[Variations in the diagnostic confirmation process between breast cancer mass screening units]

Area of Science:

• Oncology
• Radiology
• Public Health

Background:

• Breast cancer mass screening programs aim for early detection and diagnosis.
• Standardization of diagnostic confirmation processes is crucial for consistent outcomes.
• Variability in diagnostic practices can impact lesion detection rates and patient management.

Purpose of the Study:

• To analyze variations in diagnostic confirmation processes across breast cancer screening units.
• To assess variations in episode outcomes and lesion detection rates.
• To investigate the relationship between specific diagnostic tests and lesion detection.

Main Methods:

• Observational study involving 34 breast cancer screening units in Spain (2002-2011).
• Analysis of standardized diagnostic and lesion detection test utilization.
• Statistical analysis of variation ratios and correlation between test rates and detection rates.

Main Results:

• Significant variation in diagnostic test use, with fine-needle aspiration showing the highest variation ratio (3.39).
• Detection rates for benign lesions, ductal carcinoma in situ, and invasive cancer varied (2.79, 1.99, 1.36, respectively).
• Positive correlations found between fine-needle aspiration and benign/invasive cancer detection, and core biopsy and benign/DCIS/invasive cancer detection.

Conclusions:

• Breast cancer screening units exhibit greater variability in invasive test utilization than in lesion detection.
• Higher fine-needle aspiration use correlated with increased benign lesion detection.
• Increased core biopsy use was associated with higher detection of benign lesions and cancer.