Results of intermediate measures of a population-based, randomized trial of mammographic screening prevalence and detection of breast carcinoma among Asian women: the Singapore Breast Screening Project

NG, EDWARD H K; Ng, F.C.; Tan, Puay‐Hoon; Low, Sui Pheng; Chiang, G. S. C.; Tan, Kim‐Ping; Seow, Adeline; Emmanuel, S C; Tan, Chor‐Hiang; Ho, Gay Hui; Ng, Lkl; Wilde, C.

doi:10.1002/(sici)1097-0142(19980701)83:1<191::aid-cncr27>3.0.co;2-r

Cited by 40 publications

(46 citation statements)

References 15 publications

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“…25 In Singapore all citizens and permanent residents are registered in the population registry with a unique registration number. From this comprehensive population registry, 166,600 women aged 50 -64 years were potentially eligible for the study on 1 October 1994.…”

Section: Singapore Breast Cancer Screening Programme (Screen)supporting

confidence: 83%

“…25 No discussion was conducted by the radiologists, but action was taken on the basis of the most adverse of the 2 independent recommendations. For R, new films were taken and reviewed by the attending radiologist.…”

Section: Mammography Review At Screen (Review I)mentioning

confidence: 99%

“…Positive axillary nodal status is similar between Screen and Interval as is the distribution of tumour grade. DISCUSSION Ng et al 25 reported the screening of 28,321 Singaporean women aged 50 -64 years for breast cancer over a 2-year period, but the programme has not been repeated. They detected 132 (35 DCIS) cancers equivalent to a rate of 4.68 per 1,000 women screened, which is comparable to rates observed elsewhere.…”

Section: Tumour Characteristicsmentioning

confidence: 99%

“…24 At 1 October 1994, the Singapore Breast Cancer Screening Programme (Screen) was initiated in which randomly selected female residents aged 50 -64 were offered a free mammography examination. 25 The programme was closed on 28 February 1997 and to date no mass mammography screening programme has replaced it.…”

mentioning

confidence: 99%

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Interval cancers following breast cancer screening in Singaporean women

Gao

et al. 2002

Intl Journal of Cancer

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Our study reports on the interval cancers arising in the subsequent 3 years in women screened as part of the Singapore Breast Cancer Screening Programme that commenced in 1994. Women, the majority of Chinese ethnicity, were either invited or not invited by random allocation to be screened. All women, other than those identified with breast cancer at screening, whether invited or not, were followed for 3 years, and information on all breast cancers arising in this period was obtained through the national registry. In particular, the cancers arising from those women who were deemed free of the disease at screening were noted. The mammographs taken at screening of those women who developed such an interval cancer were rereviewed by 3 radiologists. In the 28,099 women who were screened and deemed free of disease, 59 interval cancers were reported with annual rates of 2.1, 10.6 and 10.8 per 10,000 womenyears in the succeeding 3-year periods. In 39,425 women who were invited but declined screening, the rates were 17.0, 15.5 and 11.7, while the corresponding rates from 97,294 women not invited were 12.8, 13.3 and 13.0. Whereas the annual incidence at 1 year in women who have been screened is much lower than those in the 2 groups who were not screened, it is of a similar magnitude by 2 years. This suggests that locally an optimal screening interval may be close to 1 year. The rereview of the mammograms of those 59 women with interval cancers suggested that the maximum possible number of these that might have been detected at screening was 10 (17%).

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Section: Singapore Breast Cancer Screening Programme (Screen)supporting

confidence: 83%

Section: Mammography Review At Screen (Review I)mentioning

confidence: 99%

Section: Tumour Characteristicsmentioning

confidence: 99%

mentioning

confidence: 99%

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Interval cancers following breast cancer screening in Singaporean women

Gao

et al. 2002

Intl Journal of Cancer

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“…Within the Singapore Breast Screening Project (Ng et al, 1998), we conducted a case -control study, with 174 breast cancer cases and 348 controls, matched for age and screening status (Jakes et al, 2000). For each case and control, we had data on reproductive history, socioeconomic status as represented by education and occupation, and racial group.…”

Section: Methodsmentioning

confidence: 99%

Interaction of dense breast patterns with other breast cancer risk factors in a case–control study

Duffy

Jakes

et al. 2004

Br J Cancer

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The question of interactions between breast density and other breast cancer risk factors is of interest, since it bears upon the use of density as a marker for changes in breast cancer risk. We studied breast parenchymal patterns and 13 other potential risk factors for breast cancer in 172 breast cancer cases and 338 age-matched controls in Singapore. Dense breast patterns were defined as having Tabar parenchymal pattern IV or V. We found significant interactions between dense patterns and ethnic group (P ¼ 0.046), and between dense patterns and number of deliveries (P ¼ 0.04). Among women with nondense breast patterns, the non-Chinese had lower risk than the Chinese with an odds ratio (OR) of 0.47 (95% CI 0.24, 0.88), whereas in those with dense patterns, the nonChinese had considerably higher risks (OR ¼ 5.34, 95% CI 0.54, 52.51). Alternatively expressed, the increased risk with dense patterns was only observed in the non-Chinese (OR ¼ 13.99, 95% CI 1.33, 146.99). Among parous women, the protective effect of three or more deliveries was only observed in those with dense breast patterns (OR ¼ 0.21, 95% CI 0.06, 0.70). Suggestive but nonsignificant interactions with dense patterns were observed for ever having delivered, age at first delivery, breast feeding and body mass index. The results are consistent with dense breast patterns as a marker for hormonal modification of breast cancer risk. In recent years, there has been increasing interest in breast density as a risk factor for breast cancer, as a potential marker for changes in the breast and as a criterion for inclusion in prevention trials (Warner et al, 1992;Sala et al, 1998;Harrison et al, 2002;Warwick et al, 2003). Radiologically dense breasts are known to be associated with increased risk of breast cancer (Warner et al, 1992;Sala et al, 1998), to be associated with other risk factors for breast cancer (Jakes et al, 2000;Warwick et al, 2003) and to be amenable to exogenous hormonal stimuli (Atkinson et al, 1999;Atkinson and Bingham, 2002;Greendale et al, 2003).The last phenomenon is of particular interest. Increased density (i.e. high-risk pattern) is associated with preparations such as hormone replacement therapy, which increases exposure to oestrogens (Greendale et al, 2003) and therefore risk of breast cancer, and decreased density is associated with preparations such as tamoxifen or isoflavones, which reduce oestrogen exposure and breast cancer risk (Atkinson et al, 1999;Greendale et al, 2003). This suggests that breast density may be of use as an interim marker of response to hormonal chemoprevention therapy. The fundamental issue to be resolved is whether an induced change in breast density automatically confers the corresponding change in breast cancer risk. This may be ascertained by substudies within the chemoprevention trials such as IBIS (Cuzick et al, 2002;Warwick et al, 2003). In the meantime, however, some clues can be gained by studying the interrelationships of dense breast patterns, hormonal and other risk factors, and occurrence of br...

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Pathologic-radiologic correlations in screen-detected ductal carcinoma in situ of the breast: Findings of the Singapore breast screening project

Tan

et al. 2000

Int. J. Cancer

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Results of intermediate measures of a population-based, randomized trial of mammographic screening prevalence and detection of breast carcinoma among Asian women: the Singapore Breast Screening Project

Cited by 40 publications

References 15 publications

Interval cancers following breast cancer screening in Singaporean women

Interval cancers following breast cancer screening in Singaporean women

Interaction of dense breast patterns with other breast cancer risk factors in a case–control study

Pathologic-radiologic correlations in screen-detected ductal carcinoma in situ of the breast: Findings of the Singapore breast screening project

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