Weighing the Benefits and Burdens of Mammography Screening Among Women Age 80 Years or Older
Mara A. Schonberg, Rebecca A. Silliman, and Edward R. Marcantonio
J Clin Oncol 27:1774-1780, 2009
Link to Journal
The majority of women ≥ 80 years are screened with mammography yet few benefit.
Meanwhile, 12.5% experience a burden from screening.
The data from this study can be used to inform elderly women's decision making and potentially lead to more rational use of screening.
Thursday, 9 April 2009
Wednesday, 1 April 2009
Breast-conserving surgery with or without radiotherapy vs mastectomy for ductal carcinoma in situ: French Survey experience
Breast-conserving surgery with or without radiotherapy vs mastectomy for ductal carcinoma in situ: French Survey experience
B Cutuli, C Lemanski, A Fourquet, B de Lafontan, S Giard, A Meunier, R Pioud-Martigny, F Campana, H Marsiglia, S Lancrenon, E Mery, F Penault-Llorca, E Fondrinier & C Tunon de Lara
Br J Cancer 2009 100: 1048-1054
Link to Journal
Ductal carcinoma in situ was diagnosed by mammography in 87.6% of patients. Mastectomy, conservative surgery alone (CS) and CS with radiotherapy (CS+RT) were performed in 30.5, 7.8 and 61.7% of patients, respectively. Thus, 89% of patients treated by CS received adjuvant RT. Sentinel node biopsy (SNB) and axillary dissection (AD) were performed in 21.3 and 10.4% of patients, respectively. Hormone therapy was administered to 13.4% of the patients (80% tamoxifen).
Median tumour size was 14.5 mm (6, 11 and 35 mm for CS, CS+RT and mastectomy, respectively, P<0.0001). Nuclear grade was high in 21% of patients, intermediate in 38.5% and low in 40.5%. Excision was considered complete in 92% (CS) and 88.3% (CS+RT) of patients. Oestrogen receptors were positive in 69.8% of assessed cases (31%). Treatment modalities varied widely according to region: mastectomy rate, 20–37%; adjuvant RT, 84–96%; hormone treatment, 6–34%.
This survey on current DCIS management in France has highlighted correlations between pathological features (tumour size, margin and grade) and treatment options, with several similar variations to those observed in recent UK and US studies.
B Cutuli, C Lemanski, A Fourquet, B de Lafontan, S Giard, A Meunier, R Pioud-Martigny, F Campana, H Marsiglia, S Lancrenon, E Mery, F Penault-Llorca, E Fondrinier & C Tunon de Lara
Br J Cancer 2009 100: 1048-1054
Link to Journal
Ductal carcinoma in situ was diagnosed by mammography in 87.6% of patients. Mastectomy, conservative surgery alone (CS) and CS with radiotherapy (CS+RT) were performed in 30.5, 7.8 and 61.7% of patients, respectively. Thus, 89% of patients treated by CS received adjuvant RT. Sentinel node biopsy (SNB) and axillary dissection (AD) were performed in 21.3 and 10.4% of patients, respectively. Hormone therapy was administered to 13.4% of the patients (80% tamoxifen).
Median tumour size was 14.5 mm (6, 11 and 35 mm for CS, CS+RT and mastectomy, respectively, P<0.0001). Nuclear grade was high in 21% of patients, intermediate in 38.5% and low in 40.5%. Excision was considered complete in 92% (CS) and 88.3% (CS+RT) of patients. Oestrogen receptors were positive in 69.8% of assessed cases (31%). Treatment modalities varied widely according to region: mastectomy rate, 20–37%; adjuvant RT, 84–96%; hormone treatment, 6–34%.
This survey on current DCIS management in France has highlighted correlations between pathological features (tumour size, margin and grade) and treatment options, with several similar variations to those observed in recent UK and US studies.
Evaluation of extension of breast screening to women aged 65–70 in England using screening performance measures
Evaluation of extension of breast screening to women aged 65–70 in England using screening performance measures
R L Bennett, R G Blanks & S M Moss
Br J Cancer 2009 100: 1043-1047
Link to Journal
Average uptake was 72.8% for women aged 65–70 and 76.7% for women aged 50–64. For women screened within the last 5 years, uptake was 88.7% for older women and 89.1% for younger women. For women previously screened within 5 years the invasive cancer detection rate was 17% higher in the 65–70 age group than in the 60–64 age group.
The rates of recall to assessment and PPV were 3.5 and 27.6% in women aged 65–70 and 3.4 and 24.6% in women aged 50–64 respectively.
These results suggest that, as in the earlier demonstration studies, uptake rates remain high in older women, and many more older women attend following an invitation than had previously self-referred.
The cancer detection rate is higher in this older age group, whereas rates of recall are generally similar to those in younger women; consequently the PPV is also higher in older women.
R L Bennett, R G Blanks & S M Moss
Br J Cancer 2009 100: 1043-1047
Link to Journal
Average uptake was 72.8% for women aged 65–70 and 76.7% for women aged 50–64. For women screened within the last 5 years, uptake was 88.7% for older women and 89.1% for younger women. For women previously screened within 5 years the invasive cancer detection rate was 17% higher in the 65–70 age group than in the 60–64 age group.
The rates of recall to assessment and PPV were 3.5 and 27.6% in women aged 65–70 and 3.4 and 24.6% in women aged 50–64 respectively.
These results suggest that, as in the earlier demonstration studies, uptake rates remain high in older women, and many more older women attend following an invitation than had previously self-referred.
The cancer detection rate is higher in this older age group, whereas rates of recall are generally similar to those in younger women; consequently the PPV is also higher in older women.
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