Evaluation of the Possible Benefits of Breast Cancer Screening in Women Aged 40 to 49 Years in the Steel Valley Region, Brazil Early Breast Cancer Test
Abstract
Background: This study investigates the effectiveness of mammographic screening for women aged 40 to 49 in Brazil's Steel Valley Region. Despite a Ministry of Health recommendation to start screenings at 50, 25% of breast cancer cases occur in the 40-49 age group.
Methods: The retrospective analysis, spanning 2008-2019 at Marcio Cunha Hospital, compared two groups: cancer diagnosed via screening mammography (277) and diagnostic mammography (229).
Results: Results showed delayed diagnoses for non-screened women, with 4.16 times higher mortality rate. Screening facilitated earlier detection of less malignant cancers (85.9% vs. 43.7%). Women diagnosed through screening were more likely to preserve their breasts (28.9% vs. 55.5% for Radical Breast Surgery and 71.1% vs. 28.9% for Breast-Sparing Surgery), and fewer axillary lymphadenectomies were performed. All statistical tests performed returned a p-value lower than 0.05 showing high statistical significance.
Conclusion: The findings support extending screening mammography access to all women over 40 in the Steel Valley region and underscore the need for broader-scale research in other areas. Recommendations include enhancing public awareness and establishing a breast cancer surveillance service.
Full text article
References
Federação Brasileira das Associações de Ginecologia e Obstetrícia. Manual de Orientação Mastologia. Available from: https://www.febrasgo.org.br/pt/component/zoo/category/mastologia; 2010.
American College of Physicians. ACP issues guidance statement for breast cancer screening of average-risk women with no symptoms. Available from: https://www.acponline.org/acp-newsroom/acp-issues-guidance-statement-for-breast-cancer-screening-of-average-risk-women-with-no-symptoms2022
World Heath Organization. Breast cancer now most common form of cancer: WHO taking action. Available from: https://www.who.int/news/item/03-02-2021-breast-cancer-now-most-common-form-of-cancer-who-taking-action2021
MINISTÉRIO DA SAÚDE - INSTITUTO NACIONAL DO CÂNCER. Controle do câncer de mama/ conceito e magnitude. Available from: https://www.inca.gov.br/controle-do-cancer-de-mama/conceito-e-magnitude2022
Rosa DD, Bines J, Werutsky G, Barrios CH, Cronemberger E, Queiroz GS, et al. The impact of sociodemographic factors and health insurance coverage in the diagnosis and clinicopathological characteristics of breast cancer in Brazil: AMAZONA III study (GBECAM 0115). Breast Cancer Res Treat. 2020;183(3):749-57. doi: 10.1007/s10549-020-05831-y.
Berry DA. Benefits and Risks of Screening Mammography for Women in Their Forties: a Statistical Appraisal. JNCI. 1998;90(19):1431-9. doi: 10.1093/jnci/90.19.1431.
International Commission on Radiological Protection. ICRP 60: Occupational radiological protection in interventional procedures. Available from: https://www.icrp.org/publication.asp?id=icrp%20publication%2060: International Commission on Radiological Protection. ICRP Publication 21; 1991.
Hospital Márcio Cunha. Sobre nós. Available from: https://www.anahp.com.br/associado/hospital-marcio-cunha/2022
Estado de Minas Gerais - Região Metropolitana do Vale do Aço. Conheça os municípios. Available from: https://www.agenciarmva.mg.gov.br/conheca-os-municipios/2022
National Cancer Institute. AJCC staging system. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/ajcc-staging-system2022
Webb ML, Cady B, Michaelson JS, Bush DM, Calvillo KZ, Kopans DB, et al. A failure analysis of invasive breast cancer: most deaths from disease occur in women not regularly screened. Cancer. 2014;120(18):2839-46. doi: 10.1002/cncr.28199.
Simon SD, Bines J, Werutsky G, Nunes JS, Pacheco FC, Segalla JG, et al. Characteristics and prognosis of stage I-III breast cancer subtypes in Brazil: The AMAZONA retrospective cohort study. Breast. 2019;44:113-9. doi: 10.1016/j.breast.2019.01.008.
Alanko J, Tanner M, Vanninen R, Auvinen A, Isola J. Triple-negative and HER2-positive breast cancers found by mammography screening show excellent prognosis. Breast Cancer Res Treat. 2021;187(1):267-74. doi: 10.1007/s10549-020-06060-z.
Moss SM, Wale C, Smith R, Evans A, Cuckle H, Duffy SW. Effect of mammographic screening from age 40 years on breast cancer mortality in the UK Age trial at 17 years' follow-up: a randomised controlled trial. Lancet Oncol. 2015;16(9):1123-32. doi: 10.1016/S1470-2045(15)00128-X.
Ernst MF, Voogd AC, Coebergh JW, Repelaer van Driel OJ, Roukema JA. The introduction of mammographical screening has had little effect on the trend in breast-conserving surgery: a population-based study in Southeast Netherlands. Eur J Cancer. 2001;37(18):2435-40. doi: 10.1016/s0959-8049(01)00316-1.
Paci E, Duffy SW, Giorgi D, Zappa M, Crocetti E, Vezzosi V, et al. Are breast cancer screening programmes increasing rates of mastectomy? Observational study. BMJ. 2002;325(7361):418. doi: 10.1136/bmj.325.7361.418.
Lefeuvre D, Catajar N, Le Bihan Benjamin C, Ifrah N, De Bels F, Viguier J, et al. Breast cancer screening: Impact on care pathways. Cancer Med. 2019;8(8):4070-8. doi: 10.1002/cam4.2283.
Samnakay N, Tinning J, Ives A, Willsher P, Archer S, Wylie E, et al. Rates for mastectomy are lower in women attending a breast-screening programme. ANZ J Surg. 2005;75(11):936-9. doi: 10.1111/j.1445-2197.2005.03584.x.
Destounis S, Santacroce A. Age to Begin and Intervals for Breast Cancer Screening: Balancing Benefits and Harms. AJR Am J Roentgenol. 2018;210(2):279-84. doi: 10.2214/AJR.17.18730.
Monticciolo DL, Newell MS, Hendrick RE, Helvie MA, Moy L, Monsees B, et al. Breast Cancer Screening for Average-Risk Women: Recommendations From the ACR Commission on Breast Imaging. J Am Coll Radiol. 2017;14(9):1137-43. doi: 10.1016/j.jacr.2017.06.001.
Ray KM, Joe BN, Freimanis RI, Sickles EA, Hendrick RE. Screening Mammography in Women 40-49 Years Old: Current Evidence. AJR Am J Roentgenol. 2018;210(2):264-70. doi: 10.2214/AJR.17.18707.
Hidding JT, Beurskens CH, van der Wees PJ, van Laarhoven HW, Nijhuis-van der Sanden MW. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS One. 2014;9(5):e96748. doi: 10.1371/journal.pone.0096748.
Howell A, Anderson AS, Clarke RB, Duffy SW, Evans DG, Garcia-Closas M, et al. Risk determination and prevention of breast cancer. Breast Cancer Res. 2014;16(5):446. doi: 10.1186/s13058-014-0446-2.
Yedjou CG, Sims JN, Miele L, Noubissi F, Lowe L, Fonseca DD, et al. Health and Racial Disparity in Breast Cancer. Adv Exp Med Biol. 2019;1152:31-49. doi: 10.1007/978-3-030-20301-6_3.
Howlader N, Altekruse SF, Li CI, Chen VW, Clarke CA, Ries LA, et al. US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst. 2014;106(5). doi: 10.1093/jnci/dju055.
Corrêa PB, Toralles MBP, Abe-Sandes K, Machado TMB, Bonfim TF, Meyer L, et al. Câncer de mama triplo negativo e sua associação com ancestralidade africana. Revista de Ciências Médicas e Biológicas. 2010;9(1):3-7. doi: 10.9771/cmbio.v9i1.4631.
INSTITUTO NACIONAL DE CÂNCER. Monitoramento das ações de controle dos cânceres de mama. https://www.inca.gov.br/publicacoes/informativos/informativo-deteccao-precoce-no-2-2021; 2021. Contract No.: Boletim ano 12, no 2.
Authors
Copyright (c) 2024 Archives of Breast Cancer
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright©. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International License, which permits copy and redistribution of the material in any medium or format or adapt, remix, transform, and build upon the material for any purpose, except for commercial purposes.