Outcome analysis for women undergoing annual versus biennial screening mammography: a review of 24,211 examinations.

Hunt, Karen A.; Rosen, Eric L.; Sickles, E A

doi:10.2214/ajr.173.2.10430120

Cited by 69 publications

(50 citation statements)

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“…16,18 Such studies are subject to the lead-time and selection biases. 30 The largest study utilized a case-control design and included 7840 cancers diagnosed in US Breast Cancer Surveillance Consortium participating centres.…”

Section: Discussionmentioning

confidence: 99%

Impact of changing from annual to biennial mammographic screening on breast cancer outcomes in women aged 50–79 in British Columbia

et al. 2008

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Objectives The objective of this study was to compare breast cancer outcomes among women subject to different policies on mammography screening frequency. Setting Data were obtained for women participating in the Screening Mammography Programme of British Columbia (SMPBC) for 1988 -2005. The SMPBC changed its policy for women aged 50 -79 years from annual to biennial mammography in 1997, but retained an annual recommendation for women aged 40 -49 years. Methods Breast cancer outcomes were compared for women participating in the programme before and after 1997 for two groups: ages 40 -49 and 50-79 years. Results There were data on 658,151 women. Comparing pre-1997 and post-1997, the median interscreen interval increased by 11.1 months in women 50 -79 but by only 0.3 months in women aged 40-49. Excluding those detected at initial screen, 6291 breast cancers were identified. Comparing pre-1997 and post-1997: the relative rates (RR) of screen detected cancer increased in women aged 40 -49 (RR ¼ 1.32) and the rate of invasive cancers !20 mm at diagnosis decreased (RR ¼ 0.83); the rate of cancers with axillary node involvement increased in women aged 50 -79 (RR ¼ 1.23). Cancer survival improved after 1997 for women diagnosed at ages 40 -49 (hazard ratio ¼ 0.62), but was unchanged for women aged 50-79. Breast cancer mortality rates did not change between the periods in either age group. Conclusion The proximal cancer outcomes considered (staging and survival) improved in women aged 40-49 but this was offset in women aged 50-79 associated with the change in screen frequency. These changes did not result in alterations in breast cancer mortality rates in either age group.

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Section: Discussionmentioning

confidence: 99%

Impact of changing from annual to biennial mammographic screening on breast cancer outcomes in women aged 50–79 in British Columbia

et al. 2008

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“…Retrospective cohort studies that examined prognostic differences of tumours detected in women who self-selected different screening frequencies have generally shown that those screened less frequently have tumours with worse prognostic profiles, including larger tumour size, more lymph node metastases, and fewer cases of isolated in-situ disease (Gabriel et al, 1997;Field et al, 1998;Carlson et al, 1999;Hunt et al, 1999). It has been shown that the higher absolute rate of false-positive screens increased with more frequent screening (Elmore et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Comparison of 1- and 2-year screening intervals for women undergoing screening mammography

et al. 2005

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We compared the long-term impact of 1-and 2-year screening mammography intervals using prognostic, screening, and outcome information for women aged 50 -74 years obtained from the Screening Mammography Program of British Columbia in two time periods, prior to 1997 (policy of annual mammography) and after 1997 (biennial mammography). Survival was estimated for both periods using a prognostic model and the expected rate of interval and screen-detected cancers. The likelihood of a screen-detected cancer with annual screening was 2.32 per thousand screens and with biennial screening was 3.32 per thousand screens. The prognostic profile of screen-detected cancers was better than that of interval cancers. Among both screen-detected and interval cancers, the prognostic profiles with annual and biennial screening were similar. The estimated breast cancer-specific survival rates for women undergoing annual and biennial screening mammography were 95.2 and 94.6% at 5 years, and 90.4 and 89.2% at 10 years, respectively. Annual compared to biennial mammography was associated with a 1.2% increase in the estimated 10-year breast cancer-specific survival for women aged 50 -74 years, diagnosed with invasive breast cancer after screening programme attendance.

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“…14 Of great importance, yearly screening reduces the incidence, size, node metastatic rate, and mortality of cancers that appear as palpable masses between regularly screenings (interval cancers) compared to every-otheryear screenings, a factor not acknowledged by the US-PSTF report but well established in actual patient data, statistical modeling, and evaluating deaths from breast cancer. 11,[14][15][16][17] With screening every 2 years, the 25% of cancers that are interval cancers are similar to breast cancers diagnosed before mammography was used. 3,4,11 Just as ''yearly'' schedules actually occur at about 16-month median intervals, ''biennial'' screening will undoubtedly be closer to 30-month intervals as a result of patient forgetfulness, difficulty booking mammograms, and other factors.…”

Section: Yearmentioning

confidence: 99%

“…11,[14][15][16][17] With screening every 2 years, the 25% of cancers that are interval cancers are similar to breast cancers diagnosed before mammography was used. 3,4,11 Just as ''yearly'' schedules actually occur at about 16-month median intervals, ''biennial'' screening will undoubtedly be closer to 30-month intervals as a result of patient forgetfulness, difficulty booking mammograms, and other factors. 16,17 Why did the USPSTF deliberately choose a less effective screening schedule?…”

Section: Yearmentioning

confidence: 99%

The “Tipping Point” for Breast Cancer Mortality Decline Has Resulted from Size Reductions Due to Mammographic Screening

2011

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Outcome analysis for women undergoing annual versus biennial screening mammography: a review of 24,211 examinations.

Cited by 69 publications

References 0 publications

Impact of changing from annual to biennial mammographic screening on breast cancer outcomes in women aged 50–79 in British Columbia

Impact of changing from annual to biennial mammographic screening on breast cancer outcomes in women aged 50–79 in British Columbia

Comparison of 1- and 2-year screening intervals for women undergoing screening mammography

The “Tipping Point” for Breast Cancer Mortality Decline Has Resulted from Size Reductions Due to Mammographic Screening

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