Abstract

BackgroundBreast cancer is the leading cause of cancer and cancer related deaths in Jamaican women. In Jamaica, women often present with advanced stages of breast cancer, despite the availability of screening mammography for early detection. The utilization of screening mammography for early breast cancer diagnosis seems to be limited, and this study investigated the national patterns of mammographic screening and the impact of mammography on the diagnosis of breast cancer in Jamaica.MethodsA retrospective analysis of the records of the largest mammography clinic in Jamaica was done for the period January 2011 to December 2016. Descriptive statistics was performed on relevant patient characteristics with calculation of rates and proportions; cross-tabulations were utilized to assess relationship of covariates being studied on the outcomes of interest. Results are reported in aggregate form with no identifiable patient data.Results48,203 mammograms were performed during the study period. 574 women (1.2%) had mammograms suspicious for breast cancer with median age of 57 years (range 30–95 years); 35% were under the age of 50. 4 women with suspicious findings had undergone ‘screening mammography’, with the remaining having ‘diagnostic mammography’. 38% reported previous mammograms, with a mean interval of 8 years between previous normal mammogram and mammogram suspicious for breast cancer. Median age at first screening mammogram was 51 years (range 41–77).ConclusionBreast cancer screening mammography is underutilized in Jamaica. An organized national breast cancer screening programme is recommended to improve adherence to international breast cancer screening guidelines.

Highlights

  • Breast cancer is the leading cause of cancer and cancer related deaths in Jamaican women

  • In this study we explored the patterns of breast cancer screening at the Jamaica Cancer Society (JCS) between 2011 and 2016

  • During the 6-year study period, 48,203 mammograms were performed at the JCS, with a mean of 8033 mammograms annually

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Summary

Introduction

Breast cancer is the leading cause of cancer and cancer related deaths in Jamaican women. In Jamaica, women often present with advanced stages of breast cancer, despite the availability of screening mammography for early detection. Breast cancer is the leading cancer affecting women and the leading cause of cancer related deaths in females in Jamaica [1, 2]. Despite the high burden of breast cancer and the widely accepted benefits of screening mammography, opportunistic screening predominates and relatively few women in Jamaica have age-appropriate regular screening mammograms. Breast cancer in Jamaican women is diagnosed at a median age of 52 years [4], which is an average of 10 years younger than in the USA [7]. One local study showed that as many as 17% of women with breast cancer were under the age of years [9], with a peak of 53% in the to 60 year age group; this is in contrast to the age distribution of breast cancer cases in the US, where fewer than 5 percent of women diagnosed with breast cancer are younger than 40, and the highest rates are seen in the over age 70 years demographic [10]

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