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Failure to appropriately screen women according to international guidelines– what are the consequences? Alison Johnston*, M Sugrue, S Curran Department of Breast Surgery, Letterkenny General Hospital and Donegal Clinical and Research Academy
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Breast Cancer outcomes- Early Dx Optimal 12341234 Stage
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Tailored personal care 50-65 Family history risk
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Family history: assess risk level 17-29% <17% ≥30% Low Moderate High 1<40 (Primary) 2 < 60 ( one Primary) 3 any age
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Moderate risk: Yearly from 40- 50yrs High risk: Imaging from >30yrs 1% genetic counselling
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Aim Assess appropriateness of breast screening in patients newly diagnosed with breast cancer.
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Results – Patient Profile 200 female patients mean age 61 ± 15.4 (range 28-99) Previous mammogram 82/200 (41%)
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Results 143 57 Appropriately Inappropriately screened screened 200 patients
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Stage at diagnosis n=200 % stage
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Tumour size (mm) n=200 mm Yates' p-value 0.001
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Results 200 patients 112 88 no criteria Appropriate 31 Failed 57 met screening criteria
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ResultsMeeting screening criteria patients 41 5 16 BC criteriaBC criteria & FH FH 57
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met Breast Check criteria Declined offer Offer-Post diagnosis No offer 46 2515 6
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Nodal status- meeting screening criteria n=88 % P-value 0.02
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Stage at presentation meeting screening criteria n=88 Stage % p-value 0.006 (0-2) (3&4)
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Conclusion Failure to risk assess and screen >25% of all breast cancer presentations Those with high risk/screening criteria failure in 65% Failure to screen More advanced cancer Donegal will continue to have poorer outcome if delayed presentations continue
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Johnston, A. Curran, S. and Sugrue, M. (2015) Failure to Engage in Breast Screening and Risk Assessment Results in More Advanced Stage at Diagnosis. Advances in Breast Cancer Research, 4, 53-62. doi: 10.4236/abcr.2015.42006.10.4236/abcr.2015.42006
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Outcomes : Contacted key stakeholders: NCCP Breast Check GPs in county Women’s Groups Local radio and press Follow on study
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