Opportunistic mammography screening provides effective detection rates in a limited resource healthcare system

BMC Cancer

Research Article

Caroline Judy Westerhout¹  Kartini Rahmat¹  Farhana Fadzli¹  Cheng-Har Yip²  Suniza Jamaris²  Gie-Hooi Tan²  Nur Aishah Taib²  Mee-Hoong See²  Yew-Ching Teh³ 

[1] Department of Biomedical Imaging, University Malaya Medical Centre, Kuala Lumpur, Malaysia;Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia;Gleneagles Medical Centre, Penang, Malaysia;

关键词: Opportunistic screening mammography;    Performance indicators;    Breast cancer;    Low and middle income country;   

DOI  :  10.1186/s12885-015-1419-2

 received in 2014-08-28, accepted in 2015-05-05,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundBreast cancer is the leading cause of cancer deaths in women world-wide. In low and middle income countries, where there are no population-based mammographic screening programmes, late presentation is common, and because of inadequate access to optimal treatment, survival rates are poor. Mammographic screening is well-studied in high-income countries in western populations, and because it has been shown to reduce breast cancer mortality, it has become part of the healthcare systems in such countries. However the performance of mammographic screening in a developing country is largely unknown.This study aims to evaluate the performance of mammographic screening in Malaysia, a middle income country, and to compare the stage and surgical treatment of screen-detected and symptomatic breast cancer.MethodsA retrospective review of 2510 mammograms performed from Jan to Dec 2010 in a tertiary medical centre is carried out. The three groups identified are the routine (opportunistic) screening group, the targeted (high risk) screening group and the diagnostic group. The performance indicators of each group is calculated, and stage at presentation and treatment between the screening and diagnostic group is analyzed.ResultsThe cancer detection rate in the opportunistic screening group, targeted screening group, and the symptomatic group is 0.5 %, 1.25 % and 26 % respectively. The proportion of ductal carcinoma in situ is 23.1 % in the two screening groups compared to only 2.5 % in the diagnostic group. Among the opportunistic screening group, the cancer detection rate was 0.2 % in women below 50 years old compared to 0.65 % in women 50 years and above. The performance indicators are within international standards. Early-staged breast cancer (Stage 0–2) were 84.6 % in the screening groups compared to 61.1 % in the diagnostic group.ConclusionFrom the results, in a setting with resource constraints, targeted screening of high risk individuals will give a higher yield, and if more resources are available, population-based screening of women 50 and above is effective.Opportunistic mammographic screening is feasible and effective in a middle income country with performance indicators within international standards. Waiting until women are symptomatic will lead to more advanced cancers.

【 授权许可】

Unknown   
© Teh et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.