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Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer

PURPOSE: To evaluate the sensitivity and specificity of different screening modalities in women with a family history of breast cancer. METHODS: Our blinded, prospective, comparative cohort analysis included three types of screening, mammography, ultrasound, and clinical breast examination once per...

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Autores principales: Liljegren, Annelie, von Wachenfeldt, Anna, Azavedo, Edward, Eloranta, Sandra, Grundström, Helene, Ståhlbom, Anne Kinhult, Sundbom, Ann, Sundén, Per, Svane, Gunilla, Ulitzsch, Dieter, Arver, Brita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842249/
https://www.ncbi.nlm.nih.gov/pubmed/29318406
http://dx.doi.org/10.1007/s10549-017-4639-0
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author Liljegren, Annelie
von Wachenfeldt, Anna
Azavedo, Edward
Eloranta, Sandra
Grundström, Helene
Ståhlbom, Anne Kinhult
Sundbom, Ann
Sundén, Per
Svane, Gunilla
Ulitzsch, Dieter
Arver, Brita
author_facet Liljegren, Annelie
von Wachenfeldt, Anna
Azavedo, Edward
Eloranta, Sandra
Grundström, Helene
Ståhlbom, Anne Kinhult
Sundbom, Ann
Sundén, Per
Svane, Gunilla
Ulitzsch, Dieter
Arver, Brita
author_sort Liljegren, Annelie
collection PubMed
description PURPOSE: To evaluate the sensitivity and specificity of different screening modalities in women with a family history of breast cancer. METHODS: Our blinded, prospective, comparative cohort analysis included three types of screening, mammography, ultrasound, and clinical breast examination once per year for 6 years. Eligible patients for this study were healthy women with ≥ 17% lifetime risk of breast cancer or with a mutation in BRCA1 or BRCA2. RESULTS: A total of 632 women were screened between 2002 and 2012 (each for 6 years). During the study, 30 women were diagnosed with breast cancer, with 10 of these diagnoses occurring between screening visits, and six of the 10 diagnosed women were gene carriers. The clinical presentation for the women diagnosed with breast cancer was followed until 2017. No consistent patterns for the diagnostic capacity of the different screening modalities were found, although mammography showed low sensitivity, whereas ultrasound showed better sensitivity in three of the six rounds. The specificity was high in mammography and improved in ultrasound over time. Most importantly, clinical breast examination provided no additional information toward the diagnosis of breast cancer. CONCLUSION: Neither mammography nor ultrasound performed yearly were sensitive enough as standalone modalities, although high specificity was confirmed. Our findings indicate that high risk (> 29% life time risk) individuals and gene carriers can be screened biannually, using the same protocol as used in mutation carriers. Our results also suggest that low-risk groups (< 20%) may continue to be referred to population mammography screening program, while clinical breast examination may be omitted in all risk groups, and could be optional in gene carriers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10549-017-4639-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-58422492018-03-19 Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer Liljegren, Annelie von Wachenfeldt, Anna Azavedo, Edward Eloranta, Sandra Grundström, Helene Ståhlbom, Anne Kinhult Sundbom, Ann Sundén, Per Svane, Gunilla Ulitzsch, Dieter Arver, Brita Breast Cancer Res Treat Clinical Trial PURPOSE: To evaluate the sensitivity and specificity of different screening modalities in women with a family history of breast cancer. METHODS: Our blinded, prospective, comparative cohort analysis included three types of screening, mammography, ultrasound, and clinical breast examination once per year for 6 years. Eligible patients for this study were healthy women with ≥ 17% lifetime risk of breast cancer or with a mutation in BRCA1 or BRCA2. RESULTS: A total of 632 women were screened between 2002 and 2012 (each for 6 years). During the study, 30 women were diagnosed with breast cancer, with 10 of these diagnoses occurring between screening visits, and six of the 10 diagnosed women were gene carriers. The clinical presentation for the women diagnosed with breast cancer was followed until 2017. No consistent patterns for the diagnostic capacity of the different screening modalities were found, although mammography showed low sensitivity, whereas ultrasound showed better sensitivity in three of the six rounds. The specificity was high in mammography and improved in ultrasound over time. Most importantly, clinical breast examination provided no additional information toward the diagnosis of breast cancer. CONCLUSION: Neither mammography nor ultrasound performed yearly were sensitive enough as standalone modalities, although high specificity was confirmed. Our findings indicate that high risk (> 29% life time risk) individuals and gene carriers can be screened biannually, using the same protocol as used in mutation carriers. Our results also suggest that low-risk groups (< 20%) may continue to be referred to population mammography screening program, while clinical breast examination may be omitted in all risk groups, and could be optional in gene carriers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10549-017-4639-0) contains supplementary material, which is available to authorized users. Springer US 2018-01-09 2018 /pmc/articles/PMC5842249/ /pubmed/29318406 http://dx.doi.org/10.1007/s10549-017-4639-0 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Clinical Trial
Liljegren, Annelie
von Wachenfeldt, Anna
Azavedo, Edward
Eloranta, Sandra
Grundström, Helene
Ståhlbom, Anne Kinhult
Sundbom, Ann
Sundén, Per
Svane, Gunilla
Ulitzsch, Dieter
Arver, Brita
Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer
title Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer
title_full Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer
title_fullStr Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer
title_full_unstemmed Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer
title_short Prospective blinded surveillance screening of Swedish women with increased hereditary risk of breast cancer
title_sort prospective blinded surveillance screening of swedish women with increased hereditary risk of breast cancer
topic Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842249/
https://www.ncbi.nlm.nih.gov/pubmed/29318406
http://dx.doi.org/10.1007/s10549-017-4639-0
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