Y Lau1, P Y Lau, C M Chan, A Yip. 1. Department of Surgery, Kwong Wah Hospital, Kowloon, Hong Kong. kwfung@hk.super.net
Abstract
BACKGROUND: Breast cancer is the second most common cancer and cause of death in women from Hong Kong. The Well Women Clinic at Kwong Wah Hospital offers breast cancer screening (physical examination and mammography) for women over 40 years of age. METHODS: Results of screening over a 2-year period revealed an overall malignancy detection rate of 2.6 per 1000 screens with a strong selection bias for symptomatic women. RESULTS: Screening only slightly increased the proportion of stage I cancers detected; of the malignancies detected, a significant percentage were in situ cancers with doubtful effects on breast cancer mortality. Teamwork and communication were useful in keeping a low referral rate to the surgical clinic of 6.1%, as well as a low biopsy rate for mammographic abnormalities. CONCLUSIONS: A re-evaluation of the real risk of breast cancer in young women together with the lack of proven value from screening has suggested a need for reconsideration of offering screening to women 40 years and over in Hong Kong.
BACKGROUND:Breast cancer is the second most common cancer and cause of death in women from Hong Kong. The Well Women Clinic at Kwong Wah Hospital offers breast cancer screening (physical examination and mammography) for women over 40 years of age. METHODS: Results of screening over a 2-year period revealed an overall malignancy detection rate of 2.6 per 1000 screens with a strong selection bias for symptomatic women. RESULTS: Screening only slightly increased the proportion of stage I cancers detected; of the malignancies detected, a significant percentage were in situ cancers with doubtful effects on breast cancer mortality. Teamwork and communication were useful in keeping a low referral rate to the surgical clinic of 6.1%, as well as a low biopsy rate for mammographic abnormalities. CONCLUSIONS: A re-evaluation of the real risk of breast cancer in young women together with the lack of proven value from screening has suggested a need for reconsideration of offering screening to women 40 years and over in Hong Kong.
Authors: Joann G Elmore; Connie Y Nakano; Thomas D Koepsell; Laurel M Desnick; Carl J D'Orsi; David F Ransohoff Journal: J Natl Cancer Inst Date: 2003-09-17 Impact factor: 13.506