WorldWideScience

Sample records for breast screening uptake

  1. Radiographer gender and breast-screening uptake.

    Science.gov (United States)

    Fitzpatrick, P; Winston, A; Mooney, T

    2008-06-03

    BreastCheck, the Irish National Breast Screening Programme, screens women aged 50-64. Radiographer recruitment has been a challenge; doubling of numbers is required for full national expansion; to date females are employed. The aim was to document attitudes to male radiographers and effect on return for subsequent screening. In all 85.8% of a random sample of 2000 women recently screened by BreastCheck completed a postal questionnaire. The commonest reaction women felt they would have if there were a male radiographer was embarrassment; significantly greater among those attending a static unit (45.6%) than mobile (38.4%) and in younger women (46%) than older (38.7%). Nine per cent would not have proceeded if the radiographer was male and 9% would only have proceeded if female chaperone present. In all 17.5% (95% CI 15.7-19.4%) agreed that 'If there were male radiographers I would not return for another screening appointment'; 18.3% were unsure. One-quarter agreed 'if I heard there could be male radiographers it would change my opinion of BreastCheck for the worse'. The proportions agreeing with these statements did not vary significantly by screening unit type, age group, area of residence or insurance status. This is the largest published study to date of this important issue; the correct balance between equality and programme performance must be identified.

  2. Influences on Polish migrants' breast screening uptake in Lothian, Scotland.

    Science.gov (United States)

    Gorman, D R; Porteous, L A

    2018-01-29

    Ethnic minorities are known to have low uptake of cancer screening programmes and Polish populations to have low breast screening uptake. Breast screening uptake by women in Poland and Polish migrants to Scotland is low. We interviewed Polish women living in Lothian, Scotland, about their attitudes to breast screening. Telephone interviews were held with a sample of 11 Polish women registered with Lothian general practices and invited for breast screening in 2013 or 2014. Interviews were between November 2014 and February 2015 and were held in Polish then translated, transcribed and analysed thematically. Women interviewed (mean age 58 years) had lived in Scotland for an average of 7.5 years. Seven had undergone breast screening in both Poland and Scotland, three in only Scotland and one in Poland alone. Respondents usually used Scottish and Polish health systems and screening programmes in parallel. Convenience and familiarity shaped screening choices with written information neither accessed nor answering key questions e.g. about coordination between programmes. Polish women living in Scotland have difficulties in accessing screening there and often use both Polish and Scottish system. Language issues, misunderstandings about screening and different health cultures are key barriers. Combined information in Polish about all cancer screening programmes could help address low uptake. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. 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.

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

    African Journals Online (AJOL)

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

  5. 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

    2009-12-03

    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.

  6. 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.

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

    OpenAIRE

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

    2009-01-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Gumber Anil K

    2010-04-01

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

  9. 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

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

    Science.gov (United States)

    Brouwers, Melissa C; De Vito, Carol; Bahirathan, Lavannya; Carol, Angela; Carroll, June C; Cotterchio, Michelle; Dobbins, Maureen; Lent, Barbara; Levitt, Cheryl; Lewis, Nancy; McGregor, S Elizabeth; Paszat, Lawrence; Rand, Carol; Wathen, Nadine

    2011-09-29

    Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale) for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Using established guideline development methodologies and the AGREE II as our methodological frameworks, we developed an implementation guideline to advise on

  11. 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.

  12. Clinical breast examination as the recommended breast cancer screening modality in a rural community in Malaysia; what are the factors that could enhance its uptake?

    Directory of Open Access Journals (Sweden)

    Nik Daliana Nik Farid

    Full Text Available Breast cancer is the most common cause of deaths and the most frequently diagnosed cancer among women worldwide. This study aimed to determine the prevalence of breast cancer screening, specifically on clinical breast examination, and the predictors of its uptake among women in Malaysia. A cross-sectional study was carried out in five selected districts whereby women aged between 20 to 64 years old, from a total of 1000 households were interviewed. A total of 1192 women responded to the survey of which 53.3% reported had ever done clinical breast examination. Significant associations with clinical breast examination were noted for income and distance from the hospital. These factors should be considered in developing interventions aimed at promoting clinical breast examination. In particular, healthcare providers should be proactive in raising awareness about clinical breast examination among women in Malaysia.

  13. Breast cancer screening

    Science.gov (United States)

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

  14. Health beliefs, illness perceptions and determinants of breast screening uptake in Malta: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Danika Marmarà

    2017-05-01

    Full Text Available Abstract Background Women’s beliefs and representations of breast cancer (BC and breast screening (BS are salient predictors for BS practices. This study utilized the health belief model (HBM and common-sense model (CSM of illness self-regulation to explore factors associated with BS uptake in Malta and subsequently, to identify the most important predictors to first screening uptake. Methods This cross-sectional survey enrolled Maltese women (n = 404 ages 50 to 60 at the time of their first screening invitation, invited to the National Breast Screening Programme by stratified random sampling, with no personal history of BC. Participants responded to a 121-item questionnaire by telephone between June–September 2015. Data were analyzed using descriptive statistics, chi-square tests and logistic regression. Results There is high awareness of BC signs and symptoms among Maltese women (>80% agreement for 7 out of 8 signs, but wide variation about causation (e.g., germ or virus: 38.6% ‘agree’, 30.7% ‘disagree’. ‘Fear’ was the key reason for non-attendance to first invitation (41%, n = 66 and was statistically significant across all subscale items (p < 0.05. Most items within HBM constructs (perceived barriers; cues to action; self-efficacy were significantly associated with first invitation to the National Breast Screening Programme, such as fear of result (χ2 = 12.0, p = 0.017 and life problems were considered greater than getting mammography (χ2 = 38.8, p = 0.000. Items within CSM constructs of Illness Representation (BC causes; cyclical cancer timeline; consequences were also significantly associated, such as BC was considered to be life-changing (χ2 = 18.0, p = 0.000 with serious financial consequences (χ2 = 13.3, p = 0.004. There were no significant associations for socio-demographic or health status variables with uptake, except for family income (χ2 = 9.7, p = 0.047. Logistic regression analyses

  15. Breast and cervical cancer-screening uptake among females in Ardabil, northwest Iran: a community-based study

    Directory of Open Access Journals (Sweden)

    Farzaneh E

    2017-02-01

    Full Text Available Esmaeil Farzaneh,1 Heshmatolah Heydari,2 Ali Akbar Shekarchi,3 Aziz Kamran4 1Department of Forensic Medicine and Toxicology, Ardabil University of Medical Sciences, Ardabil, Iran; 2Department of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran; 3Department of Pathology, 4Department of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran Purpose: Breast and cervical cancers are the most commonly diagnosed type of cancer and cause of cancer-related deaths in Iranian females. In contrast to previous studies, this study was carried out with a large sample size for assessment of breast self-examination (BSE-, clinical breast examination (CBE-, mammography-, and Pap smear-uptake rates and determination of associations among these screening behaviors with sociodemographic and cognitive variables in Azeri females. Materials and methods: This was a cross-sectional, community-based study that was carried out among 1,134 females 20–60 years old during March–June 2016. Data-collection variables included sociodemographic questions, screening behaviors for breast and cervical cancer, self-efficacy, beliefs, and barriers to breast and cervical cancer screening. Collected data were analyzed by SPSS version 13 using χ2, Mann–Whitney U, and logistic regression tests. Results: Among the 1,134 participants, 53.9%, 9.8%, and 28.1% had done BSE, CBE, and Pap smear tests, respectively, and among the 625 females aged >40 years, 187 (29.9% had done the mammography test. Moreover, 416 (36.7%, 103 (16.5%, and 64 (5.6% females had done BSE, mammography, and CBE regularly, respectively. Beliefs, barriers, income, health insurance, number of children, and age were all important factors for BSE and regular BSE and mammography. Females who had high belief scores were more likely to undertake mammography (odds ratio [OR]: 1.2, 95% confidence interval [CI]: 1.03–1.5, regular mammography (OR: 4.2, 95% CI: 1.9–9.3, regular CBE (OR: 1

  16. Risks of Breast Cancer Screening

    Science.gov (United States)

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

  17. Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics

    Directory of Open Access Journals (Sweden)

    Price Charlotte

    2008-10-01

    Full Text Available Abstract Background A number of studies have reported low uptake of cancer screening programmes by South Asian populations in the UK. However, studies to date have not adjusted findings for differences in demographics and socio-economic status of these populations. Methods Subjects: All residents in Coventry and Warwickshire, UK, eligible for screening. Uptakes compared for round 1 (2000–02 and round 2 (2003–05 of a national bowel cancer screening pilot, and for rounds 1, 2 and 5 of the established NHS breast cancer screening programme (commenced 1989. Data: Bowel screening data were analysed for 123,367 invitees in round 1 and 116,773 in round 2 (total 240,140 cases. Breast screening data were analysed for 61,934, 62,829 and 86,749 invitees in rounds 1, 2 and 5 respectively (total 211,512 cases. Analysis: Screening uptake was compared for two broad meta-categories (South Asian and non-Asian and for five Asian subgroups (Hindu-Gujarati; Hindu-Other; Muslim; Sikh; South Asian Other. Univariate and multivariate analyses examined screening uptake and various demographic attributes of invitees, including age, gender, deprivation and ethnic group. Results South Asians demonstrated significantly lower (p For Muslims registered with an Asian (vs. non-Asian GP, bowel screening uptake was significantly lower (p p = 0.12 in the same period. Colonoscopy and breast assessment uptakes were similar for both meta-categories, but Asian response time appeared slower for colonoscopy. The percentage of abnormal FOBT results was significantly higher for South Asian invitees. A slight increase in abnormal mammograms was observed for Muslims over time (2.7% to 4.2% in rounds 1 and 5 respectively. Conclusion The lower cancer screening uptakes observed for the South Asian population cannot be attributed to socio-economic, age or gender population differences. Although breast screening disparities have reduced over time, significant differences remain. We conclude

  18. Screening for Breast Cancer.

    Science.gov (United States)

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

    2017-11-01

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

  19. Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review

    Science.gov (United States)

    Islam, Rakibul M; Billah, Baki; Hossain, Md Nassif; Oldroyd, John

    2017-07-27

    Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs. Creative Commons Attribution License

  20. breast cancer screening in

    African Journals Online (AJOL)

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

  1. TMIST Breast Screening Study

    Science.gov (United States)

    TMIST is a randomized breast screening trial that compares two Food and Drug Administration (FDA)-approved types of digital mammography, standard digital mammography (2-D) with a newer technology called tomosynthesis mammography (3-D).

  2. Major ethnic group differences in breast cancer screening uptake in Scotland are not extinguished by adjustment for indices of geographical residence, area deprivation, long-term illness and education

    Science.gov (United States)

    Bansal, N; Bhopal, R S; Steiner, M F C; Brewster, D H

    2012-01-01

    Background: Breast cancer screening data generally show lower uptake in minority ethnic groups. We investigated whether such variations occur in Scotland. Methods: Using non-disclosive computerised linkage we combined Scottish breast screening and Census 2001 data. Non-attendance at first breast-screening invitation (2002–2008) was compared between 11 ethnic groups using age-adjusted risk ratios (RR) with 95% confidence intervals (CI), multiplied by 100, using Poisson regression. Results: Compared with the White Scottish (RR=100), non-attendance was similar for Other White British (99.5, 95% CI 96.1–103.2) and Chinese (112.8, 95% CI 96.3–132.2) and higher for Pakistani (181.7, 95% CI 164.9–200.2), African (162.2, 95% CI 130.8–201.1), Other South Asian (151.7, 95% CI 118.9–193.7) and Indian (141.7, 95% CI 121.1–165.7) groups. Adjustment for rural vs urban residence, long-term illness, area deprivation and education, associated with risk of non-attendance, increased the RR for non-attendance except for Pakistani women where it was modestly attenuated (RR=164.9, 149.4–182.1). Conclusion: Our data show important inequality in breast cancer screening uptake, not attenuated by potential confounding factors. Ethnic inequalities in breast screening attendance are of concern especially given evidence that the traditionally lower breast cancer rates in South Asian groups are converging towards the risks in the White UK population. Notwithstanding the forthcoming review of breast cancer screening, these data call for urgent action. PMID:22415231

  3. [Organized breast cancer screening].

    Science.gov (United States)

    Rouëssé, Jacques; Sancho-Garnier, Hélèn

    2014-02-01

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

  4. Explaining variation in Down's syndrome screening uptake

    DEFF Research Database (Denmark)

    Crombag, Neeltje M T H; Vellinga, Ynke E; Kluijfhout, Sandra A

    2014-01-01

    BACKGROUND: The offer of prenatal Down's syndrome screening is part of routine antenatal care in most of Europe; however screening uptake varies significantly across countries. Although a decision to accept or reject screening is a personal choice, it is unlikely that the widely differing uptake...... rates across countries can be explained by variation in individual values alone.The aim of this study was to compare Down's syndrome screening policies and programmes in the Netherlands, where uptake is relatively low ( 90% respectively....... RESULTS: There were many similarities in the demographics, healthcare systems, government abortion legislation and Down's syndrome screening policy across the studied countries. However, the additional cost for Down's syndrome screening over and above standard antenatal care in the Netherlands...

  5. Overdiagnosis in breast cancer screening

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  6. 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.

  7. Overdiagnosis in breast cancer screening

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  8. Implementation of Whole-Breast Screening Ultrasonography.

    Science.gov (United States)

    Durand, Melissa A; Hooley, Regina J

    2017-05-01

    Whole-breast screening ultrasonography is being increasingly implemented in breast imaging centers because numerous studies have shown the benefit of supplemental screening for women with dense breasts and breast density notification laws are becoming more widespread. This article reviews the numerous considerations involved in integrating a screening ultrasonography program into a busy practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Breast Cancer Screening in Denmark

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  10. Women with Disabilities and Breast Cancer Screening

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2017-07-01

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

  12. Patterns of radioiodine uptake by the lactating breast

    Energy Technology Data Exchange (ETDEWEB)

    Bakheet, S.M. (Dept. of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)); Hammami, M.M. (Dept. of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia))

    1994-07-01

    Breast uptake of radioiodine, if not suspected, may be misinterpreted as thyroid cancer metastasis to the lung. To characterize the patterns of radioiodine breast uptake, we retrospectively studied 20 radioiodine scans that were performed within 1 week of cessation of breast feeding. Four patterns of uptake were identified: ''full'', ''focal'', ''crescent'' and ''irregular''. The uptake was asymmetric in 60% (left>right in 45%, right>left in 15%), symmetric in 25% and unilateral in 15% of cases. A characteristic full bilateral uptake was present in 40% of cases. In three cases with the irregular pattern, caused in part by external contamination with radioactive milk, the uptake closely mimicked lung metastases. Delayed images, obtained in one case, showed an apparent radioiodine shift from the breast to the thyroid, suggesting that the presence of breast uptake can modulate radioiodine uptake by thyroid tissue. In a case of unilateral breast uptake, a history of mastitis was obtained, which to our knowledge has not been previously reported. Breast uptake of radioiodine may take several scintigraphic patterns that are not always characteristic of the lactating breast and may affect the apparent extent of thyroid remnant/metastasis. (orig.)

  13. 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%.

  14. Is the tide turning against breast screening?

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl

    2012-01-01

    ABSTRACT: Herein I argue that mammographic screening has not delivered on its fundamental premise: to reduce the incidence of advanced breast cancer. Indeed, achieving this goal is required if screening is to reduce breast cancer mortality or mastectomy use. Rather, screening has caused substanti...

  15. Screening Mammography and Digital Breast Tomosynthesis: Controversies.

    Science.gov (United States)

    Funaro, Kimberly; Drukteinis, Jennifer; Falcon, Shannon

    2017-10-01

    Breast cancer screening with mammography reduces breast cancer mortality; however, diverging recommendations regarding screening have caused controversy. The emerging technology of digital breast tomosynthesis (DBT) may soon become the mainstay of breast cancer screening. We present recommendations for breast cancer screening based on guidelines. A PubMed literature review was performed and the results from five large clinical studies comparing the efficacy of digital mammography alone versus digital mammography with DBT are examined. We emphasize the importance of annual screening to reduce breast cancer mortality. Our review of the literature demonstrates that DBT increases cancer detection rates and reduces callbacks. Additional research is needed to determine whether the increased cancer detection rates are associated with a decrease in mortality.

  16. 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...

  17. Testing Precision Screening for Breast Cancer

    Science.gov (United States)

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  19. Primary care patient experience and cancer screening uptake among women: an exploratory cross-sectional study in a Japanese population.

    Science.gov (United States)

    Aoki, Takuya; Inoue, Machiko

    2017-01-01

    Patient experience and clinical quality, which are represented by preventive care measures such as cancer screening, are both widely used for the evaluation of primary care quality. The aim of this study was to examine the association between patient experience and cancer screening uptake among women in a Japanese population. We conducted a cross-sectional mail survey. The questionnaire was sent to 1000 adult female residents randomly selected from a basic resident register in Yugawara town, Kanagawa, Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT) and uptake of breast and cervical cancer screening. The overall response rate was 46.5%. Data were analyzed for 190 female participants aged 21-74 years who had a usual source of primary care. Multivariate logistic regression analyses revealed that the JPCAT total score was significantly associated with uptake of breast cancer screening [odds ratio (OR) per 1 standard deviation increase = 1.63; 95% CI 1.11-2.41], but not with uptake of cervical cancer screening (OR per 1 standard deviation increase = 1.47; 95% CI 0.97-2.24). Patient experience of primary care was associated with uptake of breast cancer screening among Japanese women. The results of our study might support the argument that patient experience of primary care and the clinical process of preventive care, such as breast cancer screening, are linked.

  20. 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....

  1. Outcome of breast cancer screening in Denmark

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  2. Overview of guidelines on breast screening

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...

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

    Science.gov (United States)

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

    2015-04-02

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

  4. Uptake of Cancer Screening Tests Among Recipients of Solid Organ Transplantation.

    Science.gov (United States)

    Acuna, S A; Sutradhar, R; Camacho, X; Daly, C; Del Giudice, M E; Kim, S J; Baxter, N N

    2017-09-01

    Population-based cancer screening recommendations are also suggested for solid organ transplant recipients (SOTR); however, recommendation adherence is unknown. In a population-based cohort of SOTR in Ontario between 1997 and 2010, we determined the uptake of breast, cervical, and colorectal cancer screening tests and identified factors associated with up-to-date screening using recurrent event analysis. We identified 4436 SOTR eligible for colorectal, 2252 for cervical, and 1551 for breast cancer screening. Of those, 3437 (77.5%), 1572 (69.8%), and 1417 (91.4%), respectively, were not up-to-date for cancer screening tests during the observation period. However, these rates are likely an overestimate due to the inability to differentiate between tests done for screening or for diagnosis. SOTR with fewer comorbidities had higher rates of becoming screen up-to-date. Assessment by a primary care provider (PCP) was associated with becoming up-to-date with cancer screening (breast relative risk [RR] = 1.40, 95% confidence interval [CI]: 1.12-1.76, cervical RR = 1.29, 95% CI: 1.06-1.57, colorectal RR = 1.30, 95% CI: 1.15-1.48). Similar results were observed for continuity of care by transplant specialist at a transplant center. In conclusion, cancer screening for most SOTR does not adhere to standard recommendations. Involvement of PCPs in posttransplant care and continuity of care at a transplant center may improve the uptake of screening. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

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

    African Journals Online (AJOL)

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

  6. Uptake of cervical cancer screening: awareness, willingness and ...

    African Journals Online (AJOL)

    Background: Cervical cancer remains the commonest genital tract cancer and yet it is preventable through cytologic screening with Pap smear. Awareness and willingness among target population is an imperative for uptake of screening services. Aim: To contribute to the existing knowledge base, and in particular, bridge ...

  7. Capsule colonoscopy increases uptake of colorectal cancer screening

    Directory of Open Access Journals (Sweden)

    Groth Stefan

    2012-06-01

    Full Text Available Abstract Background Screening colonoscopy effectiveness is hampered by limited adherence by the general population. The present prospective study was performed to evaluate whether adding capsule colonoscopy to the endoscopic screening options increases uptake. Methods Invitation letters were sent to 2150 persons above the age of 55 insured with a German medical insurance company in the area of Rinteln, Lower Saxony with a baseline spontaneous annual screening colonoscopy uptake of 1 %. Both capsule or conventional colonoscopy were offered. Interested persons were given information about the two screening options by four local gastroenterologists and examinations were then performed according to screenees’ final choice. Results 154 persons sought further information, and 34 and 90 underwent conventional and capsule colonoscopy, respectively. Colonoscopy uptake was thus increased by the invitation process by 60 % (1.6 % vs. 1 %; p = 0.075, while the option of capsule endoscopy led to a fourfold increase of screening uptake (4.2 % vs. 1 %, p  Conclusions The present study suggests that offering the option of capsule colonoscopy increases uptake of endoscopic colorectal cancer screening. However, capsule endoscopy sensitivity for adenoma detection needs to be improved.

  8. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Nielsen, Margrethe

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  11. 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

  12. 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

  13. European Breast Cancer Service Screening Outcomes

    DEFF Research Database (Denmark)

    Paci, Eugenio; Broeders, Mireille; Hofvind, Solveig

    2014-01-01

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

  14. Outcome of breast cancer screening in Denmark

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  15. Cervical Cancer Awareness and Screening Uptake among Rural ...

    African Journals Online (AJOL)

    femi oloka

    Cervical Cancer Awareness and Screening Uptake among Rural. Women in Lagos, Nigeria. 1. 2. 1. 3. Oluwole E.O ., Mohammed A.S ., Akinyinka M.R ., Salako O . ABSTRACT. Background: Cervical cancer is the most common cause of female genital cancer and female cancer deaths in developing countries such as ...

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

    Science.gov (United States)

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

    2012-12-01

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

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

    Science.gov (United States)

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

    2013-06-01

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

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

    Science.gov (United States)

    Uematsu, Takayoshi

    2017-01-01

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

  19. 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......-69 years. We collected information for the years 1991-2001 on screening outcome, incident BCs (screen-, interval-, and later detected), and BC deaths. Breast density was dichotomised into fatty (F) and mixed/dense (M/D) breasts. Screening sensitivity was measured as the odds ratio of interval versus screen...

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

    Science.gov (United States)

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

    2017-10-26

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

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

    National Research Council Canada - National Science Library

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

    2012-01-01

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

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

    NARCIS (Netherlands)

    ScafKlomp, W; VanSonderen, E; VandenHeuvel, W

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

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

    Science.gov (United States)

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

    2014-12-01

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

  4. Medical auditing of whole-breast screening ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Jung [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-07-15

    Since breast ultrasonography (US) has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes.

  5. Medical auditing of whole-breast screening ultrasonography

    Directory of Open Access Journals (Sweden)

    Min Jung Kim

    2017-07-01

    Full Text Available Since breast ultrasonography (US has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes.

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

    Science.gov (United States)

    Houssami, Nehmat

    2017-01-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

  9. BREAST CANCER IN SLOVENIA: EPIDEMIOLOGY AND SCREENING

    Directory of Open Access Journals (Sweden)

    Maja Primic Žakelj

    2003-12-01

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

  10. Alternative screening for women with dense breasts: breast-specific gamma imaging (molecular breast imaging).

    Science.gov (United States)

    Holbrook, Anna; Newel, Mary S

    2015-02-01

    OBJECTIVE. Given mammography's limitations in evaluating dense breasts, examination with breast-specific gamma imaging (BSGI)-also called molecular breast imaging (MBI)-has been proposed. We review the literature pertinent to the performance of BSGI in patients with dense breasts. CONCLUSION. Many studies have reported the sensitivity of BSGI in finding cancers even in dense breasts. However, BSGI has not yet been validated as an effective screening tool in large prospective studies. In addition, whole-body dose remains a significant concern.

  11. Background parenchymal uptake on molecular breast imaging as a breast cancer risk factor: a case-control study.

    Science.gov (United States)

    Hruska, Carrie B; Scott, Christopher G; Conners, Amy Lynn; Whaley, Dana H; Rhodes, Deborah J; Carter, Rickey E; O'Connor, Michael K; Hunt, Katie N; Brandt, Kathleen R; Vachon, Celine M

    2016-04-26

    Molecular breast imaging (MBI) is a functional test used for supplemental screening of women with mammographically dense breasts. Additionally, MBI depicts variable levels of background parenchymal uptake (BPU) within nonmalignant, dense fibroglandular tissue. We investigated whether BPU is a risk factor for breast cancer. We conducted a retrospective case-control study of 3027 eligible women who had undergone MBI between February 2004 and February 2014. Sixty-two incident breast cancer cases were identified. A total of 179 controls were matched on age, menopausal status, and MBI year. Two radiologists blinded to case status independently assessed BPU as one of four categories: photopenic, minimal to mild, moderate, or marked. Conditional logistic regression analysis was performed to estimate the associations (OR) of BPU categories (moderate or marked vs. minimal to mild or photopenic) and breast cancer risk, adjusted for other risk factors. The median age was 60.2 years (range 38-86 years) for cases vs. 60.2 years (range 38-88 years) for controls (p = 0.88). Women with moderate or marked BPU had a 3.4-fold (95 % CI 1.6-7.3) and 4.8-fold (95 % CI 2.1-10.8) increased risk of breast cancer, respectively, compared with women with photopenic or minimal to mild BPU, for two radiologists. The results were similar after adjustment for BI-RADS density (OR 3.3 [95 % CI 1.6-7.2] and OR 4.6 [95 % CI 2.1-10.5]) or postmenopausal hormone use (OR 3.6 [95 % CI 1.7-7.7] and OR 5.0 [95 % CI 2.2-11.4]). The association of BPU with breast cancer remained in analyses limited to postmenopausal women only (OR 3.8 [95 % CI 1.5-9.3] and OR 4.1 [95 % CI 1.6-10.2]) and invasive breast cancer cases only (OR 3.6 [95 % CI 1.5-8.8] and OR 4.4 [95 % CI 1.7-11.1]). Variable BPU was observed among women with similar mammographic density; the distribution of BPU categories differed across density categories (p risk factor for breast cancer. Among women with dense breasts, who

  12. Overdiagnosis in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  14. Prostate screening uptake in Australian BRCA1 and BRCA2 carriers

    Directory of Open Access Journals (Sweden)

    McKinley Joanne M

    2007-09-01

    Full Text Available Abstract Men who carry mutations in BRCA1 or BRCA2 are at increased risk for prostate cancer. However the efficacy of prostate screening in this setting is uncertain and limited data exists on the uptake of prostate screening by mutation carriers. This study prospectively evaluated uptake of prostate cancer screening in a multi-institutional cohort of mutation carriers. Subjects were unaffected male BRCA1 and BRCA2 mutation carriers, aged 40–69 years, enrolled in the Kathleen Cuningham Consortium for Research into Familial Breast Cancer (kConFab and who had completed a mailed, self-report follow-up questionnaire 3 yearly after study entry. Of the 75 male carriers in this study, only 26 (35% had elected to receive their mutation result. Overall, 51 (68% did not recall having received a recommendation to have prostate screening because of their family history, but 41 (55% had undergone a prostate specific antigen (PSA test and 32 (43% a digital rectal examination (DRE in the previous 3 years. Those who were aware of their mutation result were more likely to have received a recommendation for prostate screening (43 vs. 6%, p = 0.0001, and to have had a PSA test (77 vs. 43%, p = 0.005 and a DRE (69 vs. 29%, p = 0.001 in the previous 3 years. The majority of unaffected males enrolled in kConFab with a BRCA1/2 mutation have not sought out their mutation result. However, of those aware of their positive mutation status, most have undergone at least one round of prostate screening in the previous 3 years.

  15. 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.

  16. 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…

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

    Science.gov (United States)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

    Wanders, J.O.P .

    2017-01-01

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

  19. Cancer screening uptake: association with individual characteristics, geographic distribution, and time trends in Italy.

    Science.gov (United States)

    Carrozzi, Giuliano; Sampaolo, Letizia; Bolognesi, Lara; Sardonini, Laura; Bertozzi, Nicoletta; Giorgi Rossi, Paolo; Zappa, Marco; Baldissera, Sandro; Campostrini, Stefano; Ferrante, Gianluigi; Masocco, Maria; Minardi, Valentina; D'Argenzio, Angelo; Moghadam, Pirous Fateh; Quarchioni, Elisa; Ramigni, Mauro; Trinito, Massimo Oddone; Salmaso, Stefania

    2015-01-01

    In Italy, organized screening programmes invite the vast majority of the population for cervical and breast cancer, and about one half of the population for colorectal cancer. Programme activity and quality are closely monitored. Nevertheless, there is a vast spontaneous activity, both public and private, for which information on service and coverage is missing. To estimate actual population coverage for the three types of screening the extent of spontaneous screening needs to be known. PASSI is a national telephone-interview surveillance system that continuously collects information about behavioural health risk factors and the diffusion of preventive health interventions. From 2010 to 2013, more than 151,000 18- to 69-year-olds were interviewed. During 2013, 136 out of 147 Italian local health authorities participated in the survey. Information about screening includes: test uptake (Pap smear, HPV, mammography, faecal occult blood test, colonoscopy), date of the last test, provider of the last test (whether paid or for free, proxy of the organized screening programme), reason for not participating in screening, and screening promotion/recommendation received. Individual information on socio-economic characteristics is available. Seventy-seven percent of the 25-64 year-old women interviewed said they had undergone a Pap smear or HPV test in the three years before the interview, 40%within the screening programme, 37% spontaneously and paying. Seventy percent of the 50-69 year-old women interviewed reported having had a mammography in the two years before the interview, 51% within the screening programme, 19% spontaneously and paying. Thirty-eight percent of the 50-69 year olds interviewed reported having undergone colorectal screening in the two years before the interview, 31% within the screening programme, 7% spontaneously and paying. All three screening programmes showed a decreasing North-South trend in coverage. From 2010 to 2013, coverage increased for all

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

    African Journals Online (AJOL)

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

  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...

  2. The Clinical Breast Examination: A Useful Screening Tool?

    Directory of Open Access Journals (Sweden)

    Jennifer Lo

    2015-01-01

    Full Text Available The standardization of the clinical breast examination as a screening tool for breast cancer has been a topic of controversy. Current recommendations vary significantly from organization to organization without consensus. There currently does not seem to be sufficient evidence regarding overall survival benefit of the clinical breast exam. However, as adjunct screening with mammography, it may help find earlier breast cancers and the up to 5–10% of cancers missed by mammography. The most appropriate standardized protocol may be that the clinical breast exam can be performed at the discretion of the provider and patient, with more inclination toward use in women in whom the exam carries greater sensitivity.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  4. [Can a mobile phone short message increase participation in breast cancer screening programmes?].

    Science.gov (United States)

    Arcas, M M; Buron, A; Ramis, O; Esturi, M; Hernández, C; Macià, F

    2014-01-01

    To evaluate the impact of a mobile phone short message on women's uptake in a breast cancer screening programme. A total of 703 women from a Basic Health Area of Barcelona, and with a mobile phone number registered, were invited to participate in a breast cancer screening programme between 25 January 2011 and 22 March 2011. The control group (n=470) followed the usual appointment track, and the intervention group (n=233) received, after the first letter of invitation, a mobile phone short message reminder. The differences between the two groups were analysed, comparing the uptake rates according to age, educational level, and participation in previous round, as well as the number of re-invitation calls to non-attenders according to uptake, age and level of education;and the percentages of exclusions of both groups. The intervention group had a greater uptake than the control group (78.1% vs. 72.3%), with a significant trend observed in the 55-59 years age group (P=.036) and the low secondary educational level (P=.014).The intervention group mean of re-invitation calls of non-attenders lower than the control group (.41 vs. .65, Pcancer screening programme may increase uptake rates and lead to a management improvement. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  5. 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....

  6. Beyond Mammography: New Frontiers in Breast Cancer Screening

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

  9. Breast Cancer Screening in an Era of Personalized Regimens

    Science.gov (United States)

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

    2014-01-01

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

  10. Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009.

    Science.gov (United States)

    Hennedige, Anusha A; Kong, Tze Yean; Gandhi, Ashu

    2011-07-01

    Bilateral Breast Reduction (BBR) is a common procedure performed by Breast and Plastic surgeons in the UK. No consensus exists regarding preoperative screening for malignancy or for selective criteria for such screening. Preoperative BBR screening practices among UK Breast and Plastic surgeons are unknown. Ascertain the preoperative and postoperative BBR screening practices of UK Breast and Plastic surgeons. A questionnaire was posted to all 434 Breast and 335 Plastic surgeons in the UK. All results were analysed with relevant statistical methods. 64% of Breast surgeons and 72% of Plastic surgeons responded. 40% of Breast surgeons and 91% of Plastic surgeons perform BBR. Routine radiological screening: 92% Breast 41% Plastic (p Plastic. Routine histology for BBR specimens: 96% Breast 90% Plastic. Selective screening of patients aged 30-40 years old: Breast 38% Plastic 10%. Selective screening of patients aged 40-50: Breast 78%, Plastic 53%. Selective screening of patients with strong family history of breast cancer: Breast 72%, Plastic 91%. Selective screening of patients with previous breast cancer: Breast 77%, Plastic 93%. There are significant differences in practice between UK Breast surgeons and Plastic surgeons in preoperative oncological screening for BBR. The large discrepancy in preoperative radiological screening, reflects a ubiquitous pro-screening ideology among Breast surgeons not prevalent among Plastic surgeons. These results will provoke debate towards the direction of consensus to ultimately reflect best practice. Copyright © 2010. Published by Elsevier Ltd.

  11.   Personal invitations for population-based breast cancer screening

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-09-15

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

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

    Science.gov (United States)

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

    2012-06-18

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

  14. Paid- and family-carers' views on supporting women with intellectual disability through breast screening.

    Science.gov (United States)

    Willis, D S; Kilbride, L; Horsburgh, D; Kennedy, C M

    2015-07-01

    The cancer needs of people with intellectual disabilities are increasingly being debated. This paper explores the views and experiences of paid- and family-carers when supporting women with intellectual disabilities through breast screening. An ethnographic approach was drawn on and purposive sampling methods were employed. One-to-one semi-structured interviews with 13 carers (10 paid-carers, three family-carers) were undertaken and supported by periods of focused observation on behaviour related to breast awareness and breast screening. Findings indicated that most women with intellectual disabilities needed some support but the quality and quantity of support depended upon both the woman's level of intellectual disability and who was supporting them. In terms of breast screening, the findings suggested that the women were potentially being let down at all the different stages of the breast screening process, from the arrival of the invitation letter to the experience of having a mammogram. The conclusion drawn was that there was evidence of equality of service provision but inequality of service delivery and uptake. © 2014 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Freer, Phoebe E

    2015-01-01

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

  16. 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Evaluation of The Netherlands breast cancer screening programme.

    NARCIS (Netherlands)

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

    2003-01-01

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

  19. What Influences Women with Intellectual Disabilities to Attend Breast Screening? Experiences of Women Who Have and Have Not Participated

    Science.gov (United States)

    Willis, Diane S.

    2016-01-01

    Background: Despite breast screening in Britain being free to all women within the allotted age range, uptake of this service is often poor in women with intellectual disabilities. Reasons put forward are numerous, including poor knowledge, pain and difficulty travelling to the centre. However, what influences the decision to attend is rarely…

  20. Radiation risk of breast screening in England with digital mammography.

    Science.gov (United States)

    Warren, Lucy M; Dance, David R; Young, Kenneth C

    2016-11-01

    To estimate the risks and benefits of breast screening in terms of number of deaths due to radiation-induced cancers and the number of lives saved owing to modern screening in the National Health Service Breast Screening Programme (NHSBSP) in England. Radiation risk model, patient dose data and data from national screening statistics were used to estimate the number of deaths due to radiation-induced breast cancers in the NHSBSP in England. Dose and dose effectiveness factors (DDREFs) equal to one and two were assumed. The breast cancer mortality reduction in the invited population due to screening and the percentage of females diagnosed with symptomatic breast cancer, who die from breast cancer, were collated from the literature. The number of lives saved owing to screening was calculated. Assuming, a total of 1,770,436 females between the ages of 50-70 years were screened each year, and a breast cancer mortality reduction of 20% due to screening in the invited population, the number of screen-detected cancers were 14,872 annually, resulting in 1071 lives saved. Conversely, for the same mortality reduction, the number of radiation-induced cancers was 36 and 18 for DDREFs of 1 and 2, respectively. This resulted in seven and three deaths due to radiation-induced cancers annually for DDREFs of 1 and 2, respectively. The ratios of lives saved owing to screening to radiation-induced cancers were 30 : 1 and 60 : 1 for DDREFs of 1 and 2. The ratios of lives saved owing to screening to deaths due to radiation-induced cancers were 156 : 1 and 312 : 1 for DDREFs of 1 and 2. For the 1.8% of the screening population with very thick breasts, the latter ratios decrease to 94 : 1 and 187 : 1 for DDREFs of 1 and 2. The breast cancer mortality reduction due to screening greatly outweighs the risk of death due to radiation-induced cancers. Advances in knowledge: Estimation of the radiation risk for modern breast screening in England using digital mammography.

  1. 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.

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Science.gov (United States)

    Cowley, Helen C.; Gale, Alastair G.

    1999-05-01

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

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

    Science.gov (United States)

    Autier, Philippe

    2013-12-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2017-02-15

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

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

    Science.gov (United States)

    Spurlock, Wanda Raby; Cullins, Leah S

    2006-01-01

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

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

    Science.gov (United States)

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

    2016-06-07

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

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

    Science.gov (United States)

    Bonneux, Luc G A; Autier, Philippe

    2011-01-01

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

  10. 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 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...... screening and in the Programme's own 2008 Annual Review, which celebrated 20 years of screening. The debate on screening has been heated after new data published in the last two years questioned the benefit and documented substantial harm. We therefore analysed whether the recent debate and new pivotal data...

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

    Science.gov (United States)

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

    2009-02-01

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

  12. 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

  13. 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.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  16. Occult Primary Neuroendocrine Tumor Metastasis to the Breast Detected on Screening Mammogram

    Directory of Open Access Journals (Sweden)

    Fabiana Policeni

    2016-01-01

    Full Text Available Metastatic tumors are rare in the breast. Well-differentiated neuroendocrine tumors (WDNETs are slow-growing neoplasms that arise from neuroendocrine cells, particularly in the gastrointestinal tract and bronchial tree. Metastatic WDNET to the breast is a rare entity. We present a case report of ileal WDNET metastatic to the breast which was initially identified as a small mass in the patient′s left breast on screening mammography. Targeted ultrasound identified a suspicious mass, and ultrasound-guided percutaneous core biopsy was performed. Pathology revealed metastatic WDNET. Breast magnetic resonance imaging (MRI was then performed and demonstrated left axillary Level 2 lymphadenopathy, and liver lesions were suspicious for metastasis. The patient underwent abdominal computed tomography (CT to evaluate for distant metastatic disease. A spiculated mass was found near the ileocecal valve, suggestive of primary ileal WDNET. In addition, CT identified multiple liver lesions, most compatible with metastasis. Indium 111 OctreoScan confirmed radiotracer uptake in the ileum consistent with primary neuroendocrine tumor. In this report, we review the imaging characteristics of metastatic WDNET to the breast by different imaging modalities including mammogram, ultrasound, and breast MRI.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-09-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    Directory of Open Access Journals (Sweden)

    ilknur Aydin Avci

    2015-06-01

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

  2. Compliance after 17 years of breast cancer screening

    NARCIS (Netherlands)

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

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Philippe Autier

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

  4. Appalachian women’s perspectives on breast and cervical cancer screening

    Science.gov (United States)

    Schoenberg, NE; Kruger, TM; Bardach, S; Howell, BM

    2016-01-01

    Introduction Although breast and cervical cancer screening rates have been increasing over the three past decades, many Appalachian women in the USA do not receive screening, leading to disproportionate mortality rates. The aims of this study were to: (1) better understand barriers to and facilitators of breast and cervical cancer screening among Appalachian women; and (2) identify strategies to increase cancer screening. Methods Eight focus groups and 19 key informant interviews were conducted with 79 participants. Tape-recorded session were transcribed and content analyzed. Results Findings consistent with screening determinants research include: inadequate personal and community resources, attitudinal and knowledge barriers, and competing demands. Less commonly described factors include family cancer history, personal health habits, and the multiple influences of healthcare providers. Conclusions Interpreting findings in terms of consumer information processing theory, healthcare providers and supports play a key role in educating and influencing the screening uptake among Appalachian Kentucky women. These findings have the potential to inform innovative and culturally consonant intervention approaches capable of increasing screening and decreasing mortality rates. PMID:24016336

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

    Science.gov (United States)

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

    2011-09-01

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

  6. 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.

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

    Science.gov (United States)

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

    2018-01-01

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

  8. 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.

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

    Science.gov (United States)

    Brkljacić, Boris; Miletić, Damir; Sardanelli, Francesco

    2013-06-01

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

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

    African Journals Online (AJOL)

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

  11. Diffuse Intense {sup 18}F-FDG Uptake at PET in Unilateral Breast Related to Breastfeeding Practice

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kyung Hee; Jung, Hye Kyoung [Department of Radiololgy, CHA Bundang Medical Center, CHA University, Seongnam 463-712 (Korea, Republic of); Jeon, Tae Joo [Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam 463-712 (Korea, Republic of)

    2013-07-01

    We present an interesting case of incidental diffuse fluorodeoxyglucose (FDG) uptake at PET in her left breast, related to atypical breastfeeding practice. Clinically, differential diagnoses of diffuse intense FDG uptake in unilateral breast include advanced breast cancer, breast lymphoma and inflammatory condition. However, normal physiologic lactation may also show increased FDG uptake in the breasts. Therefore, if we encounter that finding in daily practice, we should question the patient regarding unilateral breastfeeding. In addition, mammography and ultrasound would be helpful to confirm the diagnosis.

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

    Science.gov (United States)

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

    2017-04-01

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

  13. Breast density in multiethnic women presenting for screening mammography.

    Science.gov (United States)

    Oppong, Bridget A; Dash, Chiranjeev; O'Neill, Suzanne; Li, Yinan; Makambi, Kepher; Pien, Edward; Makariou, Erini; Coleman, Tesha; Adams-Campbell, Lucile L

    2017-10-24

    Data on ethnic variations in breast density are limited and often not inclusive of underrepresented minorities. As breast density is associated with elevated breast cancer risk, investigating racial and ethnic difference may elucidate the observed differences in breast cancer risk among different populations. We reviewed breast density from initial screening of women from the Capital Breast Care Center and Georgetown University Hospital from 2010 to 2014. Patient demographics including race, age at screening, education, menopausal status, and body mass index were abstracted. We recorded the BI-RADS density categories: (1) "fatty," (2) "scattered fibroglandular densities," (3) "heterogeneously dense," and (4) "extremely dense." Multivariable unconditional logistic regression was used to identify predictors of breast density. Density categorization was recorded for 2146 women over the 5-year period, comprising Blacks (n = 940), Hispanics (n = 893), and Whites (n = 314). Analysis of subject characteristics by breast density showed that high category is observed in younger, Hispanic, nulliparous, premenopausal, and nonobese women (t-test or chi-square test, P-values density. Being Hispanic, premenopausal, and nonobese were predictive of high density on logistic regression. In this analysis of density distribution in a diverse sample, Hispanic women have the highest breast density, followed by Blacks and Whites. Unique in our findings is women who identify as Hispanic have the highest breast density and lower rates of obesity. Further investigation of the impact of obesity on breast density, especially in the understudied Hispanic group is needed. © 2017 Wiley Periodicals, Inc.

  14. Awareness and Uptake of Family Screening in Patients Diagnosed with Colorectal Cancer at a Young Age

    Directory of Open Access Journals (Sweden)

    Niamh M. Hogan

    2015-01-01

    Full Text Available Background. One-fifth of people who develop colorectal cancer (CRC have a first-degree relative (FDR also affected. There is a large disparity in guidelines for screening of relatives of patients with CRC. Herein we address awareness and uptake of family screening amongst patients diagnosed with CRC under age 60 and compare guidelines for screening. Study Design. Patients under age 60 who received surgical management for CRC between June 2009 and May 2012 were identified using pathology records and theatre logbooks. A telephone questionnaire was carried out to investigate family history and screening uptake among FDRs. Results. Of 317 patients surgically managed for CRC over the study period, 65 were under age 60 at diagnosis (8 deceased. The mean age was 51 (30–59. 66% had node positive disease. 25% had a family history of colorectal cancer in a FDR. While American and Canadian guidelines identified 100% of these patients as requiring screening, British guidelines advocated screening for only 40%. Of 324 FDRs, only 40.9% had been screened as a result of patient’s diagnosis. Conclusions. Uptake of screening in FDRs of young patients with CRC is low. Increased education and uniformity of guidelines may improve screening uptake in this high-risk population.

  15. 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.

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

    Science.gov (United States)

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

    2014-06-01

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

  17. Accessibility and screening uptake rates for gestational diabetes mellitus in Ireland.

    LENUS (Irish Health Repository)

    Cullinan, John

    2012-03-01

    Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with a range of maternal and neonatal complications and conditions. Given increasing levels of prevalence worldwide, there are growing calls for the implementation of screening practices to identify and treat positive GDM cases. This paper uses a unique dataset to investigate the role of healthcare centre accessibility on the decision to attend for screening, employing geographic information systems, econometric and simulation techniques. We focus on the extent to which \\'travel distance to screening hospital site\\' impacts upon the individual\\'s screen uptake decision, whether significant geographic inequalities exist in relation to accessibility to screening, and the likely impact on uptake rates of providing screening services at a local level via primary care. Our findings have important implications for the provision of GDM screening services.

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Science.gov (United States)

    Hogben, Rosalyn Katy F

    2008-12-01

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

  20. Breast cancer screening implementation and reassurance

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  1. Annual Screening Mammogram and its Relation to Breast Density

    Directory of Open Access Journals (Sweden)

    Sabek EAS

    2017-11-01

    Full Text Available Background: Current national screening programs totally depend on mammographic evaluation. After increased incidence of breast cancer in women under the age of 35, mammography sensitivity in now a question. Several factors added to decrease sensitivity of mammography, such as increased density in older age groups and increased aggressiveness of tumour biology. All these factors will change the reliability of the screening program. The study is a retrospective study conducted at Ain Shams University. Method: 138 patients diagnosed with cancer breast underwent both mammography and sonography to determine percentage of patient with more than one focus, age and density distribution breast cancer in the affected patient and accuracy of both mammography and US. Results: By studying this population, we found that around 61,44% have areas of density ranging from dense breast, heterogenous density or scattered density. These areas of density render the mammography a less sensitive tool as its sensitivity fall to 34.09%, while that of US was 77.27%. Conclusion: As breast cancer is prevalent in younger population, also with increased density in older population who are relatively insensitive to mammography, we recommended the use of Automated Breast Ultrasound (ABUS in the national screening program.

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

    Science.gov (United States)

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

    2015-03-01

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

  3. Cervical and Breast Cancer Screening After CARES: A Community Program for Immigrant and Marginalized Women.

    Science.gov (United States)

    Dunn, Sheila F; Lofters, Aisha K; Ginsburg, Ophira M; Meaney, Christopher A; Ahmad, Farah; Moravac, M Catherine; Nguyen, Cam Tu Janet; Arisz, Angela M

    2017-05-01

    Marginalized populations such as immigrants and refugees are less likely to receive cancer screening. Cancer Awareness: Ready for Education and Screening (CARES), a multifaceted community-based program in Toronto, Canada, aimed to improve breast and cervical screening among marginalized women. This matched cohort study assessed the impact of CARES on cervical and mammography screening among under-screened/never screened (UNS) attendees. Provincial administrative data collected from 1998 to 2014 and provided in 2015 were used to match CARES participants who were age eligible for screening to three controls matched for age, geography, and pre-education screening status. Dates of post-education Pap and mammography screening up to June 30, 2014 were determined. Analysis in 2016 compared screening uptake and time to screening for UNS participants and controls. From May 15, 2012 to October 31, 2013, a total of 1,993 women attended 145 educational sessions provided in 20 languages. Thirty-five percent (118/331) and 48% (99/206) of CARES participants who were age eligible for Pap and mammography, respectively, were UNS on the education date. Subsequently, 26% and 36% had Pap and mammography, respectively, versus 9% and 14% of UNS controls. ORs for screening within 8 months of follow-up among UNS CARES participants versus their matched controls were 5.1 (95% CI=2.4, 10.9) for Pap and 4.2 (95%=CI 2.3, 7.8) for mammography. Hazard ratios for Pap and mammography were 3.6 (95% CI=2.1, 6.1) and 3.2 (95% CI=2.0, 5.3), respectively. CARES' multifaceted intervention was successful in increasing Pap and mammography screening in this multiethnic under-screened population. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Breast Cancer Screening in Albania During 2007-2008

    Science.gov (United States)

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

    2013-01-01

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

  5. The prevalence of medical reasons for non-participation in the Scottish breast and bowel cancer screening programmes.

    Science.gov (United States)

    Mead, L; Porteous, L; Tait, M; Stoker, R; Payne, S; Calvert, C; Maxwell, D; Katikireddi, S V

    2015-06-01

    Increasing uptake of cancer screening is a priority for health systems internationally, however, some patients may not attend because they are undergoing active treatment for the cancer of interest or have other medical reasons that mean participation would be inappropriate. This study aims to quantify the proportion of non-participants who have a medical reason for not attending cancer screening. Medical reasons for not participating in breast and bowel screening were defined a priori on the basis of a literature review and expert opinion. The notes of 700 patients at two GP practices in Scotland were reviewed, to ascertain the prevalence of medical reasons amongst non-participants. Simple proportions and confidence intervals were calculated. 17.4% of breast and 2.3% of bowel screening non-participants had a medical reason to not participate. The two most common reasons were previous breast cancer follow up (8.86%) and recent mammogram (6.57%). These patients may not benefit from screening while also being distressed by receiving an invitation. This issue also makes accurate monitoring and target-setting for improving uptake difficult. Further work is needed to estimate robustly the extent to which medical reasons account for screening non-participation in a larger population. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. Clinical breast exam screening by trained laywomen in Malawi integrated with other health services

    Science.gov (United States)

    Gutnik, Lily; Lee, Clara; Msosa, Vanessa; Moses, Agnes; Stanley, Christopher; Mzumara, Suzgo; Liomba, N. George; Gopal, Satish

    2016-01-01

    Background Breast cancer awareness and early detection are limited in sub-Saharan Africa. Resource limitations make screening mammography or clinical breast exam (CBE) by physicians or nurses impractical in many settings. We aimed to assess feasibility and performance of CBE by laywomen in urban health clinics in Malawi. Methods Four laywomen were trained to deliver breast cancer educational talksand conduct CBE. After training, screening was implemented in diverse urbanhealth clinics. Eligible women were ≥30 years, with no prior breast cancer or breast surgery, and clinic attendance for reasons other than abreast concern. Wo men with abnormal CBE were referred to a study surgeon. All palpable masses confirmed by surgeon exam were pathologically sampled. Patients with abnormal screening CBE but normal surgeon exam underwentbreast ultrasound con firmation. Additionally, 50 randomly selected women with normal screening CBE underwent breast ultrasound, and 45 different women with normal CBE were randomly assigned to surgeon exam. Results Among 1,220 eligible women, 1,000 (82%) agreed to CBE. Lack of time (69%) was the commonest reason for refusal. Educational talk attendance was associated with higher CBE participation (83% vs 77%, p=0.012). Among 1,000 women screened, 7% had abnormal CBE. Of 45 women with normal CBE randomized to physician exam, 43 had normal exams and two had axillary lymphadenopathy not detected by CBE. Sixty of 67 women (90%) with abnormal CBE attended the referral visit. Of these, 29 (48%) had concordant abnormal physician exam. Thirty-one women (52%) had discordant normal physician exam, all of whom also had normal breast ultrasounds. Compared to physician exam, sensitivity for CBE by laywomen was 94% (CI 79-99%), specificity 58% (CI 46-70%), positive predictive value 48% (CI 35-62%), and negative predictive value 96% (CI 85-100%). Of 13 women who underwent recommended pathologic sampling of a breast lesion, two had cytologic dysplasia and all

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

    Directory of Open Access Journals (Sweden)

    Taghipour Sharareh

    2012-07-01

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

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

    OpenAIRE

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

    2008-01-01

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

  9. Performance Benchmarks for Screening Breast MR Imaging in Community Practice.

    Science.gov (United States)

    Lee, Janie M; Ichikawa, Laura; Valencia, Elizabeth; Miglioretti, Diana L; Wernli, Karen; Buist, Diana S M; Kerlikowske, Karla; Henderson, Louise M; Sprague, Brian L; Onega, Tracy; Rauscher, Garth H; Lehman, Constance D

    2017-10-01

    Purpose To compare screening magnetic resonance (MR) imaging performance in the Breast Cancer Surveillance Consortium (BCSC) with Breast Imaging Reporting and Data System (BI-RADS) benchmarks. Materials and Methods This study was approved by the institutional review board and compliant with HIPAA and included BCSC screening MR examinations collected between 2005 and 2013 from 5343 women (8387 MR examinations) linked to regional Surveillance, Epidemiology, and End Results program registries, state tumor registries, and pathologic information databases that identified breast cancer cases and tumor characteristics. Clinical, demographic, and imaging characteristics were assessed. Performance measures were calculated according to BI-RADS fifth edition and included cancer detection rate (CDR), positive predictive value of biopsy recommendation (PPV2), sensitivity, and specificity. Results The median patient age was 52 years; 52% of MR examinations were performed in women with a first-degree family history of breast cancer, 46% in women with a personal history of breast cancer, and 15% in women with both risk factors. Screening MR imaging depicted 146 cancers, and 35 interval cancers were identified (181 total-54 in situ, 125 invasive, and two status unknown). The CDR was 17 per 1000 screening examinations (95% confidence interval [CI]: 15, 20 per 1000 screening examinations; BI-RADS benchmark, 20-30 per 1000 screening examinations). PPV2 was 19% (95% CI: 16%, 22%; benchmark, 15%). Sensitivity was 81% (95% CI: 75%, 86%; benchmark, >80%), and specificity was 83% (95% CI: 82%, 84%; benchmark, 85%-90%). The median tumor size of invasive cancers was 10 mm; 88% were node negative. Conclusion The interpretative performance of screening MR imaging in the BCSC meets most BI-RADS benchmarks and approaches benchmark levels for remaining measures. Clinical practice performance data can inform ongoing benchmark development and help identify areas for quality improvement. (©) RSNA

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

    National Research Council Canada - National Science Library

    Lipkus, Issac

    1997-01-01

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

  11. Decision aid for women considering breast cancer screening

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2015-10-20

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

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

    Science.gov (United States)

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

    2016-10-13

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

  14. Survey of breast cancer mammography screening behaviors in Eastern Taiwan based on a health belief model

    Directory of Open Access Journals (Sweden)

    Wen-Li Wang

    2014-08-01

    Full Text Available Breast cancer is the main form of cancer affecting women and the fourth most common cause of cancer mortality in women. The aim of this study was to explore regular mammography screening in Hualien women and to identify the factors that influence its uptake based on a health belief model. This cross-sectional study was performed between July 2012 and December 2012. A total of 776 women aged 45–69 years were enrolled in the study. The results of crude and adjusted analyses showed that there were significant differences in the prevalence of regular mammography screening, which were related to different age groups, residence areas, educational levels, hormone replacement therapy status, and history of breast cancer. Women in the older age groups, with a higher educational level, in receipt of hormone replacement therapy, and with a personal history of breast cancer had significantly higher odds ratios for regular mammography screening (2.75, 1.68, 1.75, and 1.98, respectively; all p < 0.05.

  15. Breast cancer screening: An outpatient clinic study

    Directory of Open Access Journals (Sweden)

    Mustafa Girgin

    2017-03-01

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

  18. 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...

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

    NARCIS (Netherlands)

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

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

  2. 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

  3. 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.

  4. Temporal trend in socioeconomic inequalities in the uptake of cancer screening programmes in France between 2005 and 2010: results from the Cancer Barometer surveys.

    Science.gov (United States)

    Kelly, David Mark; Estaquio, Carla; Léon, Christophe; Arwidson, Pierre; Nabi, Hermann

    2017-12-14

    Cancer screening is a form of secondary prevention for a disease which is now the leading cause of death in France. Various socioeconomic indicators have been identified as potential factors for disparities in breast, cervical and colorectal cancer screening uptake. We aimed to identify the socioeconomic inequalities, which persisted in screening uptake for these cancers, and to quantify these disparities over a 5-year period. The Cancer Barometer was a population-based-survey carried out in 2005 and 2010 in France. A randomly selected sample of participants aged 15-85 years (n=3820 in 2005 and n=3727 in 2010) were interviewed on their participation in breast, cervical and colorectal cancer screening-programmes and their socioeconomic profile. For each type of screening programme, we calculated participation rates, OR and relative inequality indices (RII) for participation, derived from logistic regression of the following socioeconomic variables: income, education, occupation, employment and health insurance. Changes in participation between 2005 and 2010 were then analysed. Participation rates for breast and colorectal screening increased significantly among the majority of socioeconomic categories, whereas for cervical cancer screening there were no significant changes between 2005 and 2010. RIIs for income remained significant for cervical smear in 2005 (RII=0.25, 95% CI 0.13 to 0.48) and in 2010 (RII=0.31, 95% CI 0.15 to 0.64). RIIs for education in mammography (RII=0.43, 95% CI 0.19 to 0.98) and cervical smear (RII=0.36, 95% CI 0.21 to 0.64) were significant in 2005 and remained significant for cervical smear (RII=0.40, 95% CI 0.22 to 0.74) in 2010. There was a persistence of socioeconomic inequalities in the uptake of opportunistic cervical cancer screening. Conversely, organised screening programmes for breast and colorectal cancer saw a reduction in relative socioeconomic inequalities, even though the results were not statistically significant

  5. Strong association of epidermal growth factor receptor status with breast cancer FDG uptake

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joohee; Moon, Seung Hwan; Hyun, Seung Hyup; Cho, Young Seok; Choi, Joon Young; Kim, Byung-Tae; Lee, Kyung-Han [Sungkyunkwan University School of Medicine, Department of Nuclear Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Lee, Eun Jeong [Seoul Medical Center, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Seokhwi [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea, Republic of)

    2017-08-15

    Imaging tumor FDG uptake could complement breast cancer biomarkers of risk and treatment response. Although breast cancer FDG uptake is reputedly influenced by major biomarker states, the role of epidermal growth factor receptor (EGFR) expression remains largely unexplored. This is a retrospective study that included 499 patients with primary breast cancer at initial presentation. Tumor FDG uptake was measured on pretreatment PET/CT as maximum standardized uptake value (SUVmax), and biomarkers were assessed by immunohistochemistry of tumor tissue. Regression analysis was performed for predictors of high tumor FDG uptake (SUVmax ≥ 8.6). SUVmax was higher in ER- (36.5%; 11.2 ± 6.0 vs. 8.3 ± 5.3), PR- (42.3%; 10.9 ± 6.0 vs. 8.2 ± 5.2), and triple-negative tumors (19.8%; 12.0 ± 6.9 vs. 8.7 ± 5.2; all p < 0.0001). EGFR expression (28.5%) was more frequent in ER-, PR-, triple-negative, cytokeratin 5/6 (CK5/6) + and mutant P53 (mP53) + tumors (all p < 0.0001). EGFR+ was associated with higher SUVmax among all tumors (11.9 ± 6.0 vs. 8.3 ± 5.3), ER- tumors (p < 0.0001), PR- and + tumors (p < 0.0001 and 0.027), hormone receptor- and + tumors (p < 0.0001 and 0.004), human epidermal growth factor receptor 2 (HER2)- and + tumors (p < 0.0001 and 0.006), non-triple negative tumors (p < 0.0001), CK5/6- and + tumors (p = 0.021 and <0.0001), and mP53- and + tumors (p < 0.0001 and 0.008). Tumors had high FDG uptake in 73.2% of EGFR+ and 40.6% of EGFR- tumors. On regression analysis, significant multivariate predictors of high tumor FDG uptake were large size, EGFR+ and CK5/6+ for the entire subjects, and EGFR+ and CK5/6+ for ER- and hormone receptor negative subgroups. High FDG uptake was able to sub-stratify EGFR+ tumors that were more likely to be ER- and CK5/6+, and EGFR- tumors more likely to be mP53 +. Primary breast tumor FDG uptake is strongly influenced by EGFR status beyond that by other major biomarkers including hormone receptor and HER2 status, and EGFR

  6. Cervical Cancer Awareness and Screening Uptake among Rural ...

    African Journals Online (AJOL)

    femi oloka

    cancer by the respondents 50 (83.3%). (Table III). More than half 37(61.7%)} knew that all women are at risk of cancer of the cervix. Majority (81.7%) knew that regular screening and not having multiple sexual partners were among methods of prevention of. Table I: Socio-demographic characteristics of Respondents.

  7. Factors Contributing to Low Uptake of Cervical Screening in a ...

    African Journals Online (AJOL)

    Introduction: Many factors have been attributed to the unacceptably high incidences of cervical cancer and deaths from cervical cancer in developing countries and include lack of organized cervical cancer screening services and especially lack of information on cervical cancer by women. Aims and Objectives: This study ...

  8. 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

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

    Science.gov (United States)

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

    2017-12-01

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

  10. Race-specific impact of natural history, mammography screening, and adjuvant treatment on breast cancer mortality rates in the United States

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien); C.B. Schechter (Clyde); A.M. Near (Aimee); E.A.M. Heijnsdijk (Eveline); M.A. Stoto (Michael); G. Draisma (Gerrit); H.J. de Koning (Harry); J.S. Mandelblatt (Jeanne)

    2011-01-01

    textabstractBackground: U.S. Black women have higher breast cancer mortality rates than White women despite lower incidence. The aim of this study is to investigate how much of the mortality disparity can be attributed to racial differences in natural history, uptake of mammography screening, and

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

    Science.gov (United States)

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

    2009-10-01

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

  12. Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study.

    Science.gov (United States)

    Gitsels-van der Wal, Janneke T; Verhoeven, Pieternel S; Manniën, Judith; Martin, Linda; Reinders, Hans S; Spelten, Evelien; Hutton, Eileen K

    2014-08-09

    Two prenatal screening tests for congenital anomalies are offered to all pregnant women in the Netherlands on an opt-in basis: the Combined Test (CT) for Down syndrome at twelve weeks, and the Fetal Anomaly Scan (FAS) at around twenty weeks. The CT is free for women who are 36 or older; the FAS is free for all women. We investigated factors associated with the CT and FAS uptake. This study is part of the DELIVER study that evaluated primary care midwifery in the Netherlands. Associations between the women's characteristics and the CT and FAS uptake were measured using multivariate and multilevel logistic regression analyses. Of 5216 participants, 23% had the CT and 90% had the FAS, with uptake rates ranging from 4% to 48% and 62% to 98% respectively between practices. Age (OR: 2.71), income (OR: 1.38), ethnicity (OR: 1.37), being Protestant (OR: 0.25), multiparous (OR: 0.64) and living in the east of the country (OR: 0.31) were associated with CT uptake; education (OR: 1.26), income (OR: 1.66), being Protestant (OR: 0.37) or Muslim (OR: 0.31) and being multiparous (OR: 0.74) were associated with FAS uptake. Among western women with a non-Dutch background, first generation (OR: 2.91), age (OR: 2.00), income (OR: 1.97), being Protestant (OR: 0.32) and living in the east (OR: 0.44) were associated with CT uptake; being Catholic (OR: 0.27), Protestant (OR: 0.13) were associated with FAS uptake. Among non- western women with a non-Dutch background, age (OR: 1.73), income (OR: 1.97) and lacking proficiency in Dutch (OR: 2.18) were associated with CT uptake; higher education (OR: 1.47), being Muslim (OR: 0.37) and first generation (OR: 0.27) were associated with FAS uptake. The uptake of the CT and FAS varied widely between practices. Income, parity and being Protestant were associated with uptake of both tests; ethnicity, age and living in the east were associated with CT uptake, and education and being Muslim with FAS uptake. These findings help to explain some

  13. Will supplemental screening ultrasound increase breast cancer overdiagnosis?

    Science.gov (United States)

    Molleran, Virginia M

    2015-08-01

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

  14. Digital Compared with Screen-Film Mammography: Measures of Diagnostic Accuracy among Women Screened in the Ontario Breast Screening Program.

    Science.gov (United States)

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

    2016-02-01

    To compare measures of diagnostic accuracy between large concurrent cohorts of women screened with digital computed radiography (CR), direct radiography (DR), and screen-film mammography (SFM). This study was approved by the University of Toronto Research Ethics Board; informed consent was not required. Three concurrent cohorts of women aged 50-74 years who were screened from 2008-2009 in the Ontario Breast Screening Program with SFM (487,334 screening examinations, 403,688 women), DR (254,758 screening examinations, 220,520 women), or CR (74,140 screening examinations, 64,210 women) were followed for 2 years or until breast cancer diagnosis. Breast cancers were classified as screening-detected or interval on the basis of the woman's final screening and assessment results. Interval cancer rate (per 10 000 negative screening examinations), sensitivity, and specificity were compared across the cohorts by using mixed-effects logistic regression analysis. Interval cancer rates were higher, although not significantly so, for CR (15.2 per 10,000; 95% confidence interval [CI]: 12.8, 17.8) and were similar for DR (13.7 per 10,000; 95% CI: 12.4, 15.0) compared with SFM (13.0 per 10,000; 95% CI: 12.1, 13.9). For CR versus SFM, specificity was similar while sensitivity was significantly lower (odds ratio [OR] = 0.62; 95% CI: 0.47, 0.83; P = .001), particularly for invasive cancers detected at a rescreening examination, for women with breast density of less than 75%, for women with no family history, and for postmenopausal women. For DR versus SFM, sensitivity was similar while specificity was lower (OR = 0.92; 95% CI: 0.87, 0.98; P = .01), particularly for rescreening examinations, for women aged 60-74 years, for women with breast density of less than 75%, for women with a family history, and for women who were postmenopausal. Given the 38% lower sensitivity of CR imaging systems compared with SFM, programs should assess the continued use of this technology for breast

  15. Analysis of the determinants of low cervical cancer screening uptake among Nigerian women

    Directory of Open Access Journals (Sweden)

    Humphrey Nwobodo

    2016-08-01

    Full Text Available Cervical cancer causes an estimated 266,000 deaths globally, 85% of which occurs in developing countries. It is a preventable disease, if detected and treated early via screen and treat, yet its burden is still huge in Nigeria. In 2012, 21.8% cases and 20.3% deaths due to cervical cancer were recorded in Nigeria. This review, therefore, aims at understanding the determinants of low cervical cancer screening in Nigeria in order to contribute in reducing the burden of the disease. Literature were obtained from Global Health, Popline and PubMed databases; WHO and other relevant websites using Eldis search engine; and from libraries in the University of Leeds and WHO in Geneva. Conceptual framework for analyzing the determinants of cervical cancer screening uptake among Nigerian women was formed by inserting service delivery component of the WHO health system framework into a modified Health Belief Model. Wrong perception of cervical cancer and cervical cancer screening due to low level of knowledge about the disease and inadequate cervical cancer preventive were identified as the major determinants of low cervical cancer screening uptake in Nigeria. Among women, belief in being at risk and/or severity of cervical cancer was low just as belief on benefits of cervical cancer screening, unlike high belief in barriers to screening. Support from the community and screening skills among health-workers were inadequate. Improving uptake of cervical cancer screening will reduce the burden of the disease. Therefore, researchers and other stakeholders interested in prevention of cervical cancer should carry-out studies to identify interventions that could address the key determinants of low cervical cancer screening among Nigerian women.

  16. Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study

    Directory of Open Access Journals (Sweden)

    Rebekah Pratt

    2017-03-01

    Full Text Available Abstract Background Screening rates for breast and cervical cancer for Muslim women in the United States are low, particularly for first-generation immigrants. Interpretations of the Muslim faith represent some of the barriers for breast and cervical cancer screening. Working to understand how faith influences breast and cervical screening for Somali women, and working with the community to identify and utilize faith-based assets for promoting screening, may lead to life-saving changes in screening behaviors. Methods We partnered with an Imam to develop faith-based messages addressing the concerns of modesty and predetermination and promoting cancer testing and screening. A total of five focus groups were convened, with 34 Somali women (three groups and 20 Somali men (two groups. Each focus group first discussed participant views of breast and cervical cancer screening in general and then viewed and discussed video clips of the Imam delivering the faith-based messages. Results Both Somali women and men had an overwhelmingly positive response to the faith-based messages promoting breast and cervical cancer screening. The faith-based messages appeared to reinforce the views of those who were already inclined to see screening positively, with participants describing increased confidence to engage in screening. For those who had reservations about screening, there was feedback that the faith-based messages had meaningfully influenced their views. Conclusions Somali immigrant women and men found faith-based messages addressing topics of predestination and modesty and encouraging the use of screening and treatment to be both acceptable and influential. Faith can play an important role as an asset to promote breast and cervical cancer screening, and there may be substantial benefits to adding faith-based messaging to other interventions that focus on improving screening uptake. This may help to address health disparities for Somali women in this area.

  17. Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study.

    Science.gov (United States)

    Pratt, Rebekah; Mohamed, Sharif; Dirie, Wali; Ahmed, Nimo; VanKeulen, Michael; Ahmed, Huda; Raymond, Nancy; Okuyemi, Kola

    2017-03-20

    Screening rates for breast and cervical cancer for Muslim women in the United States are low, particularly for first-generation immigrants. Interpretations of the Muslim faith represent some of the barriers for breast and cervical cancer screening. Working to understand how faith influences breast and cervical screening for Somali women, and working with the community to identify and utilize faith-based assets for promoting screening, may lead to life-saving changes in screening behaviors. We partnered with an Imam to develop faith-based messages addressing the concerns of modesty and predetermination and promoting cancer testing and screening. A total of five focus groups were convened, with 34 Somali women (three groups) and 20 Somali men (two groups). Each focus group first discussed participant views of breast and cervical cancer screening in general and then viewed and discussed video clips of the Imam delivering the faith-based messages. Both Somali women and men had an overwhelmingly positive response to the faith-based messages promoting breast and cervical cancer screening. The faith-based messages appeared to reinforce the views of those who were already inclined to see screening positively, with participants describing increased confidence to engage in screening. For those who had reservations about screening, there was feedback that the faith-based messages had meaningfully influenced their views. Somali immigrant women and men found faith-based messages addressing topics of predestination and modesty and encouraging the use of screening and treatment to be both acceptable and influential. Faith can play an important role as an asset to promote breast and cervical cancer screening, and there may be substantial benefits to adding faith-based messaging to other interventions that focus on improving screening uptake. This may help to address health disparities for Somali women in this area.

  18. 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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  2. 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

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

    Science.gov (United States)

    Sebuødegård, Sofie; Sagstad, Silje; Hofvind, Solveig

    2016-09-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  8. Cholesterol Dependent Uptake and Interaction of Doxorubicin in MCF-7 Breast Cancer Cells

    Directory of Open Access Journals (Sweden)

    Herbert Schneckenburger

    2013-04-01

    Full Text Available Methods of fluorescence spectroscopy and microscopy—including intensity and lifetime (FLIM images—are used to examine uptake, intracellular location and interaction of the chemotherapeutic drug doxorubicin in MCF-7 human breast cancer cells as a function of cholesterol content. By comparing cells with natural and decreased cholesterol levels after 2 h or 24 h incubation with doxorubicin, we observed that higher fluorescence intensities and possibly shortened fluorescence lifetimes—reflecting increased uptake of the drug and more pronounced drug response—are concomitant with higher membrane fluidity.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

    Carreira Gómez, M C; Estrada Blan, M C

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

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

    Science.gov (United States)

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

    1999-06-01

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

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

    Science.gov (United States)

    Arevian, Mary; Noureddine, Samar; Abboud, Sarah

    2011-11-01

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

  15. Screening for Bioactive Metabolites in Plant Extracts Modulating Glucose Uptake and Fat Accumulation

    Directory of Open Access Journals (Sweden)

    Rime B. El-Houri

    2014-01-01

    Full Text Available Dichloromethane and methanol extracts of seven different food and medicinal plants were tested in a screening platform for identification of extracts with potential bioactivity related to insulin-dependent glucose uptake and fat accumulation. The screening platform included a series of in vitro bioassays, peroxisome proliferator-activated receptor (PPAR γ-mediated transactivation, adipocyte differentiation of 3T3-L1 cell cultures, and glucose uptake in both 3T3-L1 adipocytes and primary porcine myotubes, as well as one in vivo bioassay, fat accumulation in the nematode Caenorhabditis elegans. We found that dichloromethane extracts of aerial parts of golden root (Rhodiola rosea and common elder (Sambucus nigra as well as the dichloromethane extracts of thyme (Thymus vulgaris and carrot (Daucus carota were able to stimulate insulin-dependent glucose uptake in both adipocytes and myotubes while weekly activating PPARγ without promoting adipocyte differentiation. In addition, these extracts were able to decrease fat accumulation in C. elegans. Methanol extracts of summer savory (Satureja hortensis, common elder, and broccoli (Brassica oleracea enhanced glucose uptake in myotubes but were not able to activate PPARγ, indicating a PPARγ-independent effect on glucose uptake.

  16. An ongoing case-control study to evaluate the NHS breast screening programme

    National Research Council Canada - National Science Library

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

    2013-01-01

    In England, a national breast screening programme (NHSBSP) has been in place since 1988, and assessment of its impact on breast cancer incidence and mortality is essential to ensure that the programme is indeed doing more good than harm...

  17. 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...

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

    NARCIS (Netherlands)

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

    1991-01-01

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

  19. Uptake, delivery, and anticancer activity of thymoquinone nanoparticles in breast cancer cells

    Science.gov (United States)

    Fakhoury, Isabelle; Saad, Walid; Bouhadir, Kamal; Nygren, Peter; Schneider-Stock, Regine; Gali-Muhtasib, Hala

    2016-07-01

    Thymoquinone (TQ) is a promising anticancer molecule but its development is hindered by its limited bioavailability. Drug encapsulation is commonly used to overcome low drug solubility, limited bioavailability, and nonspecific targeting. In this project, TQ nanoparticles (TQ-NP) were synthesized and characterized. The cytotoxicity of the NP was investigated in nontumorigenic MCF-10-A breast cells, while the uptake, distribution, as well as the anticancer potential were investigated in MCF-7 and MDA-MB-231 breast cancer cells. Flash Nanoprecipitation and dynamic light scattering coupled with scanning electron microscopy were used to prepare and characterize TQ-NP prior to measuring their anticancer potential by MTT assay. The uptake and subcellular intake of TQ-NP were evaluated by fluorometry and confocal microscopy. TQ-NP were stable with a hydrodynamic average diameter size around 100 nm. Entrapment efficiency and loading content of TQ-NP were high (around 80 and 50 %, respectively). In vitro, TQ-NP had equal or enhanced anticancer activity effects compared to TQ in MCF-7 and aggressive MDA-MB-231 breast cancer cells, respectively, with no significant cytotoxicity of the blank NP. In addition, TQ and TQ-NP were relatively nontoxic to MCF-10-A normal breast cells. TQ-NP uptake mechanism was both time and concentration dependent. Treatment with inhibitors of endocytosis suggested the involvement of caveolin in TQ-NP uptake. This was further confirmed by subcellular localization findings showing the colocalization of TQ-NP with caveolin and transferrin as well as with the early and late markers of endocytosis. Altogether, the results describe an approach for the enhancement of TQ anticancer activity and uncover the mechanisms behind cell-TQ-NP interaction.

  20. Uptake, delivery, and anticancer activity of thymoquinone nanoparticles in breast cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Fakhoury, Isabelle [American University of Beirut, Department of Biology (Lebanon); Saad, Walid [American University of Beirut, Department of Chemical and Petroleum Engineering (Lebanon); Bouhadir, Kamal [American University of Beirut, Department of Chemistry (Lebanon); Nygren, Peter [Uppsala University, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology (Sweden); Schneider-Stock, Regine [University of Erlangen-Nuremberg, Experimental Tumor Pathology, Institute for Pathology (Germany); Gali-Muhtasib, Hala, E-mail: amro@aub.edu.lb [American University of Beirut, Department of Biology (Lebanon)

    2016-07-15

    Thymoquinone (TQ) is a promising anticancer molecule but its development is hindered by its limited bioavailability. Drug encapsulation is commonly used to overcome low drug solubility, limited bioavailability, and nonspecific targeting. In this project, TQ nanoparticles (TQ-NP) were synthesized and characterized. The cytotoxicity of the NP was investigated in nontumorigenic MCF-10-A breast cells, while the uptake, distribution, as well as the anticancer potential were investigated in MCF-7 and MDA-MB-231 breast cancer cells. Flash Nanoprecipitation and dynamic light scattering coupled with scanning electron microscopy were used to prepare and characterize TQ-NP prior to measuring their anticancer potential by MTT assay. The uptake and subcellular intake of TQ-NP were evaluated by fluorometry and confocal microscopy. TQ-NP were stable with a hydrodynamic average diameter size around 100 nm. Entrapment efficiency and loading content of TQ-NP were high (around 80 and 50 %, respectively). In vitro, TQ-NP had equal or enhanced anticancer activity effects compared to TQ in MCF-7 and aggressive MDA-MB-231 breast cancer cells, respectively, with no significant cytotoxicity of the blank NP. In addition, TQ and TQ-NP were relatively nontoxic to MCF-10-A normal breast cells. TQ-NP uptake mechanism was both time and concentration dependent. Treatment with inhibitors of endocytosis suggested the involvement of caveolin in TQ-NP uptake. This was further confirmed by subcellular localization findings showing the colocalization of TQ-NP with caveolin and transferrin as well as with the early and late markers of endocytosis. Altogether, the results describe an approach for the enhancement of TQ anticancer activity and uncover the mechanisms behind cell-TQ-NP interaction.Graphical Abstract.

  1. MIBI Uptake in a Huge Breast Mass Obscuring the Anterior and Lateral Myocardial Walls in Perfusion Imaging

    Directory of Open Access Journals (Sweden)

    Forough Kalantari

    2015-02-01

    Full Text Available Background: Cardiac risk assessment with myocardial perfusion imaging (MPI is a common practice for some elderly breast cancer patients who are candidates for operation. In rare cases the tumor may become visible in the images.Case presentation: This is the report of a case with a huge slow-growing breast tumor suspicious for malignancy and presenting with methoxy-isobutyl-isonitrile (MIBI uptake in the tumor. The patient was referred to the nuclear medicine department for preoperative cardiac risk assessment with MPI.Conclusion: There was high uptake in the tumor was note worthy in two different aspects: 1high MIBI uptake in the tumor is more suggestive of malignant rather than benign tumors and thus, underscores the importance of extra-cardiac uptake sites in pre-operation MPI; and 2high uptake in the left breast tumor may obscure the MPI image and hinder proper interpretation.

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

    Science.gov (United States)

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

    2016-12-01

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

  3. 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...

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

    Directory of Open Access Journals (Sweden)

    Z Heidari

    2008-08-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

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

    Science.gov (United States)

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

    2012-03-01

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

  7. Cancer prevention-the feasibility and acceptability of promoting breast cancer risk reduction in the screening setting through a lifestyle magazine.

    Science.gov (United States)

    Macleod, Maureen; Anderson, Annie S

    2018-01-30

    Cancer prevention and early detection strategies are fundamental to reducing breast cancer burden. Offering prevention guidance on modifiable risk factors within early detection settings is rare. We aimed to evaluate the acceptability of a magazine focused on lifestyle and cancer prevention for use in breast screening clinics. A lifestyle magazine was developed and distributed within two breast screening settings in the West of Scotland over a 2-month period. Women were either offered the magazine on arrival or in a self-service format. Uptake was recorded by NHS staff. Women's views were sought via an evaluation questionnaire. Staff were interviewed on their experiences of intervention delivery. Uptake was greatest when offered to attendees (95% vs. 20% self-service). The evaluation questionnaire response rate was 17.3%. Almost 60% of respondents reported an increased knowledge about breast cancer and lifestyle and felt motivated to find out more about cancer prevention and 40% expressed intentions to make lifestyle changes. Over 90% of respondents thought lifestyle factors were important in breast cancer prevention. Staff feedback was positive, indicating no detrimental effects on workloads. In conclusion, a cancer prevention lifestyle magazine can be successfully delivered in the breast screening setting and deserves further exploration for roll out. © 2018 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2013-02-19

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

  9. [Participation rates in the third round (2006-2007) of the breast cancer screening program in Hungary].

    Science.gov (United States)

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

    2013-09-01

    Organised, nationwide screening for breast cancer with mammography in the age group of 45-65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyse the attendance rate of breast screening programme for the 2006/2007 years, including the analysis of the ratio of screening and diagnostic mammography examinations. The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the 8 years period between 2000 and 2007. The ratio of women in the age group of 45-65 years was calculated having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 before and 2006-2007 after the implementation of nationwide organised programme. In the years 2000-2001 7.26% of the women aged 45-65 years had an opportunistic screening mammography while in 2006-2007 29.4% of the target population had screening mammography within the organised programme. During the same periods 19.8% (2000-2001) and 21.8% (2006-2007) of women aged 45-65 years had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.2% (2000-2001) to 49.7% (2006-2007). The attendance of the Hungarian organised breast cancer screening programme slightly declined in 2006-2007 compared to 2002-2003/2004-2005, and to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.

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

    Science.gov (United States)

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

    2013-06-01

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

  11. Dynamic contrast-enhanced MR imaging in screening detected microcalcification lesions of the breast: is there any value?

    Science.gov (United States)

    Uematsu, Takayoshi; Yuen, Sachiko; Kasami, Masako; Uchida, Yoshihiro

    2007-07-01

    To prospectively evaluate whether dynamic contrast-enhanced magnetic resonance (MR) imaging findings can help predict the presence of malignancy when screening detected microcalcification lesions, and its contribution to patient management of stereotactic vacuum-assisted breast biopsy (SVAB). Dynamic contrast-enhanced breast MR imaging was performed when screening 100 detected microcalcification lesions not visualized by ultrasonography with 11-gauge SVAB. Definitive surgery was performed on all patients with the biopsy resulting in the diagnosis of breast cancer or atypical ductal hyperplasia (ADH). Positive predictive values (PPVs) and negative predictive values (NPVs) were calculated on the basis of a BI-RADS (Breast Imaging Reporting and Data System) category and the absence or presence of contrast uptake in the area of microcalcification. The BI-RADS mammography category correlated with the diagnosis of breast cancer (ADH excluded): category 3 = 7% (4/55); category 4 = 48% (13/27); category 5 = 94% (17/18). After dynamic contrast-enhanced MR imaging, three of four malignancies with BI-RADS mammography category 3 were diagnosed as true positive. Therefore, the PPV of BI-RADS mammography category 3 with MR imaging was 1.8% (1/55). The PPV of contrast uptake of MR imaging was 86% (32/37), significantly higher than the 67% (30/45) PPV of BI-RADS mammography 4 and 5 (P = 0.033). The NPV of BI-RADS mammography 3 was 93% (51/55) versus 97% (61/63) NPV of MR imaging (P = 0.167). In the evaluation of screening detected microcalcification lesions, dynamic contrast-enhanced breast MR imaging provides additional information with high PPV and NPV, and may therefore offer an alternative to SVAB for women who do not want to undergo SVAB with equivocal findings following full diagnostic mammographic assessment, but breast MR imaging with imperfect PPV and NPV cannot replace SVAB. Dynamic contrast-enhanced breast MR imaging can demonstrate malignant microcalcifications

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    1990-02-28

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

  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

  15. {sup 18}F-FDG uptake in breast cancer correlates with immunohistochemically defined subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Hye Ryoung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, Jeong Seon [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kang, Keon Wook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Cho, Nariya; Chang, Jung Min; Bae, Min Sun; Kim, Won Hwa; Lee, Su Hyun; Seo, Mirinae; Moon, Woo Kyung [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Mi Young [Konkuk University Medical Center, Department of Radiology, Seoul (Korea, Republic of); Kim, Jin You [Pusan National University Hospital, Department of Radiology, Pusan (Korea, Republic of)

    2014-03-15

    To determine whether a correlation exists between maximum standardized uptake value (SUV{sub max}) on {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) and the subtypes of breast cancer. This retrospective study involved 548 patients (mean age 51.6 years, range 21-81 years) with 552 index breast cancers (mean size 2.57 cm, range 1.0-14.5 cm). The correlation between {sup 18}F-FDG uptake in PET/CT, expressed as SUV{sub max}, and immunohistochemically defined subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative) was analyzed. The mean SUV{sub max} value of the 552 tumours was 6.07 ± 4.63 (range 0.9-32.8). The subtypes of the 552 tumours were 334 (60 %) luminal A, 66 (12 %) luminal B, 60 (11 %) HER2 positive and 92 (17 %) triple negative, for which the mean SUV{sub max} values were 4.69 ± 3.45, 6.51 ± 4.18, 7.44 ± 4.73 and 9.83 ± 6.03, respectively. In a multivariate regression analysis, triple-negative and HER2-positive tumours had 1.67-fold (P < 0.001) and 1.27-fold (P = 0.009) higher SUV{sub max} values, respectively, than luminal A tumours after adjustment for invasive tumour size, lymph node involvement status and histologic grade. FDG uptake was independently associated with subtypes of invasive breast cancer. Triple-negative and HER2-positive breast cancers showed higher SUV{sub max} values than luminal A tumours. circle {sup 18} F-FDG PET demonstrates increased tissue glucose metabolism, a hallmark of cancers. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Khadijeh Nasiriani

    2017-10-01

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

  17. A systematic review of special events to promote breast, cervical and colorectal cancer screening in the United States.

    Science.gov (United States)

    Escoffery, Cam; Rodgers, Kirsten C; Kegler, Michelle C; Haardörfer, Regine; Howard, David H; Liang, Shuting; Pinsker, Erika; Roland, Katherine B; Allen, Jennifer D; Ory, Marcia G; Bastani, Roshan; Fernandez, Maria E; Risendal, Betsy C; Byrd, Theresa L; Coronado, Gloria D

    2014-03-24

    Special events are common community-based strategies for health promotion. This paper presents findings from a systematic literature review on the impact of special events to promote breast, cervical or colorectal cancer education and screening. Articles in English that focused on special events involving breast, cervical, and/or colorectal cancer conducted in the U.S. and published between January 1990 and December 2011 were identified from seven databases: Ovid, Web of Science, CINAHL, PsycINFO, Sociological Abstract, Cochrane Libraries, and EconLit. Study inclusion and data extraction were independently validated by two researchers. Of the 20 articles selected for screening out of 1,409, ten articles on special events reported outcome data. Five types of special events were found: health fairs, parties, cultural events, special days, and plays. Many focused on breast cancer only, or in combination with other cancers. Reach ranged from 50-1732 participants. All special events used at least one evidence-based strategy suggested by the Community Guide to Preventive Services, such as small media, one-on-one education, and reducing structural barriers. For cancer screening as an outcome of the events, mammography screening rates ranged from 4.8% to 88%, Pap testing was 3.9%, and clinical breast exams ranged from 9.1% to 100%. For colorectal screening, FOBT ranged from 29.4% to 76%, and sigmoidoscopy was 100% at one event. Outcome measures included intentions to get screened, scheduled appointments, uptake of clinical exams, and participation in cancer screening. Special events found in the review varied and used evidence-based strategies. Screening data suggest that some special events can lead to increases in cancer screening, especially if they provide onsite screening services. However, there is insufficient evidence to demonstrate that special events are effective in increasing cancer screening. The heterogeneity of populations served, event activities, outcome

  18. A Comparison of Cholesterol Uptake and Storage in Inflammatory and Noninflammatory Breast Cancer Cells

    Directory of Open Access Journals (Sweden)

    Breonna J. Martin

    2012-01-01

    Full Text Available Although there are many subtypes of breast cancer, inflammatory breast cancer (IBC is arguably the deadliest. Research over the past decade has demonstrated that IBC is a distinct entity from other forms of breast cancer. Important risk factors that have been associated with the development of aggressive breast cancers, such as IBC, include obesity and diet, which are evident in the United States, where the overconsumption of high-fat foods continues to contribute to obesity in the nation. Here we investigate differences in cholesterol uptake and storage between IBC, non-IBC, and mammary epithelial cell lines. Our results demonstrate that compared with human mammary epithelial cells (HMECs, both IBC and non-IBC cells have increased cholesterol content. IBC cells retain intracellular cholesterol esters, free cholesterol, and triglycerides in lipid-deficient environments. In contrast, we observe in cell-type-of-origin-matched non-IBC a significant decrease in lipid content under the same lipid-deficient conditions. These data suggest that cholesterol storage may be affected by the cholesterol content of the environment where the tumor cell was isolated. Here, we suggest that breast cancer cells may migrate when they are unable to obtain cholesterol from their extracellular environments.

  19. Retrospective Proteomic Screening of 100 Breast Cancer Tissues

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

  2. Factors Affecting 18F-Fluorodeoxyglucose (FDG) Uptake in Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sun Hye; Lee, Eun Hye; Park, Jung Mi; Lee, Hae Kyung; Yi, Boem Ha [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Choi, Na Mi [Konkuk University Medical Center, Seoul (Korea, Republic of)

    2010-06-15

    To evaluate factors affecting 18F-Fluorodeoxyglucose (FDG) uptake in breast cancer. For 3 years from 2006, 180 patients (mean age 48-years-old) with 187 breast cancers underwent positron emission tomography-computed tomography (PET/CT; biograph2, Siemens) at our institute and were enrolled in this study. We evaluated whether there was a correlation between the peak standardized uptake value (pSUV) of PET/CT and the histologic type of the breast cancers (n=187), grade of the invasive ductal cancers (n=142), and tumor size (n=153). The different histologic types of breast cancers include IDCs (n=156), in situ ductal carcinoma (n=10), papillary cancer (n=6), mucinous cancer (n=6), invasive lobular cancer (n=4), medullary cancer (n=3), metaplastic cancer (n=1), and neuroendocrine cancer (n=1). pSUV showed significant differences according to histologic type (p<0.005). For the available cases (n=142), IDCs were classified as grade 1 (n=25), grade 2 (n=66), and grade 3 (n=51) and correlated with the histologic grade of IDCs (rho=0.41, p<0.001). pSUV was correlated with tumor size regardless of histologic type (rho=0.525, p<0.001). In low grade IDCs, pSUV was correlated with tumor size (rho=0.48-0.86, p<0.001), but not in high grade IDCs (p>0.001). Regardless of histologic type, the larger the breast cancer, the higher the pSUV; in addition, the higher the grade of IDCs, the higher the pSUV. For the low grade IDCs, pSUV is correlated with tumor size; however, this is not the case in high grade IDCs

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

    Directory of Open Access Journals (Sweden)

    Lawrence von Karsa

    2013-05-01

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

  4. 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...

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

    NARCIS (Netherlands)

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

    2002-01-01

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

  6. 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....

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

    Science.gov (United States)

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

    2011-06-17

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

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

    Science.gov (United States)

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

    2012-03-01

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

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

    National Research Council Canada - National Science Library

    Erramilli, Shyamsunder

    2001-01-01

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

  10. Awareness and practice of breast screening and its impact on early ...

    African Journals Online (AJOL)

    Background: Breast cancer is the most common malignancy among females in Nigeria. The concept of breast screening (BS) is that it would result in presentation at earlier stages. We evaluated the impact of BS on early detection and presentation of breast cancer and determined the aspects BS need improvement. Patients ...

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

    Science.gov (United States)

    Annas, G J

    1992-11-01

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

  12. Identifying factors to improve oral cancer screening uptake: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Fatemeh Vida Zohoori

    Full Text Available To engage with high risk groups to identify knowledge and awareness of oral cancer signs and symptoms and the factors likely to contribute to improved screening uptake.Focus group discussions were undertaken with 18 males; 40+ years of age; smokers and/or drinkers (15+ cigarettes per day and/or 15+ units of alcohol per week, irregular dental attenders living in economically deprived areas of Teesside.There was a striking reported lack of knowledge and awareness of oral cancer and its signs and symptoms among the participants. When oral/mouth cancer leaflets produced by Cancer Research UK were presented to the participants, they claimed that they would seek help on noticing such a condition. There was a preference to seek help from their general practitioner rather than their dentist due to perceptions that a dentist is 'inaccessible' on a physical and psychological level, costly, a 'tooth specialist' not a 'mouth specialist', and also not able to prescribe medication and make referrals to specialists. Interestingly, none of the 18 participants who were offered a free oral cancer examination at a dental practice took up this offer.The uptake of oral cancer screening may be improved by increasing knowledge of the existence and signs and symptoms of oral cancer. Other factors that may increase uptake are increased awareness of the role of dentists in diagnosing oral cancer, promotion of oral cancer screening by health professionals during routine health checks, and the use of a "health" screening setting as opposed to a "dental" setting for such checks.

  13. 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…

  14. 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....

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  18. An ongoing case-control study to evaluate the NHS breast screening programme.

    Science.gov (United States)

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

    2013-12-13

    In England, a national breast screening programme (NHSBSP) has been in place since 1988, and assessment of its impact on breast cancer incidence and mortality is essential to ensure that the programme is indeed doing more good than harm. This article describes large observation studies designed to estimate the effects of the current programme in terms of the benefits on breast cancer incidence and mortality and detrimental effect in terms of overdiagnosis. The case-control design of the cervical screening programme evaluation was highly effective in informing policy on screening intervals and age ranges. We propose innovative selection of cases and controls and gathering of additional variables to address new outcomes of interest and develop new methodologies to control for potential sources of bias. Traditional case-control evaluation of breast screening uses women who have died from breast cancer as cases, and women known to be alive at the time of case death as controls. Breast screening histories prior to the cases' date of first diagnosis are compared. If breast screening is preventing mortality from breast cancer, cases will be characterised by a lesser screening history than controls. All deaths and incident cases of primary breast cancer in England within each 2-year study period will be included in this ongoing evaluation. Cases will be age- and area-matched to controls and variables related to cancer treatment and breast tumour pathology will be obtained to investigate the interplay between screening and treatment, and the effect of screening on incidence of advanced stage disease. Screening attendance at other national screening programmes will also be collected to derive superior adjustment for self-selection bias.The study is registered and has received full ethics approval.

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

    Science.gov (United States)

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

    2017-05-15

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

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

    Directory of Open Access Journals (Sweden)

    Jari Haukka

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

  1. Metastatic Male Breast Cancer With Increased Uptake on 18F-Fluciclovine PET/CT Scan.

    Science.gov (United States)

    Gill, Harkanwar S; Tade, Funmilayo; Greenwald, David Theodore; Yonover, Paul M; Savir-Baruch, Bital

    2018-01-01

    Prostate imaging with F-labeled 1-amino-3-fluorocyclobutane-1-carboxylic acid (FACBC, F-fluciclovine) PET/CT scan (Axumin) was recently approved by the US Food and Drug Administration for men with suspected prostate cancer recurrence based on elevated blood prostate-specific antigen levels following prior treatment. We present a rare case of a 77-year-old man with suspected recurrent prostate cancer with an incidental finding of advanced-stage breast cancer showing different degrees of F-fluciclovine uptake.

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

    Science.gov (United States)

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

    2017-08-01

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

  3. 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

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Science.gov (United States)

    Byrne, Sharon K

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sharon K Byrne

    2017-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

  8. Distribution of dense breasts using screening mammography in Korean women: a retrospective observational study

    OpenAIRE

    Bae, Jong-Myon; Shin, Sang Yop; Kim, Eun Hee; Kim, Yoon-Nam; Nam, Chung Mo

    2014-01-01

    OBJECTIVES: This retrospective observational study evaluated the distribution of dense breasts by age group among healthy Korean women. METHODS: Participants were women aged 30 years and older who voluntarily underwent screening mammography between January 2007 and December 2011. Women who received the Breast Imaging Reporting and Data System for mammographic density of 3 or 4 were defined as having dense breasts. The proportion of women with dense breasts (PDB, %) was calculated by dividing ...

  9. Induction of iodide uptake in transformed thyrocytes: a compound screening in cell lines

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, Eleonore [University of Tuebingen, Department of Endocrinology, Metabolism, Nephrology and Clinical Chemistry, Internal Medicine, Tuebingen (Germany); Brossart, Peter [University of Tuebingen, Department of Haematology, Oncology, Immunology and Rheumatology, Internal Medicine, Tuebingen (Germany); Wahl, Richard [University of Tuebingen, Department of Endocrinology, Metabolism, Nephrology and Clinical Chemistry, Internal Medicine, Tuebingen (Germany); Department IV, Internal Medicine, Tuebingen (Germany)

    2009-05-15

    Retinoic acid presently is the most advanced agent able to improve the efficacy of radioiodine therapy in differentiated thyroid carcinoma. In order to identify compounds with higher efficacy a panel of pharmacologically well-characterized compounds with antitumour action in solid cancer cell lines was screened. The effects of the compounds on iodide uptake, cell number, proliferation and apoptosis were evaluated. In general, compounds were more effective in cell lines derived from more aggressive tumours. The effectiveness in terms of number of responsive cell lines and maximal increase in iodide uptake achieved decreased in the order: APHA > valproic acid {approx} sirolimus {approx} arsenic trioxide > retinoic acid {approx} lovastatin > apicidine {approx} azacytidine {approx} retinol {approx} rosiglitazone {approx} bortezomib. We hypothesize that testing of cells from primary tumours or metastases in patients may be a way to identify compounds with optimum therapeutic efficacy for individualized treatment. (orig.)

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

    Science.gov (United States)

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

    2015-10-01

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

  11. Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Koolen, B.B.; Aukema, T.S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Vrancken Peeters, M.J.T.F.D.; Rutgers, E.J.T. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Wesseling, J.; Lips, E.H. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Pathology and Experimental Therapy, Amsterdam (Netherlands); Vogel, W.V.; Valdes Olmos, R.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Werkhoven, E. van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Biometrics, Amsterdam (Netherlands); Gilhuijs, K.G.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); Rodenhuis, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Medical Oncology, Amsterdam (Netherlands)

    2012-12-15

    The aim of this study was to evaluate the association of primary tumour {sup 18}F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake. PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUV{sub max}). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses. In 203 tumours (95 %) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUV{sub max} was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUV{sub max}. Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Patrick De Pelsmacker

    2017-09-01

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

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

    Science.gov (United States)

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

    2017-09-27

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  16. Construction of yeast strains useful for screening drugs that inhibit glucose uptake and glycolysis.

    Science.gov (United States)

    Roy, Adhiraj; Shin, Yong Jae; Kim, Jeong-Ho

    2013-05-01

    The budding yeast Saccharomyces cerevisiae expresses different isoforms of glucose transporters (HXTs) in response to different levels of glucose. Here, we constructed reporter strains in which the nourseothricin (NAT) resistance gene is expressed under the control of the HXT1, 2, or 3 promoter. The resulting HXT-NAT reporter strains exhibited a strict growth dependence on glucose, and their growth could be easily controlled and optimized by adjusting glucose concentration, demonstrating the value of the reporter strains for studying the molecular basis of differential expression of HXT genes, as well as for screening drugs that inhibit glucose uptake and glycolysis. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Women's preferences for the delivery of the National Health Service Breast Screening Programme: a cross-sectional survey.

    Science.gov (United States)

    Linsell, Louise; Forbes, Lindsay J L; Patnick, Julietta; Wardle, Jane; Austoker, Joan; Ramirez, Amanda J

    2010-01-01

    To elicit women's preferences for delivery of the National Health Service (NHS) Breast Screening Programme. Interview survey. Private households in the UK. Five hundred and ninety-seven women aged 45-75 interviewed as part of the National Statistics Omnibus Survey, December 2008 and January 2009. Preferred setting (hospital or community) and preferred type of screening unit (mobile or permanent). Rated importance of distance, time, convenience and cost of travelling to a screening unit. Forty per cent of women did not mind whether the screening unit was based in a community or hospital setting, and 52% did not mind whether the unit was permanent or mobile. Among those who expressed a preference, 59% preferred a hospital to a community setting, and 62% preferred a permanent to a mobile unit. Many women (63%) said distance to a breast screening unit was an important factor, as was time to travel (58%). Among those with access to a car, 80% regarded the availability of parking as important, but only 40% regarded the cost of car travel as important. Among women with no access to a car, there was a similar pattern for ease of public transport (76%) and cost of public transport (48%). Many women were unconcerned about the type and setting of breast screening units. Among those who were concerned, most preferred hospital over community settings and permanent over mobile units, but nonetheless most women said time and distance were important. Well-situated units with advanced publicity about public transport links and parking facilities may encourage greater uptake.

  18. Background 99mTc-methoxyisobutylisonitrile uptake of breast-specific gamma imaging in relation to background parenchymal enhancement in magnetic resonance imaging.

    Science.gov (United States)

    Yoon, Hai-Jeon; Kim, Yemi; Lee, Jee Eun; Kim, Bom Sahn

    2015-01-01

    This study investigated factors that could affect background uptake of (99m)Tc- methoxyisobutylisonitrile (MIBI) on normal breast by breast-specific gamma imaging (BSGI). In addition, the impact of background (99m)Tc-MIBI uptake on the diagnostic performance of BSGI was further investigated. One hundred forty-five women with unilateral breast cancer who underwent BSGI, MRI, and mammography were retrospectively enrolled. Background uptake on BSGI was evaluated qualitatively and quantitatively. Patients were classified into non-dense and dense breast groups according to mammographic breast density. Background parenchymal enhancement (BPE) was rated according to BI-RADS classification. The relationship of age, menopausal status, mammographic breast density, and BPE with background (99m)Tc-MIBI uptake was analyzed. Heterogeneous texture and high background uptake ratio on BSGI were significantly correlated with younger age (p background MIBI uptake (p background MIBI uptake and BPE grade increased. BPE on MRI was the most important factor for background MIBI uptake on BSGI. High background MIBI uptake or marked BPE can diminish the diagnostic performance of BSGI. • Age, menopause, density, and background parenchymal enhancement affect background MIBI uptake. • BPE is an independent factor for background MIBI uptake on BSGI. • Marked BPE may impair BSGI interpretation.

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

    Energy Technology Data Exchange (ETDEWEB)

    Smallenburg, Vivian van Breest, E-mail: vivianvbreestsm@hotmail.com [Department of Radiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven (Netherlands); Duijm, Lucien E.M., E-mail: lemduijm@hotmail.com [Department of Radiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven (Netherlands); Heeten, Gerard J. den, E-mail: g.denheeten@lrcb.nl [National Expert and Training Centre for Breast Cancer Screening, PO Box 6873, 6503 GJ Nijmegen (Netherlands); Groenewoud, Johanna H., E-mail: j.h.groenewoud@hro.nl [Expertise Centre Transitions of Care, Rotterdam University of Applied Sciences, PO Box 25035, 3001 HA Rotterdam (Netherlands); Jansen, Frits H., E-mail: frits.jansen@cze.nl [Department of Radiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven (Netherlands); Fracheboud, Jacques, E-mail: j.fracheboud@erasmusmc.nl [National Evaluation Team for Breast Cancer Screening, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam (Netherlands); Plaisier, Menno L., E-mail: m.plaisier@planet.nl [Department of Radiology, Maxima Medical Centre, PO Box 7777, 5500 MB Veldhoven (Netherlands); Doorne-Nagtegaal, Heidi J. van, E-mail: h.vandoorne@ikca.nl [Comprehensive Cancer Centre Amsterdam (CCCA), PO Box 9236, Amsterdam 1006 AE (Netherlands); Broeders, Mireille J.M., E-mail: M.Broeders@ebhumcn.nl [National Expert and Training Centre for Breast Cancer Screening, PO Box 6873, 6503 GJ Nijmegen (Netherlands); Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen (Netherlands)

    2012-09-15

    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.

  20. Efficacy of interventions to increase the uptake of chlamydia screening in primary care: a systematic review

    Directory of Open Access Journals (Sweden)

    Donovan Basil

    2011-08-01

    Full Text Available Abstract Background As most genital chlamydia infections are asymptomatic, screening is the main way to detect and cases for treatment. We undertook a systematic review of studies assessing the efficacy of interventions for increasing the uptake of chlamydia screening in primary care. Methods We reviewed studies which compared chlamydia screening in the presence and the absence of an intervention. The primary endpoints were screening rate or total tests. Results We identified 16 intervention strategies; 11 were randomised controlled trials and five observational studies, 10 targeted females only, five both males and females, and one males only. Of the 15 interventions among females, six were associated with significant increases in screening rates at the 0.05 level including a multifaceted quality improvement program that involved provision of a urine jar to patients at registration (44% in intervention clinics vs. 16% in the control clinic; linking screening to routine Pap smears (6.9% vs. 4.5%, computer alerts for doctors (12.2% vs. 10.6%; education workshops for clinic staff; internet-based continuing medical education (15.5% vs. 12.4%; and free sexual health consultations (16.8% vs. 13.2%. Of the six interventions targeting males, two found significant increases including the multifaceted quality improvement program in which urine jars were provided to patients at registration (45% vs. 15%; and the offering by doctors of a test to all presenting young male clients, prior to consultation (29 vs. 4%. Conclusions Interventions that promoted the universal offer of a chlamydia test in young people had the greatest impact on increasing screening in primary care.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Jung, Su Mi; Jo, Heui-Sug

    2014-01-01

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

  3. Understanding low colorectal cancer screening uptake in South Asian faith communities in England--a qualitative study.

    Science.gov (United States)

    Palmer, Cecily K; Thomas, Mary C; McGregor, Lesley M; von Wagner, Christian; Raine, Rosalind

    2015-10-01

    Colorectal cancer screening uptake within the South Asian population in England is approximately half that of the general population (33 % vs 61 %), and varies by Muslim (31.9 %), Sikh (34.6 %) and Hindu (43.7 %) faith background. This study sought to explore reasons for low uptake of CRC screening in South Asian communities and for the variability of low uptake between three faith communities; and to identify strategies by which uptake might be improved. We interviewed 16 'key informants' representing communities from the three largest South Asian faith backgrounds (Islam, Hinduism and Sikhism) in London, England. Reasons for low colorectal cancer screening uptake were overwhelmingly shared across South Asian faith groups. These were: limitations posed by written English; limitations posed by any written language; reliance on younger family members; low awareness of colorectal cancer and screening; and difficulties associated with faeces. Non-written information delivered verbally and interactively within faith or community settings was preferred across faith communities. Efforts to increase accessibility to colorectal cancer screening in South Asian communities should use local language broadcasts on ethnic media and face-to-face approaches within community and faith settings to increase awareness of colorectal cancer and screening, and address challenges posed by written materials.

  4. The psychological profile of women attending breast-screening tests.

    Science.gov (United States)

    Kreitler, S; Chaitchik, S; Kreitler, H

    1990-01-01

    Though the benefits of early detection of breast cancer are generally known, only few women attend breast-screening examinations. The study was designed to gain insight into the problem by exploring the psychological profile of clinic attenders. In order to find out whether there is such a profile, 210 self-referred women were compared with 210 nonattending women, from the same working and social environments, matched in age, education and occupational level. All subjects were administered 10 tests in 7 domains. The tests were administered as part of a health survey. The results showed that clinic attenders scored higher on negative emotions and total emotions and lower on positive emotions; higher on repression; lower on daydreams; lower on range of self-concept, references to others and negative self-references but higher on positive self-references; scored higher on self-references describing oneself in a functional and in a passive way and scored lower on those describing oneself in terms of one's attitudes, body and appearance; scored lower on neuroticism; scored lower on different somatic complaints and health orientation but higher in alexithymia. No differences were found in authoritarianism, locus of control and self-complexity. Conclusions are that there is a psychological profile of clinic attenders, that it is focused on dysphoric emotions, psychological disease promotion and defensiveness and that it includes characteristics of the construct that is sometimes called the cancer-prone personality.

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

    Science.gov (United States)

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

    2009-11-01

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

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

    Science.gov (United States)

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

    2006-06-01

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

  7. 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.

  8. MIBI Uptake in a Huge Breast Mass Obscuring the Anterior and Lateral Myocardial Walls in Perfusion Imaging

    OpenAIRE

    Forough Kalantari; Mehrshad Abbasi; Saeed Farzanefar

    2015-01-01

    Background: Cardiac risk assessment with myocardial perfusion imaging (MPI) is a common practice for some elderly breast cancer patients who are candidates for operation. In rare cases the tumor may become visible in the images.Case presentation: This is the report of a case with a huge slow-growing breast tumor suspicious for malignancy and presenting with methoxy-isobutyl-isonitrile (MIBI) uptake in the tumor. The patient was referred to the nuclear medicine department for preoperative card...

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Cognitive-Affective Predictors of the Uptake & Sustained Adherence to Lymphedema Symptom Minimization Practices in Breast Cancer Survivors

    Science.gov (United States)

    2007-08-01

    style, on knowledge, uptake and adherence of symptom minimization precautions at baseline, 6-, and 12-month follow-up post treatment . Little is known...University 44 42.3 Graduate/Doctoral Degree 25 24.1 Missing/ Refused 1 1 Treatment History* Lumpectomy 73 70.2 Mastectomy 37 35.6 Lymph node dissection...Uptake of, & Sustained Adherence to Lymphedema Symptom Minimization Practices in Breast Cancer Survivors PRINCIPAL INVESTIGATOR: Suzanne M. Miller

  11. Racial Variation in the Uptake of Oncotype DX Testing for Early-Stage Breast Cancer.

    Science.gov (United States)

    Roberts, Megan C; Weinberger, Morris; Dusetzina, Stacie B; Dinan, Michaela A; Reeder-Hayes, Katherine E; Carey, Lisa A; Troester, Melissa A; Wheeler, Stephanie B

    2016-01-10

    Oncotype DX (ODX) is a tumor gene-profiling test that aids in adjuvant chemotherapy decision-making. ODX has the potential to improve quality of care; however, if not equally accessible across racial groups, disparities in cancer care quality may persist or worsen. We examined racial disparities in ODX testing uptake. We used data from the Carolina Breast Cancer Study, phase III, a longitudinal, population-based study of 2,998 North Carolina women who received a diagnosis of breast cancer between 2008 and 2014. Our primary analysis used modified Poisson regression to determine the association between race and whether ODX testing was ordered among two strata: node-negative and node-positive breast cancer. A total of 1,468 women with estrogen receptor-positive, human epidermal growth factor receptor-2-negative, stage I or II breast cancer met inclusion criteria. Black patients had higher-grade and larger tumors, more comorbidities, younger age at diagnosis, and lower socioeconomic status than non-black women. Overall, 42% of women had ODX test results in their pathology reports. Compared with those who did not receive ODX testing, women who received ODX testing tended to be younger and have medium tumor size and grade. Our regression analyses indicated no racial disparities in ODX uptake among node-negative patients. However, racial differences were detected among node-positive patients, with black patients being 46% less likely to receive ODX testing than non-black women (adjusted relative risk, 0.54; 95% CI, 0.35 to 0.84; P = .006). We did not find racial disparities in ODX testing for node-negative patients for whom ODX testing is guideline recommended and widely covered by insurers. However, our findings suggest that a newer, non-guideline-concordant application of ODX testing for node-positive breast cancer was accessed less by black women than by non-black women, reflecting more guideline concordant care among black women. © 2015 by American Society of

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

    Science.gov (United States)

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

    2017-06-01

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

  13. Uptake of Noninvasive Prenatal Testing in Chinese Women following Positive Down Syndrome Screening.

    Science.gov (United States)

    Poon, C F; Tse, W C; Kou, K O; Leung, K Y

    2015-01-01

    To investigate how the introduction of noninvasive prenatal testing (NIPT) influenced women's testing choices following a positive Down syndrome screening. A retrospective study was conducted to compare differences in the uptake rates of invasive prenatal diagnosis (IPD) or no testing in one public hospital 1 year before (pre-NIPT) and 1 and 2 years after the introduction of NIPT in private in August 2011 using descriptive analysis and a χ² test. Conventional screening was funded publicly, but NIPT was not. Multivariable binary logistic regression was used to determine factors affecting choices. In pre-NIPT and in years 1 and 2 after the introduction of NIPT, 306, 362 and 401 women who screened positive were seen, respectively. In year 1 and year 2, 12.6 and 26.7% of them underwent NIPT while IPD was decreased by 16.3 and 25.6%, respectively (p testing was similar before and after NIPT (p = 0.213). In multivariable analysis, first trimester screening, nulliparity and working women were significant predictors of accepting NIPT, while only nulliparity was a predictor of declining IPD (OR = 0.61). Introduction of NIPT resulted in a significant decrease in IPD for 2 consecutive years.. © 2014 S. Karger AG, Basel

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

    Science.gov (United States)

    Moshina, Nataliia; Sebuødegård, Sofie; Hofvind, Solveig

    2017-06-01

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

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

    OpenAIRE

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

    2016-01-01

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

  16. Disparities in the use of screening magnetic resonance imaging of the breast in community practice by race, ethnicity, and socioeconomic status.

    Science.gov (United States)

    Haas, Jennifer S; Hill, Deirdre A; Wellman, Robert D; Hubbard, Rebecca A; Lee, Christoph I; Wernli, Karen J; Stout, Natasha K; Tosteson, Anna N A; Henderson, Louise M; Alford-Teaster, Jennifer A; Onega, Tracy L

    2016-02-15

    Uptake of breast magnetic resonance imaging (MRI) coupled with breast cancer risk assessment offers the opportunity to tailor the benefits and harms of screening strategies for women with differing cancer risks. Despite the potential benefits, there is also concern for worsening population-based health disparities. Among 316,172 women aged 35 to 69 years from 5 Breast Cancer Surveillance Consortium registries (2007-2012), the authors examined 617,723 negative screening mammograms and 1047 screening MRIs. They examined the relative risks (RRs) of MRI use by women with a women with a ≥20% lifetime risk. Among women with a women were found to be 62% more likely than nonwhite women to undergo an MRI (95% confidence interval, 1.32-1.98). Of these women, those with an educational level of some college or technical school were 43% more likely and those who had at least a college degree were 132% more likely to receive an MRI compared with those with a high school education or less. Among women with a ≥20% lifetime risk, there was no statistically significant difference noted with regard to the use of screening MRI by race or ethnicity, but high-risk women with a high school education or less were less likely to undergo screening MRI than women who had graduated from college (RR, 0.40; 95% confidence interval, 0.25-0.63). Uptake of screening MRI of the breast into clinical practice has the potential to worsen population-based health disparities. Policies beyond health insurance coverage should ensure that the use of this screening modality reflects evidence-based guidelines. © 2015 American Cancer Society.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-15

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

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

    Science.gov (United States)

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

    2013-12-01

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

  19. 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...

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

    NARCIS (Netherlands)

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

    1999-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-05-01

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

  2. Trends in breast biopsies for abnormalities detected at screening mammography: a population-based study in the Netherlands

    OpenAIRE

    van Breest Smallenburg, V; Nederend, J; Voogd, A C; Coebergh, J W W; van Beek, M; Jansen, F H; Louwman, W J; Duijm, L E M

    2013-01-01

    Background: Diagnostic surgical breast biopsies have several disadvantages, therefore, they should be used with hesitation. We determined time trends in types of breast biopsies for the workup of abnormalities detected at screening mammography. We also examined diagnostic delays. Methods: In a Dutch breast cancer screening region 6230 women were referred for an abnormal screening mammogram between 1 January 1997 and 1 January 2011. During two year follow-up clinical data, breast imaging-, bio...

  3. Breast density in screening mammography in Indian population - Is it different from western population?

    Science.gov (United States)

    Singh, Tulika; Khandelwal, Niranjan; Singla, Veenu; Kumar, Dileep; Gupta, Madhu; Singh, Gurpreet; Bal, Amanjit

    2017-11-15

    Mammography is the only method presently considered appropriate for mass screening of breast cancer. However, higher breast density was strongly associated with lower mammographic sensitivity. Breast density is also identified as independent and strongest risk factors for breast cancer. Studies have shown women with high breast density have four to six times increased risk of breast cancer as compare to women with fatty breast. It varies between different age group it generally decreases with increasing age in postmenopausal women and it can be different in different ethnic groups and people from different geographical areas. This study evaluates the breast density in Indian population and its relationship with the age. We reviewed of all screening mammography examinations performed from May 2012 to January 2015 at our institute PGIMER, Chandigarh, INDIA. Descriptive analyses were used to examine the association between age and breast density. A total of 6132 screening mammograms were performed. Each subgroup categorized by decade of age. There was a significant inverse relationship between age and breast density (P density in Indian and Western population with more Indians having ACR Grade 1 and 2 and Western population having 2 and 3. We found an inverse relationship between patient age and mammographic breast density. However, there were a large proportion of young women who had lower grades of mammographic density which could potentially benefit from the use of routine screening mammography in this subgroup of patients. Moreover, the breast density of Indian population is less when compared to the Western population. This might suggest that mammography is a good modality of choice for screening Indian population. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2011-03-01

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

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

    Science.gov (United States)

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

    2014-08-15

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

    Kırca, Nurcan; Tuzcu, Ayla; Gözüm, Sebahat

    2018-01-01

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

  8. Experiences and unmet needs of women undergoing Pap smear cervical cancer screening: impact on uptake of cervical cancer screening in south eastern Nigeria.

    Science.gov (United States)

    Chigbu, Chibuike O; Onyebuchi, Azubuike K; Egbuji, Chuma C; Ezugwu, Eusebus C

    2015-03-01

    The burden of cervical cancer is on the increase in sub-Saharan Africa mainly due to inadequate provision and utilisation of cervical cancer prevention services. Several evidence-based strategies have been deployed to improve cervical cancer screening uptake without much success. However, patients' experiences and satisfaction with service provision has not been adequately studied. Inefficiencies in service delivery and less fulfilling experiences by women who attend cervical cancer screening could have considerable impact in future voluntary uptake of cervical cancer screening. Six hundred and eighty women who underwent Pap smear screening in three health care facilities in two states in south eastern Nigeria were interviewed to evaluate their satisfaction, willingness to undertake future voluntary screening, unmet needs and correlation between satisfaction level and willingness to undergo future screening. Satisfaction with Pap smear screening correlated positively with willingness to undertake future voluntary screening (Pearson's correlation coefficient = 0.78, P = 0.001). The mean satisfaction score was significantly higher among participants handled by nurses than those handled by the physicians (3.16 ± 0.94 vs 2.52 ± 0.77, P = 0.001). 'Scrapping discomfort' of the spatula was reported as the most dissatisfying aspect of Pap smear experience. The need for less invasive screening procedures was the most unmet need. It was concluded that improving the Pap smear screening experience of women and providing less invasive methods of cervical cancer screening with immediate results could improve uptake of cervical cancer screening in south eastern Nigeria.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  10. 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

  11. Standardized uptake value and quantification of metabolism for breast cancer imaging with FDG and L-[1-C-11]tyrosine PET

    NARCIS (Netherlands)

    Kole, AC; Nieweg, OE; Pruim, J; Paans, AMJ; Plukker, JTM; Hoekstra, HJ; Vaalburg, W; Schraffordt Koops, H.

    The aims of the study were to compare the value of L-[1-C-11]tyrosine (TYR) and [F-18]fluoro-2-deoxy-D-glucose (FDG) as tumor tracers in patients with breast cancer, to investigate the correlation between quantitative values and standardized uptake values (SUVs) and to estimate the value of SUVs for

  12. 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...

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

    Science.gov (United States)

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

    2011-03-01

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

  14. 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%....

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

    Science.gov (United States)

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

    2009-09-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2011-11-01

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

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

    Science.gov (United States)

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

    2015-02-27

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

  19. Relationship between reticuloendothelial systems' FDG uptake level and clinicopathological features in patient with invasive ductal breast cancer.

    Science.gov (United States)

    Şahin, Ertan; Elboğa, Umut

    2017-10-01

    The reticuloendothelial system (RES) is a part of the immune system and plays a major role in the protection of against diseases. We thought that FDG-PET/CT may show the degree of systemic immune response induced with malignancy in the organs with the high RES activity. Our objective is to investigate FDG uptake levels of high RES activity organs (liver, spleen, bone marrow) in invasive ductal breast cancer and to evaluate the association with the clinicopathological features. In the present study, 193 patients with invasive ductal breast cancer who performed FDG-PET/CT were categorized according to the clinicopathological features including age, tumor size, axillary nodal status, histological grade, the presence of lymphavascular invasion, receptor status, Ki-67 proliferation index and biological subgroup. Also, a control group of 100 subjects were identified for comparison with breast cancer patients. We analyzed the relation of FDG uptake levels in high RES activity organs and clinicopathological features in patients. There was a statistically significant difference of SUVmax of the liver, spleen, and bone marrow between cancer and control groups (P features in patient with invasive ductal breast cancer. FDG uptake level in high RES activity organs is associated with the presence of tumor, and also directly relating clinicopathological features for patients with invasive ductal breast cancer.

  20. A study of the changes of breast uptake in menstrual cycle on {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hoon Hee; Tak, Yeo Jin [Dept. of Radiological Technology, Shingu College, Sungnam (Korea, Republic of); Park, Min Soo [Dept. of Nuclear Medicine, Severance Hospital, Yonsei University Health System, Seoul (Korea, Republic of); Lee, Ju Young [Graduate School of Public Health, Yonsei University, Seoul (Korea, Republic of)

    2015-04-15

    {sup 18}F-FDG PET/CT has been known a useful modality to diagnose high-glucose-using cells such as cancer cells by glucose metabolism of FDG. Mainly, FDG takes on cancer and inflammatory cells; however, there have been FDG uptakes on normal tissues by individual physiological characteristics, occasionally. Especially, in fertile females, unusual FDG uptake of breast changes as the menstrual cycle, and disturb diagnosis. Therefore, the study aimed to evaluate the change of breast FDG uptake in menstrual cycle on {sup 18}F-FDG PET/CT. 160 females (34±3.5 years old) who do not undergo a gynecologic anamnesis and have regular menstrual cycle over the previous 6 months were examined. They were divided 4 groups (each 40 patients) as flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator 0.14. and history taking. Discovery Ste (GE Healthcare, Milwaukee, Mi, USA) was used a s PET/CT. We analyzed SUVs on a ccumulated r egion on b reast, and 3 nuclear medicine specialists did the Blind test. SUVs on the Breast were flow phase (1.64±0.25), proliferative phase (0.93±0.28), ovulatory phase (1.66±0.26) and secretory phase (1.77±0.28). It showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In gross analysis, the accumulation of breast was divided into 3 grades as comparing with lung and liver. The breast’s uptake was equal to lung (Grade Ⅰ); between lung and liver (Grade II); equal to or greater than liver (Grade III). The results showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In fertile females, FDG uptake of breast changed as menstrual cycle, and it available to diagnose breast disease. Therefore, we consider reducing false-negative finding of breast disease, by doing examination on appropriate period through history taking about individual menstrual cycle.

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

    Science.gov (United States)

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

    2015-09-03

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

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

    National Research Council Canada - National Science Library

    Waseem Khaliq; Ali Aamar; Scott M Wright

    2015-01-01

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

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

    National Research Council Canada - National Science Library

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

    Sano, Hiroshi; Goto, Rei; Hamashima, Chisato

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  7. 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

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

    Directory of Open Access Journals (Sweden)

    Montazeri Ali

    2008-12-01

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

  9. Cost effectiveness of the NHS breast screening programme: life table model

    OpenAIRE

    Pharoah, Paul D.P.; Sewell, Bernadette; Fitzsimmons,Deborah; Bennett, Hayley S; Pashayan, Nora

    2013-01-01

    Objective To assess the overall cost effectiveness of the NHS breast screening programme, based on findings of the Independent UK Panel on Breast Cancer Screening and taking into account the uncertainty of associated estimates of benefits, harms, and costs. Design A life table model comparing data from two cohorts. Setting United Kingdom?s health service. Participants and interventions 364?500 women aged 50 years?the population of 50 year old women in England and Wales who would be eligible f...

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

    Science.gov (United States)

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

    2015-02-01

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

  11. Screening uptake rates and the clinical and cost effectiveness of screening for gestational diabetes mellitus in primary versus secondary care: study protocol for a randomised controlled trial.

    LENUS (Irish Health Repository)

    O Dea, Angela

    2014-01-17

    The risks associated with gestational diabetes mellitus (GDM) are well recognized, and there is increasing evidence to support treatment of the condition. However, clear guidance on the ideal approach to screening for GDM is lacking. Professional groups continue to debate whether selective screening (based on risk factors) or universal screening is the most appropriate approach. Additionally, there is ongoing debate about what levels of glucose abnormalities during pregnancy respond best to treatment and which maternal and neonatal outcomes benefit most from treatment. Furthermore, the implications of possible screening options on health care costs are not well established. In response to this uncertainty there have been repeated calls for well-designed, randomised trials to determine the efficacy of screening, diagnosis, and management plans for GDM. We describe a randomised controlled trial to investigate screening uptake rates and the clinical and cost effectiveness of screening in primary versus secondary care settings. The objective of this study is to assess screening uptake rates, and the clinical and cost effectiveness of screening for GDM in primary versus secondary care.

  12. Correlation of primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Jo, I; Kim, Sung Hoon; Kim, Hae Won; Kang, Sung Hee [Keimyung University, School of Medicine, Daegu (Korea, Republic of); Zeon, Seok Kil [Dept. of Nuclear Medicine, Bundang Jesaeng General Hospital, Sungnam (Korea, Republic of); Kim, Su Jin [Dept. of Anesthesiology and Pain Medicine, Dongguk University, School of Medicine, Gyeongju (Korea, Republic of)

    2015-03-15

    The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUV{sub max}) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. The high SUV{sub max} of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUV{sub max} compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer.

  13. 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

  14. Evaluation of the Utility of Screening Mammography for High-Risk Women Undergoing Screening Breast MR Imaging.

    Science.gov (United States)

    Lo, Glen; Scaranelo, Anabel M; Aboras, Hana; Ghai, Sandeep; Kulkarni, Supriya; Fleming, Rachel; Bukhanov, Karina; Crystal, Pavel

    2017-10-01

    Purpose To evaluate the value of mammography in detecting breast cancer in high-risk women undergoing screening breast magnetic resonance (MR) imaging. Materials and Methods An ethics-approved, retrospective review of prospective databases was performed to identify outcomes of 3934 screening studies (1977 screening MR imaging examinations and 1957 screening mammograms) performed between January 2012 and July 2014 in 1249 high-risk women. Performance measures including recall and cancer detection rates, sensitivity, specificity, and positive predictive values were calculated for both mammography and MR imaging. Results A total of 45 cancers (33 invasive and 12 ductal carcinomas in situ) were diagnosed, 43 were seen with MR imaging and 14 with both mammography and MR imaging. Additional tests (further imaging and/or biopsy) were recommended in 461 screening MR imaging studies (recall rate, 23.3%; 95% confidence interval [CI]: 21.5%, 25.2%), and mammography recalled 217 (recall rate, 11.1%; 95% CI: 9.7%, 12.6%). The cancer detection rate for MR imaging was 21.8 cancers per 1000 examinations (95% CI: 15.78, 29.19) and that for mammography was 7.2 cancers per 1000 examinations (95% CI: 3.92, 11.97; P imaging were 96% and 78% respectively, and those of mammography were 31% and 89%, respectively (P imaging recalls was 9.3% (95% CI: 6.83%, 12.36%) and that for mammography recalls was 6.5% (95% CI: 3.57%, 10.59%). Conclusion Contemporaneous screening mammography did not have added value in detection of breast cancer for women who undergo screening MR imaging. Routine use of screening mammography in women undergoing screening breast MR imaging warrants reconsideration. (©) RSNA, 2017 Online supplemental material is available for this article.

  15. Cost effectiveness of the NHS breast screening programme: life table model.

    Science.gov (United States)

    Pharoah, Paul D P; Sewell, Bernadette; Fitzsimmons, Deborah; Bennett, Hayley S; Pashayan, Nora

    2013-05-09

    To assess the overall cost effectiveness of the NHS breast screening programme, based on findings of the Independent UK Panel on Breast Cancer Screening and taking into account the uncertainty of associated estimates of benefits, harms, and costs. A life table model comparing data from two cohorts. United Kingdom's health service. 364,500 women aged 50 years-the population of 50 year old women in England and Wales who would be eligible for screening-were followed up for 35 years without screening, compared with a similar cohort who had regular mammographic screening between ages 50 and 70 years and were then followed for another 15 years. Between the cohorts, we compared the number of breast cancer diagnoses, number of deaths from breast cancer, number of deaths from other causes, person years of survival adjusted for health quality, and person years of survival with breast cancer. We also calculated the costs of treating primary and end stage breast cancer, and the costs of screening. Probabilistic sensitivity analysis explored the effect of uncertainty in key input parameters on the model outputs. Under the base case scenario (using input parameters derived from the Independent Panel Review), there were 1521 fewer deaths from breast cancer and 2722 overdiagnosed breast cancers. Discounting future costs and benefits at a rate of 3.5% resulted in an additional 6907 person years of survival in the screened cohort, at a cost of 40,946 additional years of survival after a diagnosis of breast cancer. Screening was associated with 2040 additional quality adjusted life years (QALYs) at an additional cost of £42.5m (€49.8m; $64.7m) in total or £20,800 per QALY gained. The gain in person time survival over 35 years was 9.2 days per person and 2.7 quality adjusted days per person screened. Probabilistic sensitivity analysis showed that this incremental cost effectiveness ratio varied widely across a range of plausible scenarios. Screening was cost effective at a

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

    Directory of Open Access Journals (Sweden)

    Ziba Farajzadegan

    2016-01-01

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

  17. 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.

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

    Science.gov (United States)

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

    2017-04-17

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

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

    Science.gov (United States)

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

    2010-09-23

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

  20. Surface modification of microparticles causes differential uptake responses in normal and tumoral human breast epithelial cells

    Science.gov (United States)

    Patiño, Tania; Soriano, Jorge; Barrios, Lleonard; Ibáñez, Elena; Nogués, Carme

    2015-01-01

    The use of micro- and nanodevices as multifunctional systems for biomedical applications has experienced an exponential growth during the past decades. Although a large number of studies have focused on the design and fabrication of new micro- and nanosystems capable of developing multiple functions, a deeper understanding of their interaction with cells is required. In the present study, we evaluated the effect of different microparticle surfaces on their interaction with normal and tumoral human breast epithelial cell lines. For this, AlexaFluor488 IgG functionalized polystyrene microparticles (3 μm) were coated with Polyethyleneimine (PEI) at two different molecular weights, 25 and 750 kDa. The effect of microparticle surface properties on cytotoxicity, cellular uptake and endocytic pathways were assessed for both normal and tumoral cell lines. Results showed a differential response between the two cell lines regarding uptake efficiency and mechanisms of endocytosis, highlighting the potential role of microparticle surface tunning for specific cell targeting. PMID:26068810

  1. Whey protein solution coating for fat-uptake reduction in deep-fried chicken breast strips.

    Science.gov (United States)

    Dragich, Ann M; Krochta, John M

    2010-01-01

    This study investigated the use of whey protein, as an additional coating, in combination with basic, well-described predust, batter, and breading ingredients, for fat-uptake reduction in fried chicken. Chicken breasts were cut into strips (1 x 5 x 10 cm) and coated with wheat flour (WF) as a predust, dipped in batter, coated with WF as a breading, then dipped in 10% denatured whey protein isolate (DWPI) aqueous solution (wet basis). A WF-batter-WF treatment with no DWPI solution dip was included as a control. Coated chicken strips were deep-fried at 160 degrees C for 5 min. A Soxhlet-type extraction was performed to determine the fat content of the meat fraction of fried samples, the coating fraction of fried samples, raw chicken, and raw coating ingredients. The WF-batter-WF-10% DWPI solution had significantly lower fat uptake than the WF-batter-WF control, by 30.67% (dry basis). This article describes applied research involving fat reduction in coated deep-fried chicken. The methods used in this article were intended to achieve maximized fat reduction while maintaining a simple procedure applicable to actual food processing lines.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-07-15

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

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

    Science.gov (United States)

    Shen, Y; Zelen, M

    2001-08-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

  5. Modulation of the uptake of critical nutrients by breast cancer cells by lactate: Impact on cell survival, proliferation and migration.

    Science.gov (United States)

    Guedes, Marta; Araújo, João R; Correia-Branco, Ana; Gregório, Inês; Martel, Fátima; Keating, Elisa

    2016-02-15

    This work aimed to characterize the uptake of folate and glucose by breast cancer cells and to study the effect of lactate upon the transport of these nutrients and upon cell viability, proliferation and migration capacity. Data obtained showed that: a) MCF7 cells uptake (3)H-folic acid ((3)H-FA) at physiological but not at acidic pH; b) T47D cells accumulate (3)H-FA and (14)C-5-methyltetrahydrofolate ((14)C-5-MTHF) more efficiently at acidic than at physiological pH; c) (3)H-deoxyglucose ((3)H-DG) uptake by T47D cells is sodium-independent, inhibited by cytochalasin B (CYT B) and stimulated by insulin. Regarding the effect of lactate, in T47D cells, acute (26 min) and chronic (24 h) exposure to lactic acid (LA) stimulated (3)H-FA uptake. Acute exposure to LA also stimulated (3)H-DG uptake and chronic exposure to LA significantly stimulated T47D cell migratory capacity. In conclusion, the transport of folates is strikingly different in two phenotypically similar breast cancer cell lines: MCF7 and T47D cells. Additionally, lactate seems to act as a signaling molecule which increases the uptake of nutrients and promotes the migration capacity of T47D cells. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Kwok, Cannas; Fethney, Judith; White, Kate

    2012-01-01

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

  7. Influence of provider factors and race on uptake of breast cancer gene expression profiling.

    Science.gov (United States)

    Reeder-Hayes, Katherine E; Wheeler, Stephanie B; Baggett, Christopher D; Zhou, Xi; Meng, Ke; Roberts, Megan C; Carey, Lisa A; Meyer, Anne-Marie

    2018-01-16

    Gene expression profiling (GEP) has been rapidly adopted for early breast cancer and can aid in chemotherapy decision making. Study results regarding racial disparities in testing are conflicting, and may reflect different care settings. To the authors' knowledge, data regarding the influence of provider factors on testing are scarce. The authors used a statewide, multipayer, insurance claims database linked to cancer registry records to examine the impact of race and provider characteristics on GEP uptake in a cohort of patients newly diagnosed with breast cancer between 2005 and 2012. Incidence proportion models were used to examine the adjusted likelihood of testing. Models were stratified by lymph node status (N0 vs N1). Among 11,958 eligible patients, 23% of black and 26% of non-Hispanic white patients received GEP. Among patients with N0 disease, black individuals were 16% less likely to receive testing after adjustment for clinical factors and the provider's specialty and volume of patients with breast cancer (95% confidence interval, 0.77-0.93). Adjustment for provider characteristics did not attenuate the effect of race on testing. Patients of middle-volume providers were more likely to be tested compared with those with either high-volume or low-volume providers, whereas patients seeing a medical oncologist were more likely to be tested compared with those whose only providers were from surgical specialties. Provider volume and specialty were found to be significant predictors of GEP use, but did not explain racial disparities in testing. Further research concerning the key contributors to lagging test use among black women is needed to optimize the equitable use of GEPs and support personalized treatment decision making for all patients. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  8. Evaluation of a Worksite Cervical Screening Initiative to Increase Pap Smear Uptake in Malaysia: A Cluster Randomized Controlled Trial

    Science.gov (United States)

    O'Rorke, Michael; Murray, Liam; Su, Tin Tin

    2013-01-01

    Background. Despite the significant burden of cervical cancer, Malaysia like many middle-income countries relies on opportunistic cervical screening as opposed to a more organized population-based program. The aim of this study was to ascertain the effectiveness of a worksite screening initiative upon Papanicolaou smear test (Pap test) uptake among educated working women in Malaysia. Methods. 403 female teachers who never or infrequently attended for a Pap test from 40 public secondary schools in Kuala Lumpur were recruited into a cluster randomized trial conducted between January and November 2010. The intervention group participated in a worksite cervical screening initiative whilst the control group received usual care from the existing cervical screening program. Multivariate logistic regression was performed to determine the impact of the intervention program on Pap smear uptake after 24 weeks of followup. Results. The proportion of women attending for a Pap test was significantly higher in the intervention than in the control group (18.1% versus 10.1%, P value < 0.05) with the worksite screening initiative doubling the Pap smear uptake, adjusted odds ratio 2.44 (95% CI: 1.29–4.62). Conclusion. Worksite health promotion interventions can effectively increase cervical smear uptake rates among eligible workers in middle-income countries. Policy makers and health care providers in these countries should include such interventions in strategies for reducing cervical cancer burden. This trial is registered with IRCT201103186088N1. PMID:24073411

  9. 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

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

    Science.gov (United States)

    Laing, Sharon S; Makambi, Kepher

    2008-11-01

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

  11. Quercetin and epigallocatechin gallate inhibit glucose uptake and metabolism by breast cancer cells by an estrogen receptor-independent mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Liliana, E-mail: lilianam87@gmail.com [Department of Biochemistry (U38-FCT), Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto (Portugal); Araújo, Isabel, E-mail: isa.araujo013@gmail.com [Department of Biochemistry (U38-FCT), Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto (Portugal); Costa, Tito, E-mail: tito.fmup16@gmail.com [Department of Biochemistry (U38-FCT), Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto (Portugal); Correia-Branco, Ana, E-mail: ana.clmc.branco@gmail.com [Department of Biochemistry (U38-FCT), Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto (Portugal); Faria, Ana, E-mail: anafaria@med.up.pt [Department of Biochemistry (U38-FCT), Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto (Portugal); Chemistry Investigation Centre (CIQ), Faculty of Sciences of University of Porto, Rua Campo Alegre, 4169-007 Porto (Portugal); Faculty of Nutrition and Food Sciences of University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto (Portugal); Martel, Fátima, E-mail: fmartel@med.up.pt [Department of Biochemistry (U38-FCT), Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto (Portugal); Keating, Elisa, E-mail: keating@med.up.pt [Department of Biochemistry (U38-FCT), Faculty of Medicine of University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto (Portugal)

    2013-07-15

    In this study we characterized {sup 3}H-2-deoxy-D-glucose ({sup 3}H -DG) uptake by the estrogen receptor (ER)-positive MCF7 and the ER-negative MDA-MB-231 human breast cancer cell lines and investigated the effect of quercetin (QUE) and epigallocatechin gallate (EGCG) upon {sup 3}H-DG uptake, glucose metabolism and cell viability and proliferation. In both MCF7 and MDA-MB-231 cells {sup 3}H-DG uptake was (a) time-dependent, (b) saturable with similar capacity (V{sub max}) and affinity (K{sub m}), (c) potently inhibited by cytochalasin B, an inhibitor of the facilitative glucose transporters (GLUT), (d) sodium-independent and (e) slightly insulin-stimulated. This suggests that {sup 3}H-DG uptake by both cell types is mediated by members of the GLUT family, including the insulin-responsive GLUT4 or GLUT12, while being independent of the sodium-dependent glucose transporter (SGLT1). QUE and EGCG markedly and concentration-dependently inhibited {sup 3}H-DG uptake by MCF7 and by MDA-MB-231 cells, and both compounds blocked lactate production by MCF7 cells. Additionally, a 4 h-treatment with QUE or EGCG decreased MCF7 cell viability and proliferation, an effect that was more potent when glucose was available in the extracellular medium. Our results implicate QUE and EGCG as metabolic antagonists in breast cancer cells, independently of estrogen signalling, and suggest that these flavonoids could serve as therapeutic agents/adjuvants even for ER-negative breast tumors. -- Highlights: • Glucose uptake by MCF7 and MDA-MB-231 cells is mainly mediated by GLUT1. • QUE and EGCG inhibit cellular glucose uptake thus abolishing the Warburg effect. • This process induces cytotoxicity and proliferation arrest in MCF7 cells. • The flavonoids’ effects are independent of estrogen receptor signalling.

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

    Science.gov (United States)

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

    2017-09-27

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

  13. Association between {sup 18}F-FDG uptake and molecular subtype of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro; Fukushima, Kazuhito; Igarashi, Yoko; Katsuura, Takayuki; Maruyama, Kaoru [Hyogo College of Medicine, Department of Nuclear Medicine and PET center, Nishinomiya, Hyogo (Japan); Miyoshi, Yasuo; Nishimukai, Arisa [Hyogo College of Medicine, Department of Breast and Endocrine Surgery, Nishinomiya, Hyogo (Japan); Hirota, Seiichi [Hyogo College of Medicine, Department of Surgical Pathology, Nishinomiya, Hyogo (Japan); Hirota, Shozo [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan)

    2015-08-15

    To determine whether {sup 18}F-FDG uptake in breast cancer correlates with immunohistochemically defined subtype and is able to predict molecular subtypes. This retrospective study involved 306 patients with 308 mass-type invasive breast cancers (mean size 2.65 cm, range 1.0-15.0 cm) who underwent {sup 18}F-FDG PET/CT before therapy. The correlations between primary tumour {sup 18}F-FDG uptake on PET/CT, expressed as SUVmax, and clinicopathological findings and molecular subtype, i.e. luminal A, luminal B (HER2-negative), luminal B (HER2-positive), HER2-positive and triple-negative, were analysed. The predictors of these subtypes were investigated. The mean SUVmax of the 308 tumours was 5.33 ± 3.63 (range 1.15-19.01). Among the subtypes of the 308 tumours, 87 (28.2 %) were luminal A, 111 (36.0 %) were luminal B (HER2-negative), 31 (10.1 %) were luminal B (HER2-positive), 26 (8.4 %) were HER2-positive and 53 (17.2 %) were triple-negative, and the corresponding mean SUVmax were 3.41 ± 2.07 (range 1.18-14.30), 5.17 ± 3.52 (range 1.35-19.01), 6.57 ± 3.84 (range 1.42-15.58), 7.55 ± 3.63 (range 2.30-13.60) and 6.97 ± 4.17 (range 1.15-16.06), respectively. A cut-off value of 3.60 yielded 70.1 % sensitivity and 66.1 % specificity with an area under the receiver operating characteristics curve (AUC) of 0.734 for predicting that a tumour was of the luminal A subtype. A cut-off value of 6.75 yielded 65.4 % sensitivity and 75.2 % specificity with an AUC of 0.704 for predicting a HER2-positive subtype. SUVmax, a metabolic semiquantitative parameter, shows a significant correlation with the molecular subtype of breast cancer, and is useful for predicting the luminal A or HER2-positive subtype. (orig.)

  14. Screening breast magnetic resonance imaging in women with atypia or lobular carcinoma in situ.

    Science.gov (United States)

    Schwartz, Theresa; Cyr, Amy; Margenthaler, Julie

    2015-02-01

    Atypical lesions and lobular carcinoma in situ (LCIS) are associated with an increased risk of breast malignancy. The utility of breast magnetic resonance imaging (MRI) screening in this cohort of women after excision of a high-risk lesion has not been previously established. The objective of this study was to investigate outcomes of breast MRI surveillance in this subgroup of high-risk patients. We performed a retrospective review of women who required excision of an atypical lesion or LCIS who underwent at least one screening breast MRI from April 2005-December 2011. We collected information on demographics, number of second-look imaging studies recommended, number of biopsies performed and pathologic outcomes. A total of 179 patients met the inclusion criteria, including 131 (73%) with atypical lesions and 48 (27%) with LCIS. Second-look imaging was recommended for 31 of 131 (23.7%) patients with atypical lesions and 8 of 48 (16.7%) with LCIS. Ten biopsies were performed in the atypical cohort (7.6%) with two revealing a malignancy (Positive Predictive Value [PPV] of 20%). In the LCIS cohort, five biopsies were performed (10.4%) with one revealing a malignancy (PPV of 20%). The benefit of breast MRI surveillance in patients after excision of atypical lesions or LCIS has not been clearly delineated previously. Our data demonstrate that the use of screening breast MRI in this cohort results in additional work-up in one-fifth of patients, but a PPV of only 20%. Large, prospective studies would be needed to determine whether breast cancer outcomes differ between patients undergoing conventional breast screening and those undergoing conventional breast screening plus breast MRI surveillance. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    DEFF Research Database (Denmark)

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

    2003-01-01

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

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

    Science.gov (United States)

    Parker, Lisa; Rychetnik, Lucie; Carter, Stacy

    2015-01-01

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

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

    Science.gov (United States)

    Parker, Lisa; Rychetnik, Lucie; Carter, Stacy

    2015-05-20

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

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

    Science.gov (United States)

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

    2008-05-01

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

  20. Comparison of direct digital mammography, computed radiography, and film-screen in the French national breast cancer screening program.

    Science.gov (United States)

    Séradour, Brigitte; Heid, Patrice; Estève, Jacques

    2014-01-01

    The purpose of this article was to compare the performance of digital mammography using hardcopy image reading against film-screen mammography in a French national routine population-based screening program with a decentralized organization. The French context offered the opportunity to examine separately computed radiography and direct digital mammography performances in a large cohort. The study includes 23,423 direct digital mammography, 73,320 computed radiography, and 65,514 film-screen mammography examinations performed by 123 facilities in Bouches du Rhône, France, for women 50-74 years old between 2008 and 2010. We compared abnormal mammography findings rate, cancer detection rate, and tumor characteristics among the technologies. Abnormal finding rates were higher for direct digital mammography (7.78% vs 6.11% for film-screen mammography and 5.34% for computed radiography), particularly in younger women and in denser breasts. Cancer detection rates were also higher for direct digital mammography (0.71% vs 0.66% for film-screen mammography and 0.55% for computed radiography). The contrast between detection rates was stronger for ductal carcinoma in situ. Breast density was the main factor explaining the differences in detection rates. For direct digital mammography only, the detection rate was clearly higher in dense breasts whatever the age (odds ratio, 2.20). Except for grade, no differences were recorded concerning tumor characteristics in which the proportion of high-grade tumors was larger for direct digital mammography for invasive and in situ tumors. Direct digital mammography has a higher detection rate than film-screen mammography in dense breasts and for tumors of high grade. This latter association warrants further study to measure the impact of technology on efficacy of screening. The data indicate that computed radiography detects fewer tumors than film-screen mammography in most instances.

  1. Screen-detected breast carcinoma with macroscopic dystrophic calcification: A pictorial essay with radiolological pathological correlation.

    Science.gov (United States)

    Ebrahim, Lamya; Dissanayake, Deepthi; Metcalf, Cecily; Wylie, Elizabeth

    2016-04-01

    Breast calcifications are among the most common abnormal radiographic findings detected at screening mammography. This essay illustrates the clinico-pathological features of nine screen-detected breast carcinomas, which had benign-appearing macrocalcifications, as a radiographically dominant presenting feature. We aimed to demonstrate that benign-appearing calcifications within a breast lesion are not diagnostic of a benign process if the other imaging characteristics of the lesion are suspicious of malignancy. © 2016 The Royal Australian and New Zealand College of Radiologists.

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

    Science.gov (United States)

    Mounga, Va; Maughan, Erin

    2012-01-01

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

  3. Evaluation of the introduction of the national Down syndrome screening program in the Netherlands: age-related uptake of prenatal screening and invasive diagnostic testing

    NARCIS (Netherlands)

    Engels, M.A.M.J.; Bhola, S.L.; Twisk, J.W.R.; Blankenstein, M.A.; van Vugt, J.M.G.

    2014-01-01

    Objective To study the effect of different government prenatal screening (PNS) policies on the uptake of PNS and prenatal diagnostic testing (PND) over the periods 2001-2003 (PNS on request), 2004-2006 (permission to offer the first-trimester combined test (FCT) to women of advanced maternal age

  4. Evaluation of the introduction of the national Down syndrome screening program in the Netherlands: age-related uptake of prenatal screening and invasive diagnostic testing

    NARCIS (Netherlands)

    Engels, M.A.J.; Bhola, S.L.; Twisk, J.W.R.; Blankenstein, M.A.; Vugt, J.M.G. van

    2014-01-01

    OBJECTIVE: To study the effect of different government prenatal screening (PNS) policies on the uptake of PNS and prenatal diagnostic testing (PND) over the periods 2001-2003 (PNS on request), 2004-2006 (permission to offer the first-trimester combined test (FCT) to women of advanced maternal age

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

    Science.gov (United States)

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

    2017-01-17

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

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

    Science.gov (United States)

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

    2015-11-01

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

  7. Cost-effectiveness of annual versus biennial screening mammography for women with high mammographic breast density.

    Science.gov (United States)

    Pataky, Reka; Ismail, Zahra; Coldman, Andrew J; Elwood, Mark; Gelmon, Karen; Hedden, Lindsay; Hislop, Greg; Kan, Lisa; McCoy, Bonnie; Olivotto, Ivo A; Peacock, Stuart

    2014-12-01

    The sensitivity of screening mammography is much lower among women who have dense breast tissue, compared with women who have largely fatty breasts, and they are also at much higher risk of developing the disease. Increasing mammography screening frequency from biennially to annually has been suggested as a policy option to address the elevated risk in this population. The purpose of this study was to assess the cost-effectiveness of annual versus biennial screening mammography among women aged 50-79 with dense breast tissue. A Markov model was constructed based on screening, diagnostic, and treatment pathways for the population-based screening and cancer care programme in British Columbia, Canada. Model probabilities and screening costs were calculated from screening programme data. Costs for breast cancer treatment were calculated from treatment data, and utility values were obtained from the literature. Incremental cost-effectiveness was expressed as cost per quality adjusted life year (QALY), and probabilistic sensitivity analysis was conducted. Compared with biennial screening, annual screening generated an additional 0.0014 QALYs (95% CI: -0.0480-0.0359) at a cost of $819 ($ = Canadian dollars) per patient (95% CI: 506-1185), resulting in an incremental cost effectiveness ratio of $565,912/QALY. Annual screening had a 37.5% probability of being cost-effective at a willingness-to-pay threshold of $100,000/QALY. There is considerable uncertainty about the incremental cost-effectiveness of annual mammography. Further research on the comparative effectiveness of screening strategies for women with high mammographic breast density is warranted, particularly as digital mammography and density measurement become more widespread, before cost-effectiveness can be reevaluated. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. The Role of Learning Disability Nurses in Promoting Cervical Screening Uptake in Women with Intellectual Disabilities: A Qualitative Study

    Science.gov (United States)

    Lloyd, Jennifer L.; Coulson, Neil S.

    2014-01-01

    Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women…

  9. 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:…

  10. Mammographic positioning quality of newly trained versus experienced radiographers in the Dutch breast cancer screening programme

    NARCIS (Netherlands)

    van Landsveld-Verhoeven, Cary; den Heeten, Gerard J.; Timmers, Janine; Broeders, Mireille J. M.

    2015-01-01

    Our purpose was to compare mammographic positioning quality of new (NR) versus experienced screening radiographers (ER) in the Netherlands. Before starting to work in breast screening, NR must complete an education programme including a theoretical course (four days), practical training (six weeks),

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2005-10-27

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

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

    Science.gov (United States)

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

    2015-12-01

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

  15. 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.

  16. Mean glandular dose in a breast screening programme

    Science.gov (United States)

    Galván, H. A.; Pérez-Badillo, M. P.; Villaseñor, Y.

    2012-10-01

    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 "Quality assurance programme for digital mammography", 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.

  17. Correlation between {sup 99m}Tc-MIBI uptake and angiogenesis in MIBI-positive breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Bekis, Recep [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey)]. E-mail: recep.bekis@deu.edu.tr; Degirmenci, Berna [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Aydin, Aysel [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Ozdogan, Ozhan [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Canda, Tulay [Department of Pathology, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Durak, Hatice [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey)

    2005-07-01

    This study was undertaken to assess the correlation between the degree of accumulation and the washout of 99m technetium methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) and angiogenesis in MIBI-positive breast lesions. Twenty-eight patients (mean age, 51{+-}11 years) with 31 breast lesions who underwent scintimammography were studied. Anterior, left and right prone lateral images were obtained 20 min and 3 h after the injection of 740 MBq {sup 99m}Tc-MIBI. All breast lesions showed increased {sup 99m}Tc-MIBI uptake. Early and delayed tumor to background activity ratios (T/BG) and washout index (early tumor uptake-delayed tumor uptake divided by early tumor uptake) were calculated. Vascular endothelium was immunohistochemically labeled using a biotinylated monoclonal antibody directed against the factor-VIII-associated antigen using standard biotin-avidin technique. Angiogenesis was evaluated by assessing the vascular surface density (VSD) and the microvessel number (NVES) within 10 randomly chosen areas. All pathological data were compared with early and delayed T/BG activity ratios and washout index of {sup 99m}Tc-MIBI. Statistical analysis was performed using Spearman correlation test. There was no statistically significant correlation between the degree of angiogenesis and early T/BG (r=.287, P>.05 with VSD, r=.351, P>.05 with NVES), delayed T/BG (r=.277, P>.05 with VSD, r=.315, P>.05 with NVES) and the washout index (r=.268, P>.05 with VSD, r=.285, P>.05 with NVES) of {sup 99m}Tc-MIBI in all breast lesions. There was no statistically significant correlation between the degree of angiogenesis and early T/BG (r=.235, P>.05 with VSD, r=.356, P>.05 with NVES), delayed T/BG (r=.181, P>.05 with VSD, r=.285, P>.05 with NVES) and the washout index (r=.158, P>.05 with VSD, r=.187, P>.05 with NVES) of {sup 99m}Tc-MIBI in 24 invasive breast lesions. No statistically significant correlation was found between the degree of angiogenesis and early T/BG (r=-.036, P>.05 with VSD

  18. 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

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

    Science.gov (United States)

    Peltzer, Karl; Phaswana-Mafuya, Nancy

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-11-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Lee, Fang-Hsin

    2017-08-10

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

  5. Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates.

    Science.gov (United States)

    Kaczorowski, Janusz; Hearps, Stephen J C; Lohfeld, Lynne; Goeree, Ron; Donald, Faith; Burgess, Ken; Sebaldt, Rolf J

    2013-06-01

    To evaluate the effect of the Provider and Patient Reminders in Ontario: Multi-Strategy Prevention Tools (P-PROMPT) reminder and recall system and pay-for-performance incentives on the delivery rates of cervical and breast cancer screening in primary care practices in Ontario, with or without deployment of nurse practitioners (NPs). Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system. Southwestern Ontario. A total of 232 physicians from 24 primary care network or family health network groups across 110 different sites eligible for pay-for-performance incentives. The P-PROMPT project combined pay-for-performance incentives with provider and patient reminders and deployment of NPs to enhance the delivery of preventive care services. The mean delivery rates at the practice level of time-appropriate mammograms and Papanicolaou tests completed within the previous 30 months. Before-and-after comparisons of time-appropriate delivery rates (performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.

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

    DEFF Research Database (Denmark)

    Roman, Marta; Castells, Xavier; Hofvind, Solveig

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  9. Background Intestinal 18F-FDG Uptake Is Related to Serum Lipid Profile and Obesity in Breast Cancer Patients.

    Directory of Open Access Journals (Sweden)

    Hai-Jeon Yoon

    Full Text Available This study investigated the relationships between background intestinal uptake on 18F-FDG PET and cardio-metabolic risk (CMR factors.A total of 326 female patients that underwent 18F-FDG PET to determine the initial stage of breast cancer were enrolled. None of the patients had history of diabetes or hypertension. The background intestinal uptake on PET was visually graded (low vs. high uptake group and quantitatively measured using the maximal standardized uptake value (SUVmax. SUVmax of 7 bowel segments (duodenum, jejunum, ileum, cecum, hepatic flexure, splenic flexure, and descending colon-sigmoid junction were averaged for the total bowel (TB SUVmax. Age, body mass index (BMI, fasting blood glucose level (BST, triglyceride (TG, cholesterol, high density lipoprotein (HDL, and low density lipoprotein (LDL were the considered CMR factors. The relationships between background intestinal 18F-FDG uptake on PET and diverse CMR factors were analyzed.The visual grades based on background intestinal 18F-FDG uptake classified 100 (30.7% patients into the low uptake group, while 226 (69.3% were classified into the high uptake group. Among CMR factors, age (p = 0.004, BMI (p<0.001, and TG (p<0.001 were significantly different according to visual grade of background intestinal 18F-FDG uptake. Quantitative TB SUVmax showed significant positive correlation with age (r = 0.203, p<0.001, BMI (r = 0.373, p<0.001, TG (r = 0.338, p<0.001, cholesterol (r = 0.148, p = 0.008, and LDL (r = 0.143, p = 0.024 and significant negative correlation with HDL (r = -0.147, p = 0.022. Multivariate analysis indicated that BMI and TG were independent factors in both visually graded background intestinal 18F-FDG uptake (p = 0.027 and p = 0.023, respectively and quantitatively measured TB SUVmax (p = 0.006 and p = 0.004, respectively.Increased background intestinal 18F-FDG uptake on PET may suggest alteration of lipid metabolism and risk of cardio-metabolic disease in non

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

    Science.gov (United States)

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

    2016-05-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    Directory of Open Access Journals (Sweden)

    Frede Thomas

    2010-02-01

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

  14. Comparing Visually Assessed BI-RADS Breast Density and Automated Volumetric Breast Density Software: A Cross-Sectional Study in a Breast Cancer Screening Setting.

    Directory of Open Access Journals (Sweden)

    Daniëlle van der Waal

    Full Text Available The objective of this study is to compare different methods for measuring breast density, both visual assessments and automated volumetric density, in a breast cancer screening setting. These measures could potentially be implemented in future screening programmes, in the context of personalised screening or screening evaluation.Digital mammographic exams (N = 992 of women participating in the Dutch breast cancer screening programme (age 50-75y in 2013 were included. Breast density was measured in three different ways: BI-RADS density (5th edition and with two commercially available automated software programs (Quantra and Volpara volumetric density. BI-RADS density (ordinal scale was assessed by three radiologists. Quantra (v1.3 and Volpara (v1.5.0 provide continuous estimates. Different comparison methods were used, including Bland-Altman plots and correlation coefficients (e.g., intraclass correlation coefficient [ICC].Based on the BI-RADS classification, 40.8% of the women had 'heterogeneously or extremely dense' breasts. The median volumetric percent density was 12.1% (IQR: 9.6-16.5 for Quantra, which was higher than the Volpara estimate (median 6.6%, IQR: 4.4-10.9. The mean difference between Quantra and Volpara was 5.19% (95% CI: 5.04-5.34 (ICC: 0.64. There was a clear increase in volumetric percent dense volume as BI-RADS density increased. The highest accuracy for predicting the presence of BI-RADS c+d (heterogeneously or extremely dense was observed with a cut-off value of 8.0% for Volpara and 13.8% for Quantra.Although there was no perfect agreement, there appeared to be a strong association between all three measures. Both volumetric density measures seem to be usable in breast cancer screening programmes, provided that the required data flow can be realized.

  15. 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...

  16. 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.

  17. Image quality and breast dose of 24 screen-film combinations for mammography.

    Science.gov (United States)

    Dimakopoulou, A D; Tsalafoutas, I A; Georgiou, E K; Yakoumakis, E N

    2006-02-01

    In this study the effect of different mammographic screen-film combinations on image quality and breast dose, and the correlation between the various image quality parameters, breast dose and the sensitometric parameters of a film were investigated. Three Agfa (MR5-II, HDR, HT), two Kodak (Min-R M, Min-R 2000), one Fuji (AD-M), one Konica (CM-H) and one Ferrania (HM plus) single emulsion mammographic films were combined with three intensifying screens (Agfa HDS, Kodak Min-R 2190 and Fuji AD-MA). The film characteristics were determined by sensitometry, while the image quality and the dose to the breast of the resulting 24 screen-film combinations were assessed using a mammography quality control phantom. For each combination, three images of the phantom were acquired with optical density within three different ranges. Two observers assessed the quality of the 72 phantom images obtained, while the breast dose was calculated from the exposure data required for each image. Large differences among screen-film combinations in terms of image quality and breast dose were identified however, that, could not be correlated with the film's sensitometric characteristics. All films presented the best resolution when combined with the HDS screen at the expense of speed, and the largest speed when combined with the AD-MA screen, without degradation of the overall image quality. However, an ideal screen-film combination presenting the best image quality with the least dose was not identified. It is also worth mentioning that the best performance for a film was not necessarily obtained when this was combined with the screen provided by the same manufacturer. The results of this study clearly demonstrate that comparison of films based on their sensitometric characteristics are of limited value for clinical practice, as their performance is strongly affected by the screens with which they are combined.

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

    Science.gov (United States)

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

    2017-03-07

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

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

    Science.gov (United States)

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

    2017-08-01

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

  20. Framing overdiagnosis in breast screening: a qualitative study with Australian experts.

    Science.gov (United States)

    Parker, Lisa M; Rychetnik, Lucie; Carter, Stacy

    2015-08-28

    The purpose of this study was to identify how the topic of overdiagnosis in breast cancer screening is framed by experts and to clarify differences and similarities within these frames in terms of problems, causes, values and solutions. We used a qualitative methodology using interviews with breast screening experts across Australia and applying framing theory to map and analyse their views about overdiagnosis. We interviewed 33 breast screening experts who influence the public and/or policy makers via one or more of: public or academic commentary; senior service management; government advisory bodies; professional committees; non-government/consumer organisations. Experts were currently or previously working in breast screening in a variety of roles including clinical practice, research, service provision and policy, consumer representation and advocacy. Each expert used one or more of six frames to conceptualise overdiagnosis in breast screening. Frames are described as: Overdiagnosis is harming women; Stop squabbling in public; Don't hide the problem from women; We need to know the overdiagnosis rate; Balancing harms and benefits is a personal matter; and The problem is overtreatment. Each frame contains a different but internally coherent account of what the problem is, the causes and solutions, and a moral evaluation. Some of the frames are at least partly commensurable with each other; others are strongly incommensurable. Experts have very different ways of framing overdiagnosis in breast screening. This variation may contribute to the ongoing controversy in this topic. The concept of experts using different frames when thinking and talking about overdiagnosis might be a useful tool for those who are trying to negotiate the complexity of expert disagreement in order to participate in decisions about screening.

  1. Cancer fatalism and poor self-rated health mediate the association between socioeconomic status and uptake of colorectal cancer screening in England.

    Science.gov (United States)

    Miles, Anne; Rainbow, Sandra; von Wagner, Christian

    2011-10-01

    Little is known about the psychological predictors of colorectal screening uptake in England and mediators of associations between uptake and socioeconomic status (SES). This study tested the hypotheses that although higher threat and efficacy beliefs, lower cancer fatalism, lower depression, and better self-rated health would predict higher screening uptake, only efficacy beliefs, fatalism, depression, and self-rated health would mediate associations between uptake and SES. Data from 529 adults aged 60 to 69 who had completed a postal survey in 2005-2006 were linked with data on fecal occult blood test (FOBt) uptake recorded at the screening "hub" following its introduction in 2007, resulting in a prospective study. Screening uptake was 56% and was higher among people with higher SES, better self-rated health, higher self-efficacy beliefs, and lower cancer fatalism in univariate analyses. Path analysis on participants with complete data (n = 515) showed that both better self-rated health and lower cancer fatalism were directly associated with higher uptake of FOBt screening and significantly mediated pathways from SES to uptake. Lower depression only had an indirect effect on uptake through better self-rated health. Efficacy beliefs did not mediate the relationship between SES and uptake. SES differences in uptake of FOBt in England are partially explained by differences in cancer fatalism, self-rated health, and depression. This is one of only a few studies to examine mediators of the relationship between SES and screening uptake, and future research could test the effectiveness of interventions to reduce fatalistic beliefs to increase equality of uptake. ©2011 AACR

  2. 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.

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

    Tuzcu, Ayla; Bahar, Zuhal

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  6. 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.

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

    Science.gov (United States)

    2015-03-01

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

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

    Science.gov (United States)

    Jansen, Sanaz A; Lin, Vicky C; Giger, Maryellen L; Li, Hui; Karczmar, Gregory S; Newstead, Gillian M

    2011-07-01

    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, E(peak)), the time to peak enhancement (T ( 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 E₁, and E(peak) (p 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.

  9. 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.)

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

    Science.gov (United States)

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

    2016-02-19

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

  11. In vitro study of tumor seeking radiopharmaceutical uptake by human breast cancer cell line MCF-7 after paclitaxel treatment

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Choi, Yong; Choe, Yearn Seong; Lee, Kyung Han; Kim, Byung Tae [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-10-15

    This study was designed to investigate the cellular uptake of various tumor imaging radiopharmaceuticals in human breast cancer cells before and after paclitaxel exposure considering viable cell number. F-18-fluorodeoxyglucose, C-11-methionine. TI-201, Tc-99m-MIBI, and Tc-99m-tetrofosmin were used to evaluate the cellular uptake in MCF-7 cells. MCF-7 cells were cultured in multi-well plates. Wells were divided into DMSO exposure control group, and paclitaxel exposure group. The exposure durations of paclitaxel with 10 nM or 100 nM were 2 h, 6 h, 12 h, 24 h, and 48 h. Viable cell fraction was reduced as the concentration and exposure time of paclitaxel increased. After 10 nM paclitaxel exposure, the cellular uptake of all 5 radiopharmaceuticals was not reduced significantly, irrespective of exposure time and viable cell fraction. After 100 nM paclitaxel exposure, the cellular uptake of all 5 radiopharmaceuticals was enhanced significantly irrespective of viable cell fraction. The peak uptake was observed in experimental groups with paclitaxel exposure for 6 to 48 h according the type of radiopharmaceutical. When the cellular uptake was adjusted for the viable cell fraction and cell count, the peak cellular uptake was observed in experimental groups with paclitaxel exposure for 48 h, irrespective of the type of radiopharmaceutical. The cellular uptake of F-18-fluorodeoxyglucose, C-11-methionine, TI-201, Tc-99m-MIBI, and Tc-99m-tetrofosmin did not reflect viable cell number in MCF-7 cells after paclitaxel exposure for up to 48 h.

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Science.gov (United States)

    VanDyke, Santana D; Shell, Madelynn D

    2017-09-01

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

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

    Directory of Open Access Journals (Sweden)

    James Ted McDonald

    2017-06-01

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

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

    Science.gov (United States)

    Duffy, Stephen W; Parmar, Dharmishta

    2013-05-16

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

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

    Science.gov (United States)

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

    2008-01-01

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

  17. Digital breast tomosynthesis (DBT): a review of the evidence for use as a screening tool.

    Science.gov (United States)

    Gilbert, Fiona J; Tucker, Lorraine; Young, Ken C

    2016-02-01

    Breast screening with full-field digital mammography (FFDM) fails to detect 15-30% of cancers. This figure is higher for women with dense breasts. A new tomographic technique in mammography has been developed--digital breast tomosynthesis (DBT)--which allows images to be viewed in sections through the breast and has the potential to improve cancer detection rates. Results from retrospective reading studies comparing DBT with FFDM have been largely favourable with improvement in sensitivity and specificity. Increases in diagnostic accuracy have been reported as being independent of breast density; however there are mixed reports regarding the detection of microcalcification. Prospective screening studies using DBT with FFDM have demonstrated increased rates in cancer detection compared with FFDM alone. A reduction in false-positive recall rates has also been shown. Screening with the addition of DBT would approximately double radiation dose; however a simulated FFDM image can be generated from a DBT scan. The combination of simulated FFDM images and DBT is being evaluated within several studies and some positive results have been published. Interval cancer rates for the UK National Health Service Breast Screening Programme (NHSBSP) demonstrate the limited sensitivity of FFDM in cancer detection. DBT has the potential to increase sensitivity and decrease false-positive recall rates. It has approval for screening and diagnostics in several countries; however, there are issues with DBT as a screening tool including additional reading time, IT storage and connectivity, over-diagnosis, and cost effectiveness. Feasibility and cost-effectiveness trials are needed before the implementation of DBT in NHSBSP can be considered. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Gibson, Lynette M

    2008-12-01

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

  19. Background {sup 18}F-FDG uptake in positron emission mammography (PEM): Correlation with mammographic density and background parenchymal enhancement in breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Hye Ryoung, E-mail: huilings@hanmail.net [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chun, In Kook, E-mail: inkook.chun@gmail.com [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Eo, Jae Seon, E-mail: jaeseon76@gmail.com [Department of Nuclear Medicine, Korea University Guro Hospital, 148 Gurodongro, Guro-gu, Seoul 152-703 (Korea, Republic of); Jeyanth, Joseph Xavier, E-mail: jeyanth7@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chang, Jung Min, E-mail: imchangjm@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Cho, Nariya, E-mail: river7774@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Keon Wook, E-mail: kangkw@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of)

    2013-10-01

    We aimed to determine whether background {sup 18}F-FDG uptake in positron emission mammography (PEM) was related to mammographic density or background parenchymal enhancement in breast MRI. Methods: We studied a total of 52 patients (mean age, 50.9 years, 26 premenopausal, 26 postmenopausal) with newly diagnosed breast cancer who underwent {sup 18}F-FDG PEM (positron emission mammography), conventional mammography and breast MRI. The background mean {sup 18}F-FDG uptake value on PEM was obtained by drawing a user-defined region of interest (ROI) in a normal area of the contralateral breast. We reviewed the mammography retrospectively for overall breast density of contralateral breast according to the four-point scale (grade 1–4) of the Breast Imaging Reporting and Data System (BI-RADS) classification. The background parenchymal enhancement of breast MRI was classified as minimal, mild, moderate, or marked. All imaging findings were interpreted by two readers in consensus without knowledge of image findings of other modalities. Results: Multiple linear regression analysis revealed a significant correlation between background {sup 18}F-FDG uptake on PEM and mammographic density after adjustment for age and menopausal status (P < 0.01), but not between background {sup 18}F-FDG uptake on PEM and background parenchymal enhancement on MRI. Conclusion: Background {sup 18}F-FDG uptake on PEM significantly increases as mammographic density increases. Background parenchymal enhancement in breast MRI was not an independent predictor of the background {sup 18}F-FDG uptake on PEM unlike mammographic density.

  20. Clinicopathological differences between interval and screen-detected breast cancers diagnosed within a screening programme in Northern Portugal.

    Science.gov (United States)

    José Bento, Maria; Gonçalves, Guilherme; Aguiar, Ana; Antunes, Luis; Veloso, Vitor; Rodrigues, Vítor

    2014-06-01

    To evaluate clinicopathological differences between screen-detected (SD) and interval (IC) breast cancers diagnosed in women enrolled in an organized breast screening programme in 2000--2007. Breast Cancer Screening Programme of the north region of Portugal. Using data from the screening programme and from the population-based North Region Cancer Registry, SD and IC were identified. Information on screening history, age, date of diagnosis, tumour size, histological type and grade, lymph node status, tumour stage, biomarkers, and treatment was obtained from the cancer registry and from clinical and pathological reports. Association between mode of detection and these clinicopathological characteristics was estimated by unconditional logistic regression. A total of 442 SD and 112 IC were identified in women aged 50--69. Compared with SD, IC were diagnosed in younger women (60.0 ± 5.8 years and 58.4 ± 6.0 years, respectively), were larger (tumour size >20 mm: 60.2% versus 25.1%), lobular (6.3% versus 16.1%), with a higher differentiation grade (grade 3: 17.7% versus 38.9%), had more lymph node metastases, more advanced stage, and oestrogen receptor (ER) negative (12.9% versus 29.0%) and progesterone negative, and HER2 positive. After multivariable analysis, compared with SD, IC were more likely to be larger than 20 mm, lobular, of grade 3 and negative for ER. Our results are consistent with other studies. IC's have a more aggressive biology than SDs. Our findings did not show any unexpected pattern requiring changes to our screening procedures, but continuous identification and characterization of IC is advisable. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

    DEFF Research Database (Denmark)

    Törnberg, Sven; Kemetli, Levent; Lynge, Elsebeth

    2006-01-01

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

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

    Science.gov (United States)

    1993-08-01

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

  3. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer

    NARCIS (Netherlands)

    Kriege, Mieke; Brekelmans, Cecile T. M.; Obdeijn, Inge Marie; Boetes, Carla; Zonderland, Harmine M.; Muller, Sara H.; Kok, Theo; Manoliu, Radu A.; Besnard, A. Peter E.; Tilanus-Linthorst, Madeleine M. A.; Seynaeve, Caroline; Bartels, Carina C. M.; Kaas, Reini; Meijer, Siebren; Oosterwijk, Jan C.; Hoogerbrugge, Nicoline; Tollenaar, Rob A. E. M.; Rutgers, Emiel J. T.; de Koning, Harry J.; Klijn, Jan G. M.

    2006-01-01

    Background The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the

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

    NARCIS (Netherlands)

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

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

  7. 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…

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  9. The effect of breast cancer screening messages on knowledge, attitudes, perceived risk, and mammography screening of African American women in the rural South.

    Science.gov (United States)

    Grindel, Cecelia Gatson; Brown, Larry; Caplan, Lee; Blumenthal, Daniel

    2004-07-01

    To determine the effect of three types of breast cancer screening messages (positive/upbeat, neutral/cognitive, and negative/fear) on knowledge, attitudes, perceived risk for breast cancer, and mammography screening of African American women. Repeated measures intervention. Three rural counties in the South. 450 African American women aged 45-65 who had not received a mammogram in the past 12 months. Following completion of pretest knowledge and attitude surveys, the women participated in a 60-minute breast health intervention session that included watching one of three videos with varied affective tones (positive/upbeat, neutral/cognitive, negative/fear). Data on knowledge, attitudes, perceived risk for breast cancer, and mammography screening were collected before, after, and 12 months following the intervention. Knowledge, attitudes, perceived risk for breast cancer, and mammography screening. No significant difference was found among video groups on mammography screening and knowledge of and attitudes about breast cancer over the three measurement periods. The affective tone of the educational videos did not make a difference in mammogram screening, attitudes, and knowledge of breast cancer screening. More women received a mammogram 12 months postintervention than prior to the intervention; however, the influence of the intervention on this outcome is uncertain. Nurses and health communication experts should design interventions that foster positive attitudes, increase knowledge about breast cancer screening, and stimulate women to participate in breast cancer screening as outlined by the American Cancer Society. These interventions need to be done in the context of the cultural norms and the education levels of the target population.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

    2000-05-02

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

  13. Audit of performance of needle core biopsy diagnoses of screen detected breast lesions.

    Science.gov (United States)

    El-Sayed, Maysa E; Rakha, Emad A; Reed, Jacquie; Lee, Andrew Hs; Evans, Andrew J; Ellis, Ian O

    2008-11-01

    Breast needle core biopsy (NCB) is now a standard diagnostic procedure in the triple assessment of screen detected breast lesions. Therefore, it is important to provide robust and up-to-date data on the performance of NCB in the screening setting. However, previous studies of NCB have suffered from either limitation in the number of assessed cases or included a mix of symptomatic and screen detected breast lesions. In this study, we have evaluated the performance of a large series of uniformly assessed NCBs of screen detected lesions (20001 cases) over a period of 10 years (1997-2007). Our results showed a gradual increase in the number of NCBs and an improvement of their performance over the period of the study; absolute sensitivity increased from 84.9% to 96.4% and complete sensitivity increased from 90.9% to 99.7%. There was also a gradual reduction in the number of surgical interventions after benign (B2) and negative (B1) NCB diagnoses. Our study provides data showing variance from the suggested thresholds for the measures of performance of NCB in the United Kingdom which could be used to provide updated evidence-based thresholds for assessment of performance of NCB diagnosis use in the assessment of breast cancer screen detected lesions in the UK and elsewhere.

  14. The Athena Breast Health Network: developing a rapid learning system in breast cancer prevention, screening, treatment, and care.

    Science.gov (United States)

    Elson, Sarah L; Hiatt, Robert A; Anton-Culver, Hoda; Howell, Lydia P; Naeim, Arash; Parker, Barbara A; Van't Veer, Laura J; Hogarth, Michael; Pierce, John P; Duwors, Robert J; Hajopoulos, Kathy; Esserman, Laura J

    2013-07-01

    The term breast cancer covers many different conditions, whose clinical course ranges from indolent to aggressive. However, current practice in breast cancer prevention and care, and in breast cancer epidemiology, does not take into account the heterogeneity of the disease. A comprehensive understanding of the etiology and progression of different breast cancer subtypes would enable a more patient-centered approach to breast health care: assessing an individual's risk of getting specific subtypes of the disease, providing risk-based screening and prevention recommendations, and, for those diagnosed with the disease, tailored treatment options based on risk and timing of progression and mortality. The Athena Breast Health Network is an initiative of the five University of California medical and cancer centers to prototype this approach and to enable the development of a rapid learning system-connecting risk and outcome information from a heterogeneous patient population in real time and using new knowledge from research to continuously improve the quality of care. The Network is based on integrating clinical and research processes to create a comprehensive approach to accelerating patient-centered breast health care. Since its inception in 2009, the Network has developed a multi-site, transdisciplinary collaboration that enables the learning system. The five-campus collaboration has implemented a shared informatics platform, standardized electronic patient intake questionnaires, and common biospecimen protocols, as well as new clinical programs and multi-center research projects. The Athena Breast Health Network can serve as a model of a rapid learning system that integrates epidemiologic, behavioral, and clinical research with clinical care improvements.

  15. Modeling the impact of population screening on breast cancer mortality in the United States‡

    Science.gov (United States)

    Mandelblatt, Jeanne S.; Cronin, Kathleen A.; Berry, Donald A.; Chang, Yaojen; de Koning, Harry J.; Lee, Sandra J.; Plevritis, Sylvia K.; Schechter, Clyde B.; Stout, Natasha K.; van Ravesteyn, Nicolien T.; Zelen, Marvin; Feuer, Eric J.

    2012-01-01

    Summary Objective Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. Methods The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. Results The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50–74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Conclusion Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations. PMID:22015298

  16. Modeling the impact of population screening on breast cancer mortality in the United States.

    Science.gov (United States)

    Mandelblatt, Jeanne S; Cronin, Kathleen A; Berry, Donald A; Chang, Yaojen; de Koning, Harry J; Lee, Sandra J; Plevritis, Sylvia K; Schechter, Clyde B; Stout, Natasha K; van Ravesteyn, Nicolien T; Zelen, Marvin; Feuer, Eric J

    2011-10-01

    Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50-74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. 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

  18. Explaining variation in Down's syndrome screening uptake: comparing the Netherlands with England and Denmark using documentary analysis and expert stakeholder interviews.

    Science.gov (United States)

    Crombag, Neeltje M T H; Vellinga, Ynke E; Kluijfhout, Sandra A; Bryant, Louise D; Ward, Pat A; Iedema-Kuiper, Rita; Schielen, Peter C J I; Bensing, Jozien M; Visser, Gerard H A; Tabor, Ann; Hirst, Janet

    2014-09-25

    The offer of prenatal Down's syndrome screening is part of routine antenatal care in most of Europe; however screening uptake varies significantly across countries. Although a decision to accept or reject screening is a personal choice, it is unlikely that the widely differing uptake rates across countries can be explained by variation in individual values alone.The aim of this study was to compare Down's syndrome screening policies and programmes in the Netherlands, where uptake is relatively low ( 90% respectively), in an attempt to explain the observed variation in national uptake rates. We used a mixed methods approach with an embedded design: a) documentary analysis and b) expert stakeholder analysis. National central statistical offices and legal documents were studied first to gain insight in demographic characteristics, cultural background, organization and structure of healthcare followed by documentary analysis of primary and secondary sources on relevant documents on DSS policies and programme. To enhance interpretation of these findings we performed in-depth interviews with relevant expert stakeholders. There were many similarities in the demographics, healthcare systems, government abortion legislation and Down's syndrome screening policy across the studied countries. However, the additional cost for Down's syndrome screening over and above standard antenatal care in the Netherlands and an emphasis on the 'right not to know' about screening in this country were identified as potential explanations for the 'low' uptake rates of Down's syndrome screening in the Netherlands. The social context and positive framing of the offer at the service delivery level may play a role in the relatively high uptake rates in Denmark. This paper makes an important contribution to understanding how macro-level demographic, social and healthcare delivery factors may have an impact on national uptake rates for Down's syndrome screening. It has suggested a number of policy

  19. HDAC inhibition induces increased choline uptake and elevated phosphocholine levels in MCF7 breast cancer cells.

    Directory of Open Access Journals (Sweden)

    Christopher S Ward

    Full Text Available Histone deacetylase (HDAC inhibitors have emerged as effective antineoplastic agents in the clinic. Studies from our lab and others have reported that magnetic resonance spectroscopy (MRS-detectable phosphocholine (PC is elevated following SAHA treatment, providing a potential noninvasive biomarker of response. Typically, elevated PC is associated with cancer while a decrease in PC accompanies response to antineoplastic treatment. The goal of this study was therefore to elucidate the underlying biochemical mechanism by which HDAC inhibition leads to elevated PC. We investigated the effect of SAHA on MCF-7 breast cancer cells using (13C MRS to monitor [1,2-(13C] choline uptake and phosphorylation to PC. We found that PC synthesis was significantly higher in treated cells, representing 154±19% of control. This was within standard deviation of the increase in total PC levels detected by (31P MRS (129±7% of control. Furthermore, cellular choline kinase activity was elevated (177±31%, while cytidylyltransferase activity was unchanged. Expression of the intermediate-affinity choline transporter SLC44A1 and choline kinase α increased (144% and 161%, respectively relative to control, as determined by mRNA microarray analysis with protein-level confirmation by Western blotting. Taken together, our findings indicate that the increase in PC levels following SAHA treatment results from its elevated synthesis. Additionally, the concentration of glycerophosphocholine (GPC increased significantly with treatment to 210±45%. This is likely due to the upregulated expression of several phospholipase A2 (PLA2 isoforms, resulting in increased PLA2 activity (162±18% in SAHA-treated cells. Importantly, the levels of total choline (tCho-containing metabolites, comprised of choline, PC and GPC, are readily detectable clinically using (1H MRS. Our findings thus provide an important step in validating clinically translatable non-invasive imaging methods for follow

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2013-07-15

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

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

    Science.gov (United States)

    Smith, R A

    2000-01-01

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

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

    Science.gov (United States)

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

    2013-11-01

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

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

    OpenAIRE

    Ka’opua, Lana Sue

    2008-01-01

    This article presents findings from research to develop the promotional component of a breast cancer screening program for Native Hawaiian women associated with historically Hawaiian churches in medically underserved communities. The literature on adherence to health recommendations and health promotions marketing guided inquiry on screening influences. Focus groups and individual interviews patterned on the culturally familiar practice of talk story were conducted with 60 Hawaiian women recr...

  5. Breast cancer screening among women in Namibia: explaining the effect of health insurance coverage and access to information on screening behaviours.

    Science.gov (United States)

    Kangmennaang, Joseph; Mkandawire, Paul; Luginaah, Isaac

    2017-09-01

    Breast cancer contributes substantially to morbidity and mortality in Namibia as is the case in most countries in Sub-Saharan Africa (SSA). However, there is a dearth of nationally representative studies that examine the odds of screening for breast cancer in Namibia and SSA at large. This paper aims to fill this gap by examining the determinants of breast cancer screening guided by the Health Belief Model. We applied hierarchical binary logit regression models to explore the determinants of breast cancer screening using the 2013 Namibia Demography and Health Survey (NDHS). We accounted for the effect of unobserved heterogeneity that may affect breast cancer, testing behaviours among women cluster level. The NDHS is a nationally representative dataset that has recently started to collect information on cancer screening. The results show that women who have health insurance coverage (odds ratio (OR) = 1.62, p ≤ 0.01), maintain contact with health professionals (OR = 1.47, p = 0.01), and who have secondary (OR = 1.38, p = 0.01) and higher (OR = 1.77, p ≤ 0.01) education were more likely to be screened for breast cancer. Factors that influence women's perception of their susceptibility to breast cancer such as birthing experience, age, region and place of residence were associated with screening in this context. Overall, the health belief model predicted women's testing behaviours and also revealed the absence of relevant risk factors in the NDHS data that might influence screening. Overall, our results show that strategies for early diagnosis of breast cancer should be given major priority by cancer control boards as well as ministries of health in SSA. These strategies should centre on early screening and may involve reducing or eliminating barriers to health care, access to relevant health information and encouraging breast self-examination.

  6. Breast Density Awareness and Knowledge, and Intentions for Breast Cancer Screening in a Diverse Sample of Women Age Eligible for Mammography.

    Science.gov (United States)

    Santiago-Rivas, Marimer; Benjamin, Shayna; Andrews, Janna Z; Jandorf, Lina

    2017-08-14

    The objectives of this study were to assess breast density knowledge and breast density awareness, and to identify information associated with intention to complete routine and supplemental screening for breast cancer in a diverse sample of women age eligible for mammography. We quantitatively (self-report) assessed breast density awareness and knowledge (N = 264) in black (47.7%), Latina (35.2%), and white (17%) women recruited online and in the community. Most participants reported having heard about breast density (69.2%); less than one third knew their own breast density status (30.4%). Knowing their own breast density, believing that women should be notified of their breast density in their mammogram report, and feeling informed if being provided this information are associated with likelihood of completing mammogram. Intending mammogram completion and knowledge regarding the impact of breast density on mammogram accuracy are associated with likelihood of completing supplemental ultrasound tests of the breast. These findings help inform practitioners and policy makers about information and communication factors that influence breast cancer screening concerns and decisions. Knowing this information should prepare practitioners to better identify women who may have not been exposed to breast density messages.

  7. Women’s views on overdiagnosis in breast cancer screening: a qualitative study

    Science.gov (United States)

    Hersch, Jolyn; Jansen, Jesse; Barratt, Alexandra; Irwig, Les; Houssami, Nehmat; Howard, Kirsten; Dhillon, Haryana

    2013-01-01

    Objective To elicit women’s responses to information about the nature and extent of overdiagnosis in mammography screening (detecting disease that would not present clinically during the woman’s lifetime) and explore how awareness of overdiagnosis might influence attitudes and intentions about screening. Design Qualitative study using focus groups that included a presentation explaining overdiagnosis, incorporating different published estimates of its rate (1–10%, 30%, 50%) and information on the mortality benefit of screening, with guided group discussions Setting Sydney, Australia Participants Fifty women aged 40–79 years with no personal history of breast cancer and with varying levels of education and participation in screening. Results Prior awareness of breast cancer overdiagnosis was minimal. Women generally reacted with surprise, but most came to understand the issue. Responses to overdiagnosis and the different estimates of its magnitude were diverse. The highest estimate (50%) made some women perceive a need for more careful personal decision making about screening. In contrast, the lower and intermediate estimates (1–10% and 30%) had limited impact on attitudes and intentions, with many women remaining committed to screening. For some women, the information raised concerns, not about whether to screen but whether to treat a screen detected cancer or consider alternative approaches (such as watchful waiting). Information preferences varied: many women considered it important to take overdiagnosis into account and make informed choices about whether to have screening, but many wanted to be encouraged to be screened. Conclusions Women from a range of socioeconomic backgrounds could comprehend the issue of overdiagnosis in mammography screening, and they generally valued information about it. Effects on screening intentions may depend heavily on the rate of overdiagnosis. Overdiagnosis will be new and counterintuitive for many people and may

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

    Science.gov (United States)

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

    2017-04-01

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

  9. [Breast cancer screening: have there been any changes during the last decade? A study in a Spanish unit].

    Science.gov (United States)

    Martínez-Ramos, David; Escrig-Sos, Javier; García-Redón, Teresa; Fortea-Sanchis, Carlos; Alcalde-Sánchez, Miguel; Salvador-Sanchis, José Luis

    2011-01-01

    Breast screening programs in Spain cover almost 100% of population. The objective of the present study was to analyze if there have been any changes during the last decade in our breast screening unit (Unidad de Prevención del Cáncer de Mama de Castellón) that can also be extrapolated to other breast screening units. We conducted a retrospective and descriptive analysis reviewing patients seen in our breast screening unit between January 1, 2000 and December 31, 2009. Patients with a final diagnosis of carcinoma, year of diagnosis, age, histological type, infiltration, surgical procedure and tumor extension were analyzed. A total of 311 breast cancers were diagnosed among 90,010 women who were seen at our breast screening unit. Mean age of the patients was 56 years. A progressive increase of the target population was seen (24,004 persons in 2000 and 31,950 in 2009). Histological type, percentage of infiltrative tumors and lymph node involvement did not show significant differences by year. Differences were observed for tumor size (pT category of TNM classification) and breast conservation surgery. Tumor stage in cancers diagnosed in breast screening units progressively decreased when the program was being implemented. There is a maximum level among which tumor characteristics remain constant. Changes in screening programs can modify these characteristics.

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

    Science.gov (United States)

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

    2012-01-01

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

  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.

    Science.gov (United States)

    Timmermans, Lore; De Hauwere, An; Bacher, Klaus; Bosmans, Hilde; Lemmens, Kim; Bleyen, Luc; Van Limbergen, Erik; Martens, Patrick; Van Steen, Andre; Mortier, Griet; Van Herck, Koen; Thierens, Hubert

    2014-08-01

    To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30% in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. • Performance parameters showed no major differences after digitalisation to CR or DR. • Transition from SFM to CR results in a higher mean glandular dose. • Transition from SFM to DR results in a lower mean glandular dose.

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

    Science.gov (United States)

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

    2011-03-01

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

  14. 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

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

    DEFF Research Database (Denmark)

    Rubæk, Tonny; Zhurbenko, Vitaliy

    2009-01-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

    2006-10-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

    D.A. Berry (Donald); K.A. Cronin (Kathleen); S.K. Plevritis (Sylvia); D.G. Fryback (Dennis); L. Clarke (Lauren); M. Zelen (Marvin); J.S. Mandelblatt (Jeanne); A.Y. Yakovlev (Andrei); J.D.F. Habbema (Dik); E. Feuer (Eric)

    2005-01-01

    textabstractBACKGROUND: We used modeling techniques to assess the relative and absolute contributions of screening mammography and adjuvant treatment to the reduction in breast-cancer mortality in the United States from 1975 to 2000. METHODS: A consortium of investigators developed seven independent

  3. An abnormal screening mammogram causes more anxiety than a palpable lump in benign breast disease

    NARCIS (Netherlands)

    Keyzer-Dekker, C. M. G.; van Esch, L.; de Vries, J.; Ernst, Marloes; Nieuwenhuijzen, G. A. P.; Roukema, J. A.; van der Steeg, A. F. W.

    Being recalled for further diagnostic procedures after an abnormal screening mammogram (ASM) can evoke a high state anxiety with lowered quality of life (QoL). We examined whether these adverse psychological consequences are found in all women with benign breast disease (BBD) or are particular to

  4. An abnormal screening mammogram causes more anxiety than a palpable lump in benign breast disease

    NARCIS (Netherlands)

    Keyzer-Dekker, C. M. G.; van Esch, L.; de Vries, J.; Ernst, M. F.; Nieuwenhuijzen, G. A. P.; Roukema, J. A.; van der Steeg, A. F. W.

    2012-01-01

    Being recalled for further diagnostic procedures after an abnormal screening mammogram (ASM) can evoke a high state anxiety with lowered quality of life (QoL). We examined whether these adverse psychological consequences are found in all women with benign breast disease (BBD) or are particular to

  5. 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…

  6. 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.…

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Li Rita Zhang

    2012-01-01

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

  9. Changes in the magnitude of social inequality in the uptake of cervical cancer screening in Taiwan, a country implementing a population-based organized screening program.

    Science.gov (United States)

    Chiou, Shu-Ti; Wu, Chien-Yuan; Hurng, Baai-Shyun; Lu, Tsung-Hsueh

    2014-01-09

    We sought to examine changes in the magnitude of social inequality in the uptake of cervical cancer screening between 2001 and 2009 in Taiwan. We used data from the 2001 and 2009 Taiwan National Health Interview Surveys to calculate the absolute (slope of index of inequality, SII) and relative (relative index of inequality, RII) summary measures of social inequality in the uptake of Pap smear tests to indicate the magnitude of social inequality. The prevalence of having had a Pap smear during the previous 3 years increased in each age and socioeconomic group from 2001 to 2009. The SII and RII by urbanization and education level decreased significantly, while the SII and RII by income level increased significantly between the two study years. The largest increase in inequality of prevalence from 2001 to 2009 was between women living in suburban and rural areas with highest income level and women live in metropolitan areas with lowest income level. The changes in magnitude of social inequality in the uptake of cervical cancer screening differed by indicators of socioeconomic position. Further studies are needed to explore the mechanisms that result in social inequality by different indicators of socioeconomic position.

  10. Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Mirembe Florence

    2007-06-01

    Full Text Available Abstract Background Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits. Methods We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers. We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake. Results Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context. Conclusion Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (Sengas and involve them in the awareness campaign. Cultural and economic

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-03-31

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

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

    Science.gov (United States)

    Ahmadian, Maryam; Samah, Asnarulkhadi Abu

    2013-01-01

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

  14. Cost-effectiveness of MRI for breast cancer screening in BRCA1/2 mutation carriers.

    Science.gov (United States)

    Pataky, Reka; Armstrong, Linlea; Chia