Comparative analysis between screening mammography performed in patients at usual risk and at high risk for breast cancer

Abstract

Introduction: Breast cancer is currently considered as a public health issue. To avoid late diagnosis, there is an attempt to use appropriate screening programs addressed to the early detection by testing the asymptomatic population in order to identify preclinical stage lesions. Methods: This is a retrospective, analytical, cross-sectional study of the notifications available in the cancer information system. The incidence of notifications from the reports of the BI-RADS™ notification system (Breast Imaging Reporting Data System) was compared between women at high and usual risk for breast cancer. Results: In the analyzed period, from 2013 to 2021, 16,065,383 screening mammographies were performed and notified in Brazil. Of these, 13,167,259 were performed in usual-risk women, whereas 2,898,124 were performed in high-risk women. To analyze the difference between reports of women at usual and high risk, the relative risk between them was calculated, as well as the necessary number to causa damage; the relative risk we found was of 0.5412 (95%CI 0.5341–0.5483) in B4 and relative risk of 0,433 (95%CI 0.4203–0.4462). As to the necessary number to cause damage, we observed 203 (95%CI 198–209) for B4 and 788 (95%CI 754–825) for B5. Despite the well-established need for breast cancer screening programs to reduce mortality, some aspects of screening do not have such a consensus. In this study, the incidence of reports that are suggestive of malignant breast lesions was higher among women at high risk. Conclusions: The study showed an increased prevalence of reports suggestive of malignancy in high-risk patients when compared to those at usual risk.