An assessment of the influence of clinical breast examination reports on the interpretation of mammograms in a breast screening program.

1998 ◽  
Vol 48 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Julia A. Knight ◽  
Alyssa R. Libstug ◽  
Veronika Moravan ◽  
Norman F. Boyd
Keyword(s):  
Breast Screening ◽  
Screening Program ◽  
Clinical Breast Examination ◽  
Breast Examination ◽  
Clinical Breast

Estimation of the benefit and harms of including clinical breast examination in an organized breast screening program

The Breast ◽  
2019 ◽  
Vol 43 ◽  
pp. 105-112
Author(s):  
Huan Jiang ◽  
Stephen D. Walter ◽  
Patrick Brown ◽  
Parminder Raina ◽  
Anna M. Chiarelli
Keyword(s):  
Breast Screening ◽  
Screening Program ◽  
Clinical Breast Examination ◽  
Breast Examination ◽  
Clinical Breast

The randomized trial of mammography screening that was not—A cautionary tale

2021 ◽  
pp. 096914132110594
Author(s):  
Martin J Yaffe ◽  
Jean M. Seely ◽  
Paula B. Gordon ◽  
Shushiela Appavoo ◽  
Daniel B. Kopans
Keyword(s):  
Breast Cancer ◽  
Breast Screening ◽  
Clinical Breast Examination ◽  
Control Group ◽  
Multiple Indicators ◽  
National Breast ◽  
Breast Examination ◽  
Screening Study ◽  
Clinical Breast ◽  
And Performance

Two randomized trials were conducted in Canada in the 1980s to test the efficacy of breast cancer screening. Neither of the trials demonstrated benefit. Concerns were raised regarding serious errors in trial design and conduct. Here we describe the conditions that could allow subversion of randomization to occur and the inclusion of many symptomatic women in a screening trial. We examine anomalies in data where the balance would be expected between trial arms. “Open book” randomization and performance of clinical breast examination on all women before allocation to a trial arm allowed women with palpable findings to be mis-randomized into the mammography arm. Multiple indicators raising suspicion of subversion are present including a large excess in poor-prognosis cancers in the mammography trial arm at prevalence screen. Personnel described shifting of women from the control group into the mammography group. There is compelling evidence of subversion of randomization in Canadian National Breast Screening Study. Mis-randomization of even a few women with advanced breast cancer could markedly affect measured screening efficacy. The Canadian National Breast Screening Study trials should not influence breast screening policies.

Results from the Ontario breast screening program, 1990–1995

1998 ◽  
Vol 5 (2) ◽  
pp. 73-80 ◽  
Author(s):  
A R Libstug ◽  
V Moravan ◽  
S E Aitken
Keyword(s):  
Cancer Detection ◽  
Breast Screening ◽  
Screening Programme ◽  
Screening Program ◽  
Tumour Size ◽  
Clinical Breast Examination ◽  
Nodal Status ◽  
Detection Rates ◽  
Intermediate Outcomes ◽  
Clinical Breast

Objective The Ontario breast screening program (OBSP) is a provincial breast screening programme offering two view mammography, clinical breast examination, instruction in breast self examination, and systematic two year recall to Ontario women 50 years and older. This paper presents the results of the programme's intermediate outcomes from 1990 to 1995 and compares them with recommended standards and other published programmes. Methods Programme data from a provincial screening programme in a large Canadian province were collated from 18 sites in operation between July 1990 and December 1995. Results In its first five years of operation, 215 738 screens were performed on 142 173 women. The referral rates for initial and rescreens are 13.8% and 8.6% respectively. A total of 1718 women were diagnosed with cancer, 1325 at initial screens and 393 at rescreens, resulting in cancer detection rates of 9.3 and 5.3/1000. The cancer detection rates for invasive cancers were 8.3/1000 at initial screens and 4.5/1000 at rescreens. The benign to malignant biopsy ratio was 1.5:1 at initial screens and 1.3:1 at rescreens. Of the 1358 cancers diagnosed at initial screens, 11.6% were in situ and 50.3% of invasive cancers of known size were <15 mm. For women with invasive cancer where nodal status was known, 71.3% were node negative. The proportions at rescreens were 15.7%, 60.0%, and 76.0% respectively. Conclusions While the OBSP has achieved the standards suggested by other studies and programmes during its first five years of operation, there is work to be done to increase participation and obtain more complete data on tumour size and nodal status.

scholarly journals The Contribution of Clinical Breast Examination to the Accuracy of Breast Screening

2009 ◽  
Vol 101 (18) ◽  
pp. 1236-1243 ◽  
Author(s):  
A. M. Chiarelli ◽  
V. Majpruz ◽  
P. Brown ◽  
M. Theriault ◽  
R. Shumak ◽  
...  
Keyword(s):  
Breast Screening ◽  
Clinical Breast Examination ◽  
Breast Examination ◽  
Clinical Breast

scholarly journals ARE WE DOING ENOUGH IN PROMOTING BREAST CANCER SCREENING: AN EVALUATION OF MALAYSIA BREAST CANCER SCREENING PROGRAM

2021 ◽  
Vol 21 (3) ◽  
pp. 230-239
Author(s):  
Zakiah Mohd Said ◽  
Rosnah Sutan
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Cancer Control ◽  
Participation Rate ◽  
Clinical Breast Examination ◽  
Cancer Screening Program ◽  
Breast Examination ◽  
Clinical Breast

Breast cancer is the most common cancer affecting  women globally. Several ways of breast cancer screening tools are available. This study aims to evaluate Malaysia's breast cancer screening program using the national database based on participation and performance indicators for the past five years. A retrospective cumulative analysis of clinical breast examination and mammogram screening services were performed using the national dataset of 2016-2020 obtained from the Health Informatics Centres, Ministry of Health Malaysia. The performance indicator represents the percentage of breast abnormality detected during clinical breast examination and the proportion of confirmed cancer through mammogram screening.  A reduction in the participation rate for clinical breast examination was noted from 2016 (25.8%) to 2020(25.1%). However, a high participation rate in 2019 (29.1%) was noted following active health promotion intervention. The rate of high-risk women who underwent mammogram screening fluctuated by years according to active breast awareness campaign. The average rate of confirmed breast cancer annually was 0.7% and was noted highest in 2020 (1.17%).  Improving early diagnosis is an eminent strategy for cancer control in all settings, including strengthening health systems and providing universal health coverage. Successful breast cancer prevention and control programs require intersectoral planning and active community participation. Ensuring sustainability and accessibility of breast cancer screening programs is highly needed. Fostering good collaborative multiagency partnership and community participation for the cancer control program urges an innovative approach through a policy formulation.

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