The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice
Background: In Dutch breast cancer screening, solitary, new or growing well-circumscribed masses should be recalled for further assessment. This results in cancers detected but also in false positive recalls, especially at initial screening. The aim of this study was to determine characteristics of...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-06-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977623004514 |
| _version_ | 1797804686204469248 |
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| author | Tanya D. Geertse Daniëlle van der Waal Willem Vreuls Eric Tetteroo Lucien E.M. Duijm Ruud M. Pijnappel Mireille J.M. Broeders |
| author_facet | Tanya D. Geertse Daniëlle van der Waal Willem Vreuls Eric Tetteroo Lucien E.M. Duijm Ruud M. Pijnappel Mireille J.M. Broeders |
| author_sort | Tanya D. Geertse |
| collection | DOAJ |
| description | Background: In Dutch breast cancer screening, solitary, new or growing well-circumscribed masses should be recalled for further assessment. This results in cancers detected but also in false positive recalls, especially at initial screening. The aim of this study was to determine characteristics of well-circumscribed masses at mammography and identify potential methods to improve the recall strategy. Methods: A systematic literature search was performed using PubMed. In addition, follow-up data were retrieved on all 8860 recalled women in a Dutch screening region from 2014 to 2019. Results: Based on 15 articles identified in the literature search, we found that probably benign well-circumscribed masses that were kept under surveillance had a positive predictive value (PPV) of 0–2%. New or enlarging solitary well-circumscribed masses had a PPV of 10–12%. In general the detected carcinomas had a favorable prognosis. In our exploration of screening practice, 25% of recalls (2133/8860) were triggered by a well-circumscribed mass. Those recalls had a PPV of 2.0% for initial and 10.6% for subsequent screening. Most detected carcinomas had a favorable prognosis as well. Conclusion: To recognize malignancies presenting as well-circumscribed masses, identifying solitary, new or growing lesions is key. This information is missing at initial screening since prior examinations are not available, leading to a low PPV. Access to prior clinical examinations may therefore improve this PPV. In addition, given the generally favorable prognosis of screen-detected malignant well-circumscribed masses, one may opt to recall these lesions at subsequent screening, if grown, rather than at initial screening. |
| first_indexed | 2024-03-13T05:40:56Z |
| format | Article |
| id | doaj.art-b1124f3f02494f7692360180354272c3 |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-03-13T05:40:56Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-b1124f3f02494f7692360180354272c32023-06-14T04:32:44ZengElsevierBreast1532-30802023-06-0169431440The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practiceTanya D. Geertse0Daniëlle van der Waal1Willem Vreuls2Eric Tetteroo3Lucien E.M. Duijm4Ruud M. Pijnappel5Mireille J.M. Broeders6Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; Corresponding author. Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands.Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the NetherlandsCanisius Wilhelmina Hospital, Department of Radiology Weg Door, Jonkerbos 100, 6532 SZ, Nijmegen, the NetherlandsAmphia Hospital, Department of Radiology Molengracht 21, 4818 CK, Breda, the NetherlandsCanisius Wilhelmina Hospital, Department of Radiology Weg Door, Jonkerbos 100, 6532 SZ, Nijmegen, the NetherlandsDutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; University Medical Centre Utrecht, Utrecht UniversityDepartment of Radiology, Heidelberglaan 100, 3584 CX, Utrecht, the NetherlandsDutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; Radboud University Medical CenterDepartment for Health Evidence Geert Grooteplein 21, 6525 EZ, Nijmegen, the NetherlandsBackground: In Dutch breast cancer screening, solitary, new or growing well-circumscribed masses should be recalled for further assessment. This results in cancers detected but also in false positive recalls, especially at initial screening. The aim of this study was to determine characteristics of well-circumscribed masses at mammography and identify potential methods to improve the recall strategy. Methods: A systematic literature search was performed using PubMed. In addition, follow-up data were retrieved on all 8860 recalled women in a Dutch screening region from 2014 to 2019. Results: Based on 15 articles identified in the literature search, we found that probably benign well-circumscribed masses that were kept under surveillance had a positive predictive value (PPV) of 0–2%. New or enlarging solitary well-circumscribed masses had a PPV of 10–12%. In general the detected carcinomas had a favorable prognosis. In our exploration of screening practice, 25% of recalls (2133/8860) were triggered by a well-circumscribed mass. Those recalls had a PPV of 2.0% for initial and 10.6% for subsequent screening. Most detected carcinomas had a favorable prognosis as well. Conclusion: To recognize malignancies presenting as well-circumscribed masses, identifying solitary, new or growing lesions is key. This information is missing at initial screening since prior examinations are not available, leading to a low PPV. Access to prior clinical examinations may therefore improve this PPV. In addition, given the generally favorable prognosis of screen-detected malignant well-circumscribed masses, one may opt to recall these lesions at subsequent screening, if grown, rather than at initial screening.http://www.sciencedirect.com/science/article/pii/S0960977623004514Breast cancerScreening populationWell-circumscribed massesProbably benign lesionsFalse positive screening outcomes |
| spellingShingle | Tanya D. Geertse Daniëlle van der Waal Willem Vreuls Eric Tetteroo Lucien E.M. Duijm Ruud M. Pijnappel Mireille J.M. Broeders The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice Breast Breast cancer Screening population Well-circumscribed masses Probably benign lesions False positive screening outcomes |
| title | The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice |
| title_full | The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice |
| title_fullStr | The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice |
| title_full_unstemmed | The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice |
| title_short | The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice |
| title_sort | dilemma of recalling well circumscribed masses in a screening population a narrative literature review and exploration of dutch screening practice |
| topic | Breast cancer Screening population Well-circumscribed masses Probably benign lesions False positive screening outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S0960977623004514 |
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