Abstract
To evaluate the screening performance of individual and combined use of clinical breast examination, ultrasonography and mammography in Chinese women, we conducted a biennial breast cancer screening program among 14,464 women aged 35 to 74 years old who lived in Qibao County, Minhang district of Shanghai, China, between May 2008 and Sept 2012. All participants were submitted to clinical breast examination, and then women with positive results and all women at age of 45-69 years old were preformed breast ultrasonography and mammography. The examination results were compared against pathological findings as the gold standard of reference. A total of 66 women were diagnosed with breast cancer in the two rounds of the screening, yielding an incident rate of 194 per 100,000 person-years. The sensitivity of clinical breast examination, ultrasonography and mammography alone were 61.4%, 53.7% and 67.3%, respectively. While mammography performed better in elder age groups and hormone receptor positive disease groups, ultrasonography had a higher sensitivity in younger age group and did not differ in sensitivity by estrogen receptor or progesterone receptor status. Combined use of the two imaging examinations increased the sensitivity in almost all age groups, but had a higher sensitivity in hormone receptor positive cancers than in those negative. Our results suggest that the Qibao modality is an effective strategy for breast cancer screening among Chinese women, especially for early detection of elder and hormone receptor positive breast cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-2-276) contains supplementary material, which is available to authorized users.
Highlights
Breast cancer is the most common malignancy among women around the world
By taking advantage of the data from the Shanghai Society-based Breast Screening Program (SBSP) initiated in May 2008, a biennial mass screening of breast cancer designed based on recommended screening strategies in Western countries and the experience in clinical practice, we evaluated the performance of screening methods and screening modality, aiming at seeking an optimal breast cancer screening modality in Chinese women
The peak incidence was observed among women around 45 years old in non-participants while the incidence increased with age among the participants, for those participating in the 1st round of screening
Summary
Breast cancer is the most common malignancy among women around the world. In 2008, 1.38 million women were newly-diagnosed with breast cancer and 458,000 died of the malignancy (Ferlay et al 2010). No effective approach has been developed to prevent the incidence of breast cancer. Early detection of the malignancy is of the most important to improve the life of quality, prolong the survival of patients and prevent the premature death from the disease. While both incidence and mortality of breast cancer have been rising in China and other. Besides the improvement of treatment (Burton et al 2012), early detection of breast cancer has been suggested to be one of the most important contributors (Narod 2011; Smith et al 2012)
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