Accuracy of breast screening among women with and without a family history of breast and/or ovarian cancer
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To compare interval cancer rates, sensitivity and specificity of breast cancer screening between women with moderate or strong family history and women without a family history.
From 1996 to 1997, 115,460 women aged 50 to 69 screened by the Ontario Breast Screening Program, offering eligible women screening with mammography and clinical breast examination, were examined. Women were followed for up to 12 months after their screening examination. Family history definitions were based on the number of affected first degree relatives and their ages at diagnosis. Multivariate analysis was conducted to adjust for potential confounding variables.
Interval cancer rates increased across family history groups and were greatest in women with a strong family history. The rate ratio (RR) for interval cancer rate in women with a strong family history compared to women without a family history approached significance (RR=2.28, 95% confidence interval (CI) 0.97–5.34), while for women with a moderate family history it did not (RR=1.37, 95% CI 0.62–3.04). A slightly but not significantly lower sensitivity was observed in women with a strong family history compared to women without a family history. There was little variation in specificity across family history groups.
Screening was able to detect a large proportion of invasive breast cancers in women with a family history, indicating their potential to benefit from regular breast cancer screening. However, due to increased interval cancer rates, screening with one-year intervals may be important even in an older population of women with a family history.
Keywordsbreast cancer family history interval cancer rate screening sensitivity specificity
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- 2.(CGHFBC) CollaborativeGrouponHormonalFactorsinBreast Cancer, 2001,Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease,Lancet,358:1389--1399.Google Scholar
- 4.Tabar, L, Fagerberg, CJ, Gad, A, Baldetorp, L, Holmberg, LH, Grontoft, O, Ljungquist, U, Lundstrom, B, Manson, JC, Eklund, G 1985Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and WelfareLancet1829832PubMedGoogle Scholar
- 8.Banks, E, Reeves, G, Beral, V, Bull, D, Crossley, B, Simmonds, M, Hilton, E, Bailey, S, Barrett, N, Briers, P, English, R, Jackson, A, Kutt, E, Lavelle, J, Rockall, L, Wallis, MG, Wilson, M, Patnick, J 2004Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort studyBMJ329477482PubMedGoogle Scholar
- 14.Kleinbaum, DG, Klein, M 2002Logistic regression: a self-learning text2nd EditionSpringer-Verlag New York, Inc.New York195198Google Scholar
- 15.SAS Institute Inc.1999–2001SAS System Version 8.02CaryNorth Carolina, USAGoogle Scholar
- 17.Carney, PA, Miglioretti, DL, Yankaskas, BC, Kerlikowske, K, Rosenberg, R, Rutter, CM, Geller, BM, Abraham, LA, Taplin, SH, Dignan, M, Cutter, G, Ballard-Barbash, R 2003Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammographyAnn Intern Med138168175PubMedGoogle Scholar