast cancer is one of the most common cancers in women and the main cause of death due to malignancy in women between 40-44 years of age.This cancer is responsible for 33% of all cancers in women and 20% of all deaths due to cancer in women."nMammography is the main modality for screening and diagnosis of breast lesions, but in dense breasts it has low sensitivity (about 48% with low possibility for visualization of mass lesions or calcifications, and this results in fading abnormal findings and increasing the risk of malignancy. This defect is compensated by ultrasonography."nSonography also elegantly shows hidden areas, which are covered by normal breast tissue in mammography, and also shows the pictures real time without overlap."nPresence of any palpable mass in clinical exam was an excluding criterion for patients from the study. Any lesion as a cystic or solid mass or echo change or calcification was recorded in the database. If a lesion had a malignant picture, FNA or core biopsy was done for it and the sample was sent for pathologic report."nThis study showed that correlation with sonography is mandatory in women who have dense breasts in mammography, even if it is a low-grade dense breast. If this correlation was not done, breast cancers present in 1.5% of the studied population would be missed."nSo due to the high false negativity of mammography in dense breasts, in the time being, sonography is considered as the second line screening method and complementary modality for mammography. It not only increases the diagnostic accuracy, but also as the only real time imaging modality, it can be used for localization and precise biopsy of breast lesions. Also, it can be used without any limitation as a cheap and harmless way for follow up imaging in short intervals for suspected patients.

  5. Breast dosimetry system in screen/film mammography

    OpenAIRE

    Goto, Sachiko; Azuma, Yoshiharu; Toshinori MARUYAMA; Nakagiri, Yoshitada; TAKEDA, Yoshihiro; Sugita, Katsuhiko; Kadohisa, Shigefumi

    2000-01-01

    The average glandular dose to glandular tissue m mammography is generally assumed to be a function of beam quality (HVL), x-ray tube target material, tube voltage, breast thickness, breast composition and, to a lesser extent, x-ray tube voltage waveform. The average glandular dose is generally determined from published tables with knowledge of the above function. Tables for a high frequency x-ray generator are not yet published. In our study, the lookup tables for the average glandular dose w...

  6. Breast cancer correlates in a cohort of breast screening program participants in Riyadh, KSA

    Directory of Open Access Journals (Sweden)

    Fahad A. Al-Amri

    2015-06-01

    Conclusions: The findings of the current work suggested that age at marriage, age at menopause ⩾50 years and 1st degree family history of breast cancer were risk factors for breast cancer, while, age at menopause <50 years, number of pregnancies and practicing breast feeding were protective factors against breast cancer. There was no effect of body mass index or physical inactivity. Further studies are needed to explore the hereditary, familial and genetic background risk factors in Saudi population.

  7. Advantages and Disadvantages of Different Implementation Strategies of Non-Invasive Prenatal Testing in Down Syndrome Screening Programmes

    NARCIS (Netherlands)

    Mersy, E.; Die-Smulders, C.E. de; Coumans, A.B.; Smits, L.J.; Wert, G.M.W.R. de; Frints, S.G.; Veltman, J.A.

    2015-01-01

    BACKGROUND: Implementation of non-invasive prenatal testing (NIPT) in Down syndrome screening programmes requires health policy decisions about its combination with other tests and its timing in pregnancy. AIM: Our aim was to aid health policy decision makers by conducting a quantitative analysis of

  8. Estimating the coverage of a targeted mobile tuberculosis screening programme among illicit drug users and homeless persons with truncated models

    NARCIS (Netherlands)

    N.A.H. van Hest; G. de Vries (Gerard); F. Smit (Filip); A.D. Grant; J.H. Richardus (Jan Hendrik)

    2008-01-01

    textabstractTruncated models are indirect methods to estimate the size of a hidden population which, in contrast to the capture–recapture method, can be used on a single information source. We estimated the coverage of a tuberculosis screening programme among illicit drug users and homeless persons

  9. The efficacy of issuing a free coupon for breast cancer screening

    International Nuclear Information System (INIS)

    In 2009, the Japanese government introduced a new project in which a free coupon for breast cancer screening was issued. Our institution provided two mammography buses and visited 11 suburbs of Tokyo places a total of 233 times for screening with the free coupon. We classified the areas visited into two groups: those where we had sent the bus every year (usual areas), and other areas to which we had never sent the bus previously (new area). We also issued questionnaires to the coupon examinees. The number of mammography screenings conducted was 15,257 (a 71% increase). The recall rate was 6.3%, and the rate of responders for detailed examination was 60.3% in the new areas, being lower than in the other areas. The most serious problem in the new areas was that the rate of early cancer detection was 44.4%, being much lower than in the other areas. In response to the questionnaire items inquiring about womens' motivation for screening, 'individual notice' accounted for the majority of responses, followed by 'free screening'. In response to the question of how much women were prepared to pay for breast cancer screening, the majority of women stated that they would be willing to pay between 1,000 and 2,000 yen. In conclusion, the scheme for providing free coupons for breast cancer screening would appear to motivate women who have never undergone screening before. On the other hand, some problems have been exposed. In areas new to screening, a high proportion of advanced cancers were found, and there was a lower rate of response for more detailed examination. The answers received appear to indicate that women prefer to receive individual notice, rather than free screening. (author)

  10. Performance of computer-aided detection in false-negative screening mammograms of breast cancers

    International Nuclear Information System (INIS)

    To analyze retrospectively the abnormalities visible on the false-negative screening mammograms of patients with breast cancer and to determine the performance of computer-aided detection (CAD) in the detection of cancers. Of 108 consecutive cases of breast cancer diagnosed over a period of 6 years, of which previous screening mammograms were available, 32 retrospectively visible abnormalities (at which locations cancer later developed) were found in the previous mammograms, and which were originally reported as negative. These 32 patients ranged in age from 38 to 72 years (mean 52 years). We analyzed their previous mammographic findings, and assessed the ability of CAD to mark cancers in previous mammograms, according to the clinical presentation, the type of abnormalities and the mammographic parenchymal density. In these 32 previous mammograms of breast cancers (20 asymptomatic, 12 symptomatic), the retrospectively visible abnormalities were identified as densities in 22, calcifications in 8, and densities with calcifications in 2. CAD marked abnormalities in 20 (63%) of the 32 cancers with false-negative screening mammograms; 14 (70%) of the 20 subsequent screening-detected cancers, 5 (50%) of the 10 interval cancers, and 1 (50%) of the 2 cancers palpable after the screening interval. CAD marked 12 (50%) of the 24 densities and 9 (90%) of the 10 calcifications. CAD marked abnormalities in 7 (50%) of the 14 predominantly fatty breasts, and 13 (72%) of the 18 dense breasts. CAD-assisted diagnosis could potentially decrease the number of false-negative mammograms caused by the failure to recognize the cancer in the screening program, although its usefulness in the prevention of interval cancers appears to be limited

  11. Screening women at high risk of breast cancer on the basis of evidence

    International Nuclear Information System (INIS)

    Geneticists are able to identify the risk of breast cancer. Strategies on offer include prevention, early diagnosis by screening, and prophylactic surgery. This paper analyses the evidence for offering screening. The radiation dose of mammography has been measured, but the risk is not fully known. Mammography screening of women of 40-50 years in the normal population has known effect. Little evidence is available for women under 40 years or for women with genetic susceptibility to breast cancer. Dense parenchymal pattern is associated with high grade cancers, and is both a risk factor and a reason for impaired screening sensitivity. Whether this applies to younger women or women at high risk is speculative. The pathological features of the cancers in gene carriers show differences from those occurring in normal women. This work should be correlated with imaging features. There is no literature to support the use of newer imaging methods in these women. Ultrasound and MRI avoid radiation and may be useful in dense breasts. SestaMIBI and PET scanning are not yet mature enough for screening, and may never have such a role. Any newer modality must be subjected to a formal randomised trial before being offered to screen women at high risk

  12. Health Care Access and Breast Cancer Screening Among Latinas Along the California–Mexican Border

    Science.gov (United States)

    Malcarne, Vanessa L.; Foster-Fishman, Pennie G.; Davidson, William S.; Mumman, Manpreet K.; Riley, Natasha; Sadler, Georgia R.

    2013-01-01

    Latinas are more likely to exhibit late stage breast cancers at the time of diagnosis and have lower survival rates compared to white women. A contributing factor may be that Latinas have lower rates of mammography screening. This study was guided by the Behavioral Model of Health Services Use to examine factors associated with mammography screening utilization among middle-aged Latinas. An academic–community health center partnership collected data from community-based sample of 208 Latinas 40 years and older in the San Diego County who completed measures assessing psychosocial factors, health care access, and recent mammography screening. Results showed that 84.6 % had ever had a mammogram and 76.2 % of women had received a mammogram in the past 2 years. Characteristics associated with mammography screening adherence included a lower acculturation (OR 3.663) a recent physician visit in the past year (OR 6.304), and a greater confidence in filling out medical forms (OR 1.743), adjusting for covariates. Results demonstrate that an annual physical examination was the strongest predictor of recent breast cancer screening. Findings suggest that in this community, improving access to care among English-speaking Latinas and addressing health literacy issues are essential for promoting breast cancer screening utilization. PMID:24150421

  13. Health care access and breast cancer screening among Latinas along the California-Mexican border.

    Science.gov (United States)

    Castañeda, Sheila F; Malcarne, Vanessa L; Foster-Fishman, Pennie G; Davidson, William S; Mumman, Manpreet K; Riley, Natasha; Sadler, Georgia R

    2014-08-01

    Latinas are more likely to exhibit late stage breast cancers at the time of diagnosis and have lower survival rates compared to white women. A contributing factor may be that Latinas have lower rates of mammography screening. This study was guided by the Behavioral Model of Health Services Use to examine factors associated with mammography screening utilization among middle-aged Latinas. An academic-community health center partnership collected data from community-based sample of 208 Latinas 40 years and older in the San Diego County who completed measures assessing psychosocial factors, health care access, and recent mammography screening. Results showed that 84.6 % had ever had a mammogram and 76.2 % of women had received a mammogram in the past 2 years. Characteristics associated with mammography screening adherence included a lower acculturation (OR 3.663) a recent physician visit in the past year (OR 6.304), and a greater confidence in filling out medical forms (OR 1.743), adjusting for covariates. Results demonstrate that an annual physical examination was the strongest predictor of recent breast cancer screening. Findings suggest that in this community, improving access to care among English-speaking Latinas and addressing health literacy issues are essential for promoting breast cancer screening utilization.

  14. Knowledge on breast cancer and practice of breast self examination among selected female university students in Malaysia

    OpenAIRE

    Mehrnoosh Akhtari-Zavare; Muhamad Hanafiah Juni; Rosliza Abdul Manaf; Irmi Zarina Ismail; Salmiah Said

    2011-01-01

    Breast cancer is the most common cancer affecting women in most parts of the world including Malaysia. Even though breast self examination (BSE) is not seen as a relevant cancer screening tool anymore, it still plays an important role in the breast health awareness programme. Aim of the study to determine the knowledge of respondents on breast cancer regarding the risk factors, symptoms, and to determine respondents’ practice of breast self-examination. A cross sectional study was carried out...

  15. Comparison of conventional Papanicolaou smear and SurePath® liquid-based cytology in the Copenhagen population screening programme for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, Benny; Simonsen, Kåre; Junge, Jette

    2006-01-01

    OBJECTIVE: To compare diagnostic performance of conventional Papanicolaou smear with SurePath liquid-based cytology in a population screening programme. METHODS: A retrospective comparison was performed on data from two 18-month periods of the screening programme for cervical cancer...

  16. 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

  17. 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...

  18. The criteria for further examination in breast cancer screening using combined mammography and ultrasonography

    International Nuclear Information System (INIS)

    We studied the favorable criteria in breast cancer screening using mammography (MMG) and ultrasonography (US). We examined 1,542 females who had never undergone combined screening, and evaluated the following criteria: Need to recall due to category 3 in either MMG or US. To evaluate MMG and US films together. To estimate the next time recall rate. We identified the benefit of combined screening, which is able to rule out benign lesions in category 3 of MMG. So, it is important to evaluate MMG and US films together. It is also necessary to interpret results in comparison with previous films. Our results showed that the recall rate was 8% in the first screening, and it was 4-5% in the repeat screening. Therefore, the target recall rate on combined screening would be less than 5%. (author)

  19. 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.…

  20. Breast Cancer Screening Knowledge and Skills of Students upon Entering and Exiting a Medical School.

    Science.gov (United States)

    Kann, P. Elizabeth; Lane, Dorothy S.

    1998-01-01

    A study compared the breast cancer screening knowledge of 27 medical students in first and fourth years. In the fourth year additional questions were asked about training and training needs. Although students performed significantly better on knowledge-based questions in the fourth year, considerable room for improvement remained. Most students…

  1. 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…

  2. Culturally Competent Training Program: A Key to Training Lay Health Advisors for Promoting Breast Cancer Screening

    Science.gov (United States)

    Yu, Mei-yu; Song, Lixin; Seetoo, Amy; Cai, Cuijuan; Smith, Gary; Oakley, Deborah

    2007-01-01

    The lay health advisor (LHA) training program for breast cancer screening was conducted among Chinese-English bilingual trainees residing in Southeast Michigan. Guided by Bandura's Social Learning Theory, the development of the training curriculum followed the health communication process recommended by the National Cancer Institute. Data analysis…

  3. 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…

  4. Advancing Social Workers' Responsiveness to Health Disparities: The Case of Breast Cancer Screening

    Science.gov (United States)

    Altpeter, Mary; Mitchell, James F.; Pennell, Joan

    2005-01-01

    This study provides the basis for customizing culturally responsive social work health promotion programs aimed at eliminating breast cancer screening and mortality disparities between white and African American women. Survey data collected from a random sample of 853 women in rural North Carolina were used to explore the impact of psychosocial…

  5. Quality control of breast cancer screening in Yokohama city for women in their 40 s

    International Nuclear Information System (INIS)

    Biennial screening mammography for breast cancer detection has been carried out in Yokohama City for women aged 50 years and older since October 2001. In three and a half years 49,795 eligible women have been screened, 123 have been diagnosed as having cancer, and the cancer detection rate has been 0.25%. Since 73% of the diagnosed cancers were classified as stage 0 and I, this screening system is considered to have contributed to improving the prognosis of the examines. With regard to quality control, although the rate of women requiring a detailed re-examination has been reduced significantly from 19.1% to 6.9%, the positive predictive value of less than 4% is still insufficient. It is therefore considered that there are some problems with detailed re-examinations. Since screening mammography for breast cancer was extended to women aged 40-49 years in Yokohama City in July 2005, the rate of cancer not detected by mammography was examined in age cohorts of five years among 138 women who were clinically diagnosed as having breast cancer. Because 12.2% of women aged 44 years and younger had no findings on mammography, and cancer was detected in 87.5% of these women by ultrasonography (US), it is recommended that US should be added to mammography for breast cancer examination at this age. (author)

  6. Accuracy of Self-Reported Cervical and Breast Cancer Screening by Women with Intellectual Disability

    Science.gov (United States)

    Son, Esther; Parish, Susan L.; Swaine, Jamie G.; Luken, Karen

    2013-01-01

    This study examines the accuracy of self-report of cervical and breast cancer screening by women with intellectual disability ("n" ?=? 155). Data from face-to-face interviews and medical records were analyzed. Total agreement, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Total…

  7. Validity and Reliability of Psychosocial Factors Related to Breast Cancer Screening.

    Science.gov (United States)

    Zapka, Jane G.; And Others

    1991-01-01

    The construct validity of hypothesized survey items and data reduction procedures for selected psychosocial constructs frequently used in breast cancer screening research were investigated in telephone interviews with randomly selected samples of 1,184 and 903 women and a sample of 169 Hispanic clinic clients. Validity of the constructs is…

  8. Including Antenna Models in Microwave Imaging for Breast-Cancer Screening

    DEFF Research Database (Denmark)

    Rubæk, Tonny; Meincke, Peter

    2006-01-01

    Microwave imaging is emerging as a tool for screening for breast cancer, but the lack of methods for including the characteristics of the antennas of the imaging systems in the imaging algorithms limits their performance. In this paper, a method for incorporating the full antenna characteristics,...

  9. Functional screen of paracrine signals in breast carcinoma fibroblasts.

    Directory of Open Access Journals (Sweden)

    Gui Su

    Full Text Available Stromal fibroblasts actively participate in normal mammary gland homeostasis and in breast carcinoma growth and progression by secreting paracrine factors; however, little is known about the identity of paracrine mediators in individual patients. The purpose of this study was to characterize paracrine signaling pathways between breast carcinoma cells and breast carcinoma-associated fibroblasts (CAF or normal mammary fibroblasts (NF, respectively. CAF and NF were isolated from breast carcinoma tissue samples and adjacent normal mammary gland tissue of 28 patients. The fibroblasts were grown in 3D collagen gel co-culture with T47D human breast carcinoma cells and T47D cell growth was measured. CAF stimulated T47D cell growth to a significantly greater degree than NF. We detected a considerable inter-individual heterogeneity of paracrine interactions but identified FGF2, HB-EGF, heparanase-1 and SDF1 as factors that were consistently responsible for the activity of carcinoma-associated fibroblasts. CAF from low-grade but not high-grade carcinomas required insulin-like growth factor 1 and transforming growth factor beta 1 to stimulate carcinoma growth. Paradoxically, blocking of membrane-type 1 matrix metalloprotease stimulated T47D cell growth in co-culture with NF. The results were largely mirrored by treating the fibroblasts with siRNA oligonucleotides prior to co-culture, implicating the fibroblasts as principal production site for the secreted mediators. In summary, we identify a paracrine signaling network with inter-individual commonalities and differences. These findings have significant implications for the design of stroma-targeted therapies.

  10. Determinants of the Use of Breast Cancer Screening Among Women Workers in Urban Mexico

    Directory of Open Access Journals (Sweden)

    Sergio R. Sánchez-Peña, PhD

    2008-04-01

    Full Text Available IntroductionThis case-control study aimed to determine critical factors influencing the use of clinical breast examination and mammography among women workers in Monterrey, Mexico.MethodsWe determined case and control status from survey results. Cases were defined in accordance with the guidelines of the Official Mexican Standard as lack of at least one clinical breast examination during the past year by surveyed women. For women older than 40 years, cases were further defined as lack of at least one mammogram in the previous 2 years and, for women older than 50, lack of a mammogram in the previous year. Controls were defined as adherence by surveyed women to these guidelines. Participants (N = 306 clerks aged 18–60 provided information about their practices, knowledge, and perceptions regarding breast cancer screening. Factors identified by odds ratio analysis as significantly different between cases and controls were analyzed by multivariate logistic regression.ResultsSurvey participants’ knowledge about the utility of breast self-examination (odds ratio, 6.0; 95% confidence interval, 1.0–33.9, perception that the health care system has enough equipment and personnel for clinical breast examination (odds ratio, 4.7; 95% confidence interval, 1.7–13.2, and perception that they have enough time to wait for and receive clinical breast examinations (odds ratio, 2.5; 95% confidence interval, 1.1–5.8 significantly predisposed women to use screening services independent of years of formal education, number of pregnancies, number of living children, hours worked per week, and monthly family income.ConclusionPerception of organizational and structural factors played a significant role in screening use. Our findings have implications for the general population, provider practices, community interventions, and future development of strategies to increase use of screening services in similar locales.

  11. Breast examination as a cost-effective screening tool in a clinical practice setting in Ibadan, Nigeria

    Directory of Open Access Journals (Sweden)

    Adetola M. Ogunbode

    2013-02-01

    Full Text Available Background: Breast cancer is a disease of public health importance. It results in high morbidity and mortality in women worldwide. The high morbidity and mortality from breast cancer can be decreased by measures targeted at early detection such as screening. Breast examination as a screening tool for breast cancer in developing countries is advocated in view of its costeffectiveness. Method: The article selection method was obtained from primary and secondary literature sources which included original research articles, case control studies, review articles, proceedings, transactions and textbooks. The authors cited a clinical audit and articles published between 1988 and 2011. The search strategy included the use of internet search engines. This review was part of a larger research and the study protocol was approved by the University of Ibadan/University College Hospital, Ibadan Institutional Review Board (UI/UCH IRB. Clinical trial registration number-NHREC/05/01/2008a.Results: Breast self-examination (BSE and clinical breast examination (CBE as screening tools for breast cancer were analysed in detail.Conclusion: Breast examination is a screening tool that is cost-effective and reliable and should be encouraged in resource-constrained countries. Given the high cost and expertise requiredfor mammography, current efforts at screening for breast cancer in developing countries should rely more on a combination of BSE and CBE.

  12. Breast examination as a cost-effective screening tool in a clinical practice setting in Ibadan, Nigeria

    Directory of Open Access Journals (Sweden)

    Adetola M. Ogunbode

    2013-01-01

    Full Text Available Background: Breast cancer is a disease of public health importance. It results in high morbidity and mortality in women worldwide. The high morbidity and mortality from breast cancer can be decreased by measures targeted at early detection such as screening. Breast examination as a screening tool for breast cancer in developing countries is advocated in view of its costeffectiveness.Method: The article selection method was obtained from primary and secondary literature sources which included original research articles, case control studies, review articles, proceedings, transactions and textbooks. The authors cited a clinical audit and articles published between 1988 and 2011. The search strategy included the use of internet search engines. This review was part of a larger research and the study protocol was approved by the University of Ibadan/University College Hospital, Ibadan Institutional Review Board (UI/UCH IRB. Clinical trial registration number-NHREC/05/01/2008a.Results: Breast self-examination (BSE and clinical breast examination (CBE as screening tools for breast cancer were analysed in detail.Conclusion: Breast examination is a screening tool that is cost-effective and reliable and should be encouraged in resource-constrained countries. Given the high cost and expertise required for mammography, current efforts at screening for breast cancer in developing countries should rely more on a combination of BSE and CBE.

  13. Sensitivity and specificity of computer-assisted breast cancer detection in mammography screening

    International Nuclear Information System (INIS)

    Purpose: To evaluate a system of computer-assisted diagnosis (CAD) in mammography. Material and Methods: A sample of 120 sets of two-view mammograms was examined by an expert screener, a screening radiologist, a clinical radiologist, and a CAD system. The screening and clinical radiologists examined the mammograms twice, first without and then with the help of CAD. The sample consisted of first-round screening films from a two-round population-based screening, and comprised: 32 women in whom breast cancer was detected at the first screening; 10 with cancer detected during the screening interval; 32 with cancer detected at the second screening; and 46 with normal mammograms at both screenings. Results: The expert screener, the screening radiologist, the clinical radiologist, and the CAD system detected respectively 44, 41, 34 and 37 cancers. Their respective specificities were 80%, 83%, 100% and 22%. With the help of CAD, the screening radiologist detected 1 additional cancer and the clinical radiologist detected 3; their respective specificities were 80% and 100%. Conclusion: The sensitivity of the CAD system was satisfactory. The two radiologists helped by CAD achieved a modest increase in sensitivity with unaffected specificity. However, the CAD system by itself had a very low specificity and it needs improvement before it can be useful in mammographic screening. (orig.)

  14. Breast cancer screening awareness, knowledge, and practice among arab women in the United Arab Emirates: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Yusra E Elobaid

    Full Text Available BACKGROUND: Breast cancer screening can reduce morbidity and mortality and improve the survival rate for this malignancy. Low participation in screening programs has been attributable to many factors including lack of knowledge. The aim of this study was to assess breast cancer screening knowledge, attitudes and practices among women of screening age (≥40 years old in the city of Al Ain, United Arab Emirates (UAE. METHODS: A cross-sectional survey was conducted in 2013 using the Breast Cancer Awareness Measure (CAM. Four out of twelve cultural and religious community centers in Al Ain city were randomly selected. Two hundred and forty seven women were interviewed. Chi Square test and regression analysis were used to analyze the data. RESULTS: Despite the increase in the uptake of screening modalities in our study group, a lack of knowledge about breast cancer screening is still evident. Almost half (44.8% of women who never had a Clinical Breast Exam (CBE and 44.1% of women who never had a mammography expressed a lack of knowledge about the existence of these screening techniques. Nearly one third of the participants interpreted the presence of a breast lump incorrectly and, moreover, expressed fewer worries about the nature of the lump than would normally be expected. CONCLUSIONS: The National screening program needs to be improved and directed towards more efficient and targeted utilization of resources. Healthcare professionals play a major role in alerting women to the importance of periodic screening.

  15. 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.

  16. Progress of breast cancer screening technology%乳腺癌筛查技术的进展

    Institute of Scientific and Technical Information of China (English)

    蔡卓君

    2016-01-01

    As a main threat to female health, breast cancer has shown increasing morbidity rate in recent years, and it has become an critical public health issue in society. Breast cancer screening is helpful for detecting and preventing breast cancer, and the main screening technology in China include clinical breast check, breast X-ray, breast ultrasounography, breast magnetic resonance imaging, and breast blood oxygen functional imaging. This paper made a comparison of advantages and disadvantages of breast cancer screening technology, so as to provide reference and basis for female breast cancer screening strategy.%乳腺癌是威胁女性健康的主要疾病,近年其发病率呈上升趋势,成为当前社会重大公共卫生问题。乳腺癌筛查有助于发现和预防乳腺癌,国内外目前主要筛查技术有临床乳腺检查、乳腺X 线、乳腺超声、乳腺磁共振成像、乳腺血氧功能成像等,本文对乳腺癌筛查技术的优缺点进行比较,为女性乳腺癌筛查策略提供参考和依据。

  17. Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study

    OpenAIRE

    Husebø, Anne Marie Lunde; Karlsen, Bjørg; Allan, Helen T.; Søreide, Jon Arne; Bru, Edvin

    2015-01-01

    Aims and objectives. To explore factors influencing exercise adherence among women with breast cancer while following an exercise programme. Background. Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge. Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer. Design. This was a quali...

  18. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  19. Turnaround times in breast cancer:From screening to diagnosis to treatment

    Institute of Scientific and Technical Information of China (English)

    Kaylene J Logan; Patrice M. Weiss; Catherine Hagan-Aylor; Bob Herbertson

    2013-01-01

    Objective: To compare our institution with national benchmark times, and identify rate-limiting steps in the process by conducte a retrospective review of the turnaround times in 2009 at the Carilion Clinic Breast Care Center (CCBCC). To evaluate patient satisfaction with the turn around times. Methods: A retrospective chart review was performed to evaluate the time intervals from abnormal screening mammogram to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to MRI, and MRI to surgery of all patients seen for breast cancer in 2009. A patient survey was mailed out to all patients (131) managed from abnormal screening to surgery in 2009, assessing their satisfaction with the turnaround times from screening mammogram to call back, call back to diagnostic mammogram, diagnostic mammogram to biopsy, biopsy to results call, biopsy result to MRI appointment, MRI appointment to surgery consult, and surgery consult to surgery; and assessing possible reasons why patients may perceive the process to be delayed. The MEANS procedure was applied to evaluate the turnaround times, and a Box and Whisker Plot statistical comparison was made between patient satisfaction and turnaround times. Results: The mean turnaround time at the CCBCC in 2009 from abnormal screening mammogram to surgery was 45 d. This falls within the 75th %ile of the National Quality Measures for Breast Centers (NQMBC), established by the National Consortium of Breast Centers (NCBC). Of 131 surveys mailed out, 57 were returned (44%). The patient satisfaction rates for each interval ranged from 96%-100%, with an overall satisfaction rate of 98% for abnormal screening mammogram to surgery. 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

  20. Rural physicians' perspectives on cervical and breast cancer screening: a gender-based analysis.

    Science.gov (United States)

    Ahmad, F; Stewart, D E; Cameron, J I; Hyman, I

    2001-03-01

    Several studies highlight the role of physicians in determining cervical and breast cancer screening rates, and some urban studies report higher screening rates by female physicians. Rural women in North America remain underscreened for breast and cervical cancers. This survey was conducted to determine if there were significant gender differences in practices and perceptions of barriers to breast and cervical cancer screening among rural family physicians in Ontario, Canada. One hundred ninety-one family physicians (response rate 53.1%) who practiced in rural areas, small towns, or small cities completed a mail questionnaire. The physicians' mean age was 44.4 years (SD 9.9), and mean number of years in practice was 16.6 years (SD 10.3). Over 90% of physicians reported that they were very likely to conduct a Pap test and clinical breast examination (CBE) during a periodic health examination, and they had high levels of confidence and comfort in performing these procedures. Male (68%) and female (32%) physicians were similar in their likelihood to conduct screening, levels of confidence and comfort, and knowledge of breast and cervical cancer screening guidelines. However, the self-reported screening rates for Pap tests and CBE performed during last year were higher for female than male physicians (p < 0.01). Male physicians reported they were asked more frequently by patients for a referral to another physician to perform Pap tests and CBE (p < 0.001). Also, male physicians perceived patients' embarrassment as a stronger barrier to performing Pap tests (p < 0.05) and CBE (p < 0.01) than female physicians. No gender differences were observed in screening rates or related barriers to mammography referrals. These findings suggest that physicians' gender plays a role in sex-sensitive examination, such as Pap tests and CBE. There is a need to facilitate physician-patient interactions for sex-sensitive cancer screening examinations by health education initiatives

  1. Effects of different phases of an invitational screening program on breast cancer incidence.

    Science.gov (United States)

    Seppänen, Johanna; Heinävaara, Sirpa; Anttila, Ahti; Sarkeala, Tytti; Virkkunen, Hanna; Hakulinen, Timo

    2006-08-15

    The aim of this study was to quantify the effects of separate phases of an invitational screening program on breast cancer incidence at different ages. Our database included detailed municipality-specific information about invitations for mass-screening for breast cancer in 267 Finnish municipalities from time period 1987-2001. The age range was 50-74. For this study, the program was divided into 7 separate phases, and those that had not been invited served as a baseline. The incidence rate was modeled using Poisson regression. To study the differences between age groups within each program phase, an interaction term between age group and phase of screening was included in the model. The modeling was done separately for localized breast cancers, nonlocalized breast cancers and all stages combined. For localized cancers, the risk compared to the noninvited increased during the first years of the 2-year screening rounds in all age groups, and declined below the baseline during the second years. This effect was larger during the first round compared to the subsequent ones. In nonlocalized cancers, a clear incidence peak was detected only during the first year of the first round. A decreasing post screening effect was detected in nonlocalized cancers in women aged 60-69, but not in localized cancers. Cumulating over ages 50-74, extra incidence caused by regular screening in localized cancers was 5.2% if the program was continued up to age 59, and 28.0% if it continued up to age 69. Corresponding figures for nonlocalized cancers were decreases of 19.8% and 20.9%, respectively. PMID:16550598

  2. 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.

  3. Breast density as indicator for the use of mammography or MRI to screen women with familial risk for breast cancer (FaMRIsc: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Saadatmand Sepideh

    2012-10-01

    Full Text Available Abstract Background To reduce mortality, women with a family history of breast cancer often start mammography screening at a younger age than the general population. Breast density is high in over 50% of women younger than 50 years. With high breast density, breast cancer incidence increases, but sensitivity of mammography decreases. Therefore, mammography might not be the optimal method for breast cancer screening in young women. Adding MRI increases sensitivity, but also the risk of false-positive results. The limitation of all previous MRI screening studies is that they do not contain a comparison group; all participants received both MRI and mammography. Therefore, we cannot empirically assess in which stage tumours would have been detected by either test. The aim of the Familial MRI Screening Study (FaMRIsc is to compare the efficacy of MRI screening to mammography for women with a familial risk. Furthermore, we will assess the influence of breast density. Methods/Design This Dutch multicentre, randomized controlled trial, with balanced randomisation (1:1 has a parallel grouped design. Women with a cumulative lifetime risk for breast cancer due to their family history of ≥20%, aged 30–55 years are eligible. Identified BRCA1/2 mutation carriers or women with 50% risk of carrying a mutation are excluded. Group 1 receives yearly mammography and clinical breast examination (n = 1000, and group 2 yearly MRI and clinical breast examination, and mammography biennially (n = 1000. Primary endpoints are the number and stage of the detected breast cancers in each arm. Secondary endpoints are the number of false-positive results in both screening arms. Furthermore, sensitivity and positive predictive value of both screening strategies will be assessed. Cost-effectiveness of both strategies will be assessed. Analyses will also be performed with mammographic density as stratification factor. Discussion Personalized breast cancer screening

  4. 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. 

  5. Application of epidemiologic studies of radiation-induced breast cancer to mammographic screening guidelines

    International Nuclear Information System (INIS)

    The question of benefit/risk ratio for the mammographic screening of asymptomatic women has been under intense scrutiny for several years. The studies of radiogenic breast cancer show good agreement in the quantitative estimation of the magnitude of radiation risks, in spite of the variations among the several studies in radiation quality factors, exposure fractionation, and the background population rate of breast cancer. There is a report indicating no evidence for the synergism between radiation and benign breast disease, late menopause, or the family history of breast cancer. According to the report, the radiogenic breast cancer risk is 3-fold higher in nulliparous women as compared with parous women. The analyses of lifetime risks and benefits suggest that the choice of an additive vs. multiplicative risk model is not crucial. The benefit/risk ratio shows strong age dependence which agrees well with the current U.S. guidelines, namely that the routine mammographic screening of the general population of asymptomatic women is recommended only after age of 50. (Yamashita, S.)

  6. 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.

  7. [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.

  8. [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. PMID:25402242

  9. Now, Later of Never: Multicenter Randomized Controlled Trial Call—Is Surgery Necessary after Atypical Breast Core Biopsy Results in Mammographic Screening Settings?

    OpenAIRE

    Nikita Makretsov

    2015-01-01

    Breast cancer mammographic screening leads to detection of premalignant and preinvasive lesions with an increasing frequency. Nevertheless, current epidemiologic evidence indicates that the screening reduces breast cancer specific mortality, but not overall mortality in breast cancer patients. The evidence is lacking whether aggressive eradication of DCIS (preinvasive form of breast carcinoma) by surgery and radiation is of survival benefit, as long-term breast cancer specific mortality in a ...

  10. Assessment of required resources for implementation of national breast cancer screening program in Serbia

    Directory of Open Access Journals (Sweden)

    Majstorović Nemanja

    2014-01-01

    Full Text Available Introduction. High values of standardized mortality and morbidity rates of standardized cancer mortality in Serbia, especially colorectal, cervical and breast cancer led to creation of national programs for their early detection and engagement of the international support for their implementation. Objective. Assessment of required resources (time, personnel, financial to implement the National program for screening of breast cancer in the Republic of Serbia. Methods. Three possible scenarios have been prepared (optimistic, realistic and pessimistic based on the expected coverage by screening of women aged 45 to 69 years, and time, personnel and financial feasibility estimates were made for a two-year screening cycle. Results. Time aspect of feasibility even under conditions of “relaxation” of the assumption on the number of working days during the year did not question feasibility of any of the scenarios. Personnel feasibility is only possible in the pessimistic scenario, while the financial feasibility only makes sense in optimistic scenario as the least unfavorable solution due to economies of scale. Conclusion. Establishment of the initial base of skilled radiologists and radiology technicians and the system for their continuous medical education as well as allocation of specific MoH budget line for screening program expenditures, along with donated mammographs and good organization and coordination, may provide unobstructed implementation of the National program for early detection of breast cancer in the Republic of Serbia.

  11. Does digital mammography in a decentralized breast cancer screening program lead to screening performance parameters comparable with film-screen mammography?

    International Nuclear Information System (INIS)

    To evaluate if the screening performance parameters of digital mammography (DM) in a decentralized screening organization were comparable with film-screen mammography (FSM). A nationwide screening program was launched in 2001, and since 2005 screening with DM has been allowed. Firstly, the parameters of the three regional screening units (RSUs) that first switched to DM (11,355 women) were compared with the FSM period of the same three RSUs (23,325 women). Secondly, they were compared with the results of the whole central breast unit (CBU). The recall rate (RR) of the DM group in the initial round was 2.64% [2.40% for FSM (p = 0.43)] and in the subsequent round 1.20% [1.58% for FSM (p = 0.03)]. The cancer detection rate (CDR) was 0.59% for DM and 0.64% for FSM (p = 0.56). The percentage of ductal carcinoma in situ was 0.07% for DM and 0.16% for FSM (p = 0.02). The positive predictive value was high in the subsequent rounds (DM 48.00%, FSM 45.93%) and lower in the initial round (DM 24.05%, FSM 24.86%). Compared with the results of the whole CBU, DM showed no significant difference. DM can be introduced in a decentralized screening organization with a high CDR without increasing the RR. (orig.)

  12. Digital mammography in breast cancer screening: Evaluation and innovation

    NARCIS (Netherlands)

    A.M.J. Bluekens

    2015-01-01

    With all other imaging modalities in radiology being digitised and conventional mammography being ready to phase out the transition to digital mammography was inevitable. This thesis describes the performance of digital screening mammography and the consequences of implementation in a population-bas

  13. Screening mammography. A missed clinical opportunity? Results of the NCI [National Cancer Institute] Breast Cancer Screening Consortium and national health interview survey studies

    International Nuclear Information System (INIS)

    Data from seven studies sponsored by the National Cancer Institute (NCI) were used to determine current rates of breast cancer screening and to identify the characteristics of and reasons for women not being screened. All seven studies were population-based surveys of women aged 50 to 74 years without breast cancer. While over 90% of non-Hispanic white respondents had regular sources of medical care, 46% to 76% had a clinical breast examination within the previous year, and only 25% to 41% had a mammogram. Less educated and poorer women had fewer mammograms. The two most common reasons women gave for never having had a mammogram were that they did not known they needed it and that their physician had not recommended it. Many physicians may have overlooked the opportunity to recommend mammography for older women when performing a clinical breast examination and to educate their patients about the benefit of screening mammography

  14. Cost Effectiveness of Breast Cancer Screening Using Mammography; a Systematic Review

    Directory of Open Access Journals (Sweden)

    Arash Rashidian

    2013-04-01

    Full Text Available Background: 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.

  15. A randomized trial of three marketing strategies to disseminate a screening and brief alcohol intervention programme to general practitioners.

    OpenAIRE

    Lock, C A; Kaner, E F; Heather, N.; McAvoy, B R; Gilvarry, E

    1999-01-01

    BACKGROUND: Research findings are of little benefit to patients or society if they do not reach the audience they are intended to influence. A dissemination strategy is needed to target new findings at its user group and encourage a process of consideration and adoption or rejection. AIM: To evaluate the effectiveness and cost-effectiveness of different marketing strategies for the dissemination of a screening and brief alcohol intervention (SBI) programme to general practitioners (GPs). METH...

  16. SDOCT Imaging to Identify Macular Pathology in Patients Diagnosed with Diabetic Maculopathy by a Digital Photographic Retinal Screening Programme

    OpenAIRE

    Mackenzie, Sarah; Schmermer, Christian; Charnley, Amanda; Sim, Dawn; Vikas Tah; Dumskyj, Martin; Nussey, Stephen; Egan, Catherine

    2011-01-01

    Introduction Diabetic macular edema (DME) is an important cause of vision loss. England has a national systematic photographic retinal screening programme to identify patients with diabetic eye disease. Grading retinal photographs according to this national protocol identifies surrogate markers for DME. We audited a care pathway using a spectral-domain optical coherence tomography (SDOCT) clinic to identify macular pathology in this subset of patients. Methods A prospective audit was performe...

  17. 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 delto...

  18. Promoting Breast Cancer Screening Among Asian American Women: the Asian Grocery Store-Based Cancer Education Program

    OpenAIRE

    Sadler, Georgia Robins; Beerman, Paula R.; Lee, Kathy; Hung, Jenny; Nguyen, Helene; Cho, Janet; Huang, Wennie

    2012-01-01

    Asian American women's historically low breast cancer mortality rate has remained constant as rates decreased for all other races. From 2000 to 2004, a randomized controlled trial explored the Asian grocery store-based breast cancer education program's impact on Chinese, Filipino, Korean, and Vietnamese women (n=1,540). Women aged 40 and older and non-adherent for annual screening mammograms were more likely to schedule a mammogram after receiving the breast cancer education program than wome...

  19. 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.

  20. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline

    Science.gov (United States)

    2011-01-01

    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 frameworks, we developed an

  1. 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

  2. Growth rate and characteristics of breast cancers detected by ultrasonography screening

    International Nuclear Information System (INIS)

    Breast cancer screening was carried out at our institution in a ''Human Dock'' style health check, by inspection and palpation, together with ultrasonography. Breast cancers detected were reviewed and the utility of ultrasonography was evaluated. A total of 14,063 women underwent the screening and the results were good, with a recall rate of 3.4%, a cancer detection rate of 0.30%, and a positive predictive value of 8.7%. Of 42 breast cancers detected by ultrasonography, 30 (71%) were 1.5 cm or less in diameter. For breast cancers detected by inspection and palpation, the detection rate for small cancers measuring 1.5 cm or less was 33% (10 out of 30 women), and 100% (12 women) for tumors measuring more than 1.5 cm. The cancer detection rate by mammography was 39% (9 out of 23 cancers) for tumors measuring 1.5 cm or less, and 91% (10 out of 11 cases) for those larger than 1.5 cm. Thus cancer detection by ultrasonography was optimal for tumors measuring 1.5 cm or less. Histologically proven lymph node metastasis was positive in 8 (25%) of 32 patients, among whom some had primary cancers measuring 1.5 cm or less. Tumor volume doubling time (TVDT) was measurable in 10 women; there was no change in size in one instance, and in the others TVDT was 4.8 to 32.5 months (mean 15.5 months), small cancers approximately 1 cm in size having a long TVDT. In women whose cancer size could be determined twice or more, TVDT tended to be short when a cancer measured about 1 cm or more. Cancers with a long TVDT showed low histological malignancy, and thus detection of breast cancers with a long TVDT at screening appears to be rewarding. (author)

  3. Testing the Feasibility of a Culturally Tailored Breast Cancer Screening Intervention with Native Hawaiian Women in Rural Churches

    Science.gov (United States)

    Ka'opua, Lana Sue I.; Park, Soon H.; Ward, Margaret E.; Braun, Kathryn L.

    2011-01-01

    The authors report on the feasibility of delivering a church-based breast cancer screening intervention tailored on the cultural strengths of rural-dwelling Hawaiians. Native Hawaiian women are burdened by disproportionately high mortality from breast cancer, which is attributed to low participation in routine mammography. Mammography is proven to…

  4. 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…

  5. Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women

    OpenAIRE

    Han, Hae-Ra; Lee, H.; Kim, M. T.; Kim, K. B.

    2008-01-01

    Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an intervention trial with a 6-month follow-up. Trained LHWs recruited 100 KA women 40 years of age or older who had not had a mammogram during the pas...

  6. 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...... II and above predicted a larger reduction in breast cancer mortality (p = 0.04 and p = 0.006). This expected association was also found for node-positive cancers (p = 0.008 and p = 0.04). However, a screening effectiveness of zero (same proportion of node-positive cancers in the screened group...

  7. Breast and cervical cancer screening among migrant and seasonal farmworkers: a review.

    Science.gov (United States)

    Coughlin, Steven S; Wilson, Katherine M

    2002-01-01

    Women constitute about one in five hired farmworkers in the US. Their health may be affected by exposure to unhealthy living and working conditions, by increased exposure to health hazards, by poverty, and by poor utilization of health care and preventive services. About 69% of migrant and seasonal farmworkers were born outside the US, mostly in Mexico and central America, and many speak little English. The health concerns of women who are migrant and seasonal farmworkers include breast and cervical cancer, which can be prevented or controlled through routine screening, but cancer incidence and mortality data for migrant workers are sparse. We reviewed published studies that examined breast and cervical cancer screening in this population. These studies include cross-sectional surveys, health needs assessments, and randomized and non-randomized intervention trials. A review of published studies of cancer screening among women who are migrant and seasonal farmworkers indicates that underutilization of mammograms and Papanicolau (Pap) tests among this population may stem from their limited awareness of the importance of cancer screening and cultural beliefs. Other barriers include cost, lack of health insurance, lack of transportation and child care difficulties. The extent to which results obtained in selected localities are generalizable to other settings is uncertain, but results to date provide important information about possible approaches for increasing cancer screening among women migrant farmworkers. PMID:12269767

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

    International Nuclear Information System (INIS)

    Breast cancer susceptibility gene, type 1(BRCA1) has been thought to be responsible for ∼45% of families with multiple breast carcinomas and for ∼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 which are biologically insignificant. PTT, DHPLC, and sequence analyses revealed a novel mutation in exon 11 involving GT insertion that resulted to a stop codon which generated a 29.7 kDa truncated protein product. This is the second documented mutation in BRCA1 exon 11 in a Filipino BC patient since 1998. Initial genotype-phenotype correlations in Filipino BC patients may be elucidated based on screening tests performed. Our results corroborate the findings of a study on unselected incident Filipino BC cases where the reported prevalence of BRCA1 mutation is low. The higher prevalence of putative polypmorphisms may be attributed to the increased stringency in patient prospecting. The Gail, Claus, and BRCAPRO models can be utilized to estimate BC risk in unaffected high-risk individuals but validation is needed. Most of the BRCAPRO and Myriad.com prior probability estimates coincide with the presence of BRCA1 mutation and/or putative polymorphisms. This pioneering

  9. Investigation of breast dose in five screening mammography centres in Greece

    Energy Technology Data Exchange (ETDEWEB)

    Tsapaki, V [Medical Physics Department, Konstantopoulio Hospital, Nea Ionia, 142 33, Athens (Greece); Tsalafoutas, I A [Medical Physics Department, Agios Savvas Hospital, 171 Alexandras Avenue, 115 22, Athens (Greece); Poga, V; Louizi, A; Kottou, S [Medical Physics Department, Medical School, Athens University, University of Athens, 75 Mikras Asias, 115 27, Athens (Greece); Koulentianos, E [Radiology Department, Konstantopoulio Hospital, Nea Ionia, 142 33, Athens (Greece)

    2008-09-01

    The objectives of this study were to investigate the techniques currently used for screening mammography in Greece, to estimate the mean glandular dose (MGD) for establishing a baseline radiation dose database, to analyse the effects of various factors on MGD, and to compare the results with others in the literature. Five mammographic facilities and 250 women having as a routine screening mammogram one craniocaudal (CC) and one mediolateral oblique (MLO) projection in each breast were included in the study. The parameters recorded were age, weight, compressed breast thickness (CBT), tube potential (kV), tube loading (mA s) and MLO projection angle. Large differences were observed among the different mammography facilities, mainly in terms of the tube potential setting and the MLO angle used. The average MGD per exposure was 1.4 {+-} 0.6 mGy while the respective averages separately for the CC and MLO projections were 1.2 {+-} 0.5 and 1.5 {+-} 0.7 mGy, respectively. The average MGD values recorded in this study were below the limit of 2 mGy established for the reference medium-sized breast of 4.5 cm CBT. However, the variety of techniques observed revealed the need for a nationwide survey concerning screening mammography in Greece.

  10. Use of risk projection models to estimate mortality and incidence from radiation-induced breast cancer in screening programs

    International Nuclear Information System (INIS)

    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 10-6, 6 x 10-4] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 x 10-3. The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs

  11. 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.

  12. Understanding Breast Health Awareness in an Arabic Culture: A qualitative exploration

    OpenAIRE

    Madkhali, Norah Abdullah; Santin, Olinda; Noble, Helen; Reid, Joanne

    2016-01-01

    Aims: To explore breast health awareness and the early diagnosis and detection methods of breast cancer from the perspective of women and primary health care providers in the Jizan region of the Kingdom of Saudi Arabia. Background: While there is a high incidence of advanced breast cancer in young women in the Kingdom of Saudi Arabia, there is no standardised information regarding breast self-examination, nor is there a national screening programme involving clinical breast examination and ma...

  13. Survey of breast cancer screening by mammography. Results of a questionnaire sent to local self-governing bodies

    International Nuclear Information System (INIS)

    In order to grasp the current status of breast cancer screening in Japan, a questionnaire was distributed to all local self-governing bodies (LSGB). The results indicated that breast cancer screening with mammography was performed by 97.9% of LSGB. Breast cancer screening was started for women aged less than 40 years at 11.9% of the LSGB, and from 40 years of age at 86.8%. Breast cancer screening for women aged 30-39 years was performed at 51.2% of the LSGB. The proportions of studies involving palpation, mammography, and ultrasonography (US) were 34.0%, 24.5%, and 41.6%, respectively. The coverage of screening invitations between April 2006 and March 2007 was grasped at 94.7% of LSGB. At 23.2%, the coverage was less than 10%, and at 33.8% was 10-19.9%. At 7.1%, the coverage was 50% or more. The national average for coverage was 10%, and was especially low in large cities. The recall rate for LSBG between April 2006 and March 2007 was 85.2%. At 22.4% of the LSBG, recall rates were less than 5%, and at 15.6% the recall rates were 50% or more. Screening mammography for women aged 30-39 years needs to be examined in the future. When recall rates exceed 20%, it is necessary to re-examine the accuracy management of breast cancer screening. (author)

  14. Radiation-induced breast cancer: the question of early breast cancer screening in Hodgkin's lymphoma survivors

    OpenAIRE

    Hilal, Talal; Rudy, David W.

    2016-01-01

    Chest irradiation is associated with numerous early and late complications that arise from ionizing radiation-induced damage to cellular structures within the field of therapy. In patients exposed to chest irradiation at an early age as part of the treatment of childhood cancer, specifically Hodgkin's lymphoma, the increased risk of breast cancer in the long run should be considered. A case of a 35-year-old woman who exposed to chest irradiation as part of the treatment of Hodgkin's lymphoma ...

  15. 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.

  16. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    Directory of Open Access Journals (Sweden)

    Lu Mingshan

    2012-06-01

    Full Text Available Abstract Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear. 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective

  17. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    Science.gov (United States)

    2012-01-01

    Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening

  18. 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.

  19. Risk of non-sentinel node metastases in patients with symptomatic cancers compared to screen-detected breast cancers

    DEFF Research Database (Denmark)

    Tvedskov, Tove F; Jensen, Maj-Britt; Balslev, Eva;

    2015-01-01

    BACKGROUND: Symptomatic breast cancers may be more aggressive as compared to screen-detected breast cancers. This could favor axillary lymph node dissection (ALND) in patients with symptomatic breast cancer and positive sentinel nodes. METHOD: We identified 955 patients registered in the Danish...... Breast Cancer Cooperative Group (DBCG) Database in 2008 - 2010 with micrometastases (773) or isolated tumor cells (ITC) (182) in the sentinel node. Patients were cross-checked in the Danish Quality Database of Mammography Screening and 481 patients were identified as screen-detected cancers....... The remaining 474 patients were considered as having symptomatic cancers. Multivariate analyses of the risk of non-sentinel node metastases were performed including known risk factors for non-sentinel node metastases as well as method of detection. RESULTS: 18% of the patients had metastases in non...

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

    DEFF Research Database (Denmark)

    Jensen, Line F; Mukai, Thomas; Andersen, Berit;

    2012-01-01

    Artiklen undersøger om der er sammenhæng mellem den praktiserede læges holdning til brystkræftscreening og kvinders deltagelse i screening. Data omkring de praktiserende lægers holdning til screening blev indsamlet via en spørgeskemaundersøgelse blandt praktiserende læger i Region Midtjylland. Data...... brystkræft screening var mere tilbøjelig til ikke at deltage, sammenlignet med kvinder som var tilknyttet en læge med en positiv holdning. Ved justering for kvindes socio-demografi og afstand til screeningenheden blev estimatet reduceret lidt og konfidensintervallet kom tættere på 0, men var stadigvæk...

  1. Family Caregivers' Perspectives on Barriers and Facilitators of Cervical and Breast Cancer Screening for Women with Intellectual Disability

    Science.gov (United States)

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

    2013-01-01

    Women with intellectual disability do not receive cervical and breast cancer screening at the same number as women without disabilities. Numerous barriers to receipt of screening have been reported by individuals with intellectual disability, paid caregivers, nurses, and other medical professionals. This study utilized semi-structured qualitative…

  2. A Community Capacity-Enhancement Approach to Breast and Cervical Cancer Screening among Older Women of Color

    Science.gov (United States)

    Bullock, Karen; McGraw, Sarah A.

    2006-01-01

    In the Screening Older Minority Women project, the authors applied a community capacity-enhancement approach to promoting breast and cervical cancer screening among older women of color. Members of informal support networks were recruited for this health promotion intervention to empower Latina and African American women to engage in positive…

  3. Preconceptions influence women’s perceptions of information on breast cancer screening

    DEFF Research Database (Denmark)

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

    2015-01-01

    condensation for our initial analysis, and further analysis was guided by the theory of cognitive dissonance. Results: 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...... 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 theintention 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. Methods: We used a qualitative design and interviewed six women who were soon to receive their first...

  4. 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.

  5. A community-based collaborative approach to improve breast cancer screening in underserved African American women.

    Science.gov (United States)

    Karcher, Rachel; Fitzpatrick, Dawn C; Leonard, Dawn J; Weber, Scott

    2014-09-01

    Although African American women in the United States have a lower incidence of breast cancer compared with white women, those younger than 40 years actually have a higher incidence rate; additionally, African American women are more likely to die from breast cancer at every age compared with white women. Racial disparities in breast cancer mortality rates are especially significant in Maryland, which ranks fifth in the nation for breast cancer mortality, and in Baltimore City, which has the second highest annual death rate for African American women in Maryland. To address this disparity in care, Med-IQ, an accredited provider of CME, collaborated with Sisters Network Baltimore Metropolitan, Affiliate Chapter of Sisters Network® Inc., the only national African American breast cancer survivorship organization, to sponsor their community-based educational outreach initiative. The collaborative mission was to engage at-risk African American women, their families, local organizations, healthcare professionals, and clinics, with the goals of increasing awareness, addressing fears that affect timely care and diagnosis, and encouraging women to obtain regular mammograms. Intervention strategies included (1) a "Survivor Stories" video, (2) patient outreach consisting of neighborhood walks and an educational luncheon, and (3) a community outreach utilizing direct mailings to local businesses, community groups, and healthcare professionals. Trusted and well-known community resources were presented as mediums to promote the initiative, yielding achievement of broader and more effective outcomes. As a result of this patient-friendly initiative, two (2) of the women who sought screening were diagnosed with breast cancer and underwent treatment. PMID:24446167

  6. The significance of X-ray mammography for breast cancer screening

    International Nuclear Information System (INIS)

    One high-priority health problem in our society are the high, age-specifically standardized mortality rates of breast cancer. Breast-conserving therapies are increasingly applied today whenever appropriate, as the patient outcome depends less on the local size of the tumor than on the existing micrometastases and general spreading of the tumor in terms of a systemic tumor lesion at the time of diagnosis and primary therapy. Among the available diagnostic methods, X-ray mammography is the modality of choice for detection of small, pre-clinical carcinoma or pre-invasive stages. Although one should not overestimate the true correct findings in detection of tumors less than 1 cm of size, the proportion of correct findings indicating T1-tumors or minimal cancer obtained in multiple screening projects is surprising. The fact that the number of detected cases involving the lymph nodes is 50% in patients with clinical symptoms and only 20% or even less in diognoses obtained by screening gives reason enough to speak of ''early detection'' in the latter case. Finally, the results of the HIP study, (reduction of mortality rates for women over 50 by 40%), and of the Oestergoetland study (for women between 40 and 70 years of age, 31%) are very convincing. Furthermore, a meta-analysis on the value of breast cancer screening reveals a mortality reduction of 22% in women between 40 and 49 years of age. Further improvement of the mammographic method and quality control in medical evaluation hopefully will contribute to more widespread screening activities also in Germany, and hence to a further reduction of mortality rates. (Orig./vhe)

  7. Utilization of breast cancer screening methods in a developing nation: results from a nationally representative sample of Malaysian households.

    Science.gov (United States)

    Dunn, Richard A; Tan, Andrew K G

    2011-01-01

    As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays. PMID:21615819

  8. 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.

  9. Breast and Cervical Cancer Screening in Women Referred to Urban Healthcare Centers in Kerman, Iran, 2015.

    Science.gov (United States)

    Ahmadipour, Habibeh; Sheikhizade, Sahar

    2016-01-01

    Breast and cervical cancers are among leading causes of morbidity and mortality in women worldwide. Regular screening is very important for early detection of these cancers, but studies indicate low rates of screening participation. In this survey we studied the rate of screening participation among women 18-64 years old referred to urban health centers in Kerman, Iran in 2015. A cross-sectional study was carried out on 240 women who were selected using a multistage sampling method. Data collected using a questionnaire covered demographics and questions about common cancer screening status in women. Analysis was by SPSS 19. The mean age of participants was 31.7± 7. Most (97.1%) were married, housewives (83.3%), had high school diploma (43.8%) and a monthly income more than ten million Rls. The frequency of the Pap test performance was higher in women who were employed and with a university degree (pperformance in women over 40 years was also higher in women with university degree (p0.05). Our study found that the rate of screening participation among women is low. Investigation of the barriers, increasing the awareness of women about the importance and advantages of screening and also more incentives for health personnel especially family physicians to pay more attention to preventive programs could be effective. PMID:27165219

  10. A review of breast cancer screening in the city of Sagamihara in 2005

    International Nuclear Information System (INIS)

    We reviewed the outcome of breast cancer screening in Sagamihara conducted in 2005. As only palpation was done, for females 30 years-old and older in Sagamihara (N=124,700), the check-up number was 11,551, the overall check-up rate was low (9.3%), and particularly lower among females in their 30s and 40s. A follow-up was suggested to 25.8% who joined the screening. This ratio was higher among subjects in their 50s. Out of those who were recommended to take a work-up, 89.2% actually took this suggestion, however a relatively lower percentage (86.3%, 86.4%) of those in their 30s and 40s had the work-up. Breast cancer was discovered in 16 cases (0.14%), which is comparable to the incidence in other geographical areas. Eight of 16 subjects who were diagnosed with breast cancer were in their 60 s without subjective symptoms including a lump, and 44% of the cancers was in the early stages. Pathological analysis showed that 44% of the cancer types was of a specific type. Sagamihara started to use mammography together with palpation in 2006. We will continue monitoring this trend in this city to identify any changes from these analyses. (author)

  11. Community-based intervention to promote breast cancer awareness and screening: The Korean experience

    Directory of Open Access Journals (Sweden)

    Kim Myung-hyun

    2011-06-01

    Full Text Available Abstract Background There are many differences in culture, community identity, community participation, and ownership between communities in Western and Asian countries; thus, it is difficult to adopt the results of community intervention studies from Western countries. In this study, we conducted a multicity, multicomponent community intervention trial to correct breast cancer myths and promote screening mammography for women living in an urban community in Korea. Methods A 6-month, 2-city community intervention trial was conducted. In the intervention city, 480 women were surveyed at baseline and 7 months later to evaluate the effects of the intervention program. Strategies implemented in the intervention city included community outreach and clinic and pharmacy-based in-reach strategies. Results This study showed a 20.4-percentage-point decrease in myths about the link between cancer and breast size, a 19.2-percentage-point decrease in myths concerning mammography costs, and a 14.1-percentage-point increase in intention to undergo screening mammography. We also saw a 23.4-percentage-point increase in the proportion of women at the action stage of the transtheoretical model in the intervention city. In the comparison city, smaller decreases and increases were observed. Conclusions Our study showed the value of an intervention study aimed at reducing belief in breast cancer myths in an urban community in Korea. The invention also made women more likely to undergo mammography in future.

  12. 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 screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution. It is our hope that by sharing our history other centers can learn from our mistakes and successes to better design their own prospective screening program to best serve their patient population.

  13. Women's satisfaction with information at breast biopsy in breast cancer screening

    DEFF Research Database (Denmark)

    Rehnberg, G; Absetz, P; Aro, A R

    2001-01-01

    Information needs, satisfaction with information and information sources of women referred for surgical biopsy in mammography screening were explored. Forty-five Finnish women (23 benign and 22 malignant finding) replied to a mailed questionnaire containing fixed-choice and open-ended questions 1...

  14. Reasons for participating in the Valencian Community Colorectal Cancer Screening Programme by gender, age, and social class

    Directory of Open Access Journals (Sweden)

    Ana Molina-Barceló

    2014-08-01

    Full Text Available Objective: To know the reasons to participate or not in a colorectal cancer (CCR screening programme and to analyze the differences by sex, age and social class. Methods: Cross-sectional study by a telephone survey directed to a sample of men and women aged between 50-74 year old, participants (n = 383 and non participants (n = 383 in the CCR screening programme of Valencian Community. Descriptive analysis and logistic regression models estimating the Odds Ratio (p < 0.05. Results: The main reasons to participate are "it is important for health" (97.9 % and "the test is easy" (97.6 %; and to non participate are "no CCR symptoms" (49.7 % and "didn't receive invitation letter" (48.3 %. Women are more likely not to participate if the reason was to consider the "test unpleasant" (OR: 1.82; IC: 1.00-3.28, and men if the reason was "lack of time" (OR 0.51; IC: 0.27-0.97; persons 60 or more years old if the reason was "diagnostic fear" (OR: 2.31; IC: 1.11-4.80, and persons 50-59 years old if was "lack of time" (OR 0.44; IC: 0.23-0.85; non manual social class persons if the reason was "lack of time" (OR: 2.66; IC: 1.40-5.10; manual women if the reason was "embarrassment to perform the test" (OR: 0.37; IC: 0.14-0.97; and non manual men if was "lack of time" (OR: 4.78; IC: 1.96-11.66. Conclusions: There are inequalities in the reasons for not participating in CCR screening programmes by sex, age and social class. It would be advisable to design actions that incorporate specific social group needs in order to reduce inequalities in participation.

  15. Knowledge, attitude and practice for breast cancer risk factors and screening modalities in staff nurses of Ayub teaching hospital Abbottabad

    International Nuclear Information System (INIS)

    Background: Breast cancer is the commonest cancer modality in female worldwide. Avoiding the risk factors can reduce its incidence and adhering to screening and early detection can reduce its mortality. A sufficient knowledge regarding the risk factors and screening modalities is therefore essential. We assessed the knowledge level about these parameters in our staff nurses. Methods: A self-administered questionnaire survey was performed. Knowledge regarding the risk factors and screening modalities were categorised into good, fair, poor and very poor categories. Results: Knowledge regarding most of the factors was found to be fair. A few things were termed as good knowledge like role of breast-feeding in protecting against breast cancer. Practice regarding the screening modalities was not satisfactory. Only a few nurses had good knowledge of the risk factors and screening modalities. Practice of the Screening modalities was also poor. Conclusion: There is a need to improve the nursing curriculum, training at the workplace and motivate them for screening practices. They should be encouraged to talk to their patients and their female attendants about prevention and early detection of breast cancer. (author)

  16. The psychological impact of mammographic screening on women with a family history of breast cancer--a systematic review.

    Science.gov (United States)

    Watson, Eila K; Henderson, Bethan J; Brett, Joanne; Bankhead, Clare; Austoker, Joan

    2005-11-01

    This systematic review aims to assess the psychological impact of mammographic screening on women with a family history of breast cancer. Women with a family history, and hence increased risk, of breast cancer are known to experience higher levels of anxiety about cancer. They are also often offered screening from an earlier age. The psychological consequences of screening are therefore of particular importance for this group of women. A comprehensive search of 4 electronic databases was conducted from 1982 to 2003, combining sets of terms relating to (1) breast screening or mammography (breast screen*; mammogra*), (2) psychological impact (adverse effects; anxi*; distress; nervous; psych*, psychological consequences; stress; worry) and (3) family history. Reference lists from relevant papers were examined for additional papers. The review identified seven papers from four countries. Overall, the findings indicate that, similar to women in the general population, most women with a family history do not appear to experience high levels of anxiety associated with mammographic screening. Although women who are recalled for further tests do experience increased anxiety the levels appear to be no greater than for women without a family history. We conclude that further research on this topic is required--this should include studies designed specifically to consider both the negative and positive impact of mammographic screening on women with a family history, using validated measures of anxiety and worry in combination with qualitative research.

  17. 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

  18. Interval breast cancers: Absolute and proportional incidence and blinded review in a community mammographic screening program

    International Nuclear Information System (INIS)

    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

  19. Distance to screening site and non-participation in screening for breast cancer

    DEFF Research Database (Denmark)

    Jensen, L F; Pedersen, A F; Andersen, B;

    2013-01-01

    Dette studie undersøger, om der er en sammenhæng mellem afstand til screeningsenhederne og deltagelse i screening for brystkræft. Resultaterne viser, at kvinder, som bor tæt på screeningsenheden, og kvinder, som bor længere væk, er mere tilbøjelige til ikke at deltage i første screeningsrunde. Ved...

  20. Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women.

    Science.gov (United States)

    Han, Hae-Ra; Lee, H; Kim, M T; Kim, K B

    2009-04-01

    Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an intervention trial with a 6-month follow-up. Trained LHWs recruited 100 KA women 40 years of age or older who had not had a mammogram during the past 2 years. Ninety-three completed follow-up questionnaires. A 120-min, in-class education combined with LHW follow-up counseling and navigation assistance through the health care system was provided. Rates of breast cancer screening behaviors significantly increased at 6 months (P < 0.001); changes between pre- and post-intervention were 31.9% for mammography, 23% for clinical breast examination and 36.2% for breast self-examination. Modesty toward screening significantly decreased over time, but we did not find any significant differences in breast cancer knowledge and beliefs before and after the intervention. Results support the efficacy of this neighborhood-based, culturally sensitive intervention. Further research should seek to replicate these findings and to incorporate more self-care skills such as health literacy when designing an intervention program for linguistically and culturally isolated immigrant women. PMID:18463411

  1. Health literacy and breast cancer screening among Mexican American women in South Texas.

    Science.gov (United States)

    Pagán, José A; Brown, Cynthia J; Asch, David A; Armstrong, Katrina; Bastida, Elena; Guerra, Carmen

    2012-03-01

    Breast cancer is the main cause of cancer deaths for Hispanic women. This study analyzes the role of functional health literacy on mammography screening behavior and adherence of Hispanic women. Survey data from 722 Mexican American women age 40 and over residing in the Lower Rio Grande Valley of Texas in 2008 were used to estimate logistic regression models to assess the role of functional health literacy on mammography screening behavior and adherence. About 51% of survey respondents had a functional health literacy level deemed as inadequate or marginally functional. After adjusting for other factors, women with adequate health literacy levels were more likely to report to have ever had a mammogram (odds ratio [OR] = 2.92; 95% confidence interval [CI] = 1.62-5.28), to have had a mammogram within the last 2 years (OR = 1.70; 95% CI = 1.14-2.53) or to have had one within the last year (OR = 2.30; 95% CI = 1.54-3.43), compared to women with inadequate or marginally adequate functional health literacy levels. Inadequate/marginal functional health literacy is strongly associated with lower mammography screening. Large improvements in breast cancer control in this population may come from either basic advances in health literacy or by tailored approaches to help women with low literacy navigate local health care systems.

  2. Screening for cancer-related distress: Summary of evidence from tools to programmes

    DEFF Research Database (Denmark)

    Bidstrup, P. E.; Johansen, C.; Mitchell, A. J.

    2011-01-01

    Introduction. A number of studies have addressed the development and testing of tools for measuring cancer-related distress. Except for studies of diagnostic validity, knowledge on the effect of screening for psychological distress on psychological well-being is limited. We aimed to describe...... interventions. Provisional work suggests that screening for psychological distress holds promise and is often clinically valuable, but it is too early to conclude definitively that psychological screening itself affects the psychological well-being of cancer patients....

  3. Diagnostic Yield of Fine-Needle Aspiration for Axillary Lymph Nodes During Screening Breast Ultrasound.

    Science.gov (United States)

    Youn, Inyoung; Kim, Eun-Kyung; Yoon, Jung Hyun; Moon, Hee Jung; Kim, Min Jung

    2016-06-01

    The purpose of our study was to assess the positive predictive value (PPV) of ultrasound (US)-guided fine-needle aspiration (FNA) and the cancer detection rate for incidentally detected abnormal axillary lymph node (LN) in patients who underwent screening US. We retrospectively reviewed 72 LNs of 69 patients (mean age, 44.9 years) who underwent US-FNA for incidentally detected abnormal axillary LNs on 50,488 screening US from January 2005 to December 2011. The PPV of US-FNA and the cancer detection rate were calculated. We evaluated US images for lymph node size, abnormal findings (hilum loss, eccentric cortical thickening, round shape, extranodal extension, or marked hypoechoic cortex), and mammography for the identification of abnormal LNs. The PPV of each finding was also calculated. The PPV of US-FNA and the cancer detection rate were 2.8% (2/72) and 0.004% (2/50,488), respectively. The mean (SD) measurements for long-axis, short-axis, and cortical thickening of the LNs were 14.9 (5.9) mm, 8.5 (3.5) mm, and 5.8 (2.8) mm, respectively. Of the positive LNs, US findings of hilum loss, eccentric cortical thickening, and extranodal extension were found, and each corresponding PPV was 6.3% (1/16), 1.8% (1/56), and 14.3% (1/7), respectively. The PPV of mammography was 14.3% (1/7). Our results suggest that the PPVs of US-FNA and the cancer detection rate for incidentally detected abnormal axillary LNs during screening US are too low to recommend axillary US during breast US screening and that follow-up is acceptable for abnormal LNs detected during screening breast US that do not have extranodal extension or are negative on mammography. PMID:27054655

  4. Implementing Case Management in New York State’s Partnerships for Publicly Funded Breast Cancer Screening

    Directory of Open Access Journals (Sweden)

    Patricia P. Lillquist, PhD, MSW

    2008-04-01

    Full Text Available IntroductionThis research aimed to explore differences in the implementation of case management among local breast cancer screening partnerships in New York State after changes in federal public policy in 1998 and to achieve a better understanding of case management in a new and distinct practice setting. Capacity and willingness to implement change were theorized to explain local differences in implementation. Local breast cancer screening programs that received federal funding through the New York State Department of Health were invited to participate in the study.MethodsA mail survey was administered to the directors of New York’s 53 local breast cancer screening partnerships in 2003. The survey included questions about willingness and capacity to implement case management and a scale to assess case management program philosophy. Factor analysis and correlations were used to compare willingness and capacity with differences in implementation.ResultsTwo common factors — task focus and self-identity focus — were identified as factors that differentiated case management programs. Task-focus partnerships undertook a broader range of tasks but were less likely to report autonomy in making program changes. Self-identity partnerships were less likely to report difficulties with other agencies and scored highly on innovation, involvement in work, and interest in client service. Having a nurse as the case manager, being aware of the standards of case management, and providing health education were associated with both task focus and self-identity focus.ConclusionThe study identified distinct styles of implementation. These styles have implications for the breadth of services provided, such as whether client-level services only are offered. Interagency coordination was facilitated in partnerships with comprehensive case management.

  5. Differences between first and subsequent rounds of the MRISC breast cancer screening program for women with a familial or genetic predisposition

    NARCIS (Netherlands)

    Kriege, M; Brekelmans, CTM; Boetes, C; Muller, SH; Zonderland, HM; Obdeijn, IM; Manoliu, RA; Kok, T; Rutgers, EJT; de Koning, HJ; Klijn, JGM

    2006-01-01

    BACKGROUND. within the Dutch MRI Screening (MRISC) study, a Dutch multicenter screening study for hereditary breast cancer, the authors investigated whether previously reported increased diagnostic accuracy of magnetic resonance imaging (MRI) compared with mammography would be maintained during subs

  6. Evaluation of an Automated Information Extraction Tool for Imaging Data Elements to Populate a Breast Cancer Screening Registry.

    Science.gov (United States)

    Lacson, Ronilda; Harris, Kimberly; Brawarsky, Phyllis; Tosteson, Tor D; Onega, Tracy; Tosteson, Anna N A; Kaye, Abby; Gonzalez, Irina; Birdwell, Robyn; Haas, Jennifer S

    2015-10-01

    Breast cancer screening is central to early breast cancer detection. Identifying and monitoring process measures for screening is a focus of the National Cancer Institute's Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) initiative, which requires participating centers to report structured data across the cancer screening continuum. We evaluate the accuracy of automated information extraction of imaging findings from radiology reports, which are available as unstructured text. We present prevalence estimates of imaging findings for breast imaging received by women who obtained care in a primary care network participating in PROSPR (n = 139,953 radiology reports) and compared automatically extracted data elements to a "gold standard" based on manual review for a validation sample of 941 randomly selected radiology reports, including mammograms, digital breast tomosynthesis, ultrasound, and magnetic resonance imaging (MRI). The prevalence of imaging findings vary by data element and modality (e.g., suspicious calcification noted in 2.6% of screening mammograms, 12.1% of diagnostic mammograms, and 9.4% of tomosynthesis exams). In the validation sample, the accuracy of identifying imaging findings, including suspicious calcifications, masses, and architectural distortion (on mammogram and tomosynthesis); masses, cysts, non-mass enhancement, and enhancing foci (on MRI); and masses and cysts (on ultrasound), range from 0.8 to1.0 for recall, precision, and F-measure. Information extraction tools can be used for accurate documentation of imaging findings as structured data elements from text reports for a variety of breast imaging modalities. These data can be used to populate screening registries to help elucidate more effective breast cancer screening processes. PMID:25561069

  7. The additional yield of a periodic screening programme for open-angle glaucoma : a population-based comparison of incident glaucoma cases detected in regular ophthalmic care with cases detected during screening

    NARCIS (Netherlands)

    Stoutenbeek, R.; de Voogd, S.; Wolfs, R. C. W.; Hofman, A.; de Jong, P. T. V. M.; Jansonius, N. M.

    2008-01-01

    Aim: To study the additional yield of a periodic screening programme for open-angle glaucoma (OAG) by comparing, in a population-based setting, incident OAG (iOAG) cases detected in regular ophthalmic care with those detected during screening. Methods: Participants aged 55 and over from the populati

  8. First epidemiological analysis of breast cancer incidence and tumor characteristics after implementation of population-based digital mammography screening

    International Nuclear Information System (INIS)

    Purpose: to epidemiologically evaluate the impact of digital mammography screening on incidence rates and tumor characteristics for breast cancer. Materials and methods: the first German digital screening units in the clinical routine were evaluated during the implementation period by using data from the cancer registry to compare the incidence rate of breast cancers and prognostic characteristics. 74% of women aged 50-69 within the region of Muenster/Coesfeld/Warendorf were invited between 10/2005 and 12/2007 for initial screening; 55% participated (n = 35961). Results: in 2002-2004 the average breast cancer incidence rate (per 100000) was 297.9. During the implementation of screening, the rate rose to 532.9 in 2007. Of the 349 cancers detected with screening, 76% (265/349) were invasive compared to 90% (546/608) of cases not detected with screening during the same period. 37% (97/265) of cancers detected in the screening program had a diameter of ≤ 10 mm and 75% (198/265) were node-negative compared to 15% (79/546) and 64% (322/503), respectively, in cancers detected outside the screening program. The distribution of invasive tumor size (pT categories) and the nodal status differed with statistical significance between cancers detected in and outside the program (p = 0.005 and p = 0.004, respectively). (orig.)

  9. A project for increasing the rate of participation in mammographic breast cancer screening in Kyoto prefecture to 50%

    International Nuclear Information System (INIS)

    The rate of participation in breast cancer screening carried out by inspection and palpation associated with mammography in Kyoto Prefecture has been still low. In order to decrease the rate of breast cancer death, a high rate of screening participation must be achieved. We have organized the Kyoto Executive Committee of Pink Ribbon Activity aiming at the goal of achieving a 50% rate of participation in mammography screening by the end of 2010, and undertaken the following campaign activities: performing free screening, distribution and display of posters and leaflets about breast cancer screening, cooperation with various media to spread educational and informative messages, cooperation with a commercial institute in Kyoto City to distribute useful information, performing free breast cancer screening, and holding public lecture meetings, distribution of leaflets at student festivals at universities and colleges in Kyoto, and holding a ''Pink Ribbon symposium'' in a cosponsored company. All the above projects were performed successfully and many participants attended. We will continue these activities until the 50% participation rate is achieved. (author)

  10. Register-based studies of cancer screening effects

    DEFF Research Database (Denmark)

    Von Euler-Chelpin, My; Lynge, Elsebeth; Rebolj, Matejka

    2011-01-01

    INTRODUCTION: There are two organised cancer screening programmes in Denmark, against cervical and breast cancers. The aim with this study was to give an overview of the available register-based research regarding these two programmes, to demonstrate the usefulness of data from the national regis...

  11. SDOCT imaging to identify macular pathology in patients diagnosed with diabetic maculopathy by a digital photographic retinal screening programme.

    Directory of Open Access Journals (Sweden)

    Sarah Mackenzie

    Full Text Available INTRODUCTION: Diabetic macular edema (DME is an important cause of vision loss. England has a national systematic photographic retinal screening programme to identify patients with diabetic eye disease. Grading retinal photographs according to this national protocol identifies surrogate markers for DME. We audited a care pathway using a spectral-domain optical coherence tomography (SDOCT clinic to identify macular pathology in this subset of patients. METHODS: A prospective audit was performed of patients referred from screening with mild to moderate non-proliferative diabetic retinopathy (R1 and surrogate markers for diabetic macular edema (M1 attending an SDOCT clinic. The SDOCT images were graded by an ophthalmologist as SDOCT positive, borderline or negative. SDOCT positive patients were referred to the medical retina clinic. SDOCT negative and borderline patients were further reviewed in the SDOCT clinic in 6 months. RESULTS: From a registered screening population of 17 551 patients with diabetes mellitus, 311 patients met the inclusion criteria between (March 2008 and September 2009. We analyzed images from 311 patients' SDOCT clinic episodes. There were 131 SDOCT negative and 12 borderline patients booked for revisit in the OCT clinic. Twenty-four were referred back to photographic screening for a variety of reasons. A total of 144 were referred to ophthalmology with OCT evidence of definite macular pathology requiring review by an ophthalmologist. DISCUSSION: This analysis shows that patients with diabetes, mild to moderate non-proliferative diabetic retinopathy (R1 and evidence of diabetic maculopathy on non-stereoscopic retinal photographs (M1 have a 42.1% chance of having no macular edema on SDOCT imaging as defined by standard OCT definitions of DME when graded by a retinal specialist. SDOCT imaging is a useful adjunct to colour fundus photography in screening for referable diabetic maculopathy in our screening population.

  12. Knowledge, attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city

    OpenAIRE

    Omuemu Vivian O; Akhigbe Adenike O

    2009-01-01

    Abstract Background Late presentation has been observed as the hallmark of breast cancer in Nigerian women and an earlier onset has been reported in this population. This study was designed to assess the awareness of female health workers about risk factors and screening methods for early detection of breast cancer. Methods A cross-sectional descriptive study was carried out among female health workers in the two major government health institutions in Benin City, Edo State capital in Nigeria...

  13. Mammography with and without radiolucent positioning sheets : Comparison of projected breast area, pain experience, radiation dose and technical image quality

    NARCIS (Netherlands)

    Timmers, Janine; ten Voorde, Marloes; van Engen, Ruben E.; van Landsveld-Verhoeven, Cary; Pijnappel, Ruud; Droogh-de Greve, Kitty; den Heeten, Gerard J.; Broeders, Mireille J. M.

    2015-01-01

    Purpose: To compare projected breast area, image quality, pain experience and radiation dose between mammography performed with and without radiolucent positioning sheets. Methods: 184 women screened in the Dutch breast screening programme (May-June 2012) provided written informed consent to have on

  14. The validation of a simulation model incorporating radiation risk for mammography breast cancer screening in women with a hereditary-increased breast cancer risk

    NARCIS (Netherlands)

    Greuter, Marcel J. W.; Jansen-van der Weide, Marijke C.; Jacobi, Cathrien E.; Oosterwijk, Jan C.; Jansen, Liesbeth; Oudkerk, Matthijs; de Bock, Geertruida H.; Jansen-van der Weide MC, [No Value

    2010-01-01

    Introduction: For women with a BRCA1 or BRCA2 mutation or a strong family history of breast cancer, there is no clear estimation of the risk of tumour induction versus the beneficial effects of mammography screening available. This study aims to validate the Simulation Model on Radiation Risk and br

  15. Breast cancer screening disparities among immigrant women by world region of origin: a population-based study in Ontario, Canada.

    Science.gov (United States)

    Vahabi, Mandana; Lofters, Aisha; Kumar, Matthew; Glazier, Richard H

    2016-07-01

    Rates of mammography screening for breast cancer are disproportionately low in certain subgroups including low-income and immigrant women. The purpose of the study was to examine differences in rates of appropriate breast cancer screening (i.e., screening mammography every 2 years) among Ontario immigrant women by world region of origin and explore the association between appropriate breast cancer screening among these women groups and individual and structural factors. A cohort of 183,332 screening-eligible immigrant women living in Ontario between 2010 and 2012 was created from linked databases and classified into eight world regions of origin. Appropriate screening rates were calculated for each region by age group and selected sociodemographic, immigration, and healthcare-related characteristics. The association between appropriate screening across the eight regions of origin and selected sociodemographic, immigration, and health-related characteristics was explored using multivariate Poisson regression. Screening varied by region of origin, with South Asian women (48.5%) having the lowest and Caribbean and Latin American women (63.7%) the highest cancer screening rates. Factors significantly associated with lower screening across the world regions of origin included living in the lowest income neighborhoods, having a refugee status, being a new immigrant, not having a regular physical examination, not being enrolled in a primary care patient enrollment model, having a male physician, and having an internationally trained physician. Multiple interventions entailing cross-sector collaboration, promotion of patient enrollment models, community engagement, comprehensive and intensive outreach to women, and knowledge translation and transfer to physicians should be considered to address screening disparities among immigrant population. Consideration should be given to design and delivery of culturally appropriate and easily accessible cancer screening programs

  16. Breast cancer screening disparities among immigrant women by world region of origin: a population-based study in Ontario, Canada.

    Science.gov (United States)

    Vahabi, Mandana; Lofters, Aisha; Kumar, Matthew; Glazier, Richard H

    2016-07-01

    Rates of mammography screening for breast cancer are disproportionately low in certain subgroups including low-income and immigrant women. The purpose of the study was to examine differences in rates of appropriate breast cancer screening (i.e., screening mammography every 2 years) among Ontario immigrant women by world region of origin and explore the association between appropriate breast cancer screening among these women groups and individual and structural factors. A cohort of 183,332 screening-eligible immigrant women living in Ontario between 2010 and 2012 was created from linked databases and classified into eight world regions of origin. Appropriate screening rates were calculated for each region by age group and selected sociodemographic, immigration, and healthcare-related characteristics. The association between appropriate screening across the eight regions of origin and selected sociodemographic, immigration, and health-related characteristics was explored using multivariate Poisson regression. Screening varied by region of origin, with South Asian women (48.5%) having the lowest and Caribbean and Latin American women (63.7%) the highest cancer screening rates. Factors significantly associated with lower screening across the world regions of origin included living in the lowest income neighborhoods, having a refugee status, being a new immigrant, not having a regular physical examination, not being enrolled in a primary care patient enrollment model, having a male physician, and having an internationally trained physician. Multiple interventions entailing cross-sector collaboration, promotion of patient enrollment models, community engagement, comprehensive and intensive outreach to women, and knowledge translation and transfer to physicians should be considered to address screening disparities among immigrant population. Consideration should be given to design and delivery of culturally appropriate and easily accessible cancer screening programs

  17. The Seoul Metropolitan Preschool Vision Screening Programme: results from South Korea

    OpenAIRE

    Lim, H T; Yu, Y. S.; Park, S-H; Ahn, H; Kim, S.; Lee, M.; Jeong, J-Y; Shin, K H; Koo, B S

    2004-01-01

    Aim: To report on a new model of preschool vision screening that was performed in metropolitan Seoul and to investigate the distribution of various ocular disorders in this metropolitan preschool population.

  18. Development in incidence of breast cancer in non-screened Danish women, 1973-2002--a population-based study

    DEFF Research Database (Denmark)

    Fuglede, Niels; Langballe, Oline; Svendsen, Anne Louise;

    2006-01-01

    The authors report on the incidence rates of breast cancer overall and by histology in a population of unscreened women constituting approximately 80% of the total population of women in Denmark from 1973-2002, utilizing the files of the nationwide Danish Cancer Registry. The age-specific incidence...... no disproportionate changes by histology in any age group from 1988-2002. Thus, previous reports of a disproportionate increase in lobular breast cancer could not be confirmed in a non-screened population, whereas important changes over the past decade in the age-specific incidence pattern of breast cancer particular...

  19. The Breast Cancer Screening Program. The first year of activity on the territory of Pomeranian Region

    International Nuclear Information System (INIS)

    Objectives. The Breast Cancer Screening Program (BCSP) has been launched in January 2007. There are 16 Regional Coordinating Centers. The headquarters are located the the Maria Sklodowska-Curie Memorial Cancer Center - Institute of Oncology, in Warsaw. In Poland breast cancer (BC) accounts for a 20.5% morbidity rate and causes 13% of deaths. Women between 50 and 69 years of age make up half of the breast cancer morbidity group. There is a tendency towards an increase in BC morbidity. Of all the 13385 registered in Poland throughout 2005 641 occurred in the Pomeranian Voivodeship. Material and Methods. There are 31 mammography units in the Pomeranian region. Mammography for women between the ages of 50 and 69 is performed free of charge and financed by the governmental health insurance. In 2007 over 57,500 mammographies were performed in the Pomeranian Voivodeship accounting for some 33.1% of all the women eligible for the BCSP. Results. 298 cases of BC were detected. BCSP increased the likelihood of detecting early BC (T1). T1 BCs were detected in 61.1% and were described by radiologists as stages BIRADS 4 and BIRADS 5. Conclusions. The main aim of the BCSP is reducing the coefficient of BC mortality. The results of BCSP confirmed the need for the continuation of such a program. (authors)

  20. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... your stomach on a narrow table with your breasts hanging down into cushioned openings. The table slides ...

  1. 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 ...

  2. 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 ...

  3. Data: ‘Initial Clinical Referral Standards after Newborn Screening for Congenital Hypothyroidism: Final Report of the UK Newborn Screening Programme Centre Expert Working Group and Systematic Evidence Review 2010-2011’.

    Directory of Open Access Journals (Sweden)

    Rachel L. Knowles

    2013-07-01

    Full Text Available The multidisciplinary Expert Working Group was tasked with revising the existing standards of the UK NHS National Screening Programme for diagnosis and management of babies in whom congenital hypothyroidism (CHT is suspected after newborn bloodspot screening. This report includes a systematic evidence review and account of the proceedings of the working group in key areas: screening test performance, referral pathways, diagnostic investigations, treatment and communication with parents. After public consultation, the recommendations were adopted as policy. This final report provides an evidence base for reviewing newborn screening for CHT in other populations and outlines a transparent consensus-based process for agreeing changes to screening standards and policy.

  4. Mammography in breast cancer screening. A radiographic analysis of the carcinomas found at Utrecht, Nijmegen and Kopparberg county

    International Nuclear Information System (INIS)

    Population-based screening for carcinoma of the breast by mammography has yielded an abundance of data, not all of which have been processed yet, the mammographic (radiographic) data in particular. The present study concerns an analysis of the mammographic signs in the histologically proven carcinomas (invasive and intraductal) detected by these three screening programs. The radiographic signs of the screened carcinomas were compared with those of the clinical carcinomas diagnosed in the Utrecht University Hospital (to be called AZU carcinomas). These AZU carcinomas were taken as reference material, and were therefore analysed in the same way as the screening material. (Auth.)

  5. Population estimates of survival in women with screen-detected and symptomatic breast cancer taking account of lead time and length bias.

    NARCIS (Netherlands)

    Lawrence, G.; Wallis, M.; Allgood, P.; Nagtegaal, I.D.; Warwick, J.; Cafferty, F.H.; Houssami, N.; Kearins, O.; Tappenden, N.; O'Sullivan, E.; Duffy, S.W.

    2009-01-01

    BACKGROUND: Evidence of the impact of breast screening is limited by biases inherent in non-randomised studies and often by lack of complete population data. We address this by estimating the effect of screen detection on cause-specific fatality in breast cancer, corrected for all potential biases,

  6. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet

    DEFF Research Database (Denmark)

    Paci, Eugenio; Lynge, Elsebeth

    2012-01-01

    To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women.......To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women....

  7. Five-year analysis of magnetic resonance imaging as a screening tool in women at hereditary risk of breast cancer

    International Nuclear Information System (INIS)

    Women at very high risk of breast cancer are recommended to undertake enhanced surveillance with annual MRI in addition to mammography. We aimed to review the performance of breast MRI as a screening modality over its first 5 years at our institution. The study used a retrospective review using prospectively collected data from a consecutive series of women at high risk of developing breast cancer undergoing surveillance MRI. Two hundred twenty-three women had at least one screening MRI. The median age was 42 years old. Sixty-nine (30.9%) were confirmed genetic mutation carriers. The remaining 154 (69.1%) women were classified as high risk based on family history, without a confirmed genetic mutation. Three hundred forty screening MRI studies were performed. Of these, 69 patients (20.3%) were recalled for further assessment. There was a significant reduction in the recall rate throughout the study for prevalent screens, from 50% (17/34) in 2008 to 14% (9/54) in 2011 (P=0.004). The overall biopsy rate was 39 in 340 screens (11.5%). Four cancers were identified. Three were in confirmed BRCA1/BRCA2 mutation carriers, and one was found to be a carrier after the cancer was diagnosed. All four were identified as suspicious on MRI, with two having normal mammography. The cancer detection rate of MRI was 1.2% (4/340 screens). The overall positive predictive value was 7.0%, 6.7% for prevalent screens and 7.1% for subsequent screens. Breast MRI as a screening modality for malignant lesions in women with high hereditary risk is valuable. The recall rate, especially in the prevalent round, improved with radiologist experience.

  8. Detection of Breast Cancer with Mammography in the First Screening Round in Relation to Expected Incidence in Different Age Groups

    International Nuclear Information System (INIS)

    The ratio (R) of prevalence of screening-detected breast cancer in the first screening round (P) was compared with the expected incidence rate (I) for different age groups in several screening programs. Published data on the first screening round from three Swedish randomized trials and six counties with service screening were used. The women invited to take part in the screening were aged 40-74 years. Not only P and I but also R increased with increasing age. With the youngest age group as reference, the increase was statistically significant for both invasive cancer and invasive cancer and carcinoma in situ together. The studied ratio (R) can be thought of as a measure of efficiency in detecting breast cancer cases in mammography screening. The reasons for the increase are probably that the breast tissue of younger women is denser, which makes the cancer more difficult to detect by mammography, and that slow-growing cancers tend to appear more frequently in older women

  9. 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

    OpenAIRE

    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

    2013-01-01

    Background 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. Methods/design The study has three specific aims: 1) Identify and survey 3,000 young breast cancer s...

  10. Comparative performance of modern digital mammography systems in a large breast screening program

    Energy Technology Data Exchange (ETDEWEB)

    Yaffe, Martin J., E-mail: martin.yaffe@sri.utoronto.ca; Bloomquist, Aili K.; Hunter, David M.; Mawdsley, Gordon E. [Physical Sciences Division, Sunnybrook Research Institute, Departments of Medical Biophysics and Medical Imaging, University of Toronto, Ontario M4N 3M5 (Canada); Chiarelli, Anna M. [Prevention and Cancer Control, Cancer Care Ontario, Dalla Lana School of Public Health, University of Toronto, Ontario M4N 3M5, Canada and Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Muradali, Derek [Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Mainprize, James G. [Physical Sciences Division, Sunnybrook Research Institute, Toronto, Ontario M4N 3M5 (Canada)

    2013-12-15

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography.

  11. Comparative performance of modern digital mammography systems in a large breast screening program

    International Nuclear Information System (INIS)

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography

  12. 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

  13. How well do the theory of reasoned action and theory of planned behaviour predict intentions and attendance at screening programmes? A meta-analysis.

    Science.gov (United States)

    Cooke, Richard; French, David P

    2008-01-01

    Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers.

  14. Awareness of breast cancer among adolescent girls in Colombo, Sri Lanka: a school based study

    OpenAIRE

    Ranasinghe, Hasanthika M; Ranasinghe, Nilakshika; Rodrigo, Chaturaka; Seneviratne, Rohini De A; Rajapakse, Senaka

    2013-01-01

    Background Breast cancer is the commonest cancer in women worldwide. Although programmes promoting breast cancer awareness are being carried out throughout Sri Lanka, few have targeted school students. We conducted this study to assess the knowledge, attitudes and practices regarding breast cancer with reference to screening, services available, breast self-examination, and sources of information, among adolescent schoolgirls in the Colombo District of Sri Lanka. Methods The knowledge, attitu...

  15. Participation behaviour following a false positive test in the Copenhagen mammography screening programme

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Vejborg, Ilse; von Euler-Chelpin, My

    2008-01-01

    INTRODUCTION: There is an ongoing debate concerning possible disadvantages of mammography screening, one being the consequence of receiving a false positive test-result. It is argued that receiving a false positive answer may have short- and/or long-term adverse psychological effects on women, bu...

  16. Development of the Psychosocial Distress Questionnaire—Breast Cancer (PDQ-BC): a breast cancer-specific screening instrument for psychosocial problems

    OpenAIRE

    Bogaarts, M.P.J.; Den Oudsten, B. L.; Roukema, J.A.; van Riel, J M G H; Beerepoot, L V; de Vries, J

    2010-01-01

    Purpose The aim of the present study was to develop a short, easy-to-use, and acceptable psychosocial screening instrument specific for breast cancer patients. Methods Before the start of adjuvant chemotherapy, 164 (98.8%) women completed the Psychosocial Distress Questionnaire-Breast Cancer (PDQ-BC) as part of routine care. The PDQ-BC consists of questions about psychological risk factors (i.e., trait anxiety and (lack of) social support), psychosocial problems (i.e., state anxiety and depre...

  17. 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

  18. Cancer Screening in Women with Intellectual Disabilities: An Irish perspective

    Science.gov (United States)

    Reidy, Mary; Denieffe, Suzanne; Foran, Sinéad

    2014-01-01

    In the Republic of Ireland, more than 8000 women with intellectual disabilities (IDs), aged 20 years and over, are registered for service provision. Their health needs challenge preventative health services including breast and cervical cancer screening programmes. This review explores the literature about cancer screening participation rates and…

  19. Background parenchymal enhancement on baseline screening breast MRI: impact on biopsy rate and short-interval follow-up.

    LENUS (Irish Health Repository)

    Hambly, Niamh M

    2011-01-01

    Background parenchymal enhancement on breast MRI refers to normal enhancement of the patient\\'s fibroglandular tissue. The aim of this study was to determine the effect of background parenchymal enhancement on short-interval follow-up, biopsy, and cancer detection rate on baseline screening MRI in a high-risk group.

  20. Test of an Intervention to Improve Knowledge of Women with Intellectual Disabilities about Cervical and Breast Cancer Screening

    Science.gov (United States)

    Swaine, J. G.; Parish, S. L.; Luken, K.; Son, E.; Dickens, P.

    2014-01-01

    Background: There is a critical need for evidence-based health education interventions for women with intellectual disabilities (IDs) to promote receipt of preventive health screenings. Previous research has established "Women Be Healthy," an 8-week classroom-style intervention designed to teach women with IDs about breast and cervical…

  1. Breast Cancer Screening among Dominican Latinas: A Closer Look at Fatalism and Other Social and Cultural Factors

    Science.gov (United States)

    Abraído-Lanza, Ana F.; Martins, Mariana Cunha; Shelton, Rachel C.; Flórez, Karen R.

    2015-01-01

    With the marked increase of the Latino population in the United States during the past 20 years, there has been growing interest in the social, cultural, and structural factors that may impede breast cancer screening among Latino women, especially among those subgroups that have been understudied. Acculturation and fatalism are central cultural…

  2. A Peer Health Educator Program for Breast Cancer Screening Promotion: Arabic, Chinese, South Asian, and Vietnamese Immigrant Women's Perspectives.

    Science.gov (United States)

    Crawford, Joanne; Frisina, Angela; Hack, Tricia; Parascandalo, Faye

    2015-01-01

    This study explored Arabic, Chinese, South Asian, and Vietnamese immigrant women's experiences with a peer health educator program, a public health program that facilitated access to breast health information and mammography screening. Framed within critical social theory, this participatory action research project took place from July 2009 to January 2011. Ten focus groups and 14 individual interviews were conducted with 82 immigrant women 40 years of age and older. Qualitative methods were utilized. Thematic content analysis derived from grounded theory and other qualitative literature was employed to analyze data. Four dominant themes emerged: Breast Cancer Prevention focused on learning within the program, Social Support provided by the peer health educator and other women, Screening Services Access for Women centered on service provision, and Program Enhancements related to specific modifications required to meet the needs of immigrant women accessing the program. The findings provide insights into strategies used to promote breast health, mammography screening, and the improvement of public health programming. Perceived barriers that continue to persist are structural barriers, such as the provision of information on breast cancer and screening by family physicians. A future goal is to improve collaborations between public health and primary care to minimize this barrier.

  3. Nonlinear 3-D Microwave Imaging for Breast-Cancer Screening: Log, Phase, and Log-Phase Formulation

    DEFF Research Database (Denmark)

    Jensen, Peter Damsgaard; Rubæk, Tonny; Mohr, Johan Jacob;

    2011-01-01

    The imaging algorithm used in the 3-D microwave imaging system for breast cancer screening, currently being developed at the Technical University of Denmark, is based on an iterative Newton-type algorithm. In this algorithm, the distribution of the electromagnetic constitutive parameters is updat...

  4. Nonlinear Microwave Imaging for Breast-Cancer Screening Using Gauss–Newton's Method and the CGLS Inversion Algorithm

    DEFF Research Database (Denmark)

    Rubæk, Tonny; Meaney, P. M.; Meincke, Peter;

    2007-01-01

    Breast-cancer screening using microwave imaging is emerging as a new promising technique as a supplement to X-ray mammography. To create tomographic images from microwave measurements, it is necessary to solve a nonlinear inversion problem, for which an algorithm based on the iterative Gauss...

  5. 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

    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...... 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...... interpreted as pathogenic, 3 missense mutations were suggested to be pathogenic based on in silico analysis, 6 mutations were suggested to be benign since they were identified in patients together with a well-known disease-causing BRCA1/BRCA2 mutation, while 12 were variants of unknown significance....

  6. Being there for women : the work of breast care nurses

    OpenAIRE

    Topping, Annie

    2001-01-01

    Breast cancer is a major health challenge. It is also is a high profile disease with extraordinary media attention that places an immense burden on women, families, children and health resources. Over the last two decades the way in which women experience breast cancer has undergone significant changes. The implementation of the National Health Service Breast Screening Programme, development of specialist multidisciplinary teams, and greater involvement of women in decision mak...

  7. Randomized controlled trial on effectiveness of ultrasonography screening for breast cancer in women aged 40-49 (J-START). Research design

    International Nuclear Information System (INIS)

    In cancer screening, it is essential to undertake effective screening with appropriate methodology, which should be supported by evidence of a reduced mortality rate. At present, mammography is the only method for breast cancer screening with such evidence. However, mammography does not achieve sufficient accuracy in breasts with high density at ages below 50. Although ultrasonography achieves better accuracy in Breast Cancer detection even in dense breasts, the effectiveness has not been verified. We have planned a randomized controlled trial to assess the effectiveness of ultrasonography in women aged 40-49, with a design to study 50,000 women with mammography and ultrasonography (intervention group), and 50,000 controls with mammography only (control group). The participants are scheduled to take second round screening with the same modality 2 years on. The primary endpoints are sensitivity and specificity, and the secondary endpoint is the rate of advanced breast cancers. (author)

  8. What Are the Recommended Timing and Screening Modalities in Women at Higher Risk for Developing Breast Cancer? A Clin-IQ

    Science.gov (United States)

    Jatala, Summer; Fitzgerald, Shawn; Tietze, Pamela; Ramakrishnan, Kalyanakrishnan; McCarthy, Laine H.; Wickersham, Elizabeth

    2016-01-01

    Early detection of breast cancer is desirable to prevent progression to advanced disease. This subject has been one of significant study and debate for women at normal risk, and recommendations continue to evolve. However, with regard to women at high risk, the recommendations from various health care professional organizations, including the recent recommendations from the United States Preventative Services Task Force, are different and also inconsistent concerning when to begin screening and which modalities should be used. We review several randomized controlled trials and consensus opinions regarding when to begin screening for breast cancer and how to best screen women at high risk. Specifically, we address women with known personal history of breast cancer, prior mantle radiation, or specific family history (including genetic family history) of breast cancer. The purpose of this inquiry is to present current evidence and suggest a clinical pathway regarding the screening of women at high risk for breast cancer. PMID:26848484

  9. What Are the Recommended Timing and Screening Modalities for Women at Higher Risk of Developing Breast Cancer? A Clin-IQ

    Directory of Open Access Journals (Sweden)

    Summer Jatala

    2015-01-01

    Full Text Available Early detection of breast cancer is desirable to prevent progression to advanced disease. This subject has been one of significant study and debate for women at normal risk, and recommendations continue to evolve. However, with regard to women at high risk, the recommendations from various health care professional organizations, including the U.S. Preventive Services Task Force, are different and also inconsistent concerning when to begin screening and which modalities should be used. We review several randomized controlled trials and consensus opinions regarding when to begin screening for breast cancer and how to best screen women at high risk. Specifically, we address women with known personal history of breast cancer, prior mantle radiation or specific family history (including genetic family history of breast cancer. The purpose of this inquiry is to present current evidence and suggest a clinical pathway regarding the screening of women at high risk for breast cancer.

  10. Diagnostic service effectiveness during the first year of breast cancer screening in the region of Lower Silesia

    International Nuclear Information System (INIS)

    Background. The Polish Government and the National Health Fund introduced population-based breast cancer screening in 2007 aimed to reduce breast cancer mortality. Objectives. To evaluate the diagnostic quality of the program during its initial year in the region of Lower Silesia. Material and Methods. This nation-wide program targets women aged 50-69, excluding females undergoing treatment or being followed up due to breast cancer. Biennial two-view screen-film mammography is used as the standard screening test. A significant reduction in breast cancer mortality requires measurement of long-term screening. Some early performance indicators are therefore widely used and accepted in monitoring the effectiveness of a screening program. These parameters were calculated and compared with those recommended by the European Union. Results. In 2007, 79,143 women were screened in the region of Lower Silesia. Only 0.26% of them were re-examined for technical reasons. The recall for reassessment, short-term recall, and invasive examination rates were 6.85, 0.91, and 0.39%, respectively. Pathologically confirmed breast cancer was found in 460 women, giving a detection rate 5.8/1000. The ratio of cancer detection rate to expected incidence was 3.54. There were only 17 (3.7%) ductal carcinoma in situ found among all the cancers. Three hundred twenty-five cancers were histologically verified by open biopsy, giving a non-operative biopsy rate for malignancy as low as 29%. Conclusions. The effectiveness of the diagnostic service for cancer detection during the initial phase of the breast cancer screening program corresponds to the parameters specified by the European guidelines for quality assessment of initial screening examinations. The main disadvantage is the rate of minimal-invasive biopsy for malignancy, one third of that recommended. Another challenge is the low incidence of DCIS. This needs to be carefully evaluated in the future together with the time interval and false

  11. Cytotoxicity screening of Melastoma malabathricum extracts on human breast cancer cell lines in vitro

    Institute of Scientific and Technical Information of China (English)

    Nurfariza; Ahmad; Roslen; Nur; Aizura; Mat; Alewi; Hadji; Ahamada; Mohammad; Syaiful; Bahari; Abdull; Rasad

    2014-01-01

    Objective:To screen the cytotoxic activity of Melasloma malabathricum(M,malubathricum)against human breast carreer cell line(MCF-7)in vitro.Methods:A three steps extraction protocol using n-hexane,chloroform and methanol as the solvents systems was carried out on leaves,stems and flowers of M.nalabathricum.Dimethyl sulfoxide was used in extracts dilution and serial dilutions were conducted to obtain five different extract concentrations(100μg/mL,50μg/mL,25μg/mL,123μg/rnL and 6.25μg/mL).The evaluation of cell growth was determined using methylene blue assay.Results:Methanol extract from the leaves showed significant anticancer activity against MCF-7cell lines with the TC50value of 7.14μg/ml while methanol and chloroform extract from the flowers exhibited a moderate activity towards MCF-7 cell line,with the IC50value of 33.63μg/mL and 45.76μg/mL respectively after 72 h of treatment.Conclusions:The extracts from leaves and flowers of M.nulabatkricum showed promising anticancer activity toward human breast cancer cell lines with the lowest IC50at 7.14μg/mL while the extracts from stems showed less growth inhibition activity.

  12. Cytotoxicity screening of Melastoma malabathricum extracts on human breast cancer cell lines in vitro

    Institute of Scientific and Technical Information of China (English)

    Nurfariza Ahmad Roslen; Nur Aizura Mat Alewi; Hadji Ahamada

    2014-01-01

    Objective: To screen the cytotoxic activity of Melastoma malabathricum (M. malabathricum) against human breast cancer cell line (MCF-7) in vitro. Methods: A three steps extraction protocol using n-hexane, chloroform and methanol as the solvents systems was carried out on leaves, stems and flowers of M. malabathricum. Dimethyl sulfoxide was used in extracts dilution and serial dilutions were conducted to obtain five different extract concentrations (100 µg/mL, 50 µg/mL, 25 µg/mL, 12.5 µg/mL and 6.25 µg/mL). The evaluation of cell growth was determined using methylene blue assay.Results:Methanol extract from the leaves showed significant anticancer activity against MCF-7 cell lines with the IC50 value of 7.14 µg/ml while methanol and chloroform extract from the flowers exhibited a moderate activity towards MCF-7 cell line with the IC50 value of 33.63 µg/mL and 45.76 µg/mL respectively after 72 h of treatment.Conclusions:The extracts from leaves and flowers of M. malabathricum showed promising anticancer activity toward human breast cancer cell lines with the lowest IC50 at 7.14 µg/mL while the extracts from stems showed less growth inhibition activity.

  13. Barriers to breast cancer screening among a sample of Egyptian females

    Directory of Open Access Journals (Sweden)

    Heba M. Mamdouh

    2014-01-01

    Full Text Available Background: Breast cancer (BC is usually diagnosed in late stages in countries with limited resources. Early detection of BC is likely to improve the outcome of the disease for women in these areas. Objective: The aim of this study was to understand the possible personal, economic, and systems barriers to BC screening in a sample of Egyptian women. Materials and Methods: A cross-sectional study was conducted in family health centers representing the seven districts of Alexandria governorate, Egypt. A total of 612 women were randomly selected from the chosen centers. Results: In this sample of Egyptian women, the most frequently identified potential barriers to BC screening were the following: 81.8% would not seek care until they were ill, 77% were unwilling to have a mammogram until it was recommended by the doctor, 71.4% blamed the, lack of privacy, 69.2% thought that medical checkups were not worthwhile, and 64.6% blamed the cost of services. The study further revealed that women of lower education, women in the lower income category, women who did not do paid work, those who had poor knowledge of the risks of BC, and women with no family history of BC were more likely to perceive different screening barriers compared with their counterparts. Conclusion: Many potential personal, economic, and health system barriers were identified. Addressing these barriers by increasing the awareness of BC and dealing with the misconceptions that the women have can help the policy makers to design more culturally relevant strategies to motivate women to utilize screening services.

  14. Piloting the Impact of Three Interventions on Guaiac Faecal Occult Blood Test Uptake within the NHS Bowel Cancer Screening Programme

    Directory of Open Access Journals (Sweden)

    Becky White

    2015-01-01

    Full Text Available This study evaluated the impact of three interventions on uptake of the guaiac faecal occult blood test (gFOBT in Greater London. The interventions were designed to improve awareness and understanding of the NHS Bowel Cancer Screening Programme (BCSP and assist stool sampling. Logistic regression analysis of BCSP London data (N=205,541 invitees aged 60–74 compared uptake at 12 weeks between intervention groups and a control group, sent kits as usual between January-April 2013 and January-April 2014. An endorsement flyer, included with gFOBT kits, had no impact on uptake (P=0.68. In 60–69-year-olds, there was a small but significant increase in modelled uptake amongst invitees sent both the flyer and a kit enhancement pack compared with controls (45.1% versus 43.4%, OR=1.07, P=0.047. In North East London, the flyer together with outdoor advertising was associated with a small but significant increase (45.6% versus 43.4%, OR=1.09, P=0.027. The largest increases were seen when all three interventions (flyer, pack, and advertising were combined (49.5% versus 43.4%, OR=1.28, P<0.001. The increased uptake in the intervention groups was largest in “first-timers” and smaller amongst previous nonresponders and previously screened invitees.

  15. Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial

    International Nuclear Information System (INIS)

    Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population’s reasons for refusing to take part in the screening programme and to find out the health professionals’ opinion about the official programme implementation and on the new computerised tool. This is a parallel randomised trial with a cross-sectional second stage. Participants: all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50–69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient’s electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach. We expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by

  16. Using Concept Mapping to Explore Barriers and Facilitators to Breast Cancer Screening in Formerly Homeless Women with Serious Mental Illness.

    Science.gov (United States)

    Weinstein, Lara Carson; LaNoue, Marianna; Hurley, Katelyn; Sifri, Randa; Myers, Ronald

    2015-08-01

    Women with serious mental illness (SMI) have disproportionately worse breast cancer profiles than those of other women. The purpose of this project was to examine barriers to and facilitators of breast cancer screening, specifically in formerly homeless women with SMI using the participatory methodology of concept mapping. A series of three concept mapping focus groups were held with 27 women over the age of 40 with a diagnosis of a SMI who live in supportive housing programs, and with 16 housing program staff. Data from the focus groups were combined through multidimensional scaling to create a visual cluster map. Barriers and facilitators to mammography screening generated by the participants clustered into eight categories. Participants rated addressing educational issues as most important and feasible. Interventions designed to improve mammogram screening in this population should address patients' perception of personal risk and should target education and support systems as modifiable factors. PMID:26320922

  17. A group cognitive behaviour therapy programme with metastatic breast cancer patients.

    Science.gov (United States)

    Edelman, S; Bell, D R; Kidman, A D

    1999-01-01

    One-hundred and twenty-four patients with metastatic breast cancer were randomised to either a group Cognitive Behaviour Therapy (CBT) intervention, or to a no-therapy control group condition. Both groups received standard oncological care; however, therapy recipients also attended eight weekly sessions of group CBT, followed by a family night, and three further monthly sessions. Patients completed the 'Profile of Mood States' (POMS) and the Coopersmith Self-esteem Inventory (CSI) before and after therapy, and at 3 and 6 month follow-up periods. Outcome data in the period following therapy showed reduced depression and total mood disturbance, as well as improved self-esteem amongst therapy participants, relative to a no-therapy control group. These improvements were no longer evident at the 3 or 6 month follow-up assessments. We also report on the difficulties associated with conducting a group intervention with this patient cohort. PMID:10474848

  18. A Case-Control Study to Estimate the Impact of the Icelandic Population-Based Mammography Screening Program on Breast Cancer Death

    International Nuclear Information System (INIS)

    Background: The Icelandic breast cancer screening program, initiated November 1987 in Reykjavik and covering the whole country from December 1989, comprises biennial invitation to mammography for women aged 40-69 years old. Purpose: To estimate the impact of mammography service screening in Iceland on deaths from breast cancer. Material and Methods: Cases were deaths from breast cancer from 1990 onwards in women aged 40 and over at diagnosis, during the period November 1987 to December 31, 2002. Age- and screening-area-matched, population-based controls were women who had also been invited to screening but were alive at the time their case died. Results: Using conditional logistic regression on the data from 226 cases and 902 controls, the odds ratio for the risk of death from breast cancer in those attending at least one screen compared to those never screened was 0.59 (95% CI 0.41-0.84). After adjustment for healthy-volunteer bias and screening-opportunity bias, the odds ratio was 0.65 (95% CI 0.39-1.09). Conclusion: These results indicate a 35-40% reduction in breast cancer deaths by attending the Icelandic breast cancer screening program. These results are consistent with the overall evidence from other observational evaluations of mammography-based programs

  19. The number needed to invite (NNI) for breast cancer mammography screening in Japan

    International Nuclear Information System (INIS)

    In 2009, the US Preventive Services Task Force (USPSTF) recommended that the decision to start regular screening mammography (MMG) before the age of 50 years should be an individual one. They calculated the number needed to invite (NNI) to screening to prevent one death from breast cancer (BC) and concluded that the net benefit is smaller for women aged 40-49 yr with its larger NNI than that for women aged 50-59 yr. Estimating the NNI by age group is also important in Japan. There has been a need to estimate absolute differences in BC cumulative mortality between women with and without MMG. Since such data are unavailable, we assumed that BC mortality for Japanese women would be the same as that for women without MMG, and that the relative risks were the same as those reported by the USPSTF. Comparison of NNI in Japan with the USPSTF report yielded results that were similar for women aged 40-49 yr and 50-59 yr, whereas the NNI in Japan was double that reported by the USPSTF for women aged 60-69 yr. In Japan, studies for evaluating the balance between the benefits and drawbacks of MMG are needed. (author)

  20. Independent predictors of breast malignancy in screen-detected microcalcifications: biopsy results in 2545 cases

    Science.gov (United States)

    Farshid, G; Sullivan, T; Downey, P; Gill, P G; Pieterse, S

    2011-01-01

    Background: Mammographic microcalcifications are associated with many benign lesions, ductal carcinoma in situ (DCIS) and invasive cancer. Careful assessment criteria are required to minimise benign biopsies while optimising cancer diagnosis. We wished to evaluate the assessment outcomes of microcalcifications biopsied in the setting of population-based breast cancer screening. Methods: Between January 1992 and December 2007, cases biopsied in which microcalcifications were the only imaging abnormality were included. Patient demographics, imaging features and final histology were subjected to statistical analysis to determine independent predictors of malignancy. Results: In all, 2545 lesions, with a mean diameter of 21.8 mm (s.d. 23.8 mm) and observed in patients with a mean age of 57.7 years (s.d. 8.4 years), were included. Using the grading system adopted by the RANZCR, the grade was 3 in 47.7% 4 in 28.3% and 5 in 24.0%. After assessment, 1220 lesions (47.9%) were malignant (809 DCIS only, 411 DCIS with invasive cancer) and 1325 (52.1%) were non-malignant, including 122 (4.8%) premalignant lesions (lobular carcinoma in situ, atypical lobular hyperplasia and atypical ductal hyperplasia). Only 30.9% of the DCIS was of low grade. Mammographic extent of microcalcifications >15 mm, imaging grade, their pattern of distribution, presence of a palpable mass and detection after the first screening episode showed significant univariate associations with malignancy. On multivariate modeling imaging grade, mammographic extent of microcalcifications >15 mm, palpable mass and screening episode were retained as independent predictors of malignancy. Radiological grade had the largest effect with lesions of grade 4 and 5 being 2.2 and 3.3 times more likely to be malignant, respectively, than grade 3 lesions. Conclusion: The radiological grading scheme used throughout Australia and parts of Europe is validated as a useful system of stratifying microcalcifications into