• Breast cancer risk assessment and screening - Is it a persistent problem in a rural population?

      Johnston, Alison; Neary, Shane; Sugrue, Michael; Department of Breast Surgery, Breast Centre North West, Letterkenny University Hospital, Donegal Clinical Research Academy, Ireland (Remedy Publications LLC, 2017-08-09)
      Trend analysis of breast screening uptake in those meeting screening criteria that were newly diagnosed with breast cancer. Retrospective review of all breast cancer patients diagnosed between 2010 and 2014. Patients’ demographics, screening, risk assessment, pathological stages and surgical treatment utilization were recorded. 150 patients, mean ages 55.4 ± 10.2 years (range 29–90), were studied. Overall 65/150 (43.3%) had optimal screening pre cancer diagnosis and 85/150 (56.7%) suboptimal. The trend in optimal screening improved from 30% to 60% over the study period. The mean overall tumour size (excluding DCIS patients) in 131 patients was 32.8 mm; 26.9 mm in optimally and 38.5 mm in the suboptimally screened groups (p = 0.06 x2 df8). 113/150 (75.3%) diagnosed with early stage breast cancer and 37/150 (24.7%) late stage. Principally late stage at diagnosis was within the group with suboptimal screening; 100%, 100%, 63.6%, 75% and 60% respectively for years 2010–2014. This study identified improving trends in compliance with international screening and risk assessment guidelines. Failure to screen results in more advanced disease; further public health measures to engage appropriate screening may improve stage at presentation and breast cancer outcomes.