Alessandro Fancellu1, Valeria Sanna2, Maria L Sedda3, Daria Delrio3, Pietrina Cottu4, Angela Spanu5, Giuliana Giuliani4, Maurizio Conti6, Rafaela Piras7, Paola Crivelli6, Alberto Porcu4. 1. Department of Medical, Surgical, and Experimental Sciences, Unit of General Surgery 2, Clinica Chirurgica, University of Sassari, Sassari, Italy. Electronic address: afancel@uniss.it. 2. Unit of Medical Oncology, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy. 3. Mammography Screening Service, Azienda Tutela Salute Sassari, Sassari, Italy. 4. Department of Medical, Surgical, and Experimental Sciences, Unit of General Surgery 2, Clinica Chirurgica, University of Sassari, Sassari, Italy. 5. Department of Medical, Surgical, and Experimental Sciences, Unit of Nuclear Medicine, University of Sassari, Sassari, Italy. 6. Department of Medical, Surgical, and Experimental Sciences, Unit of Radiology, University of Sassari, Sassari, Italy. 7. Centre Hospitalier Universitaire Dupuytren, Limoges, France.
Abstract
BACKGROUND: The benefits of organized mammographic screening programs (OMSPs) in reducing breast cancer mortality have been addressed by several studies. This study was designed to specifically evaluate the advantages of OMPSs in terms of surgical management of patients with breast cancer. MATERIALS AND METHODS: Surgical treatment of 201 patients with breast cancer aged 50 to 69 years coming from OMSPs was compared with that of 532 non-OMSP patients in same age group. The likelihood of receiving BCS was analyzed through a multivariable regression model. RESULTS: The mean tumor size was smaller in the OMSP patients (14 mm vs. 18 mm; P < .01). The proportion of patients having metastatic lymph nodes was higher in the non-OMSP group (33.3% vs. 17.9%; P < .01). Rates of breast-conserving surgery (BCS) were significantly higher in the OMSP group (89.1% vs. 59.1%; P < .01). Sentinel node biopsy was carried out in 84.1% and 62.5% of patients in the OMSP and non-OMSP groups, respectively (P < .01). Rates of axillary lymph node dissection were significantly different (24.9% in the OMSP group and 35.8% in the non-OMSP group; P = .02). Re-excisions for infiltrated margins after BCS were lower in the OMSP group (4.8% vs. 12.7%; P < .01). Hospital stay was shorter in the OMSP group (2.13 vs. 3.02 days; P < .01). OMPS women had a 3-fold higher probability of receiving BCS. CONCLUSIONS: Patients with breast cancer belonging to OMSPs had a higher probability to receive less invasive surgery and to have shorter hospital stay. Our results support the use of campaigns aimed at increasing adhesion to mammography screening.
BACKGROUND: The benefits of organized mammographic screening programs (OMSPs) in reducing breast cancer mortality have been addressed by several studies. This study was designed to specifically evaluate the advantages of OMPSs in terms of surgical management of patients with breast cancer. MATERIALS AND METHODS: Surgical treatment of 201 patients with breast cancer aged 50 to 69 years coming from OMSPs was compared with that of 532 non-OMSP patients in same age group. The likelihood of receiving BCS was analyzed through a multivariable regression model. RESULTS: The mean tumor size was smaller in the OMSP patients (14 mm vs. 18 mm; P < .01). The proportion of patients having metastatic lymph nodes was higher in the non-OMSP group (33.3% vs. 17.9%; P < .01). Rates of breast-conserving surgery (BCS) were significantly higher in the OMSP group (89.1% vs. 59.1%; P < .01). Sentinel node biopsy was carried out in 84.1% and 62.5% of patients in the OMSP and non-OMSP groups, respectively (P < .01). Rates of axillary lymph node dissection were significantly different (24.9% in the OMSP group and 35.8% in the non-OMSP group; P = .02). Re-excisions for infiltrated margins after BCS were lower in the OMSP group (4.8% vs. 12.7%; P < .01). Hospital stay was shorter in the OMSP group (2.13 vs. 3.02 days; P < .01). OMPS women had a 3-fold higher probability of receiving BCS. CONCLUSIONS:Patients with breast cancer belonging to OMSPs had a higher probability to receive less invasive surgery and to have shorter hospital stay. Our results support the use of campaigns aimed at increasing adhesion to mammography screening.
Authors: Alessandro Fancellu; Xue Yun Zhao; Pietrina Cottu; Valeria Sanna; Yuan Ping Li; Qin Zhu; Cinzia Tanda; Ying Yi Zhang; Yan Mei Lai; Giorgio Carlo Ginesu; Shu Qin Dai; Alberto Porcu Journal: Breast Care (Basel) Date: 2020-01-21 Impact factor: 2.860
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