Population-Based Breast Cancer Screening With Risk-Based and Universal Mammography Screening Compared With Clinical Breast Examination

Yen, Amy Ming Fang; Tsau, Huei Shian; Fann, Jean Ching Yuan; Chen, Sam Li Sheng; Chiu, Sherry Yueh Hsia; Lee, Yi–Chia; Pan, Shin-Liang; Chiu, Han–Mo; Kuo, Wang-Chuang; Chang, Kang‐Tsung; Wu, Yi; Chuang, Shu Lin; Hsu, Chen Yang; Chang, Dun Cheng; Koong, Shing Lang; Wu, Chien Yuan; Chia, Shu Lih; Chen, Mei Ju; Chen, Chien-Jen; Chiou, Shu Ti

doi:10.1001/jamaoncol.2016.0447

Cited by 69 publications

(73 citation statements)

References 27 publications

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“…3,54 Second, a recent 10-year populationbased cohort study of over 1.4 million asymptomatic Taiwanese women undergoing various breastcancer screening regimens showed that universal mammography screening based only on age and sex was more effective than other screening regimens (risk-based biennial mammography screening or annual CBE alone). 49 In that study, universal biennial mammography screening was associated with a 41% reduction in mortality and a rate of overdiagnosis of only 13%. In contrast, risk-based biennial mammography (pre-selecting patients according to risk profile or risk score) did not lead to any statistically significant reduction in mortality.…”

Section: Breast-screening Programmes In Hong Kong: Room For Developmentmentioning

confidence: 89%

“…49 Since 2004, their health service has provided free breast screening to women aged 50 to 69 years, expanded in 2010 to those aged 40 to 49 years. By 2015, about 40% of the target population participated in screening.…”

Section: Breast Screening Programmes In Asiamentioning

confidence: 99%

“…Moreover, among all screening regimens, only universal biennial screening was associated with a clear downstaging shift in tumours (30% reduction of stage 2+ cancers), a crucial factor that can improve patient outcome. 49 Regarding methods of screening, conventional screening uses standard two-view full-field digital (two-dimensional; 2D) mammography. Multiple studies have proven that screening by digital breast tomosynthesis (DBT; also called three-dimensional mammography) can increase cancer detection rates compared with 2D mammography alone, and can reduce the recall rate for benign findings (falsepositives).…”

Section: Breast-screening Programmes In Hong Kong: Room For Developmentmentioning

confidence: 99%

See 2 more Smart Citations

Understanding breast cancer screening—past, present, and future

Sitt¹,

Lui²,

Sinn³

et al. 2018

Hong Kong Med J

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Section: Breast-screening Programmes In Hong Kong: Room For Developmentmentioning

confidence: 89%

Section: Breast Screening Programmes In Asiamentioning

confidence: 99%

Section: Breast-screening Programmes In Hong Kong: Room For Developmentmentioning

confidence: 99%

See 1 more Smart Citation

Understanding breast cancer screening—past, present, and future

Sitt¹,

Lui²,

Sinn³

et al. 2018

Hong Kong Med J

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“…Numerous studies have focused on ways of reducing the morbidity and mortality of breast cancer by improving early cancer detection. Breast cancer screening and early cancer detection programs include breast self-examination [7,8,9], clinical breast examination (CBE) [10,11,12,13,14,15,16,17,18,19], mammography [14,15,16,19,20,21,22,23,24], ultrasonography [14,23,24,25,26], and magnetic resonance imaging [23,27]. Although there has been constant progress in the understanding of risk factors and genetic dispositions for breast cancer [28,29,30,31,32,33,34,35,36], the majority of breast cancer cases still occur without known predictors.…”

Section: Introductionmentioning

confidence: 99%

“…Although it has not been shown that CBE has beneficial effects in reducing breast cancer mortality in a screening setting and this is a matter of debate [19,48,49,50], CBE is an integral part of everyday routine in clinical practice in diagnostic breast units. The aim of this study was therefore to analyze the predictive value of CBEs carried out by physicians, MTEs, and a combination of the two.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Breast Medical Tactile Examiners (MTEs): A Prospective Pilot Study

et al. 2019

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Background: The usefulness of clinical breast examination (CBE) in general and in breast cancer screening programs has been a matter of debate. This study investigated whether adding vision-impaired medical tactile examiners (MTEs) improves the predictiveness of CBE for suspicious lesions and analyzed the feasibility and acceptability of this approach. Methods: The prospective study included 104 patients. Physicians and MTEs performed CBEs, and mammography and ultrasound results were used as the gold standard. Sensitivity and specificity were calculated and logistic regression models were used to compare the predictive value of CBE by physicians alone, MTEs alone, and physicians and MTEs combined. Results: For CBEs by physicians alone, MTEs alone, and both combined, sensitivity was 71, 82, and 89% and specificity was 55, 45, and 35%, respectively. Using adjusted logistic regression models, the validated areas under the curve were 0.685, 0.692, and 0.710 (median bootstrapped p value (DeLong) = 0.381). Conclusion: The predictive value for a suspicious breast lesion in CBEs performed by MTEs in patients without prior surgery was similar to that of physician-conducted CBEs. Including MTEs in the CBE procedure in breast units thus appears feasible and could be a way of utilizing their skills.

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Comparison of annual percentage change in breast cancer incidence rate between Taiwan and the United States—A smoothed Lexis diagram approach

et al. 2017

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Recent studies compared the age effects and birth cohort effects on female invasive breast cancer (FIBC) incidence in Asian populations with those in the US white population. They were based on age–period–cohort model extrapolation and estimated annual percentage change (EAPC) in the age‐standardized incidence rates (ASR). It is of interest to examine these results based on cohort‐specific annual percentage change in rate (APCR) by age and without age–period–cohort model extrapolation. FIBC data (1991–2010) were obtained from the Taiwan Cancer Registry and the U.S. SEER 9 registries. APCR based on smoothed Lexis diagrams were constructed to study the age, period, and cohort effects on FIBC incidence. The patterns of age‐specific rates by birth cohort are similar between Taiwan and the US. Given any age‐at‐diagnosis group, cohort‐specific rates increased overtime in Taiwan but not in the US; cohort‐specific APCR by age decreased with birth year in both Taiwan and the US but was always positive and large in Taiwan. Given a diagnosis year, APCR decreased as birth year increased in Taiwan but not in the US. In Taiwan, the proportion of APCR attributable to cohort effect was substantial and that due to case ascertainment was becoming smaller. Although our study shows that incidence rates of FIBC have increased rapidly in Taiwan, thereby confirming previous results, the rate of increase over time is slowing. Continued monitoring of APCR and further investigation of the cause of the APCR decrease in Taiwan are warranted.

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Population-Based Breast Cancer Screening With Risk-Based and Universal Mammography Screening Compared With Clinical Breast Examination

Cited by 69 publications

References 27 publications

Understanding breast cancer screening—past, present, and future

Understanding breast cancer screening—past, present, and future

Diagnostic Accuracy of Breast Medical Tactile Examiners (MTEs): A Prospective Pilot Study

Comparison of annual percentage change in breast cancer incidence rate between Taiwan and the United States—A smoothed Lexis diagram approach

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