Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience

Abstract Background/aim Breast cancer is the most common female malignancy in the world. Nearly ninety percent of screening-detected breast cancers were diagnosed with earlier stages of 0 to II in Taiwan. It’s widely acknowledged that mammography screening of breast cancer can achieve the goal of ea...

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Main Authors: Hsin-Ju Han, Yuan-Chia Chu, Jane Wang, Yi-Chen Lai, Ling-Ming Tseng, Chi-Cheng Huang
Format: Article
Language:English
Published: BMC 2023-06-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-023-02445-6
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author Hsin-Ju Han
Yuan-Chia Chu
Jane Wang
Yi-Chen Lai
Ling-Ming Tseng
Chi-Cheng Huang
author_facet Hsin-Ju Han
Yuan-Chia Chu
Jane Wang
Yi-Chen Lai
Ling-Ming Tseng
Chi-Cheng Huang
author_sort Hsin-Ju Han
collection DOAJ
description Abstract Background/aim Breast cancer is the most common female malignancy in the world. Nearly ninety percent of screening-detected breast cancers were diagnosed with earlier stages of 0 to II in Taiwan. It’s widely acknowledged that mammography screening of breast cancer can achieve the goal of early diagnosis and treatment in terms of preventive task while neglected interval cancers are associated with unfavorable tumor characteristics and worse outcomes. The purpose of this study was to explore the characteristics of screening-detected breast cancers in Taiwan. Materials and methods Both screening and diagnostic mammography examinations with accompanied BI-RADS (breast imaging-reporting and data system) classification were extracted from the health information system and linked to cancer registry in Taiwan. Enrolled population included those attending their first mammography between 2012 and 2016, excluding subjects with previous breast cancer, or with missing or incomplete data. We compared treatment outcomes between breast cancers with either initial screening or diagnostic mammography (control group), and investigated the compositions of breast cancers detected by screening mammography through direct chart reviews. Results A total of 84,246 screening and 61,230 diagnostic mammography sessions were performed from 2010 to 2020. More positive results (BI-RADS 0, 3, 4 and 5) were observed for those attending the first diagnostic than the first screening mammography (43.58% versus 16.12%, p < 0.001). Earlier stages (0 and I) distribution (92% versus 81%, p < 0.0001), better survivorship (overall survival: 96.91% versus 92.17%, p = 0.007) and a lower HER2 (human epidermal growth factor receptor II) positive status and lower tumor grade were noted in breast cancers with initial screening rather than diagnostic mammography. Among 26,103 mammography screening invitees between 2012 and 2016, 325 breast cancers were ascertained from cancer registry. Of these, 234 had one, 72 had two and 19 had three episodes of mammography before cancer diagnosis. Extensive chart reviews revealed that women with and without breast symptoms constituted 29.9 and 70.1% of the 325 screening-detected breast cancers, with the latter further divided into false negative results (interval cancer), diagnosed at the first mammography, diagnostic at the secondary or subsequent mammography and those with a delayed biopsy or confirmatory imaging constituted (5.2, 47, 10.5 and 7.4%). Conclusion Screening-detected breast cancers were a mixture of women with and without symptoms, those with a false negative result, true negative results with cancer detected at subsequent mammography and non-adherers. Despite this, efficacy of mammography screening was ascertained in Taiwan from this study. To further enhance earlier detection and decrease false negativity, the impact of repeated mammography, and additional sonography for symptomatic women, compliance following a positive screening mammography should not be overemphasized.
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spelling doaj.art-7ded9062cc3e4a99a13080adfc9a45aa2023-06-25T11:26:37ZengBMCBMC Women's Health1472-68742023-06-012311910.1186/s12905-023-02445-6Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experienceHsin-Ju Han0Yuan-Chia Chu1Jane Wang2Yi-Chen Lai3Ling-Ming Tseng4Chi-Cheng Huang5Department of Surgery, Taipei Veterans General HospitalInformation Management Office, Taipei Veterans General HospitalDepartment of Radiology, Taipei Veterans General HospitalComprehensive Breast Health Center, Taipei Veterans General HospitalDepartment of Surgery, Taipei Veterans General HospitalDepartment of Surgery, Taipei Veterans General HospitalAbstract Background/aim Breast cancer is the most common female malignancy in the world. Nearly ninety percent of screening-detected breast cancers were diagnosed with earlier stages of 0 to II in Taiwan. It’s widely acknowledged that mammography screening of breast cancer can achieve the goal of early diagnosis and treatment in terms of preventive task while neglected interval cancers are associated with unfavorable tumor characteristics and worse outcomes. The purpose of this study was to explore the characteristics of screening-detected breast cancers in Taiwan. Materials and methods Both screening and diagnostic mammography examinations with accompanied BI-RADS (breast imaging-reporting and data system) classification were extracted from the health information system and linked to cancer registry in Taiwan. Enrolled population included those attending their first mammography between 2012 and 2016, excluding subjects with previous breast cancer, or with missing or incomplete data. We compared treatment outcomes between breast cancers with either initial screening or diagnostic mammography (control group), and investigated the compositions of breast cancers detected by screening mammography through direct chart reviews. Results A total of 84,246 screening and 61,230 diagnostic mammography sessions were performed from 2010 to 2020. More positive results (BI-RADS 0, 3, 4 and 5) were observed for those attending the first diagnostic than the first screening mammography (43.58% versus 16.12%, p < 0.001). Earlier stages (0 and I) distribution (92% versus 81%, p < 0.0001), better survivorship (overall survival: 96.91% versus 92.17%, p = 0.007) and a lower HER2 (human epidermal growth factor receptor II) positive status and lower tumor grade were noted in breast cancers with initial screening rather than diagnostic mammography. Among 26,103 mammography screening invitees between 2012 and 2016, 325 breast cancers were ascertained from cancer registry. Of these, 234 had one, 72 had two and 19 had three episodes of mammography before cancer diagnosis. Extensive chart reviews revealed that women with and without breast symptoms constituted 29.9 and 70.1% of the 325 screening-detected breast cancers, with the latter further divided into false negative results (interval cancer), diagnosed at the first mammography, diagnostic at the secondary or subsequent mammography and those with a delayed biopsy or confirmatory imaging constituted (5.2, 47, 10.5 and 7.4%). Conclusion Screening-detected breast cancers were a mixture of women with and without symptoms, those with a false negative result, true negative results with cancer detected at subsequent mammography and non-adherers. Despite this, efficacy of mammography screening was ascertained in Taiwan from this study. To further enhance earlier detection and decrease false negativity, the impact of repeated mammography, and additional sonography for symptomatic women, compliance following a positive screening mammography should not be overemphasized.https://doi.org/10.1186/s12905-023-02445-6Breast cancerScreeningMammographyInterval breast cancerTaiwanSymptomatology
spellingShingle Hsin-Ju Han
Yuan-Chia Chu
Jane Wang
Yi-Chen Lai
Ling-Ming Tseng
Chi-Cheng Huang
Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience
BMC Women's Health
Breast cancer
Screening
Mammography
Interval breast cancer
Taiwan
Symptomatology
title Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience
title_full Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience
title_fullStr Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience
title_full_unstemmed Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience
title_short Characteristics of breast cancers detected by screening mammography in Taiwan: a single institute’s experience
title_sort characteristics of breast cancers detected by screening mammography in taiwan a single institute s experience
topic Breast cancer
Screening
Mammography
Interval breast cancer
Taiwan
Symptomatology
url https://doi.org/10.1186/s12905-023-02445-6
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