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Related Experiment Videos

Incident round cancers: what lessons can we learn?

K A Duncan1, G Needham, F J Gilbert

  • 1North East Scotland Breast Screening Centre, Aberdeen, Scotland.

Clinical Radiology
|February 17, 1998
PubMed
Summary

This study analyzed breast cancers missed during screening rounds. Identifying these "missed cancers" and their features, like parenchymal deformity, can improve breast cancer screening performance indicators.

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Area of Science:

  • Radiology
  • Oncology
  • Public Health

Background:

  • The National Health Service Breast Screening Programme has established performance targets.
  • Incident round cancers, detected in subsequent screening rounds after an initial negative screen, are not currently addressed by these targets.

Purpose of the Study:

  • To evaluate a subset of breast cancers detected in the incident round.
  • To identify characteristics of "missed cancers" that were not detected in the prevalent round mammograms.
  • To propose methods for incorporating these findings into quality assurance.

Main Methods:

  • Retrospective evaluation of prevalent round mammograms from 111 women diagnosed with breast cancer in the incident round.
  • Classification of prevalent mammograms as false negative, minimal signs, or new tumors.

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  • Analysis of radiographic features, focusing on parenchymal deformity and asymmetry.

    • Main Results:

    • Out of 112 incident cancers in 111 women, 19% were false negatives and 28% had minimal signs on prevalent mammograms.
    • Parenchymal deformity (21%) and asymmetry (17%) were disproportionately represented in missed tumors compared to all screen-detected tumors.
    • A significant portion (53%) represented new tumors not visible in the prior round.

    Conclusions:

    • Incident round cancers, particularly those with subtle signs like parenchymal deformity, represent a significant proportion of missed opportunities in breast cancer screening.
    • Quantifying these "missed cancers" can enhance the Quality Assurance Data Set and serve as a valuable performance indicator.
    • Retrospective review of mammograms is a useful teaching tool and aids in developing challenging case sets for training.