Ten years of breast screening in the Screening Mammography Program of British Columbia, 1988–97

Olivotto, Ivo A.; Kan, Lisa; D’yachkova, Yulia; Burhenne, Linda J. Warren; Hayes, Malcolm; Hislop, T. Gregory; Worth, Ann; Basco, V.; King, Sheila

doi:10.1136/jms.7.3.152

Cited by 33 publications

(21 citation statements)

References 26 publications

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“…The incidence of breast cancer in age 35-44, 45-54, 55-64 are 10.5%, 22.6% and 24.1% respectively. The recommendations of (Olivotto, 2000), and the Turkish Ministry of Health has implemented a new recommendation of starting mammographic screening at the age of 40. In the current study, more than half of the cancers (55.6%) were detected between 40-49 years which was a considerable high rate among screening detected cancers.…”

Section: Discussionmentioning

confidence: 99%

Successful First Round Results of a Turkish Breast Cancer Screening Program with Mammography in Bahcesehir, Istanbul

Kayhan¹,

Gürdal²,

Ozaydin³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The Bahcesehir Breast Cancer Screening Project is the first organized population based breast cancer mammographic screening project in Turkey. The objective of this prospective observational study was to demonstrate the feasibility of a screening program in a developing country and to determine the appropriate age (40 or 50 years old) to start with screening in Turkish women. Materials and Methods: Between January 2009 to December 2010, a total of 3,758 women aged 40-69 years were recruited in this prospective study. Screening was conducted biannually, and five rounds were planned. After clinical breast examination (CBE), two-view mammograms were obtained. True positivity, false positivity, positive predictive values (PPV) according to ACR, cancer detection rate, minimal cancer detection rate, axillary node positivity and recall rate were calculated. Breast ultrasound and biopsy were performed in suspicious cases. Results: Breast biopsy was performed in 55 patients, and 18 cancers were detected in the first round. The overall cancer detection rate was 4.8 per 1,000 women. Most of the screened women (54%) and detected cancers (56%) were in women aged 40-49. Ductal carcinoma in situ (DCIS) and stage I cancer and axillary node positivity rates were 22%, 61%, and 16.6%, respectively. The positive predictivity for biopsy was 32.7%, whereas the overall recall rate was 18.4 %. Conclusions: Preliminary results of the study suggest that population based organized screening are feasible and age of onset of mammographic screening should be 40 years in Turkey.

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Section: Discussionmentioning

confidence: 99%

Successful First Round Results of a Turkish Breast Cancer Screening Program with Mammography in Bahcesehir, Istanbul

Kayhan¹,

Gürdal²,

Ozaydin³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…23 Women aged 40-79 were eligible to self-refer and received screening mammograms free of charge through community clinics or mobile vans with interpretation by radiologists affiliated to the programme. 24 From programme inception, women aged 40-49 have been recommended for annual re-screening and have received reminder letters to encourage return.…”

Section: Introductionmentioning

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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“…3 Mammography screening is available to British Columbia (BC) women free of charge through the Screening Mammography Program of British Columbia (SMPBC). 4 Women are recalled for rescreening after 12 months at ages 40-49 and at 24 months for those over 50.By detecting tumors when they are smaller, treatment recommendations and choice are affected. In particular, breast conserving surgery (BCS) is more likely to be a treatment option when the primary tumor is smaller.…”

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confidence: 99%

mentioning

confidence: 99%

A retrospective study of the effect of participation in screening mammography on the use of chemotherapy and breast conserving surgery

Coldman

Phillips

Speers

2007

Intl Journal of Cancer

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A population sample was obtained from the British Columbia (BC) Cancer Registry of all women diagnosed with a first breast cancer in 2002 who were resident in Greater Vancouver or Greater Victoria, BC. Information on treatment and prognostic factors were obtained from source records. The study group was linked to the records of the Screening Mammography Program of BC to identify screening histories on women prior to diagnosis. Logistic regression was used to determine the relationship between screening participation and treatment and to predict treatment use from prognostic factors. Fifteen hundred and eighty-nine women with breast cancer were included in the study and 1,071 (67%) had participated in screening prior to diagnosis: 786 (49%) had been screened within the 30 months prior to their diagnosis (regular participants). Breast conserving surgery (BCS) rates were higher (OR 5 2.3, p < 0.001) and chemotherapy use lower (OR 5 0.53, p < 0.001) among regular participants compared with nonparticipants after adjustment for age. A predictive model based on the distribution of prognostic factors between participants provided estimates of OR 5 1.47 and OR 5 0.54 for BCS and chemotherapy, respectively, and adjustment for self-selection changed the predicted values to OR 5 1.16 and OR 5 0.67, respectively. Participation in screening produced a considerable change in the use of chemotherapy but less on BCS use. ' 2007 Wiley-Liss, Inc.Key words: breast conserving surgery; chemotherapy; breast cancer screening Randomized clinical trials have demonstrated that screening with mammography reduces the mortality from breast cancer. 1 Evidence is less compelling for women aged 40-49 and is sparse for women over age 70. 2 Despite this, mammography screening is common in women over age 40 in North America and is recommended by many authorities. 3 Mammography screening is available to British Columbia (BC) women free of charge through the Screening Mammography Program of British Columbia (SMPBC). 4 Women are recalled for rescreening after 12 months at ages 40-49 and at 24 months for those over 50.By detecting tumors when they are smaller, treatment recommendations and choice are affected. In particular, breast conserving surgery (BCS) is more likely to be a treatment option when the primary tumor is smaller. 5 Similarly, chemotherapy is not recommended when the likelihood of spread from the primary is low. 5 Information on the effect on treatment should be provided to women, along with other information on benefits and risks, when they are considering screening. Previous studies have identified treatment trends and compared cancers detected by screening with those that were not. 6,7 However, these do not provide appropriate information for women considering screening since not all cancers will be screen detected in screened women.To determine the effect of screening on surgical management and antineoplastic chemotherapy we undertook a study of breast cancers diagnosed in BC. Previous research in BC has shown that surgical managem...

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Ten years of breast screening in the Screening Mammography Program of British Columbia, 1988–97

Cited by 33 publications

References 26 publications

Successful First Round Results of a Turkish Breast Cancer Screening Program with Mammography in Bahcesehir, Istanbul

Successful First Round Results of a Turkish Breast Cancer Screening Program with Mammography in Bahcesehir, Istanbul

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

A retrospective study of the effect of participation in screening mammography on the use of chemotherapy and breast conserving surgery

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