Delayed breast cancer diagnosis after repeated recall at biennial screening mammography: an observational follow-up study from the Netherlands
Menée aux Pays-Bas à partir de données portant sur 283 479 clichés mammographiques réalisés entre 1997 et 2006 et sur 534 177 clichés mammographiques réalisés entre 2007 et 2016, cette étude analyse l'évolution de la proportion de femmes atteintes d'un cancer du sein dont le diagnostic n'a été confirmé qu'après le second rappel d'un programme biennal de dépistage du cancer du sein, identifie les causes de ce retard et analyse l'effet de ce dernier sur les caractéristiques de la tumeur à la détection et sur le pronostic
Background : Delay in detection of breast cancer may worsen tumour characteristics, with progression of tumour size and a higher risk of metastatic lymph nodes. The purpose of this study was to investigate delayed breast cancer diagnosis after repeated recall for the same mammographic abnormality at screening.
Methods : This was a retrospective study performed in two cohorts of women enrolled in a mammography screening programme in the Netherlands. All women aged 50
−
75 who underwent biennial screening mammography either between January 1, 1997 and December 31, 2006 (cohort 1) or between January 1, 2007 and December 31, 2016 (cohort 2) were included.
Results : The cohorts showed no difference in proportions of women with delayed breast cancer diagnosis of at least 2 years (2.2% versus 2.8%, P = 0.29). Most delays were caused by incorrect BI-RADS classifications after recall (74.2%). An increase in mean tumour size was seen when comparing sizes at initial false-negative recall and at diagnosis of breast cancer (P < 0.001).
Conclusions : The proportion of women with a long delay in breast cancer confirmation following repeated recall at screening mammography has not decreased during 20 years of screening. These delays lead to larger tumour size at detection and may negatively influence prognosis.
British Journal of Cancer , résumé, 2020