[Early results of breast cancer screening research]

Abstract

Introduction: Breast cancer is the most common malignant carcinoma among women in Poland. In the year 2000 alone, 10987 new cases were registered. Mass-screening examinations are most effective method of fighting against breast cancer. The aim of this work was to estimate a mammography screening program in population of women at the ages between 50 to 69, which has been performed during 2004-2005 in the Regional General Hospital in Elblag.

Material and methods: The research was based on retrospective analysis of files from the Department of Radiology at Regional General Hospital in Elblag. Electronic database of mammography examinations and files from Oncological Outpatient Clinic and Surgery Outpatient Clinic were analyzed. Research was conducted under within the program of National Health Fund. Screening examination to detect breast cancer includes physical examination of the breast and mammography, performed in 3161 women at the ages between 50 to 69, average age being 57.8. Mammography was described according to BIRADS scale. In cases of suspected malignant lesions, patients underwent additional examinations (USG, BAC, biopsy, surgical histopathology).

Results: The largest group consisted of women at the age of 50 to 55. The total number of examined women amounted to 3161. The most frequent case was glandular-fat breast structure (1720 women, 55.3% of all cases) and the least frequent one was strictly glandular structure of breast (80 women, 2.6%). The so-called typical mammography result was detected in most cases (80.4%) and malignant lesions were detected in only 2 women (0.1%). The majority of the x-ray shadows and focus-like lesions were detected in upper-outer quadrant of breast (22.1%). 6-10 millimeters lesions were the most common ones (50.8%), followed by 10-15 millimeters (21.9%) and 16-20 millimeters lesions in size (11%). Lack of size description was detected in 61 women (1.9%). 471 (14.9%) of all women were ordered to undergo further diagnostic examinations (USG, BAC, histopathologic examination) on the base of mammography results. 315 (10.8%) of women did register for those additional examinations. 53 women came for BAC examination after mammography and ultrasound examinations. Neoplastic cells were detected in materials of 22 cases. Mastectomy (according to Patey's method) was the most frequent procedure in 2004 and 2005 and it was performed in 12 women. Conservative surgery was performed in 8 patients. Furthermore, 2 women with breast cancer were not classified for surgery because of too advanced stage of cancer. Invasive ductal (72.7%) and pre-invasive cancers were most common cases of all detected breast cancers.

Conclusions: 3161 mammography screening examinations were performed between 2004 and 2005. Women with detected breast cancer, mainly at the age 56-60, constituted 0.7% of the whole group. Patey's mastectomy was performed in above 50% of cases of all women, the remaining patients underwent conservative surgery. Only 10% of women have cancer at dissemination stage. Medical database of screening program contained incomplete descriptions of mammography results. Descriptions were not precise and not standardized.