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The occurrence of interval cancers in the Nijmegen screening programme
P H Peeters1, A L Verbeek, J H Hendriks
1Department of Social Medicine, Nijmegen University, The Netherlands.
British Journal of Cancer
|June 1, 1989
Summary
Interval breast cancers, diagnosed between mammograms, were often missed due to errors or were undetectable. New imaging techniques may improve early breast cancer detection.
Area of Science:
- Oncology
- Radiology
- Public Health
Background:
- Population-based breast cancer screening programs aim for early detection.
- Interval cancers are diagnosed between scheduled screening examinations.
Purpose of the Study:
- To analyze the characteristics and outcomes of interval breast cancers detected in a long-term screening program.
- To evaluate the effectiveness of current screening intervals and identify areas for improvement.
Main Methods:
- Review of screening and diagnostic mammograms for 158 interval cancers over five 2-year periods.
- Classification of interval cancers into 'missed,' radiographically occult, and 'true' interval cancers.
- Survival analysis comparing interval cancer patients with controls.
Main Results:
- 26% of interval cancers were 'missed' due to technical or observer errors, with no decline over time.
- 16% were radiographically occult, often in dense tissue (P2/DY), including lobular invasive and ductal non-invasive types.
- 58% were 'true' interval cancers with similar survival to non-screen-detected cancers; annual screening would miss 63% of these.
Conclusions:
- Current screening intervals may not significantly reduce interval cancer rates or mortality.
- Improving imaging techniques is crucial to reduce 'missed' cancers and detect occult or dense-tissue tumors.
- Further research into advanced imaging modalities is warranted for enhanced breast cancer detection.