基于乳腺筛查的乳腺癌患者乳腺钼靶筛查：来自澳大利亚西部的研究。

BreastScreen-based mammography screening in women with a personal history of breast cancer, Western Australian study.

机构信息

Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, NSW.

出版信息

Med J Aust. 2011 Oct 17;195(8):460-4. doi: 10.5694/mja11.10702.

DOI:10.5694/mja11.10702

PMID:22004397

Abstract

OBJECTIVE

To evaluate mammography screening outcomes in women with a personal history of breast cancer (PHBC), who have an increased risk of recurrent or new breast cancer, relative to women without PHBC.

DESIGN, SETTING AND PARTICIPANTS: Retrospective study of 713,191 screening mammograms from two groups of women - those with versus those without PHBC - who participated in the BreastScreen WA program in Western Australia between 1997 and 2006.

MAIN OUTCOME MEASURES

Cancer detection rate (CDR), recall to assessment rate, recall positive predictive value (PPV) for cancer, and distribution of cancer characteristics within and between the two groups.

RESULTS

Screening detected 4125 breast cancers: CDR per 10,000 screens was significantly higher in women with PHBC (95.5; 95% CI, 78.3-112.7) than in women without PHBC (57.2; 95% CI, 55.4-58.9). Recall to assessment rate per 10,000 screens was lower in women with PHBC (385.2; 95% CI, 350.6-419.8) than in women without PHBC (504.9; 95% CI, 499.7-510.2). Recall PPV was higher for women with PHBC (24.8%; 95% CI, 21.0%-28.9%) than those without PHBC (11.2%; 95% CI, 10.9%-11.6%). Cancer characteristics were consistent with early detection (most were smaller than 2 cm and node-negative) and were similarly distributed in both groups, except for tumour grade, with PHBC women having fewer low-grade cancers and slightly more high-grade cancers than women without PHBC.

CONCLUSIONS

The relative rate of cancer detection between women with PHBC and women without PHBC who attended an Australian population-based breast screening program was similar to estimates from international studies. Recall rates were within national standards. Screen-detected cancers had similar characteristics in both groups, except for tumour grade. These data support national integration of mammography screening for women with PHBC into BreastScreen, although evaluation of interval cancers will be necessary.

摘要

目的

评估有乳腺癌个人病史（PHBC）的女性的乳房 X 光筛查结果，这些女性有复发或新发乳腺癌的风险增加，与没有 PHBC 的女性相比。

设计、地点和参与者：对 1997 年至 2006 年期间在西澳大利亚州参加 BreastScreen WA 计划的两组女性（有 PHBC 的女性与没有 PHBC 的女性）的 713,191 次筛查乳房 X 光片进行回顾性研究。

主要观察指标

癌症检出率（CDR）、召回评估率、癌症召回阳性预测值（PPV）以及两组内和两组间癌症特征的分布。

结果

筛查发现 4125 例乳腺癌：有 PHBC 的女性每 10,000 例筛查的 CDR 显著高于无 PHBC 的女性（95.5；95%CI，78.3-112.7）。有 PHBC 的女性每 10,000 例筛查的召回评估率（385.2；95%CI，350.6-419.8）低于无 PHBC 的女性（504.9；95%CI，499.7-510.2）。有 PHBC 的女性的召回 PPV 更高（24.8%；95%CI，21.0%-28.9%），而无 PHBC 的女性为 11.2%（95%CI，10.9%-11.6%）。癌症特征与早期发现一致（大多数小于 2 厘米且无淋巴结转移），并且在两组中的分布相似，除了肿瘤分级，有 PHBC 的女性低级别癌症较少，高级别癌症略多。