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Self-reported symptoms among participants in a population-based screening program.

Marthe Larsen1, Marie Lilleborge1, Einar Vigeland2

  • 1Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway.

Breast (Edinburgh, Scotland)
|September 14, 2020
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Summary
This summary is machine-generated.

Women reporting breast cancer symptoms like lumps during screening have a significantly higher risk of both screen-detected and interval cancers. Standardized follow-up is recommended for these symptomatic individuals in breast cancer screening programs.

Keywords:
Breast cancerInterval breast cancerLumpScreeningSymptomsTumour characteristics

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Area of Science:

  • Oncology
  • Radiology
  • Public Health

Background:

  • Limited research exists on the link between self-reported symptoms and breast cancer risk in population-based screening.
  • Understanding this association is crucial for optimizing screening program efficacy.

Purpose of the Study:

  • To investigate the association between self-reported breast symptoms and the risk of screen-detected and interval breast cancers.
  • To analyze the characteristics of tumors in relation to reported symptoms.

Main Methods:

  • Descriptive statistics and logistic regression analyses were performed on data from 785,642 women aged 50-69 attending BreastScreen Norway (1996-2016).
  • Women were categorized by reported symptoms: asymptomatic, lump, or skin/nipple changes.
  • Associations between symptom groups and cancer detection (screen-detected or interval) were analyzed, with results presented as odds ratios (OR) and 95% confidence intervals (CI).

Main Results:

  • 6.2% of screening examinations involved women reporting a lump or skin/nipple changes.
  • The rate of screen-detected cancer was substantially higher for women with a reported lump (45.2/1000 examinations) compared to asymptomatic women (5.1/1000).
  • Women with a reported lump had significantly higher adjusted ORs for screen-detected cancer (10.1) and interval cancer (2.0) compared to asymptomatic women. Tumors in symptomatic women also showed less favorable histopathological characteristics.

Conclusions:

  • A notable proportion of women attending breast cancer screening report symptoms, despite the program's focus on asymptomatic individuals.
  • Self-reported symptoms, particularly a lump, are strongly associated with an increased risk of both screen-detected and interval breast cancers.
  • Implementing standardized follow-up guidelines for women reporting symptoms during screening may enhance early detection and patient outcomes.