Understanding the paradigma of opportunistic screening

Year 2022, Volume: 8 Issue: 5, 598 - 605, 04.09.2022

Nilgün Güldoğan İlke Daldal Aykut Soyder , Ebru Yılmaz Aydan Arslan

https://doi.org/10.18621/eurj.1033431

Abstract

Objectives: To provide demographical and pathological characteristics of breast cancer patients diagnosed in a tertiary clinic with opportunistic screening and diagnostic workup and compare the results with the available national and global breast cancer statistics. 

Methods: Clinical and pathological data of breast cancer patients diagnosed in our tertiary breast clinic between March 14, 2017 and February 28, 2020 have been entered into a database and analyzed retrospectively. Results were analyzed and compared with the national and global statistics. 

Results: The total number of patients included in this study were 137 and the number of tumors was 145. Sixty-four (46.7%) patients were detected in screening. All of the patients were female. The mean age was 51.8 years. Eighteen (13.1%) patients were young females (< 40 years), 55 (40.1%) were in 40-49 years, 26 (18.9%) in 50-59 years, 24 (17.5%) in > 60-69 years, 14 (10.2%) in > 70 years. Of the invasive cancers, 100 (79.4%) were invasive ductal, 15 (11.9%) invasive lobular, 6 (4.8%) pleomorphic lobular, 4 (3.2%) papillary, and 1 (0.8%) tubular cancer. Distribution of stages were: 13.1% stage 0, 38.6% stage I, 29.6% stage II, 10.3% stage III, and 8.2% stage IV. The mean tumor diameter was 26.6 mm. Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) were positive in 82.5%, 61.9% and 15.8% of the tumors respectively. 

Conclusions: Results of this study are in accordance with the latest results of the National Breast cancer database, a project governed by the Turkish Federation of Breast Disease Societies (TMHDF), considering the tumor size, age distribution, histologic subtype analysis, receptor status. However, the percentage of early-stage tumors was higher in this study.

Keywords

Breast cancer, histology, stages, molecular subtypes, opportunistic screening

References

• 1. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019;144:1941-53.
• 2. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2019-2020.pdf
• 3. Ozmen V. Breast cancer in Turkey: clinical and histopathological characteristics (analysis of 13.240 patients). J Breast Health 2014;10:98-105.
• 4. Özmen V, Özmen T, Doğru V. Breast cancer in Turkey: an analysis of 20.000 patients with breast cancer. Eur J Breast Health 2019;15:141-6.
• 5. Kayhan A, Gurdal SO, Ozaydin N, Cabioglu N, Ozturk E, Ozcinar B, et al. Successful first-round results of a Turkish breast cancer screening program with mammography in Bahcesehir, Istanbul. Asian Pac J Cancer Prev 2014;15:1693-7.
• 6. Özmen V, Gürdal SÖ, Cabioğlu N, Özcinar B, Özaydin AN, Kayhan A, et al. Cost-effectiveness of breast cancer screening in Turkey, a developing country: results from Bahçeşehir ammography Screening Project. Eur J Breast Health 2017;13:117-22.
• 7. American Joint Committee on Cancer. AJCC Cancer Staging Manual, chapter 32, Springer, Berlin, Germany, 7th edition, 2010. Available from:URL: http://www.scribd.com/doc/41422083/Complete-AJCC-CancerStaging-Manual-7e-Text
• 8. DeSantis CE, Bray F, Ferlay J, Lortet-Tieulent J, Anderson BO, Jemal A. International variation in female breast cancer incidence and mortality rates. Cancer Epidemiol Biomarkers Prev 2015;24:1495-506.
• 9. Porter P. "Westernizing" women's risks? Breast cancer in lower-income countries. N Engl J Med 2008;358:213-6.
• 10. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today, accessed: 30 October 2018
• 11. Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg 2007;31:1031-40.
• 12. Peisl S, Zimmermann S, Camey B, Betticher D, Bouchardy C. Comparison between opportunistic and organized breast cancer mammography screening in the Swiss canton of Fribourg. BMC Cancer 2019;19:469.
• 13. Bihrmann K, Jensen A, Olsen AH, Njor S, Schwartz W, Vejborg I, et al. Performance of systematic and non-systematic (“opportunistic”) screening mammography: a comparative study from Denmark. J Med Screen 2008;15:23-6.
• 14. Vanier A, Leux C, Allioux C, Billon-Delacour S, Lombrail P, Molinié F. Are prognostic factors more favorable for breast cancer detected by organized screening than by opportunistic screening or clinical diagnosis? A study in Loire-Atlantique (France). Cancer Epidemiol 2013;37:683-7.
• 15. Sickles EA, D’Orsi CJ. ACR BI-RADS follow-up and outcomes monitoring. In: ACR BI-RADS Atlas, breast imaging reporting and data system. 5th ed. Reston, Va: American College of Radiology, 2013.
• 16. Allemani C, Sant M, Weir HK, Richardson LC, Baili P, Storm H, et al. Breast cancer survival in the US and Europe: a CONCORD high-resolution study. Int J Cancer 2013;132:1170-81.
• 17. Welch HG, Prorok PC, O'Malley AJ, Kramer BS. Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness. N Engl J Med 2016;375:1438-47.
• 18. Fracheboud J, Otto SJ, Van Dijck JAAM, Broeders MJ, Verbeek AL, de Koning HJ, et al. Decreased rates of advanced breast cancer due to mammography screening in the Netherlands. Br J Cancer. 2004;91:861-7.
• 19. Swedish Organised Service Screening Evaluation Group. Effect of mammographic service screening on stage at presentation of breast cancers in Sweden. Cancer 2007;109:2205-12.
• 20. Anttila A, Sarkeala T, Hakulinen T, Heinävaara S. Impacts of the Finnish service screening programme on breast cancer rates. BMC Public Health 2008;8:38.
• 21. Paci E, Duffy SW, Giorgi D, Zappa M, Crocetti E, Vezzosi V, et al. Quantification of the effect of mammographic screening on fatal breast cancers: the Florence Programme 1990-96. Br J Cancer 2002;87:65-9.
• 22. Simbrich A, Wellmann I, Heidrich J, Heidinger O, Hense HW. Trends in advanced breast cancer incidence rates after implementation of a mammography screening program in a German population. Cancer Epidemiol 2016;44:44-51.
• 23. Molinié F, Delacour-Billon S, Tretarre B, Delafosse P, Seradour B, Colonna M. Breast cancer incidence: decreasing trend in large tumours in women aged 50-74. J Med Screen 2017;24:189-94.
• 24. Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg 2007;31:1031-40.
• 25. deGelder R, Bulliard JL, de Wolf C, Fracheboud J, Draisma G, Schopper D, et al. Cost-effectiveness of opportunistic versus organized mammography screening in Switzerland. Eur J Cancer 2009;45:127-38.