1.
Matson, Sophia, et al.
(författare)
Nonattendance in mammographic screening: a study of intraurban differences in Malmo, Sweden, 1990-1994
2001
Ingår i: Cancer Detection and Prevention. - 0361-090X. ; 25:2, s. 132-137
Tidskriftsartikel (refereegranskat) abstract
Mammographic screening may reduce breast cancer mortality. Not all women, however, come for examination. The objective in this study from Malmo has been to assess extent to which the rate of nonattendance varies between residential areas with different sociodemographic profiles. The study is based on 32,605 women, 45 to 68 years old and living in 17 areas, who between 1990 and 1994 were invited to screening. Between age groups, the age-specific nonattendance rate ranged from 31% to 35 % (P < .01). The nonattendance rate was highest for women 65 years or older. Between residential areas, age-adjusted nonattendance rates ranged from 23% to 43% (P < .01). A socioeconomic score was developed to express the socioeconomic circumstances in the residential areas and ranged from -7.18 in the most deprived area to 5.01 in the least. Nonattendance covaried in an inverse fashion with the socioeconomic score (r = -0.78; P < .01). One of three women in this urban population did not accept the invitation to mammographic screening. Our conclusion is that women in areas with less favorable circumstances seem to be less willing to participate.
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4.
Blane, Caroline E, et al.
(författare)
Decreasing rate of fatty involution at screening mammography
2002
Ingår i: Academic Radiology. - 1878-4046. ; 9:8, s. 895-898
Tidskriftsartikel (refereegranskat) abstract
RATIONALE AND OBJECTIVES: This study was performed to document the perceived decrease in fatty involution at screening mammography during the past decade and evaluate the influence of hormone replacement therapy (HRT). MATERIALS AND METHODS: In December 1996, the mammograms of 261 consecutive screening patients with a comparison study obtained 5 years earlier were evaluated, and their breasts were categorized according to Breast Imaging Reporting and Data System categories for breast density. The women, aged 50-59 years, included 119 who had been receiving HRT for 0.25-15 years (mean, 3 years). From the files, 261 age-matched screening mammograms from 1986 were obtained; these patients also had comparison mammograms from 1981. Analysis of variance was used to determine differences between the 1980s group, the 1990s group receiving HRT, and the 1990s group not receiving HRT. Scheffe tests were used for post hoc comparisons. Stepwise regression analysis was used to evaluate the relative influence of age, decade, score of the first mammogram, and HRT. RESULTS: Breast density for the 1991 mammograms did not differ significantly from that in 1981 (P < .05). Initial breast density was the best predictor of final breast density in both decades (P < .001), regardless of HRT status. The change in breast density (toward fatty) over the 5-year interval in the 1980s (mean, 0.48) was significantly greater than that in both 1990s groups (mean for HRT group, 0.11; no HRT, 0.30; P < .05). CONCLUSION: These results confirm that breast density at screening mammography in the 1990s did not decrease with age at the same rate as in the 1980s, even in patients not receiving HRT.
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Hemdal, Bengt, et al.
(författare)
Comparison of the European and Nordic protocols on dosimetry in mammography involving a standard phantom
2000
Ingår i: Radiation Protection Dosimetry. - 1742-3406. ; 90:1, s. 149-154
Tidskriftsartikel (refereegranskat) abstract
The purpose of this work was to implement the European Protocol on Dosimetry in Mammography in Sweden. The standard average glandular dose, AGD, was measured on 32 mammography units in southern Sweden, according to the European protocol as well as to the Nordic protocol. The most important difference is that the European protocol evaluates the half value layer, HVL, of the X ray beam with the compression paddle present, while it is absent in the Nordic protocol. This results in considerably higher HVL values from the European protocol and thus to higher conversion factors for the calculation of the standard AGD. When the European protocol is used instead of the Nordic protocol the standard AGD is increased by 5 ± 2% (total variation 0-9%) at clinical settings and by 9 ± 3% (4-17%) at a standardised net optical density of 1.00. These results should be considered in quality control programmes and optimisation procedures as well as in interpretation of trends and in future legislation programmes.
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Nyström, Lennarth, et al.
(författare)
Long-term effects of mammography screening : Updated overview of the Swedish randomised trials
2002
Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 359:9310, s. 909-919
Tidskriftsartikel (refereegranskat) abstract
Background: There has been much debate about the value of screening mammography. Here we update the overview of the Swedish randomised controlled trials on mammography screening up to and including 1996. The Kopparberg part of the Two-County trial was not available for the overview, but the continuation of the Malm÷ trial (MMST II) has been added. The article also contains basic data from the trials that have not been presented before. Methods: The trials (n=247 010, invited group 129 750, control group 117 260) have been followed up by record linkage to the Swedish Cancer and Cause of Death Registers. The relative risks (RR) for breast cancer death and mortality were calculated for the invited and the control groups. The trial-specific as well as the age-specific effects were analysed. RRs were calculated by the density method, with total person-time experience of the cohort by time interval of follow-up as a basis for estimating mortality rates. We calculated weighted RRs and 95% CI with the Mantel-Haenszel procedure. Findings: The median trial time - the time from randomisation until the first round was completed for the control group or if the control group was not invited, until end of follow-up - was 6.5 years (range 3.0-18.1). The median follow-up time, the time from randomisation, to the end of follow-up, was 15.8 years (5.8-20.2). There were 511 breast cancer deaths in 1 864 770 women-years in the invited groups and 584 breast cancer deaths in 1 688 440 women-years in the control groups, a significant 21% reduction in breast cancer mortality (RR=0.79, 95% CI 0.70-0.89). The reduction was greatest in the age group 60-69 years at entry (33%). Looking at 5-year age groups, there were statistically significant effects in the age groups 55-59, 60-64, and 65-69 years (RR=0.76, 0.68, and 0.69, respectively). There was a small effect in women 50-54 years at randomisation (RR=0.95). The benefit in terms of cumulative breast cancer mortality started to emerge at about 4 years after randomisation and continued to increase to about 10 years. Thereafter the benefit in absolute terms was maintained throughout the period of observation. The age-adjusted relative risk for the total mortality was 0.98 (0.96-1.00). Interpretation: The advantageous effect of breast screening on breast cancer mortality persists after long-term follow-up. The recent criticism against the Swedish randomised controlled trials is misleading and scientifically unfounded.
10.
Prat, X, et al.
(författare)
European quadricentric evaluation of a breast MR biopsy and localization device: technical improvements based on phase-I evaluation
2002
Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:7, s. 1720-1727
Tidskriftsartikel (refereegranskat) abstract
Our purpose was to report about technical success, problems and solutions, as experienced in a first multicentre study on MR-guided localisation or vacuum biopsy of breast lesions. The study was carried out at four European sites using a dedicated prototype breast biopsy device. Experiences with 49 scheduled localisation procedures and 188 vacuum biopsies are reported. Apart from 35 dropped indications, one localisation procedure and 9 vacuum biopsies were not possible (3 times space problems due to obesity, 2 times too strong compression, 3 times impaired access froth medially, 2 times impaired access due to a metal bar). Problems due to too strong compression were recognised by repeat MR without compression. During the procedure problems leading to an uncertain result occurred in eight vacuum biopsies, two related to the procedure: one limited access, and one strong post-biopsy enhancement. Improvements after phase-I study concerned removal of the metal bar, development of an improved medial access, of a profile imitating the biopsy gun, optimisation of compression plates and improved software support. The partners agreed that the improvements answered all important technical problems.
