Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

12 Issues per year

CiteScore 2016: 0.29

SCImago Journal Rank (SJR) 2016: 0.166
Source Normalized Impact per Paper (SNIP) 2016: 0.207

Open Access
See all formats and pricing
More options …
Volume 85, Issue 4 (Apr 2013)


Evaluation of the effects of mammography screening program on cancer progression and implemented treatment in patients with breast cancer

Tomasz Nowikiewicz
  • Clinical Department of Breast Cancer and Reconstruction Surgery, Oncology Center in Bydgoszcz, Koordynator: dr n. med. R. Laskowski
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Wojciech Zegarski
  • Surgical Oncology Clinic Collegium Medicum Nicolaus Copernicus University, Oncology Center in Bydgoszcz, Kierownik: dr hab. W. Zegarski, prof. UMK
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Magdalena Piątkowska
  • Department of Clinical Oncology, Oncology Center in Bydgoszcz, Koordynator: dr n. med. J. Tujakowski
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Michał Klag
  • Surgical Oncology Clinic Collegium Medicum Nicolaus Copernicus University, Oncology Center in Bydgoszcz, Kierownik: dr hab. W. Zegarski, prof. UMK
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2013-05-01 | DOI: https://doi.org/10.2478/pjs-2013-0031

The primary goal of mammography screening is to decrease mortality in patients with breast cancer.

The aim of the study was evaluation of the screening program results on course of implemented therapy and its results in breast carcinoma patients.

Material and methods. Evidence includes data on the group of 1818 patients with breast cancer that were subject to surgical treatment at the Clinic of Breast Cancer and Reconstructive Surgery of the Oncology Center in Bydgoszcz (558 patients hospitalized from January 2006 to December 2006 and 1260 patients treated from January 2011 to June 2012). Analysis included type of diagnostic procedure implemented before surgical treatment, as well as grade of cancer progression, results of pathology tests done on specimens and type of surgical procedure. Additionally, the screening group (tumor diagnosed based on screening mammography) and symptomatic group (cancer diagnosed otherwise that within the screening program) were identified.

Results. In 2006, in 28.4% of patients included in the study, primary tumor was discover in screening process (vs 61.5% in 2011-2012). In the first period, 35.7% of changes did not exceed 2 cm - cT1 (vs 48.3% in 2011-2012), while the percentage of cT4 was 9.9% (vs 4.7% in 2011-2012). In 2006, 30.8% of patients were treated in the grade I of clinical progression (vs 44.2% in 2011-2012), 53.4% in the grade II, 14% in grade III and 0.2% in grade IV (vs 45.7%, 9.7%, and 0.4%, respectively). In 45.5% (2006) and 39.9% (in 2011-2012) of patients, metastases were found in axillary lymph nodes. Differences were similar both in screening and symptomatic group. In 2006, in 12.4% of surgical patients breast conserving therapy (BCT) was implemented (vs 49.8% in 2011-2012). In the screening group, it was applied in 15.2% of patients (in 2006) and in 63% (in 2011- 2012), while in symptomatic group the percentages were 11.8% and 41%, respectively.

Conclusions. In both periods of analysis, significant differences were observed as to implementation of breast cancer screening program, as well as to grade of clinical and pathological progression of the cancer. Observable increase of screening tests allowed for significantly more frequent implementation of breast conserving surgical procedures.

Keywords : brest cancer; staging; conserving treatment; mammography screening

  • 1. Donegan W L: Tumor-related prognostic factors for breast cancer. CA Cancer Clin J 1997; 47: 28-51.Google Scholar

  • 2. Jacson VP: Screening mammography; controversies and headlines. Radiology 2002; 225: 323-26.Google Scholar

  • 3. Spillane AJ , Kennedy CW, Gillett DJ et al.: Screen- detected breast cancer compared to symptomatic presentation: an analysis of surgical treatment and end-points of effective mammographic screening. ANZ J Surg 2001; 71: 398-402.Google Scholar

  • 4. Nowikiewicz T , Mierzwa T , Zegarski W i wsp.: Wpływ populacyjnego programu profilaktyki i wczesnego wykrywania raka piersi na możliwość zastosowania leczenia oszczędzającego węzły chłonne dołu pachowego - procedura biopsji węzła wartownika. W: Profilaktyka raka piersi i raka szyjki macicy. Mierzwa T., Zegarski W. (red.). Centrum Onkologii, Bydgoszcz 2012; 31-38.Google Scholar

  • 5. Pieńkowski T : Rak piersi - leczenie ogólnoustrojowe. Medmedia, Warszawa 2011.Google Scholar

  • 6. Jassem J , Krzakowski M (red.): Rak piersi. W: Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych. Krzakowski Mi wsp. (red.). Onkologia w Praktyce Klinicznej, Warszawa 2011; 7, supl. B: 197-246.Google Scholar

  • 7. Silverstein MJ: Current controversies in DCIS: summary from the Lynn Sage Breast Cancer Symposium. J Am Coll Surg 2003; 197(1): 115-18.Google Scholar

  • 8. Jemal A , Siegel R , Ward E et al.: Cancer statistics, 2006. CA Cancer J Clin 2006; 56(2): 106-30.Google Scholar

  • 9. Yi M, Krishnamurthy S , Kuerer HM et al.: Role of primary tumor characteristics in predicting positive sentinel lymph nodes in patients with ductal carcinoma in situ or microinvasive breast cancer. Am J Surg 2008; 196(1): 81-87.Google Scholar

  • 10. Esserman L, Shieh Y, Thompson I: Rethinking screening for breast cancer and prostate cancer. JAMA 2009; 302(15): 1685-92.Google Scholar

  • 11. Welch HG, Back W C: Overdiagnosis in cancer. J Natl Cancer Inst 2010; 102(9): 605-13.Google Scholar

  • 12. Esserman LJ, Shieh Y, Rutgers EJ et al.: Impact of mammographic screening on the detection of good and poor prognosis breast cancers. BreastCancer Res Treat 2011; 130(3): 725-34.Web of ScienceGoogle Scholar

  • 13. Smith RA , Saslow D, Sawyer KA et al.: American Cancer Society guidelines for breast cancer screening: update 2003. CA Cancer J Clin 2003; 53: 141-69.Web of ScienceGoogle Scholar

  • 14. Humphrey LL, Helfand M, Chan B K et al.: Breast cancer screening: a summary of the evidence for the the U. S. Preventive Service Task Force. Ann Intern Med 2002; 137(5): 347-60.Google Scholar

  • 15. Dixon J M: Breast screening has increased the number of mastectomies. Breast Cancer Res 2009; 11; Suppl 3: S19.PubMedCrossrefGoogle Scholar

  • 16. Huober J , von Minckwitz G : Neoadjuvant Therapy - What Have We Achieved in the Last 20 Years? Breast Care 2011; 6(6): 419-26.Web of ScienceGoogle Scholar

  • 17. Goldhirsch A , Wood W C, Coates AS and panel members: Strategies for subtypes-dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. AnnOncol 2011; 22: 1736-47.Google Scholar

  • 18. Kaufmann M, Hortobagyi G N, GoldhirschA et al.: Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: an update. J Clin Oncol 2006; 24(12): 1940-49.Google Scholar

About the article

Published Online: 2013-05-01

Published in Print: 2013-04-01

Citation Information: Polish Journal of Surgery, ISSN (Print) 0032-373X, DOI: https://doi.org/10.2478/pjs-2013-0031.

Export Citation

This content is open access.

Comments (0)

Please log in or register to comment.
Log in