The occurrence of interval cancers in the Nijmegen screening programme

Peeters, Petra H.M.; Verbeek, A.L.M.; Hendriks, Jan H. C. L.; Holland, Roland; Mravunac, M.; Vooijs, G. P.

doi:10.1038/bjc.1989.196

Cited by 94 publications

(45 citation statements)

References 20 publications

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“…We paid special attention to finding all the women who got a breast cancer diagnosis within 2 years after a negative screening examination. The proportion of interval cancers (31% of the cancers in the group that participated screening) in the present work is at the same level as in many previous works (Peeters et al, 1989;Everington et al, 1999;Ernst et al, 2004). This indicates that the quality of the present screening programme is at an acceptable level.…”

Section: Discussionsupporting

confidence: 79%

Role of mammography screening as a predictor of survival in postmenopausal breast cancer patients

2005

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We examined the effect of population-based screening programme on tumour characteristics by comparing carcinomas diagnosed during the prescreening (N ¼ 341) and screening (N ¼ 552) periods. We identified screen detected (N ¼ 224), interval (N ¼ 99) and clinical cancer (N ¼ 229) cases. Median tumour size and proportion of axillary lymph node negative cases were 1.5 cm and 65% in the screen detected group, 2.0 cm and 44% in cases found outside the screening, and 3.2 cm and 41% in the cases from the prescreening period. Survival of the breast cancer patients was 66% (95% CI, 60 -71%) in the prescreening era group and 73% (95% CI, 66 -78%) in the screening era group after 10 years of follow-up. In the screening era group the survival of the screen detected cases was 86% (95% CI, 80 -90%) and that of the clinical cancer cases 73% (95% CI, 66 -78%) after 10 years. In multivariate analysis the risk of breast cancer death was not significantly different between the prescreening and screening periods (HR 0.82; 95% CI 0.59 -1.12, P ¼ 0.21). Detection by screening was not an independent prognostic factor in multivariate analysis (HR 0.75; CI 95% 0.50 -1.12; P ¼ 0.17).

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Section: Discussionsupporting

confidence: 79%

Role of mammography screening as a predictor of survival in postmenopausal breast cancer patients

2005

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“…Specificity of the test approaches 50% for nonprolifera tive benign lesions and is somewhat lower for prolifera tive benign lesions. As in previous studies, cancers in the European multicenter study produced significantly 4 greater electropotential differentials than benign lesions (Fig. 4).…”

Section: Clinical Trials Approachsupporting

confidence: 82%

“…Despite advances made in detecting and diagnosing breast disease, there is still a 10-30% false negative rate resulting in interval cancers [4,5], and an excessive amount of expense, physician concern and patient anx iety over false positives resulting from the screening and diagnostic process, A new approach, termed the Biofield test, may have the potential to augment the process of diagnosing breast cancer. This technique is based on the analysis of skin surface electrical potentials measured by an array of specially designed sensors which are placed on the breasts.…”

Section: Fattpeí Et Ai / European Journal O F Radiology 24 (1997) mentioning

confidence: 99%

Electropotential evaluation as a new technique for diagnosing breast lesions

Faupel¹,

Vanel²,

Barth³

et al. 1997

European Journal of Radiology

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A new approach, termed the Biofield test, may have the potential to augment the process of diagnosing breast cancer. This technique is based on the analysis of skin surface electrical potentials measured by an array of specially designed sensors which are placed on the breasts. Measurements are recorded noninvasively and then analyzed using pattern recognition algorithms to produce an immediate and objective assessment of breast tissue in vivo. Initial clinical trials suggest that the test can achieve a sensitivity of approximately 90% and a specificity of 40-50%, which indicates that the test might be useful for excluding cancer when it is, in fact, absent. Although research to date has focused on the differential diagnosis of suspicious breast lesions, future applications could include breast cancer screening, close surveillance and diagnosis of recurrent cancers in breasts previously treated with conservative therapy, and monitoring the effectiveness of breast cancer therapies, Improvements and new applications are expected to occur as additional research and validation in actual clinical settings is performed.

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“…cases in which mammography fails to detect a proven cancer during the time of the trial. In several screening studies (Frisell et al, 1987;Peeters et al, 1989), 50-60% of the interval cancers are regarded as 'true' interval cancers (an obvious lesion is observed on the diagnostic mammogram while no suspect signs are seen on the previous screening mammogram). Our study does not concern a screening programme and therefore the term 'interval cancer' can not be used.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity, specificity and predictive values of breast imaging in the detection of cancer

Duijm

Guit²,

Zaat³

et al. 1997

Br J Cancer

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Summary In an observational follow-up study we determined whether the combined use of mammography and breast ultrasonography is an appropriate diagnostic tool to select patients with symptomatic breast disease who need additional pathological evaluation. Mammography and ultrasound were used as complementary diagnostic modalities in 3014 consecutively referred and mainly symptomatic patients. Sensitivity, specificity, predictive values and likelihood ratios were calculated according to standard procedures. Virtually complete follow-up was obtained by correlating the radiological diagnosis with clinical records, final pathological findings, records from the Cancer Register and data from questionnaires sent to the general practitioners of all the referred patients. After an average follow-up period of 30 months, the sensitivity for breast cancer detection was 92.0% and the specificity 97.7%. A positive predictive value of 68.0%, a negative predictive value of 99.6%, a positive likelihood ratio of 40 and a negative likelihood ratio of 0.08 were found. The mean diagnostic delay as a result of false negative examinations was 9 months (range 0-20 months). We conclude that breast imaging in routine daily practice, consisting of the integral use of mammography and ultrasonography, is an appropriate tool in the detection of cancer and should be included in the work-up of symptomatic breast disease.Keywords: breast neoplasm; mammography; ultrasonography; sensitivity; specificity In many Western countries breast cancer is the most common cause of death in women aged 35-55. The sensitivity and specificity of mammography in the detection of breast cancer have been reported in several screening studies (Tabar et al, 1984;Baines et al, 1986;Bird, 1989;Sickles et al, 1990;Robertson, 1993) and diagnostic (consultative) studies (Wolfe et al, 1987;Hansell et al, 1988;Reintgen et al, 1993;Robertson, 1993;Sienko et al, 1993). However, in diagnostic studies, these parameters have frequently been determined retrospectively in pathologically proven breast cancers (Hansell et al, 1988;Reintgen et al, 1993). Moreover, the follow-up period has usually been 12 months or less (Wolfe et al, 1987;Robertson, 1993), and the proportion of patients lost to follow-up has not been well defined in many of the studies (Baines et al, 1986;Bird, 1989;Sienko et al, 1993). For these reasons, the actual sensitivity and specificity of breast imaging in the detection of breast cancer will be lower than reported.The value of ultrasound examination of the breast as an adjunct to mammography, in the work-up of symptomatic breast disease is well established (Fleischer et al, 1983;Bassett et al, 1987;Warwick et al, 1988;Jackson, 1995). No prospective series with well-specified follow-up have been published in which both modalities are used as an integrated approach to determine the sensitivity and specificity in symptomatic patients.To overcome the restrictions mentioned, we performed a prospective study with extensive follow-up of over 3000 consecutive

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The occurrence of interval cancers in the Nijmegen screening programme

Cited by 94 publications

References 20 publications

Role of mammography screening as a predictor of survival in postmenopausal breast cancer patients

Role of mammography screening as a predictor of survival in postmenopausal breast cancer patients

Electropotential evaluation as a new technique for diagnosing breast lesions

Sensitivity, specificity and predictive values of breast imaging in the detection of cancer

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