Bahçeşehir Meme Kanseri Tarama Projesi

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Özçınar B. , Özmen V. (Executive) , Cabıoğlu N.

Project Supported by Other Private Institutions, 2008 - 2019

  • Project Type: Project Supported by Other Private Institutions
  • Begin Date: January 2008
  • End Date: January 2019

Project Abstract

MEMEDER is established as a specific BC awareness and screening center in Bahcesehir County. The population in the project area was 126,837 (5 districts in Bahcesehir, Istanbul, Turkey) in 2009; and among these, the total number of women between 40-69 years was 4,257 according to the Turkish Statistical Institute. Women without prior pregnancy and diagnosis of BC, were invited for screening every two years. In the first round (the first two-year period) 3,758 (88.3%) women were successfully screened 8. During the 10-year period, once every two years, women who turned 40 years in this region were included in the screening, while women above 69 years were excluded. During the screening, new moves to the region were updated every two years (incoming and outgoing). The total number of women screened by the end of five rounds reached 8,758.

A full field digital mammographic equipment was used in this study (Selenia, Hologic, MA, USA). Mediolateral oblique (MLO) and Craniocaudal (CC) projections were obtained and read by two expert radiologists of more than 5 years of experience. In cases of discordance, a third radiologist experienced in breast imaging for more than 20 years evaluated the images for the final decision. Mammographic findings and breast parenchymal patterns were assessed in accordance with the 4th edition of Breast Imaging-Reporting and Data System  of American College of Radiology (BIRADS of ACR)9. Women with BIRADS 0 result were recalled for additional work-up including spot compression, magnification views, ultrasonography or MRI. Women with mammograms categorized as BIRADS 4 and 5 were referred to the university hospitals for biopsy and histopathological evaluation.  Patients were monitored and followed in the center continuously and periodically as a different cohort after being diagnosed and treated.

Operational definitions related with BC diagnosis in the screening program, were determined according to the standards of the European Union Breast Cancer Screening Quality Guidelines: 1) An important consideration in classifying BC in the target population was the date of diagnosis by cytology or histopathology. 2) Intermediate cancer was a finding detected on a mammogram performed out of sequence with the screening interval mammogram (e.g., at 6 or 12 months), as a result of the screening test. Cancer following screening, detected at intermediate mammography was regarded as screen-detected cancer (not interval cancer). 3) Interval cancer was defined as detection of a primary BC in a woman referred to the screening center with a complaint during the 2 years following the final round screening with a negative mammogram with/without further assessment. 4) Missed cancer was defined as the diagnosis of cancer after a false negative mammogram. 5) BC detection rate is the number of pathologically proven malignant lesions (both in situ and invasive) detected in a screening round per 1000 women screened. Cancers detected at intermediate mammography were regarded as screen-detected cancers and thus were included in the cancer detection rate. This rate differed for initial (prevalence) versus subsequent (incidental) screening examinations 10.