The Operative Management of Screen‐detected Breast Cancers

Crawford, Michael; Biankin, Andrew V.; Rickard, Mary; Coleman, Maxwell J.; West, Richard H.; Niesche, F. W.

doi:10.1046/j.1440-1622.2000.01779.x

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…These findings are similar to those of previous studies. 30,31 Unlike Olivotto et al 30 who found screen-detected cases significantly less likely to receive adjuvant hormonal therapy, we observed no significant difference. Currently in WA, hormonal therapy is likely to be given to most postmenopausal women with oestrogen receptor positive lesions, irrespective of the stage of disease at presentation, and according to our results, oestrogen receptor positive lesions were significantly more common among BSWA-detected cases.…”

Section: Discussioncontrasting

confidence: 84%

“…This is encouraging as it seems that Australian women who have lesions suitable for breast-conserving surgery still opt for mastectomy, as their choice of surgical procedure depends on a number of other factors besides the size of the lesion, such as education, culture, and availability of radiotherapy. 31 Some women in WA attend a private mammography service, and we have classified cases identified by such clinics as non-BSWA detected cases because our primary focus was the impact of the population based screening service. Since about 18% of our non-BSWA detected cases were asymptomatic and detected through private radiology practices, our estimates of the benefits associated with mammography are conservative.…”

Section: Discussionmentioning

confidence: 99%

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Assessing the effectiveness of a mammography screening service

Clayforth

Fritschi

McEvoy

et al. 2005

ANZ Journal of Surgery

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Assessing the effectiveness of a mammography screening service

Clayforth

Fritschi

McEvoy

et al. 2005

ANZ Journal of Surgery

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“…This decrease may be attributable to any of several factors, such as the growing number of studies in which age has been shown to be an independent risk factor for local recurrence and the characterization of the BRCA1 and BRCA2 genes, which has made surgeons and patients, and especially younger patients, increasingly aware of familial breast carcinoma. Only a limited number of other studies have described the effects of breast carcinoma screening on breast‐conserving therapy, and those studies have reported conflicting results 30–32…”

Section: Discussionmentioning

confidence: 99%

Breast carcinoma diagnosis, treatment, and prognosis before and after the introduction of mass mammographic screening

Ernst

Voogd

Coebergh

et al. 2004

Cancer

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BACKGROUND The introduction of breast carcinoma screening leads to early detection and is believed to reduce mortality and increase the proportion of patients for whom breast‐conserving surgery is possible. METHODS In 1992, a population‐based mammographic screening program was introduced in the Dutch city of Tilburg and its surroundings; the program achieved total coverage in 1996. The authors examined the effects of this screening program by investigating disease stage, treatment, and survival among women diagnosed with breast carcinoma at a teaching hospital in Tilburg during the periods 1985–1991 and 1992–1999. RESULTS Between January 1, 1985, and December 31, 1999, 1400 patients were diagnosed with breast carcinoma. Among patients ages 50–69 years, the proportion of TNM Stage I breast carcinoma increased from 24% in 1985–1991 to 45% in 1992–1999 (P < 0.001). The proportion of patients age < 50 years with invasive breast carcinoma who underwent breast‐conserving surgery decreased from 45% to 33% (P = 0.011). Among patients ages 50–69 years, the overall survival rate during the period from 1992 to 1999 was significantly greater than the corresponding rate during the period from 1985 to 1991 (P = 0.0009). Even after adjustments were made for tumor stage and patient age, a slight reduction in mortality risk was observed in this age group. No difference in stage distribution or prognosis was found among patients age < 50 years or among patients age ≥ 70 years. Of the 168 invasive malignancies found in patients ages 50–69 years between 1997 and 1999, 68 (40%) were detected by the screening program, 47 (28%) were interval malignancies, and 53 (32%) were detected in nonparticipants or in women who did not participate in 1 or more screening rounds. Patients with screen‐detected tumors had a much more favorable prognosis than did patients with interval malignancies (P = 0.0018) or patients with clinically detected breast carcinoma (P < 0.0001). CONCLUSIONS Between 1992 and 1999, after the introduction of breast carcinoma screening, improved prognosis and more favorable tumor stage were observed among patients ages 50–69 years. Even after the screening program was fully implemented in 1996, the majority of invasive malignancies still were detected between screening rounds or in patients who did not participate in the program. Cancer 2004;100:1337–44. © 2004 American Cancer Society.

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European Code against Cancer, 4th Edition: Cancer screening

Armaroli

Villain

Suonio

et al. 2015

Cancer Epidemiology

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In order to update the previous version of the European Code against Cancer and formulate evidence-based recommendations, a systematic search of the literature was performed according to the methodology agreed by the Code Working Groups. Based on the review, the 4th edition of the European Code against Cancer recommends: "Take part in organized cancer screening programmes for: Bowel cancer (men and women); Breast cancer (women); Cervical cancer (women)." Organized screening programs are preferable because they provide better conditions to ensure that the Guidelines for Quality Assurance in Screening are followed in order to achieve the greatest benefit with the least harm. Screening is recommended only for those cancers where a demonstrated life-saving effect substantially outweighs the potential harm of examining very large numbers of people who may otherwise never have, or suffer from, these cancers, and when an adequate quality of the screening is achieved. EU citizens are recommended to participate in cancer screening each time an invitation from the national or regional screening program is received and after having read the information materials provided and carefully considered the potential benefits and harms of screening. Screening programs in the European Union vary with respect to the age groups invited and to the interval between invitations, depending on each country's cancer burden, local resources, and the type of screening test used For colorectal cancer, most programs in the EU invite men and women starting at the age of 50-60 years, and from then on every 2 years if the screening test is the guaiac-based fecal occult blood test or fecal immunochemical test, or every 10 years or more if the screening test is flexible sigmoidoscopy or total colonoscopy. Most programs continue sending invitations to screening up to the age of 70-75 years. For breast cancer, most programs in the EU invite women starting at the age of 50 years, and not before the age of 40 years, and from then on every 2 years until the age of 70-75 years. For cervical cancer, if cytology (Pap) testing is used for screening, most programs in the EU invite women starting at the age of 25-30 years and from then on every 3 or 5 years. If human papillomavirus testing is used for screening, most women are invited starting at the age of 35 years (usually not before age 30 years) and from then on every 5 years or more. Irrespective of the test used, women continue participating in screening until the age of 60 or 65 years, and continue beyond this age unless the most recent test results are normal.

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The Operative Management of Screen‐detected Breast Cancers

Abstract: The increase in breast conservation is due to other factors such as the surgeons' approach and patient attitude. The use of pre-operative, minimally invasive tissue sampling techniques is increasing.

Cited by 5 publications

References 21 publications

Assessing the effectiveness of a mammography screening service

Assessing the effectiveness of a mammography screening service

Breast carcinoma diagnosis, treatment, and prognosis before and after the introduction of mass mammographic screening

European Code against Cancer, 4th Edition: Cancer screening

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