BreastScreen-based mammography screening in women with a personal history of breast cancer, Western Australian study.

Abstract

OBJECTIVE:

To evaluate mammography screening outcomes in women with a personal history of breast cancer (PHBC), who have an increased risk of recurrent or new breast cancer, relative to women without PHBC.

DESIGN, SETTING AND PARTICIPANTS:

Retrospective study of 713,191 screening mammograms from two groups of women - those with versus those without PHBC - who participated in the BreastScreen WA program in Western Australia between 1997 and 2006.

MAIN OUTCOME MEASURES:

Cancer detection rate (CDR), recall to assessment rate, recall positive predictive value (PPV) for cancer, and distribution of cancer characteristics within and between the two groups.

RESULTS:

Screening detected 4125 breast cancers: CDR per 10,000 screens was significantly higher in women with PHBC (95.5; 95% CI, 78.3-112.7) than in women without PHBC (57.2; 95% CI, 55.4-58.9). Recall to assessment rate per 10,000 screens was lower in women with PHBC (385.2; 95% CI, 350.6-419.8) than in women without PHBC (504.9; 95% CI, 499.7-510.2). Recall PPV was higher for women with PHBC (24.8%; 95% CI, 21.0%-28.9%) than those without PHBC (11.2%; 95% CI, 10.9%-11.6%). Cancer characteristics were consistent with early detection (most were smaller than 2 cm and node-negative) and were similarly distributed in both groups, except for tumour grade, with PHBC women having fewer low-grade cancers and slightly more high-grade cancers than women without PHBC.

CONCLUSIONS:

The relative rate of cancer detection between women with PHBC and women without PHBC who attended an Australian population-based breast screening program was similar to estimates from international studies. Recall rates were within national standards. Screen-detected cancers had similar characteristics in both groups, except for tumour grade. These data support national integration of mammography screening for women with PHBC into BreastScreen, although evaluation of interval cancers will be necessary.

• Authors: Nehmat Houssami, Janette J Tresham, Lin Fritschi, Liz E Wylie
• Journal: The Medical journal of Australia (Med J Aust) Vol. 195 Issue 8 Pg. 460-4 (Oct 17 2011) ISSN: 1326-5377 [Electronic] Australia
• PMID: 22004397 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Breast Neoplasms (diagnostic imaging)
• Early Detection of Cancer
• Female
• Humans
• Mammography
• Medical History Taking
• Middle Aged
• Neoplasm Recurrence, Local (diagnostic imaging)
• Predictive Value of Tests
• Retrospective Studies
• Sensitivity and Specificity
• Western Australia