Trends in delayed breast cancer diagnosis after recall at screening mammography

Lameijer, Joost R. C.; Voogd, Adri C.; Broeders, Mireille J. M.; Pijnappel, Ruud M.; Setz-Pels, Wikke; Strobbe, Luc J. A.; Jansen, Frits H.; Tjan-Heijnen, V.C.; Duijm, Luciën E. M.

doi:10.1016/j.ejrad.2020.109517

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…In our study, the proportion of women with a delay in subsequent confirmation was 7.3%. This value was higher than that of 4.8% from a European study, which decreased gradually from 1997 to 2016 [ 18 , 19 ]. Establishing a well-organized system for the management of recalled women from screening mammography is crucial in improving breast cancer outcomes.…”

Section: Discussionmentioning

confidence: 55%

Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience

et al. 2023

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Background/aim Breast cancer is the most common female malignancy in the world. Nearly ninety percent of screening-detected breast cancers were diagnosed with earlier stages of 0 to II in Taiwan. It’s widely acknowledged that mammography screening of breast cancer can achieve the goal of early diagnosis and treatment in terms of preventive task while neglected interval cancers are associated with unfavorable tumor characteristics and worse outcomes. The purpose of this study was to explore the characteristics of screening-detected breast cancers in Taiwan. Materials and methods Both screening and diagnostic mammography examinations with accompanied BI-RADS (breast imaging-reporting and data system) classification were extracted from the health information system and linked to cancer registry in Taiwan. Enrolled population included those attending their first mammography between 2012 and 2016, excluding subjects with previous breast cancer, or with missing or incomplete data. We compared treatment outcomes between breast cancers with either initial screening or diagnostic mammography (control group), and investigated the compositions of breast cancers detected by screening mammography through direct chart reviews. Results A total of 84,246 screening and 61,230 diagnostic mammography sessions were performed from 2010 to 2020. More positive results (BI-RADS 0, 3, 4 and 5) were observed for those attending the first diagnostic than the first screening mammography (43.58% versus 16.12%, p < 0.001). Earlier stages (0 and I) distribution (92% versus 81%, p < 0.0001), better survivorship (overall survival: 96.91% versus 92.17%, p = 0.007) and a lower HER2 (human epidermal growth factor receptor II) positive status and lower tumor grade were noted in breast cancers with initial screening rather than diagnostic mammography. Among 26,103 mammography screening invitees between 2012 and 2016, 325 breast cancers were ascertained from cancer registry. Of these, 234 had one, 72 had two and 19 had three episodes of mammography before cancer diagnosis. Extensive chart reviews revealed that women with and without breast symptoms constituted 29.9 and 70.1% of the 325 screening-detected breast cancers, with the latter further divided into false negative results (interval cancer), diagnosed at the first mammography, diagnostic at the secondary or subsequent mammography and those with a delayed biopsy or confirmatory imaging constituted (5.2, 47, 10.5 and 7.4%). Conclusion Screening-detected breast cancers were a mixture of women with and without symptoms, those with a false negative result, true negative results with cancer detected at subsequent mammography and non-adherers. Despite this, efficacy of mammography screening was ascertained in Taiwan from this study. To further enhance earlier detection and decrease false negativity, the impact of repeated mammography, and additional sonography for symptomatic women, compliance following a positive screening mammography should not be overemphasized.

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Section: Discussionmentioning

confidence: 55%

Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience

et al. 2023

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“…In our paper, the proportion of women with a delay in subsequent con rmation was 7.3%. This value was higher than 4.8% of the European study, which decreased gradually from 1997 to 2016 (19,20). Establishing a well-organized system for management of mammography recalled women is crucial in improving breast cancer outcomes.…”

Section: Discussionmentioning

confidence: 73%

Mammography Screening and the Incidence of Interval Cancer in Taiwan: A Single Institute’s Experience

Han

Lee

Tseng

et al. 2022

Preprint

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Background/aim: Breast cancer is the most common female malignancy in the world. Nearly ninety percent of screen-detected breast cancer were diagnosed with stages 0 to II in Taiwan. Identifying breast cancer through screening can achieve early diagnosis and treatment for preventive medicine while the risk of interval cancer remains, which has unfavorable tumor characteristics and worse outcomes. The purpose of this study was to explore the effectiveness of mammography screening and the incidence of interval cancer using administration data, cancer registry and chart reviews.Materials and methods: Mammography examinations with BI-RADS (breast imaging-reporting and data system) classification were extracted from the health information system and linked to cancer registry. Targeted populations were those attending the first mammography between 2012 and 2016, while subjects with previous breast cancer, missing or incomplete data were excluded. We compared the treatment outcomes of breast cancer patients with and without mammography screening, and the incidence of interval breast cancer was estimated.Results: The total of 84,246 screening mammography and 61,230 diagnostic mammography sessions were performed from 2010 to 2020. More positive results (BIRADS 0, 3, 4 and 5) were observed for those attending the first diagnostic than the first screening mammography (43.58% versus 16.12%, p<0.001). Among 26,103 mammography screening invitees from 2012 to 2016, 325 breast cancers were ascertained from cancer registry. Of these, 234 had one, 72 had two and 19 had three episodes of mammography before cancer diagnosis, with an interval cancer rate of 0.065% estimated. The proportion of contamination from symptomatic cases, screening-detected cancers, interval cancers and cancers with delayed biopsy or confirmatory image examinations in the screening group were 29.9%, 57.5%, 5.2%, and 7.4%, respectively. Earlier stage distribution (tumor less than 2 cm without regional lymph node invasion, stage 0-I) (92% versus 81%, p<0.0001), better survivorship (96.91% versus 92.17%, p=0.007) and favorable tumor characteristics such as a lower HER2 (human epidermal growth factor receptor II) positive status and lower tumor grade (p=0.0006 and 0.012 respectively) were noted in screening-detected breast cancers.Conclusion: The effectiveness of mammography screening was ascertained in Taiwan despite high contamination from symptomatic women from this study. To improve the outcomes further with earlier detection and decrease the risk of interval cancer, the impact of repeated mammography and removal of clinical cases from screening programs should be considered.

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“…This process is not always perfect [34]. The case has to be successfully worked up and biopsied for a cancer to be found and again this is not a perfect process [35,36].…”

Section: Implementation In the Real Worldmentioning

confidence: 99%

Artificial intelligence for the real world of breast screening

Wallis

2021

European Journal of Radiology

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Trends in delayed breast cancer diagnosis after recall at screening mammography

Cited by 5 publications

References 20 publications

Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience

Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience

Mammography Screening and the Incidence of Interval Cancer in Taiwan: A Single Institute’s Experience

Artificial intelligence for the real world of breast screening

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