Screening Mammography: Do Women Prefer a Higher Recall Rate Given the Possibility of Earlier Detection of Cancer?

Ganott, Marie A.; Sumkin, Jules H.; King, John A.; Klym, Amy H.; Catullo, Victor J.; Cohen, Cathy S.; Gur, David

doi:10.1148/radiol.2383050852

Cited by 53 publications

(36 citation statements)

References 21 publications

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“…This finding is at variance with the results of previous surveys, suggesting that a substantial fraction of women actively participating in screening mammography would be willing to be recalled for either a noninvasive or a invasive diagnostic procedure if it resulted in even a small increase in the chance of detecting a cancer [13,14]. Published estimates of the re-attendance rate after receiving false-positive mammograms range between 27 and 52% in Canada [15,16], 63 and 87% in the US [10,17], and 73 and 95% in Europe [6,18].…”

Section: Discussioncontrasting

confidence: 89%

Association of diagnostic work-up with subsequent attendance in a breast cancer screening program for false-positive cases

Seigneurin

Exbrayat

Labarère

et al. 2010

Breast Cancer Res Treat

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The objective of this study is to determine whether the likelihood of returning for routine breast cancer screening differed for false-positive cases depending on the diagnostic work-up. Using the original data from a French population-based breast cancer screening program, we compared the attendance rates at the subsequent round of screening for 16,946 and 1,127 participants who received negative (i.e., American College of Radiology, ACR, categories 1-2) and false-positive mammograms, respectively. False-positive mammograms were categorized ACR 0 (i.e., warranting additional imaging evaluation), 3 (i.e., warranting clinical and imaging follow-up), and 4-5 (i.e., warranting biopsy). We estimated the odds ratios of attendance at subsequent screening round using logistic regression, adjusting for age and history of previous mammography. The attendance rates at the subsequent screening round were 80.6% for women who received negative mammograms versus 69.6, 74.3, and 70.1% for women who received false-positive mammograms warranting additional imaging evaluation, clinical and imaging follow-up, or biopsy, respectively. In comparison to women who received negative mammograms, the corresponding adjusted odds ratios of returning for routine screening were 0.6 [95% confidence interval (CI) 0.4-0.8], 0.8 (95% CI 0.6-0.9), and 0.6 (95% CI 0.4-0.8). No significant differences were found in odds ratios of attendance across ACR categories among women who received false-positive mammograms. Similar figures were observed for attending at least one of the two subsequent screening rounds. In conclusion, in comparison to women with normal or benign findings on index mammograms, false-positive cases warranting additional imaging evaluation, clinical and imaging follow-up, or biopsy had uniformly decreased odds of attending subsequent routine screening rounds.

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Section: Discussioncontrasting

confidence: 89%

Association of diagnostic work-up with subsequent attendance in a breast cancer screening program for false-positive cases

Seigneurin

Exbrayat

Labarère

et al. 2010

Breast Cancer Res Treat

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“…27 Although available data suggest that some women would prefer to undergo screening despite its potential harms, many would not. [28][29][30][31][32][33] These data show that determining the preferences of individual women about the relative importance of potential benefits and harms is critical in determining who should undergo screening. Sources of information for women should accurately portray the value of mammography and the potential for harm rather than simply provide encouragement.…”

Section: Considerations For Implementationmentioning

confidence: 99%

Recommendations on screening for breast cancer in average-risk women aged 40-74 years

2011

Canadian Medical Association Journal

270

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O f the newly diagnosed cases of breast cancer in Canada, 80% were in women over the age of 50 years, and about 28% were in women aged 70 years or older (Figure 1), 1 with little variation by pro vince. Regular screening for breast cancer with mammography, breast self -examinations and clinical breast examinations are widely recommended to reduce mortality due to breast cancer. Although controversy remains over precisely which screening services should be provided and to whom, these methods are frequently used in contemporary practice. 2-4Outcomes of screening for breast cancer such as tumour detection and mortality must be put into context of the harms and costs of falsepositive results, overdiagnosis and overtreatment. Consideration of benefits, harms and costs is complicated by variations in risk factors and in the types and stages of cancer.Any positive result from screening has emotional costs such as anxiety and worry for patients and their families, and financial costs to both the patient and the health care system as a result of additional and potentially unnecessary diagnostic tests. For women with positive results on screening tests, additional diagnostic tests will usually be recommended, such as further mammography, ultrasound and/or tissue sampling with core needle biopsy.This document updates the previous guidelines issued by the Canadian Task Force on Preventive Health Care (2001). 5,6 The absence of current Canadian recommendations, the recent controversy over the best way to screen for breast cancer among women at average risk of the disease, 7,8 the availability of new technologies such as magnetic resonance imaging (MRI) and a recent review of the evidence 9 were the basis for selecting this topic for an update by the revitalized Canadian Task Force on Preventive Health Care.Recommendations are presented for the use of mammography, MRI, breast self-examination and clinical breast examination to screen for breast cancer among women at average risk of disease (defined as those with no previous breast cancer, no history of breast cancer in a firstdegree relative, no known mutations in the BRCA1/BRCA2 genes or no previous exposure of the chest wall to radiation). Re commendations are provided separately for women aged 40-49, 50-69 and 70-74 years and are aimed at clinicians and policy-makers. The recommendations are intended to inform both organized and opportunistic screening. Methods The Canadian Task Force on Preventive HealthCare is an independent panel of clinicians and methodologists with expertise in prevention, primary care, literature synthesis, critical appraisal and the application of evidence to practice and policy. The task force makes recommendations about clinical manoeuvres aimed at primary and secondary prevention. (Please see www .canadiantaskforce .ca /members_eng.html for a list of current members of the task force.)Work on each recommendation is led by a workgroup of two to five members of the task force; a list of members of the workgroup for the current guidelines is availab...

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“…4 Early detection depends on mammography and may be facilitated by a plethora of promising new diagnostic biomarkers. 3,5,6 However, no biomarker has yet proven sufficiently sensitive or specific for routine use in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Quantitative detection of methylated ESR1 and 14-3-3-σ gene promoters in serum as candidate biomarkers for diagnosis of breast cancer and evaluation of treatment efficacy

Martínez-Galán¹,

Torres²,

Moral³

et al. 2008

Cancer Biology & Therapy

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The aim of the present study was to investigate the association between gene hypermethylation and main clinicopathological features of breast cancer, including diagnosis and treatment response. A sensitive SYBR green methylation-specific PCR technique was used to analyze the utility of circulating DNA with CpG island hypermethylation of ESR1, APC, RARB, 14-3-3-sigma and E-cad gene promoter regions as breast cancer biomarkers. Analyses were conducted of preoperative sera from 106 women with breast cancer, 34 with benign breast disease and 74 with no evidence of breast disease and of post-treatment sera from 60 of the breast cancer patients. Mean serum values of methylated ESR1 and 14-3-3-sigma gene promoters significantly differed between breast cancer patients and healthy controls (p = 0.0112 for ESR1 and p = 0.0047 for 14-3-3-sigma). When their results were combined, it was found that hypermethylation of these two genes differentiated between breast cancer patients and healthy controls (p < 0.0001) with a sensitivity of 81% (95% confidence interval: 72-88%) and specificity of 88% (95% CI: 78-94%). Presence of methylated ESR1 in serum of breast cancer patients was associated with the ER negative phenotype (p = 0.0179). Serum hypermethylation at ESR1 and 14-3-3-sigma loci was observed in cancer patients, in situ carcinoma and benign breast disease. No significant differences in methylated ERS1 or 14-3-3-sigma values were observed between pre-surgery and post-treatment measurements. Preliminary clinical applications of this approach have revealed several shortcomings, including a frequent presence of methylated 14-3-3-sigma in sera from women with breast benign disease. These findings cast some doubts on the utility for early cancer diagnosis of highly sensitive techniques to identify hypermethylation of specific gene promoters in DNA extracted from serum. Although numerous issues remain to be resolved, the quantitative measurement of circulating methylated DNA remains a promising tool for cancer risk assessment.

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Screening Mammography: Do Women Prefer a Higher Recall Rate Given the Possibility of Earlier Detection of Cancer?

Abstract: A substantial fraction of women in this study would have preferred the inconvenience of and anxiety associated with a higher recall rate if it resulted in the possibility of detecting breast cancer earlier.

Cited by 53 publications

References 21 publications

Association of diagnostic work-up with subsequent attendance in a breast cancer screening program for false-positive cases

Association of diagnostic work-up with subsequent attendance in a breast cancer screening program for false-positive cases

Recommendations on screening for breast cancer in average-risk women aged 40-74 years

Quantitative detection of methylated ESR1 and 14-3-3-σ gene promoters in serum as candidate biomarkers for diagnosis of breast cancer and evaluation of treatment efficacy

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