Comparison of mammography results from individual and organized screening for breast cancer - 15/04/21

Doi : 10.1016/j.jogoh.2020.101926

Arthur Tron ^⁎ , Ségolène Caulliez, Alexandre Malmartel
Université de Paris, Faculté de Santé, UFR de Médecine, Département de médecine générale, F-75014, Paris, France

^⁎Corresponding author at: Université de Médecine Paris Descartes – Site Cochin, Département de médecine Générale, 24, rue du Faubourg Saint-Jacques, 75014, Paris, France.Université de Médecine Paris Descartes – Site CochinDépartement de médecine Générale24, rue du Faubourg Saint-JacquesParis75014France

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Highlights

•	French study comparing individual and organized screening on high-risk mammograms.
•	A propensity score matched 503 organized with 941 individual screening patients.
•	There was no association between the type of screening and high-risk mammograms.
•	Both types of screening should be maintained to maximize patients' participation.

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Abstract

Background

In France, the coexistence of individual screening (IS) and organized screening (OS) for breast cancer induces difficulties for primary care practitioners to position themselves. This study assessed whether the risk of having a mammography with a high risk of malignancy (BI-RADS 4 or 5) was different between patients aged from 50 to 74year performing it as part of an IS or of the OS.

Method

This cross-sectional multicenter study included women aged 50–74, with no personal history of breast cancer, performing mammography in radiology centers in Paris (France). The nature of the screening (OS or IS), breast cancer risk (high risk: BI-RADS 4 or 5), risk factors and clinical breast examination (CBE) abnormalities were collected. Patients in the IS and OS group were matched on age, breast density, history of benign lesions and family history of breast cancer using a propensity score. The association between the nature of screening and the risk of malignancy was evaluated by conditional logistic regression.

Results

Among 2190 included patients, 77 % performed a mammography with the IS and had more CBE abnormalities (23 % vs 11 %, p<0,001), a history of benign lesion (15 % vs 11 %, p=0.01) and a family history of breast cancer (42 % vs 29 %, p<0,001). After matching 503 OS patients with 941 IS patients, the risk of malignancy and the nature of the screening were not associated (OR=0.72 [0.35–1.47], p=0.50).