Mammographic Assessment of a Geographically Defined Population at a Mastology Referral Hospital in São Paulo Brazil

Abstract

ObjectiveTo evaluate the results of screening and diagnostic mammography in a geographically defined population attending a regional mastology referral hospital of the State Public Service of São Paulo.MethodsA total of 7508 women, who received screening or diagnostic mammography examinations from 06/2004 to 06/2005, with follow-up until 06/2006, were included in this study. Data corresponding to age, the Breast Imaging-Reporting and Data System (BI-RADS), biopsy, surgery and the stage of breast cancer were collected. Five-year survival of patients with breast cancer was posteriorly calculated during this period.ResultsThis study included a total of 713 diagnostic and 6795 screening mammograms. The average age of the population was 51.2 years, with a BI-RADS end result of 4 and 5 (abnormal) in 1.9% of the screening and 11.4% of the diagnostic mammograms, respectively. All BI-RADS category zero was complemented. Of the 228 nonsurgical biopsies performed (71 CNB, 94 mammotomy and 63 FNAB), 63 (27.6%) biopsies were malignant findings. Among the 33 surgical biopsies, 10 (30.3%) biopsies were malignant findings, and of the 82 surgeries, 55 (67, 1%) procedures showed malignant findings. Seventy-one (0.9%) breast cancers (25/6795 on screening exams and 46/713 on diagnostics) were diagnosed. A total of 28.6% small cancers (≤10 mm) were observed, with 27% of the cancers in stages zero and I. Approximately 47.6% of the cases showed nodal invasion, and 4.5% of cases were not staged. Overall detection rate of breast cancer was 8.8/1000 (3.2/1000 screening and 61.7/1000 diagnostic). The overall 5-year survival rate of patients with breast cancer in this population was 79.1%.ConclusionSurvival is a key index of the overall effectiveness of health services in the management of patients with cancer. Our results suggest that this approach is feasible and can potentially improve breast cancer outcomes for many women in São Paulo.

Epidemiological profile of the mastology clinic in a university hospital in the northwest of Paraná

“…Although this was not the study's objective, due to unreliable and/or ignored data (such as positive family history for first and/or second degree relatives, age at which the family member was diagnosed with breast CA, verified mutation in the BRCA1 or BRCA2 genes, and diagnosis of ovarian CA), it was not possible to perform an adequate analysis of hereditary risk of breast CA. In any case, it may be stated that, from the groups with negative (77 patients), positive (17) and ignored (9) family history, 18 (23.3%), 3 (17.6%) and 4 patients, respectively, were diagnosed with this disease.…”

“…In 1992, the American College of Radiology developed a system to standardize mammography reports. This system has been used in Brazil since 1998, according to the guidelines from CBR and FEBRASGO 9 . In order to monitor the quality of diagnostic imaging services performed by MMG, Ordinance No.…”

Breast cancer screening in Brazil. Barriers related to the health system

“…16 There are studies that attempt to evaluate the factors related to non-mammography. [17][18][19][20] Considering biannual mammograms, the authors evaluated a population sample of women over the age of 40 (n=290) from the state of São Paulo and found that non-white elderly women (> 70 years) with low income (≤ 5 minimum salaries) were more likely to fail to undergo mammography. However, in this study, the SUS was responsible only for 28.8% of the population undergoing mammography.…”

“…The detection rate was 8.8 cases/1,000 mammograms in asymptomatic patients (screening) and 61.7/1,000 mammograms in symptomatic patients, reflecting a large number of advanced stage at diagnosis in symptomatic women. 20 There is no organized screening in Brazil, but collective mobilization/actions to provide mammography and organized screening models are described. 4,[21][22][23] A collective action to provide mammography performed in the city of Marília (state of São Paulo) yielded 0.84 diagnosed cases/1,000 mammograms.…”

Current Trends and Future Burden of Breast Cancer Mortality in Brazil: A Population-Based Study

“…In a general manner, the highest incidence rates of breast cancer are observed in West and North Europe, in Australia, New Zealand, and North America (6). One of the most important aspects to be evaluated in Brazil is the distribution of health services in the different regions of the country.…”