Breast Cancer Screening: Current Controversies (original) (raw)
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Cancer Epidemiology, 2012
This paper presents the latest international descriptive epidemiological data for invasive breast cancer among women, including incidence, survival and mortality, as well as information on mammographic screening programs. Almost 1.4 million women were diagnosed with breast cancer worldwide in 2008 and approximately 459,000 deaths were recorded. Incidence rates were much higher in more developed countries compared to less developed countries (71.7/100,000 and 29.3/100,000 respectively, adjusted to the World 2000 Standard Population) whereas the corresponding mortality rates were 17.1/100,000 and 11.8/100,000. Five-year relative survival estimates range from 12% in parts of Africa to almost 90% in the United States, Australia and Canada, with the differential linked to a combination of early detection, access to treatment services and cultural barriers. Observed improvements in breast cancer survival in more developed parts of the world over recent decades have been attributed to the introduction of population-based screening using mammography and the systemic use of adjuvant therapies. The future worldwide breast cancer burden will be strongly influenced by large predicted rises in incidence throughout parts of Asia due to an increasingly "westernised" lifestyle. Efforts are underway to reduce the global disparities in survival for women with breast cancer using cost-effective interventions.
Understanding breast cancer screening--past, present, and future
2018
This article provides an up-to-date overview of breast cancer mammography screening and briefly discusses its history, controversies, current guidelines, practices across Asia, and future directions. An emphasis is made on shared decision-making--instead of giving just a 'yes' or 'no' answer to patients, the focus should be on providing sufficient information about the pros and cons of screening to help women make a personal, informed choice. Frontline experts, including breast surgeons, oncologists, breast radiologists, and their representative professional associations should all participate in guideline panels, with the goal of improving cancer detection, reducing mortality, and improving patient outcome.
Breast cancer screening programmes in 22 countries: current policies, administration and guidelines
2000
Background Currently there are at least 22 countries worldwide where national, regional or pilot population-based breast cancer screening programmes have been established. A collaborative effort has been undertaken by the International Breast Cancer Screening Network (IBSN), an international voluntary collaborative effort administered from the National Cancer Institute in the US for the purposes of producing international data on the policies, funding and administration, and results of population-based breast cancer screening.
Increasingly strong reduction in breast cancer mortality due to screening
Breast Diseases: A Year Book Quarterly, 2012
BACKGROUND: Favourable outcomes of breast cancer screening trials in the 1970s and 1980s resulted in the launch of populationbased service screening programmes in many Western countries. We investigated whether improvements in mammography and treatment modalities have had an influence on the effectiveness of breast cancer screening from 1975 to 2008. METHODS: In Nijmegen, the Netherlands, 55 529 women received an invitation for screening between 1975 and 2008. We designed a case -referent study to evaluate the impact of mammographic screening on breast cancer mortality over time from 1975 to 2008. A total number of 282 breast cancer deaths were identified, and 1410 referents aged 50 -69 were sampled from the population invited for screening. We estimated the effectiveness by calculating the odds ratio (OR) indicating the breast cancer death rate for screened vs unscreened women. RESULTS: The breast cancer death rate in the screened group over the complete period was 35% lower than in the unscreened group (OR ¼ 0.65; 95% CI ¼ 0.49 -0.87). Analysis by calendar year showed an increasing effectiveness from a 28% reduction in breast cancer mortality in the period 1975 -1991 (OR ¼ 0.72; 95% CI ¼ 0.47 -1.09) to 65% in the period 1992 -2008 (OR ¼ 0.35; 95% CI ¼ 0.19 -0.64). CONCLUSION: Our results show an increasingly strong reduction in breast cancer mortality over time because of mammographic screening.
Harry J. de Koning1, for the National Evaluation Team for Breast Cancer Screening
2016
raised on the outcome of our case–control study on the impact of mammography screening on the risk of death from breast cancer, but we feel that the metho-dologic limitations inherent to the case–control design are small. Aarts and colleagues (1) indeed showed that the par-ticipation rate among women of high socioeconomic sta-tus (SES) is somewhat higher than those of low SES (87% vs. 79%), in the Netherlands mostly coinciding with women of non-Western ethnic descent. The attendance rate is lower in this group of women (2), in which breast cancer incidence is also considerably lower (3) as well as the risk of death from breast cancer than in the native Dutch population (4). Aarts and colleagues further report that low SES
Breast cancer screening: its impact on clinical medicine
British journal of cancer, 1990
Breast cancer screening is generally accepted as an effective means of reducing breast cancer mortality in post-menopausal women. In this analysis the impact of nationwide screening on clinical medicine and the effects for the women involved are quantified. Effect estimates are based on results from screening trials in Utrecht (DOM-project) and Nijmegen, and on bi-annual screening of women aged 50-70. The consequences for health care are based on generally accepted assessment and treatment policies. The number of assessment procedures for non-palpable lesions will increase by 12% per year in the build-up period, and will remain slightly higher. The total number of biopsies in a real population is expected to decrease. Screening will lead to a shift in primary treatment modalities, as 15% of mastectomies will be replaced by breast conserving therapy. The temporary increase in the demand for primary treatment in the first years will be followed by a decrease in the demand for treating...
Awarness of breast cancer screening
Background: Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in developing countries. Training women how to carry out breast self-examination (BSE) can help them to be alert to any abnormalities in their breasts to speedily seek medical consultation. Health behavior may be influenced by level of awareness about breast cancer. Methods: A cross-sectional community- based study aimed to assess the level of knowledge about breast cancer risk factors, early warning signs, screening approaches and related predictors. Also, to determine the extent of practice of breast self- examination (BSE) among rural women, Minia in the period from February to May 2016. A total of 600 women were randomly included in the study. A questionnaire included socio-demographic characteristics and information related to their knowledge about breast cancer. Data analysis was carried out using SPSS version 19. Results: Moderate and high knowledge scores were presented by 46.9 %. Nearly 40% of participants had the knowledge that smoking increased the likelihood of cancer breast and almost 30% of them affirmed that being obese or having a positive family history of cancer breast made them vulnerable to cancer breast. It was found that 28.7% and 18.2% of them knew that aging and nulliparity increased the likelihood of breast cancer. Participants with better knowledge score were 4.8 times more likely to practice BSE. Conclusion: This study revealed poor knowledge among rural women regarding cancer breast. BSE and clinical breast examination were not well practiced. It is recommended to create awareness programs about breast cancer and regular patterns of BSE. Keywords: Breast cancer- knowledge- screening- rural women- Egypt
Medical Bulletin of Haseki, 2022
Breast cancer is the most prevalent cancer diagnosed in women. Screening programs to diagnose breast anomalies increase the likelihood of early diagnosis and survival. This study describes the most extensive breast cancer screening program in Istanbul/Turkey between 2018 and 2019 and offers recommendations for nationwide programs. Methods: We collected data from the Istanbul Health Directorate's cancer surveillance database from May 2018 to December 2019. We analyzed data on patients referred for further investigation due to suspicion of possible tumors in their screening radiography. The database included socio-demographic information and further examination details (tests, outcomes, and planned treatment). Results: The mean age of the 3,577 women who were invited for further examination was 52.3 [standard deviation (SD): 7.5]. The age group with the highest percentage of further investigation invitations was between 50 and 54. The mean time between the results of screening mammography was 16.2 days (SD: 15.3). 5.1% of the women referred were diagnosed with some sort of cancer. Women who went to the place of scheduled appointments, instead of getting an appointment in another place of their choosing, were diagnosed and treated earlier. Conclusion: For a breast screening program to reach the entirety of the target population, a comprehensive approach to every step of the process (screening, diagnosis, treatment) needs to be considered together.