Design and preliminary results of the Florence Breast Cancer Screening Programme (Progetto Firenze Donna)

Giorgi, Daniela; Ambrogetti, Daniela; Bianchi, Simonetta; Catarzi, S; Ciatto, Stefano; Morrone, D; Paci, Euǵenio; Pacini, P.; Pattarino, E; M, Rosselli Del Turco

doi:10.1097/00008469-199401001-00005

Cited by 18 publications

(6 citation statements)

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“…The Florentine screening program began in 1991, offering high-quality mammography every 2 years to all resident women aged 50 to 69 years [18]. The attendance rate was 56% at the prevalence round and it has increased to about 70% in recent years.…”

Section: Methodsmentioning

confidence: 99%

Balancing harms and benefits of service mammography screening programs: a cohort study

et al. 2012

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IntroductionThe use of screening mammography is still under debate within the medical community. The aim of this study is to define a balance sheet of benefits (breast cancer mortality reduction) and harms (overdiagnosis) for mammography screening programs.MethodsWe compared breast cancer incidence and mortality in two cohorts of women, defined as 'attenders' or 'non-attenders' on the basis of the individual attitudes towards screening, who were invited to the first round of the Florentine screening program. The effects of screening exposure on breast cancer incidence and mortality were evaluated by fitting Poisson regression models adjusted for age at entry, marital status and deprivation index. We performed a sensitivity analysis excluding 34 women not responding to the invitation with a breast cancer diagnosis in the following six months.ResultsIn total, we included 51,096 women aged 50 to 69 years invited at the first screening round (1991 to 1993) and followed-up for breast cancer incidence and mortality until 31 December 2007 and 31 December 2008, respectively The estimate of mortality reduction varies from 45% among 50 to 59 year-old women up to 51% among 60 to 69 year-old women. The estimate of overdiagnosis, according to the cumulative-incidence method, is an additional 10% of all breast cancer cases among 60 to 69 year-old women screened.ConclusionsComparing the breast cancer mortality and breast cancer incidence between attenders and non-attenders, we have determined that the overall cost to save one life corresponds to no more than one over-diagnosed tumor (from 0.6 to 1 depending on the selection criteria of the cohort), even if a residual self-selection bias cannot be excluded.

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Section: Methodsmentioning

confidence: 99%

Balancing harms and benefits of service mammography screening programs: a cohort study

et al. 2012

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“…1 2 Mammographic screening has been carried out in Florence district since 1970 34 and was extended to Florence city in 1990. 5 In this paper we report the results of a prospective study of independent double reading, aimed at assessing the cost effectiveness of such a policy.…”

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confidence: 99%

Independent Double Reading of Screening Mammograms

et al. 1995

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“…We also observed an improvement in patients treated recently compared with patients treated in previous decades. We believe that these results are due to a screening program that started in Florence at the beginning of 1980 (16) and also to a more rational use of adjuvant treatment.…”

Section: Discussionmentioning

confidence: 97%

Breast Cancer in the Elderly: Treatment of 1500 Patients

Livi¹,

Paiar²,

Saieva

et al. 2006

Breast Journal

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There is a significant difference in the extent of treatment offered to the elderly with breast cancer; in the United States, while 98% of patients less than 65 years of age receive standard treatment, 81% of those older than 65 years were treated according to protocol. This study's goal was to evaluate disease-specific survival and local-regional recurrence in breast cancer patients more than 65 years of age at diagnosis. A total of 1500 patients with invasive breast carcinoma were treated consecutively from May 1971 to July 2002 at the University of Florence, Florence, Italy. All patients were more than 65 years of age. The median age was 70.6 years (range 65.1-87.3 years). The median follow-up was 8.7 years (range 1-30 years). The crude probability of survival (or relapse occurrence) was estimated using the Kaplan-Meier method and survival (or relapse occurrence) comparisons were carried out using Cox proportional hazard regression models. The Cox regression model by stepwise selection showed as independent prognostic factors for disease-specific survival (DSS), the occurrence of a local relapse (p < 0.0001), pN status (p < 0.0001), the type of surgery (p < 0.0001), and the use of radiotherapy (p < 0.0006) and chemotherapy (p = 0.01). For local disease-free survival (LDFS), the Cox regression model by stepwise selection showed that mastectomy (p < 0.0001), histotype (p < 0.0001), pN status (p < 0.0001), and pT status (p = 0.001) were the only independent prognostic factors. Age was not a prognostic factor for DSS nor LDFS. We suggest treating patients with appropriate treatment for their prognostic factors.

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Design and preliminary results of the Florence Breast Cancer Screening Programme (Progetto Firenze Donna)

Cited by 18 publications

References 5 publications

Balancing harms and benefits of service mammography screening programs: a cohort study

Balancing harms and benefits of service mammography screening programs: a cohort study

Independent Double Reading of Screening Mammograms

Breast Cancer in the Elderly: Treatment of 1500 Patients

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