Skip to main content
Top
Published in: World Journal of Surgery 5/2018

01-05-2018 | Surgical Symposium Contribution

Short- and Long-Term (10-year) Results of an Organized, Population-Based Breast Cancer Screening Program: Comparative, Observational Study from Hungary

Authors: Dezső Tóth, Zsolt Varga, Judit Tóth, Péter Árkosy, Éva Sebő

Published in: World Journal of Surgery | Issue 5/2018

Login to get access

Abstract

Background

A nationwide breast cancer screening program was introduced in Hungary in the year 2002 for women aged 45–65 years to be performed biannually.

Methods

To investigate and report the short-term and 10-year follow-up results, we analyzed our Breast Unit’s prospectively led database of screened (Group A) and age-matched symptomatic (Group B) patients from 2002 to 2007. We compared the clinicopathologic features of tumors and the impact of screening on surgical treatment, as well as the overall (OS), disease-specific (DSS) and disease-free survival (DFS) of different groups.

Results

Data from 208 screen-detected and 101 symptomatic patients between 45 and 65 years of age were examined. Screen-detected women were younger (54 vs. 58.5 years; p = 0.001) had significantly smaller tumors (15.5 vs. 17 mm; p = 0.044), and more breast-conserving surgery (68.8 vs. 59.4%; p = 0.032). Survival statistics were not statistically different at the median follow-up of 123 months; however, there was a trend toward improved DFS in Group A (82.7 vs. 74.3%; p = 0.074).

Conclusions

Our study showed a significant reduction in rates of mastectomy in the screen-detected group in the short term, which does not translate into better survival rates based on initial long-term data. In order to realize the real advantage of this newly enstated screening program, a longer period of investigation is needed.
Literature
1.
go back to reference Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):359–386CrossRef Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):359–386CrossRef
2.
go back to reference Kásler M, Ottó S, Kenessey I (2017) The current situation of cancer morbidity and mortality in the light of the national cancer registry. Orv Hetil 158:84–89CrossRefPubMed Kásler M, Ottó S, Kenessey I (2017) The current situation of cancer morbidity and mortality in the light of the national cancer registry. Orv Hetil 158:84–89CrossRefPubMed
4.
go back to reference Mandelblatt JS, Stout NK, Schechter CB et al (2016) Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Ann Intern Med 164(4):215–225CrossRefPubMedPubMedCentral Mandelblatt JS, Stout NK, Schechter CB et al (2016) Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Ann Intern Med 164(4):215–225CrossRefPubMedPubMedCentral
5.
go back to reference Sobin LH, Gospodarowicz MK, Wittekind C (2011) TNM classification of malignant tumours. Wiley, Oxford Sobin LH, Gospodarowicz MK, Wittekind C (2011) TNM classification of malignant tumours. Wiley, Oxford
6.
go back to reference Újhelyi M, Pukancsik D, Kelemen P et al (2017) Reasons of non-attendance for organized breast cancer screening programme in Hungary—questionnaire of 3313 cases. Magy Seb 70(2):183 Újhelyi M, Pukancsik D, Kelemen P et al (2017) Reasons of non-attendance for organized breast cancer screening programme in Hungary—questionnaire of 3313 cases. Magy Seb 70(2):183
7.
go back to reference Dillon MF, Hill ADK, Quinn CM et al (2004) Surgical intervention in screen-detected patients versus symptomatic patients with breast cancer. J Med Screen 11:130–134CrossRefPubMed Dillon MF, Hill ADK, Quinn CM et al (2004) Surgical intervention in screen-detected patients versus symptomatic patients with breast cancer. J Med Screen 11:130–134CrossRefPubMed
8.
go back to reference Norden T, Thurfjell E, Hasselgren M et al (1997) Mammographic screening for breast cancer. What cancers do we find? Eur J Cancer 33:624–628CrossRefPubMed Norden T, Thurfjell E, Hasselgren M et al (1997) Mammographic screening for breast cancer. What cancers do we find? Eur J Cancer 33:624–628CrossRefPubMed
9.
go back to reference Újhelyi M, Pukancsik D, Kelemen P et al (2016) Does breast screening offer a survival benefit? A retrospective comparative study of oncological outcomes of screen-detected and symptomatic early stage breast cancer cases. Eur J Surg Oncol 42:1814–1820CrossRefPubMed Újhelyi M, Pukancsik D, Kelemen P et al (2016) Does breast screening offer a survival benefit? A retrospective comparative study of oncological outcomes of screen-detected and symptomatic early stage breast cancer cases. Eur J Surg Oncol 42:1814–1820CrossRefPubMed
10.
go back to reference Delaney G, Shafiq J, Chappell G, Barton M (2008) Establishing treatment benchmarks for mammography-screened breast cancer population based on a review of evidence-based clinical guidelines. Cancer 112:1912–1922CrossRefPubMed Delaney G, Shafiq J, Chappell G, Barton M (2008) Establishing treatment benchmarks for mammography-screened breast cancer population based on a review of evidence-based clinical guidelines. Cancer 112:1912–1922CrossRefPubMed
11.
go back to reference Spillane AJ, Kennedy CW, Gillett DJ et al (2001) Screen-detected breast cancer compared to symptomatic presentation: an analysis of surgical treatment and end-points of effective mammographic screening. ANZ J Surg 71:398–402CrossRefPubMed Spillane AJ, Kennedy CW, Gillett DJ et al (2001) Screen-detected breast cancer compared to symptomatic presentation: an analysis of surgical treatment and end-points of effective mammographic screening. ANZ J Surg 71:398–402CrossRefPubMed
12.
go back to reference Freedman GM, Anderson PR, Goldstein LJ et al (2003) Routine mammography is associated with earlier stage disease and greater eligibility for breast conservation in breast carcinoma patients age 40 years and older. Cancer 98:918–925CrossRefPubMed Freedman GM, Anderson PR, Goldstein LJ et al (2003) Routine mammography is associated with earlier stage disease and greater eligibility for breast conservation in breast carcinoma patients age 40 years and older. Cancer 98:918–925CrossRefPubMed
13.
14.
go back to reference Samnakay N, Tinning J, Ives A et al (2005) Rates for mastectomy are lower in women attending a breast-screening programme. ANZ J Surg 75:936–939CrossRefPubMed Samnakay N, Tinning J, Ives A et al (2005) Rates for mastectomy are lower in women attending a breast-screening programme. ANZ J Surg 75:936–939CrossRefPubMed
15.
go back to reference de Haes JC, van Oostrom MA, Welvaart K (1986) The effect of radical and conserving surgery on the quality of life of early breast cancer patients. Eur J Surg Oncol 12(4):337–342PubMed de Haes JC, van Oostrom MA, Welvaart K (1986) The effect of radical and conserving surgery on the quality of life of early breast cancer patients. Eur J Surg Oncol 12(4):337–342PubMed
16.
go back to reference Gøtzsche PC, Jørgensen KJ (2013) Screening for breast cancer with mammography. Cochrane Database Syst Rev 6:CD001877 Gøtzsche PC, Jørgensen KJ (2013) Screening for breast cancer with mammography. Cochrane Database Syst Rev 6:CD001877
17.
go back to reference Nyström L, Andersson I, Bjurstam N et al (2002) Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 359(9310):909–919CrossRefPubMed Nyström L, Andersson I, Bjurstam N et al (2002) Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 359(9310):909–919CrossRefPubMed
18.
go back to reference Zamora LI, Forastero C, Guirado D et al (2016) A Monte Carlo analysis of breast screening randomized trials. Phys Med 32(12):1609–1614CrossRefPubMed Zamora LI, Forastero C, Guirado D et al (2016) A Monte Carlo analysis of breast screening randomized trials. Phys Med 32(12):1609–1614CrossRefPubMed
19.
go back to reference Morrell S, Taylor R, Roder D, Robson B, Gregory M, Craig K (2017) Mammography service screening and breast cancer mortality in New Zealand: a national cohort study 1999–2011. Br J Cancer 116(6):828–839CrossRefPubMedPubMedCentral Morrell S, Taylor R, Roder D, Robson B, Gregory M, Craig K (2017) Mammography service screening and breast cancer mortality in New Zealand: a national cohort study 1999–2011. Br J Cancer 116(6):828–839CrossRefPubMedPubMedCentral
20.
go back to reference Nyström L, Bjurstam N, Jonsson H, Zackrisson S, Frisell J (2017) Reduced breast cancer mortality after 20+ years of follow-up in the Swedish randomized controlled mammography trials in Malmö, Stockholm, and Göteborg. J Med Screen 24(1):34–42CrossRefPubMed Nyström L, Bjurstam N, Jonsson H, Zackrisson S, Frisell J (2017) Reduced breast cancer mortality after 20+ years of follow-up in the Swedish randomized controlled mammography trials in Malmö, Stockholm, and Göteborg. J Med Screen 24(1):34–42CrossRefPubMed
21.
go back to reference Massat NJ, Sasieni PD, Tataru D et al (2016) Explaining the better prognosis of screening-exposed breast cancers: influence of tumor characteristics and treatment. Cancer Epidemiol Biomarkers Prev 25:479–487CrossRefPubMed Massat NJ, Sasieni PD, Tataru D et al (2016) Explaining the better prognosis of screening-exposed breast cancers: influence of tumor characteristics and treatment. Cancer Epidemiol Biomarkers Prev 25:479–487CrossRefPubMed
Metadata
Title
Short- and Long-Term (10-year) Results of an Organized, Population-Based Breast Cancer Screening Program: Comparative, Observational Study from Hungary
Authors
Dezső Tóth
Zsolt Varga
Judit Tóth
Péter Árkosy
Éva Sebő
Publication date
01-05-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 5/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4486-0

Other articles of this Issue 5/2018

World Journal of Surgery 5/2018 Go to the issue