Benefits of Organized Mammographic Screening Programs in Women Aged 50 to 69 years: A Surgical Perspective.


Journal

Clinical breast cancer
ISSN: 1938-0666
Titre abrégé: Clin Breast Cancer
Pays: United States
ID NLM: 100898731

Informations de publication

Date de publication:
10 2019
Historique:
received: 25 02 2019
accepted: 22 04 2019
pubmed: 28 5 2019
medline: 12 8 2020
entrez: 28 5 2019
Statut: ppublish

Résumé

The benefits of organized mammographic screening programs (OMSPs) in reducing breast cancer mortality have been addressed by several studies. This study was designed to specifically evaluate the advantages of OMPSs in terms of surgical management of patients with breast cancer. Surgical treatment of 201 patients with breast cancer aged 50 to 69 years coming from OMSPs was compared with that of 532 non-OMSP patients in same age group. The likelihood of receiving BCS was analyzed through a multivariable regression model. The mean tumor size was smaller in the OMSP patients (14 mm vs. 18 mm; P < .01). The proportion of patients having metastatic lymph nodes was higher in the non-OMSP group (33.3% vs. 17.9%; P < .01). Rates of breast-conserving surgery (BCS) were significantly higher in the OMSP group (89.1% vs. 59.1%; P < .01). Sentinel node biopsy was carried out in 84.1% and 62.5% of patients in the OMSP and non-OMSP groups, respectively (P < .01). Rates of axillary lymph node dissection were significantly different (24.9% in the OMSP group and 35.8% in the non-OMSP group; P = .02). Re-excisions for infiltrated margins after BCS were lower in the OMSP group (4.8% vs. 12.7%; P < .01). Hospital stay was shorter in the OMSP group (2.13 vs. 3.02 days; P < .01). OMPS women had a 3-fold higher probability of receiving BCS. Patients with breast cancer belonging to OMSPs had a higher probability to receive less invasive surgery and to have shorter hospital stay. Our results support the use of campaigns aimed at increasing adhesion to mammography screening.

Sections du résumé

BACKGROUND
The benefits of organized mammographic screening programs (OMSPs) in reducing breast cancer mortality have been addressed by several studies. This study was designed to specifically evaluate the advantages of OMPSs in terms of surgical management of patients with breast cancer.
MATERIALS AND METHODS
Surgical treatment of 201 patients with breast cancer aged 50 to 69 years coming from OMSPs was compared with that of 532 non-OMSP patients in same age group. The likelihood of receiving BCS was analyzed through a multivariable regression model.
RESULTS
The mean tumor size was smaller in the OMSP patients (14 mm vs. 18 mm; P < .01). The proportion of patients having metastatic lymph nodes was higher in the non-OMSP group (33.3% vs. 17.9%; P < .01). Rates of breast-conserving surgery (BCS) were significantly higher in the OMSP group (89.1% vs. 59.1%; P < .01). Sentinel node biopsy was carried out in 84.1% and 62.5% of patients in the OMSP and non-OMSP groups, respectively (P < .01). Rates of axillary lymph node dissection were significantly different (24.9% in the OMSP group and 35.8% in the non-OMSP group; P = .02). Re-excisions for infiltrated margins after BCS were lower in the OMSP group (4.8% vs. 12.7%; P < .01). Hospital stay was shorter in the OMSP group (2.13 vs. 3.02 days; P < .01). OMPS women had a 3-fold higher probability of receiving BCS.
CONCLUSIONS
Patients with breast cancer belonging to OMSPs had a higher probability to receive less invasive surgery and to have shorter hospital stay. Our results support the use of campaigns aimed at increasing adhesion to mammography screening.

Identifiants

pubmed: 31130366
pii: S1526-8209(19)30150-8
doi: 10.1016/j.clbc.2019.04.013
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e637-e642

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Alessandro Fancellu (A)

Department of Medical, Surgical, and Experimental Sciences, Unit of General Surgery 2, Clinica Chirurgica, University of Sassari, Sassari, Italy. Electronic address: afancel@uniss.it.

Valeria Sanna (V)

Unit of Medical Oncology, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy.

Maria L Sedda (ML)

Mammography Screening Service, Azienda Tutela Salute Sassari, Sassari, Italy.

Daria Delrio (D)

Mammography Screening Service, Azienda Tutela Salute Sassari, Sassari, Italy.

Pietrina Cottu (P)

Department of Medical, Surgical, and Experimental Sciences, Unit of General Surgery 2, Clinica Chirurgica, University of Sassari, Sassari, Italy.

Angela Spanu (A)

Department of Medical, Surgical, and Experimental Sciences, Unit of Nuclear Medicine, University of Sassari, Sassari, Italy.

Giuliana Giuliani (G)

Department of Medical, Surgical, and Experimental Sciences, Unit of General Surgery 2, Clinica Chirurgica, University of Sassari, Sassari, Italy.

Maurizio Conti (M)

Department of Medical, Surgical, and Experimental Sciences, Unit of Radiology, University of Sassari, Sassari, Italy.

Rafaela Piras (R)

Centre Hospitalier Universitaire Dupuytren, Limoges, France.

Paola Crivelli (P)

Department of Medical, Surgical, and Experimental Sciences, Unit of Radiology, University of Sassari, Sassari, Italy.

Alberto Porcu (A)

Department of Medical, Surgical, and Experimental Sciences, Unit of General Surgery 2, Clinica Chirurgica, University of Sassari, Sassari, Italy.

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