Should we individualize breast cancer screening?

Desreux, Jean F.; Bleret, Valerie; Lifrange, Eric

doi:10.1016/j.maturitas.2012.08.004

Cited by 17 publications

(15 citation statements)

References 31 publications

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“…In some places, supplemental screening with US and MRI and/or more frequent screening are options for women with dense breasts (4,15,16). In the United States, more than half of the states have enacted breast density legislation (17).…”

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confidence: 99%

Automated Volumetric Analysis of Mammographic Density in a Screening Setting: Worse Outcomes for Women with Dense Breasts

et al. 2018

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Purpose To describe screening outcomes from BreastScreen Norway stratified by volumetric breast density (VBD). Materials and Methods This retrospective study included data from 107 949 women aged 50-69 years (mean age ± standard deviation, 58.7 years ± 5.6) who underwent 307 015 screening examinations from 2007 to 2015. Automated software classified mammographic density as nondense (VBD <7.5%) or dense (VBD ≥7.5%). Rates and distributions of screening outcomes (recall, biopsy, screen-detected and interval breast cancer, positive predictive values of recall and of needle biopsy, sensitivity, specificity, and histopathologic tumor characteristics) were analyzed and stratified by density. Tests of proportions, including propensity score and t tests, were used. Results In 28% (87 021 of 307 015) of the screening examinations, the breasts were classified as dense. Recall rates for women with nondense versus dense breasts were 2.7% (5882 of 219 994) and 3.6% (3101 of 87 021); biopsy rates were 1.1% (2359 of 219 994) and 1.4% (1209 of 87 021); rates of screen-detected cancer were 5.5 (1210 of 219 994) and 6.7 (581 of 87 021) per 1000 examinations; and rates of interval breast cancer were 1.2 (199 of 165 324) and 2.8 (185 of 66 674) per 1000 examinations, respectively (P < .001 for all). Sensitivity was 82% (884 of 1083) for nondense breasts and 71% (449 of 634) for dense breasts, whereas specificity was 98% (160 973 of 164 440) and 97% (64 250 of 66 225), respectively (P < .001 for both). For screen-detected cancers, mean tumor diameter was 15.1 mm and 16.6 mm (P = .01), and lymph node-positive disease was found in 18% (170 of 936) and 24% (98 of 417) (P = .02) of women with nondense and dense breasts, respectively. Conclusion Screening examinations of women with dense breasts classified by using automated software resulted in higher recall rate, lower sensitivity, larger tumor diameter, and more lymph node-positive disease compared with women with nondense breasts.

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confidence: 99%

Automated Volumetric Analysis of Mammographic Density in a Screening Setting: Worse Outcomes for Women with Dense Breasts

et al. 2018

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“…In a country with limited resources like Albania, this fact should be taken into consideration. Therefore, the screening is proposed to be individually tailored in order to contain the costs (17). …”

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confidence: 99%

Breast Cancer Screening in Albania During 2007-2008

et al. 2013

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Aim:Our aim was to assess the prevalence of breast cancer among women who showed up and participated in the breast cancer screening program during October 2007-October 2008 in Tirana, the Albanian capital city.Methods:A breast cancer prevention and treatment campaign was undertaken in Tirana, Albania, in 2007 which included also mammography examination for the early detection of breast cancer. All women residing in Tirana municipality were invited to undergo a mammography examination free of charge.Results:A total number of 5224 women underwent mammography examination during October 2007 – October 2008 time period in Tirana. The highest number of mammography tests were performed in October 2008 (1284 tests), followed by June 2008 with 746 mammography examinations realized. In general, the prevalence of breast cancer positive mammography readings where higher among women older than 60 years, followed by the 51-60 and 41-50 years age-groups.Conclusion:Our findings indicate that, among 5224 examined women during a one-year period, 1.9% had a positive reading in mammography. This is one of the few reports large-scale breast cancer screening in Albania. The increasing of breast cancer rates necessitates implementation of multi-directional programs to prevent, early diagnose and control this condition in Albanian women.

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“…Several studies have provided a rationale for a shift from a 'one-size-fits-all' approach towards individualised breast cancer screening strategy that adapts the screening regimen to a woman's risk [16,17]. A principle of risk-based screening is that screening should begin at an age at which a woman's individual risk is equal to that of an average risk woman at 50 years [13,18]. Apart from the most common starting age of screening for breast cancer at age 50 years, we also provided information for countries and regions with earlier age of initial screening (at age 40 and 45 years).…”

Section: Discussionmentioning

confidence: 99%