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1.
OBJECTIVE: To investigate the relationship between utilisation of service mammography screening and breast cancer mortality in New South Wales (NSW) women. Setting : Population-based biennial mammography screening was progressively introduced in NSW from 1988, with active recruitment and re-invitation for women aged 50-69 years, and reached full geographic coverage by 1996. Biennial mammography screening participation has varied widely over time and by municipality. METHODS: Breast cancer mortality by age, period and municipality was obtained from the NSW Central Cancer Registry. Biennial mammography screening rates for the same strata were obtained from the BreastScreen NSW database. Temporal changes in breast cancer mortality for NSW were summarised as annual average declines using Poisson regression. Breast cancer mortality for 1997-2001 was examined in relation to lagged biennial screening rates by municipality, adjusted for age, area socio-economic and geographic indicators, and breast cancer incidence, also using Poisson regression. RESULTS: For the 50-69 year age group, the mean annual breast cancer mortality decline was 0.8% (not significant) for 1988-1994, and 4.4% (p < 0.0001) for 1995-2001. Statistically significant negative associations between breast cancer mortality in 1997-2001 and lagged biennial screening rates were found with the highest significance at a four-year lag for women aged 50-69 years ( p = 0.0003) and also for women aged 50-79 years (p c = 0.0002). From the regression coefficient, a 70% biennial screening rate is associated with 32% lower breast cancer mortality (compared to zero screening). CONCLUSIONS: The effect of population-based mammography screening on breast cancer mortality in NSW inferred using this method is consistent with results of trials and other service studies. This suggests that population-based mammography screening programs can achieve significant reductions in breast cancer mortality with adequate participation. 相似文献
2.
Improved Detection Rate of Early Breast Cancer in Mass Screening Combined with Mammography 总被引:1,自引:5,他引:1
Noriaki Ohuchi Koichi Yoshida Michio Kimura Akio Ouchi Shuzo Kamioki Ken-ichi Shiiba Naoya Matoba Seiichi Kojima Kiichi Takahashi Seiki Matsuno Akira Fukao Rikiya Abe Shozo Mori 《Cancer science》1993,84(7):807-812
A cohort study to compare mass screening with and without mammography was conducted in Miyagi Prefecture, Japan in order to establish whether the effectiveness of breast cancer screening would be improved when mammography was combined with physical examination. A trial of mass screening combined with mammography was carried out in 9634 women aged over 50. Lateral imaging of the breast using single-view film mammography was performed at the first stage of mass screening in addition to physical examination of the breast. Results in the trial were compared with those obtained in 35511 age-matched subjects without mammography. Thirty breast cancers were found in the trial with a detection rate of 0.31%, which was much higher than that (0.08%) obtained by physical examination without mammography. In 15 of the 30 patients the breast tumor was not palpated at the first screening, but abnormal findings were detected in the mammography. A higher rate (73%) of early breast cancer was obtained in the screening trial with mammography than that (39%) obtained in the screening with physical examination alone. Mass screening combined with mammography is superior to that without mammography for breast cancer screening, especially for the detection of non-palpable, early breast cancer. 相似文献
3.
Background To examine time trends in cervical cancer incidence and mortality in NSW women aged ¥20 years in relation to important health
service initiatives and programs.
Methods Data on cervical cancer incidence and mortality were obtained from the NSW Central Cancer Registry for 1972–2001, and corresponding
annual populations obtained from the Australian Bureau of Statistics. Direct age-standardised rates in the ¥20 year population
were calculated using the 2001 NSW census population as standard. Proportional reductions in incidence and mortality since
1972–1974 were also calculated and related to key health service factors and to published NSW 5-year cervical cancer relative
survival for similar periods.
Results Declines in cervical cancer incidence (−10%) and mortality (−20%), and increased degree-of-spread specific survival following
the introduction of universal health care in 1975 suggest effects of greater access to Pap screening, earlier access to diagnosis
and treatment services, and improved effectiveness of treatment. Incidence plateaued during the 1980s, but mortality fell
further (−7%) due to an increased proportion of localised cancers (without change to degree-of-spread specific survival).
The 1980s mortality reduction was a consequence of earlier diagnosis and/or secondary prevention, not improved treatment effectiveness
or reduced incidence. A marked and sustained incidence decline to 2001 (−35%) occurred after the introduction of the NSW Cervical
Screening Program in 1992. This was followed 3 years later by a sustained mortality decline (−20%). During the 1990s survival
across all degrees of spread remained unchanged and the mortality reduction was due entirely to reduction in incidence.
Conclusions The substantial reduction of cervical cancer incidence and mortality in NSW over the last 3 decades is associated with important
health service interventions that relate to control of cervical cancer, particularly the implementation of a population-based
organised cervical screening program. 相似文献
4.
Tadaoki Morimoto Mitsunori Sasa Tetsuo Yamaguchi Kunihiko Haráda Yasunobu Sagara 《Cancer science》1994,85(12):1193-1195
A trial of mass screening for breast cancer using both mammography and physical examination (independently) was carried out in women over 50 years of age in Tokushima Prefecture. Breast cancer was detected in eight of a total of 950 examinees by mammography alone, and no cases of breast cancer were detected by physical examination. The detection rate of breast cancer was 0.84%, which is very much higher than that obtained by conventional mass screening using physical examination alone. The detection rate increased especially in the sixth and seventh decades of life. All eight detected breast cancers were in the early stage. Based on these results, it is recommended to employ mammography in breast cancer screening for asymptomatic women aged over 50 years. 相似文献
5.
《Clinical breast cancer》2020,20(4):283-290
Breast density is an independent risk factor for breast cancer and significantly decreases the sensitivity of mammography. Assessing a woman’s risk of developing breast cancer is becoming increasingly important for establishing individual screening recommendations and preventive strategies. This article reviews the factors influencing mammographic density (MD), the available methods of MD assessment, and its effect on breast cancer. Finally, we discuss the supplemental screening methods for women with dense breast tissue. 相似文献
6.
《Asian Pacific journal of cancer prevention》2014,15(7):3105-3112
Purpose: To examine breast cancer (BC) incidence trends in relation to mammographic screening and riskfactor prevalence in South Australia (SA). Materials and Methods:Trends in annual BC incidence rates werecalculated using direct standardisation and compared with projected incidence derived from Poisson regressionanalysis of pre-screening rates. Annual percentage change and change time points were estimated using Joinpointsoftware. Biennial mammography screening participation rates were calculated using data from BreastScreenSA. Trends in overweight/obesity, alcohol use and hormone replacement therapy (HRT) use were examined using1991-2009 Health Omnibus Survey data. Trends in total fertility were examined using data from the AustralianBureau of Statistics. Results: BC incidence increased around the time BreastScreen commenced and thenstabilised in the mid-1990s. However rates have remained higher than projected, even though the proportionand age distribution of first time screening attendees stabilised around 1998. A decrease in BC incidence wasobserved among women aged 50-59yrs from the late-1990’s but not among older women. Obesity and alcoholuse have increased steadily in all age groups, while HRT use declined sharply from the late-1990s. Conclusions:BC incidence has remained higher than projected since mammography screening began. The sustained elevationis likely to be due to lead time effects, though over-diagnosis cannot be excluded. Declining HRT use has alsoimpacted incidence trends. Implications: Studies using individual level data, which can account for changes inrisk factor prevalence and lead time effects, are required to evaluate ‘over-diagnosis’ due to screening. 相似文献
7.
Comparison of False Negative Rates among Breast Cancer Screening Modalities with or without Mammography: Miyagi Trial 总被引:1,自引:2,他引:1
Noriaki Ohuchi Koichi Yoshida Michio Kimura Akio Ouchi Ken-ichi Shiiba Koji Ohnuki Akira Fukao Rikiya Abe Seiki Matsuno Shozo Mori 《Cancer science》1995,86(5):501-506
False negative rates were compared in two screening modalities, physical examination with or without mammography, in an intervention study for women aged over 50 in Miyagi Prefecture. Thirty-five breast cancers were detected in 12,515 subjects who participated in the trial consisting of physical examination and mammography, whereas 44 breast cancers were detected in 50,105 subjects who received physical examination alone, so that the detection rates were 0.28% and 0.09%, respectively. Among 50,061 subjects who received physical examination alone, 8 women were diagnosed as having breast cancer within 12 months after the screening, while only one of 12,480 screenees receiving the combined modality was so diagnosed, implying false negative rates of 15.4% and 2.8%, respectively. When the screening sensitivity in the combined system was analyzed according to each single modality, the false negative rate provided by physical examination with mammography turned out to be 2.8%, significantly lower than that (33.3%) by the physical examination alone. Minimal breast cancers represented 25.7% of all screen-detected cancers in the combined modality, compared with 9.1% in the modality without mammography. The trial thus indicates that physical examination combined with mammography may be an appropriate modality for breast cancer screening in women aged over 50 on the basis of screening sensitivity. 相似文献
8.
Chang Suk Park Na Young Jung Kijun Kim Hyun Seouk Jung Kyung-Myung Sohn Se Jeong Oh 《JOURNAL OF BREAST CANCER》2013,16(3):322-328
Purpose
We aimed to determine the sensitivity of computer-aided detection (CAD) applied to digital mammography in asymptomatic and symptomatic breast cancer patients.Methods
We retrospectively analyzed digital mammography and CAD images from 210 patients diagnosed with breast cancer. The patients were divided into symptomatic and asymptomatic groups. The sensitivity of CAD in both groups was assessed in relation to breast tissue density, histopathological type of breast cancer, and tumor size.Results
The detection rate of the CAD system was 87.8% in the asymptomatic group. The sensitivity in different tissue densities was 100% in fatty breasts (P1), 88.9% with scattered fibroglandular densities (P2), 94.4% in heterogeneously dense breasts (P3), and 66.7% in extremely dense breasts (P4). The detection rate of the CAD system in the symptomatic group was 87.2%, and the sensitivity was 90.5%, 90%, 86.6%, and 75% in P1-P4 breasts, respectively. In the asymptomatic group, the CAD system detected 90.3% of invasive ductal carcinomas, not otherwise specified (IDC-NOS) and 88.9% of ductal carcinomas in situ (DCIS), but did not detect other types of malignancy. In the symptomatic group, the CAD system detected 88.2% of IDC-NOS, 88.9% of DCIS and 75% of other types of malignancy. When analyzed according to tumor size, the sensitivity of CAD in the asymptomatic and symptomatic groups was 82.6% and 83.3% for tumors <1 cm, 76.5% and 82.4% for tumors between 1 and 2 cm, and 91.7% and 89% in tumors >2 cm.Conclusion
The sensitivity of CAD was low in P4 breasts and high for tumors larger than 2 cm, with no statistically significant differences between the asymptomatic and symptomatic groups for IDC-NOS and DCIS. CAD showed greater sensitivity for other neoplasms in symptomatic patients. 相似文献9.
10.
Henglei Dong Yubei Huang Fengju Song Hongji Dai Peifang Liu Ying Zhu Peishan Wang Jiali Han Xishan Hao Kexin Chen 《Clinical breast cancer》2018,18(3):e353-e361
Introduction
Until now, no studies have investigated whether women other than those with dense breasts are suitable for adjunctive ultrasonography after negative mammography, and investigated whether all women with negative mammography are suitable for adjunctive ultrasonography.Methods
Based on the Multi-modality Independent Screening Trial in China, a total of 31,918 women aged 45 to 65 years underwent both ultrasonography and mammography. Physicians performed ultrasonography and mammography separately and were blinded to each other's findings until their interpretations had been recorded. For both ultrasonography and mammography, suspicious results and those highly suggestive of a malignancy were confirmed by pathologic examination, whereas other results were confirmed by 1-year follow-up after initial screening.Results
Based on Breast Imaging Reporting and Data System (BIRADS) assessments, 84 (84.8%) of 99 cancers were identified on mammography (detection rate, 2.6/1000), and 61 (61.6%) of 99 cancers were identified on ultrasonography (detection rate, 1.9/1000). Integrated mammography with ultrasonography identified 94 (95.0%) of 99 cancers, with an increment of 11.9% in cancer detection rate (from 2.6/1000 to 2.9/1000) (P < .05). Moreover, among women with BIRADS 3, adjunctive ultrasonography detected no cancers. All 10 additional cancers detected by adjunctive ultrasonography were from women with BIRADS 0 to 2, at a cost of 207 women with false positives. Additionally, dense breasts and benign breast disease were significantly associated with positive ultrasonography after BIRADS 0 to 2 (all P values < .05).Conclusions
After negative mammography, adjunctive ultrasonography should only be recommended for BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease. 相似文献11.
Jiyoung Kim Se Kyung Lee Jeonghui Lee Min-Young Choi Seung Pil Jung Min Kook Kim Sangmin Kim Seok Jin Nam Jeong Eon Lee Won Ho Kil 《JOURNAL OF BREAST CANCER》2014,17(3):279-286
Purpose
Recently, through international marriage, immigrant women have rapidly increased throughout Korea. This study was performed to identify health beliefs and practices related to breast cancer screening in immigrant women in Korea.Methods
A cross-sectional survey was carried out between March and July 2012, and study population included immigrant females from six other Asian countries (Cambodia, China, Japan, Mongolia, Vietnam, and the Philippines). We surveyed 197 women and categorized them into four groups according to home countries. The questionnaire consisted of 55 items, including demographic and socioeconomic factors, breast cancer-related knowledge regarding risk factors and symptoms, beliefs and attitudes towards health and breast cancer, perceived susceptibility, barriers, and benefits of screening.Results
Japanese participants were significantly older and had resided in Korea for more years than other country-of-origin groups (all p<0.001), and showed higher screening rates without statistical significance (p=0.392). In multivariate analysis, country of origin showed a significant correlation with knowledge (p=0.001), positive beliefs (p=0.002), and perceived benefits (p=0.025) of breast cancer screening. The group with the lowest household income showed a significantly lower score of perceived benefits (p=0.022). Through analysis to identify factors affecting participation in screening mammography, we found that education level (p=0.009), occupation status (p=0.006), and Korean language fluency (p=0.002) were independent predictors for screening behavior.Conclusion
This study identified conditions related to breast cancer screening knowledge, perception, and behavior of immigrant women in Korea. The results reflect the need for increased social aids to remove barriers to medical services and more educational programs to facilitate higher rates of screening. 相似文献12.
Deborah Randall Stephen Morrell Richard Taylor Wai Tak Hung 《Cancer causes & control : CCC》2009,20(5):559-566
Objective This study examined whether offering annual mammography screening for women with the risk factor of a family history of breast
cancer resulted in more favorable prognostic indicators of diagnosed cancers than the usual approach of biennial screening.
Methods The study involved women aged 50–69 years with a family history of breast cancer, defined as having ≥1 first-degree relative
diagnosed with breast cancer, who were diagnosed with a screen-detected invasive breast cancer between 1998 and 2004 in BreastScreen
New South Wales (n = 590). The women were grouped according to whether they screened in an area offering annual screening to women with a family
history, or were offered the standard biennial screening. The odds of having favorable tumor size, grade, and nodal status
prognosis were compared between these screening groups using logistic regression. A comparison group of women without a family
history, all offered biennial screening, was also evaluated based on the same area groupings to examine whether any differences
were due to the area, rather than the screening interval policy.
Results Women with a family history who were offered annual screening at BreastScreen NSW were significantly more likely than those
who were offered biennial screening to be diagnosed with a tumor ≤20 mm in size (adjusted odds ratio (AOR) = 1.91, 95% CI:
1.21–3.02), and to have a node-negative tumor (AOR = 1.61, 95% CI: 1.03–2.50). There were also significantly higher odds of
being diagnosed with tumors ≤15 mm (p < 0.001) and ≤10 mm in size (p = 0.011) in women offered annual screening. There was no significant difference in the odds of a Grade 1 tumor being detected
(AOR = 1.26, 95% CI: 0.87–1.81), although the direction of the effect was consistent with that seen for size and nodal status.
No significant differences were found in the comparison group of women without a family history.
Conclusions Offering annual screening for women aged 50–69 years with a family history of breast cancer significantly increased the odds
of being diagnosed with a smaller, node-negative tumors. Further investigation is required to assess whether the improved
prognostic indicators translate into significantly better mortality outcomes for women with a family history offered annually
screening. 相似文献
13.
乳腺钼靶和超声诊断乳腺原位癌伴早期浸润的对照研究 总被引:3,自引:1,他引:3
目的:探讨乳腺钼靶和超声诊断乳腺原位癌伴早期浸润的影像学特点,方法:对比40例手术后病理证实的乳腺原位癌伴早期浸润患者的钼靶与超声诊断结果。结果:40例患者在乳腺钼靶摄片上有乳腺癌征象的28例(70.0%),表现为良性肿瘤征象的7例(17.5%),无肿瘤征象5例(12.5%);在乳腺超声诊断中有乳腺癌表现的13例(32.5%),表现为良性肿瘤征象的10例(25.0%),无占位表现的17例(42.5%)。结论:在乳腺原位癌伴早期浸润诊断方面,乳腺钼靶诊断与病理诊断的符合率高于乳腺超声检查;两种检查综合诊断可减少此类早期乳腺癌的漏诊。 相似文献
14.
Jun Ota Toshio Horino Tetsuo Taguchi Tsunehiro Ishida Masaru Izuo Masami Ogita Rikiya Abe Hiromu Watanabe Tadaoki Morimoto Sueyoshi Itoh Hideya Tashiro Koichi Yoshida Kazuyoshi Honda Michizou Sasakawa Kohji Enomoto Yoshitomo Kashiki Choichiro Kido Tetsuo Kuroishi Suketami Tominaga 《Cancer science》1989,80(11):1028-1034
To establish the criteria for assessing the life-prolonging effect of mass screening for breast cancer, clinical stage and prognosis of breast cancer detected by mass screening in 11 regions of Japan were compared with those for matched patients in out-patient clinics. A total of 728 patients detected by mass screening and 1,450 found in the out-patient clinics were reviewed. The stage of the disease was Tis or I in 40.9% of the patients detected by mass screening, and 28.7% of those found in the out-patient clinics. In contrast, stage III was found in 9.3% and 14.6%, respectively, indicating that early stages were significantly more common in the patients detected by mass screening. The overall survival curve for the patients detected by mass screening was compared with that for those found in the out-patient clinics. The 5-year survival rate was significantly higher in the patients detected by mass screening (91.7% vs. 85.6%; P <0.01), while the 10-year survival rate was slightly higher in the same group of patients, but the difference from the other group was not significant (80.5% vs. 78.1%). Women who had conducted breast self-examination (BSE) showed a higher survival rate than those who had not conducted BSE. 相似文献
15.
目的 探讨乳腺X线检查质量控制对乳腺癌的诊断价值.方法 选择行乳腺X线检查的乳腺癌患者83例作为研究对象,按照是否进行质量控制将其分为观察组45例及对照组38例.对两组患者乳腺X线检查结果与病理结果的诊断符合率进行分析与比较.结果 观察组诊断符合率为91.11%,对照组诊断符合率为73.68%,观察组诊断符合率明显高于对照组(P<0.05).两组内各年龄段诊断符合率比较无显著差异,组间比较亦无统计学意义(P>0.05).两组患者T3+T4期诊断符合率均显著高于T1 +T2期(P<0.05).观察组各个病理分期诊断符合率均高于对照组,但差异无统计学意义(P>0.05).观察组患者淋巴结转移情况诊断符合率为73.33%,显著高于对照组(50.00%)(P<0.05).观察组非甲级片产生率为4.44%,明显低于对照组(15.79%)(P<0.05).结论 乳腺X线检查质量控制对于提高乳腺癌诊断准确率具有积极的意义,值得临床广泛开展. 相似文献
16.
《Clinical breast cancer》2019,19(6):456-459
IntroductionThe increment of breast cancer screening coverage should lead to an increase in the proportion of early tumors diagnosed and the decrease of the cancer-related mortality. However, the effectiveness of opportunistic mammography screening is not well documented for public health systems in middle-income countries.Patients and MethodsWe conducted an ecologic study to evaluate the association of mammography coverage with trends in breast cancer stage distribution. We used data from a total of 42,850 breast cancer patients, diagnosed between 2000 and 2016, combined with estimated mammography coverage from 3 surveys (2003, 2008, and 2013).ResultsBiannual mammography coverage increased from 62.4% in 2003 to 73.9% in 2013. From 2000 to 2016, the proportion of in situ tumors increased 6.9%, the proportion of localized tumors increased 3.9%, the proportion of regional tumors decreased 6.9% and the frequency of distant tumors decreased 4% (P < .00001).ConclusionMammography coverage in the context of opportunistic breast cancer screening was associated with the increase of in situ and localized tumors and decrease of regional and distant tumors. 相似文献
17.
Comparison of Mammography in Combination with Breast Ultrasonography Versus Mammography Alone for Breast Cancer Screening in Asymptomatic Women
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《Asian Pacific journal of cancer prevention》2013,14(12):7731-7736
Aim: To compare the agreement of screening breast mammography plus ultrasound and reviewedmammography alone in asymptomatic women. Materials and Methods: All breast imaging data were obtained forwomen who presented for routine medical checkup at National Cancer Institute (NCI), Thailand from January2010 to June 2013. A radiologist performed masked interpretations of selected mammographic images retrievedfrom the computer imaging database. Previous mammography, ultrasound reports and clinical data were blindedbefore film re-interpretation. Kappa values were calculated to assess the agreement between BIRADS assessmentcategory and BIRADS classification of density obtained from the mammography with ultrasound in imagingdatabase and reviewed mammography alone. Results: Regarding BIRADS assessment category, concordancebetween the two interpretations were good. Observed agreement was 96.1%. There was moderate agreement inwhich the Kappa value was 0.58% (95%CI; 0.45, 0.87). The agreement of BI-RADS classification of density wassubstantial, with a Kappa value of 0.60 (95%CI; 0.54, 0.66). Different results were obtained when a subgroupof patients aged ≥60 years were analyzed. In women in this group, observed agreement was 97.6%. There wasalso substantial agreement in which the Kappa value was 0.74% (95%CI; 0.49, 0.98). Conclusions: The presentstudy revealed that concordance between mammography plus ultrasound and reviewed mammography alonein asymptomatic women is good. However, there is just moderate agreement which can be enhanced if agetargetedbreast imaging is performed. Substantial agreement can be achieved in women aged ≥60. Adjunctivebreast ultrasound is less important in women in this group. 相似文献
18.
《Clinical breast cancer》2014,14(4):235-240
IntroductionBreast cancer screening is known to reduce mortality. In the present study, we analyzed the prevalence of breast cancers detected through screening, before and after introduction of an organized screening, and we evaluated the overall survival of these patients in comparison with women with an extrascreening imaging-detected breast cancer or those with palpable breast cancers.Materials and MethodsWe collected data about all women who underwent a breast operation for cancer in our department between 2001 and 2008, focusing on type of tumor diagnosis, tumor characteristics, therapies administered, and patient outcome in terms of overall survival, and recurrences. Data was analyzed by R (version 2.15.2), and P < .05 was considered significant.ResultsAmong the 2070 cases of invasive breast cancer we considered, 157 were detected by regional mammographic screening (group A), 843 by extrascreening breast imaging (group B: 507 by mammography and 336 by ultrasound), and 1070 by extrascreening breast objective examination (group C). The 5-year overall survival in groups A, B, and C were, respectively, 99% (95% CI, 98%-100%), 98% (95% CI, 97%-99%), and 91% (95% CI, 90%-93%), with a significant difference between the first 2 groups and the third (P < .05) and a trend between groups A and B (P = .081).ConclusionThe diagnosis of invasive breast cancer with screening in our population resulted in a survival gain at 5 years from the diagnosis, but a longer follow-up is necessary to confirm this data. 相似文献
19.
将184例乳腺疾病患者分为乳腺癌组与非癌组,观察和比较两组钙化出现的频率和形态特征,分析乳腺癌组的钙化与病理分型,钙化与乳腺肿块的关系。乳腺癌组X线摄影显示钙化者为64%(60/93),非癌组为28%(26/91)。有钙化者患乳腺癌的相对危险性(RR)是没有钙化的4.5倍(P<0.01)。在显示钙化的乳腺癌组,47%为浸润性导管癌,没有显示钙化的乳腺癌中,浸润性导管癌为24%(P<0.05);仅显示钙化但不伴有明显肿块影的占38%(23/60)。典型的恶性钙化如泥沙样,细线样钙化有助于对X线摄影未显示肿块影的乳腺癌的诊断。 相似文献