Breast cancer patients diagnosed by National Breast Screening Programme

Abstract

Breast cancer is the most common cancer in Malta. A National Breast Screening Programme (NBSP) was introduced in 2009 for women in the 50 to 60 year old age group. The first 112 patients diagnosed by the NBSP were compared to a matched control group of symptomatic patients randomly selected from the Breast Clinic, who had presented to the clinic with a breast lump. The files of all these patients were reviewed retrospectively. In the screening group there were 94 patients with invasive cancer and 18 patients with ductal carcinoma in situ (DCIS) while in the control group there were 114 patients with invasive cancer and 3 with DCIS. In the screening group, 81 (86.2%) patients with invasive cancer underwent wide local excision (WLE) and 13 (13.8%) underwent mastectomy. In the control group 88 (77.2%) patients with invasive cancer underwent WLE and 26 (22.8%) had a mastectomy. Out of all the patients in the screened group with DCIS, 12 (66.7%) underwent WLE and 6 (33.3%) underwent mastectomy. In the control group only 3 patients had DCIS and these were all treated by WLE. The average Nottingham Prognostic Index (NPI) of the screening population with invasive cancer is (3.28 (95% CI)) and is lower than the NPI of the control group is (3.74 (95% CI)). This study shows that in the screening group there is a higher percentage of patients with DCIS when compared to the control group. Furthermore, the screened group patients with DCIS were more likely to undergo mastectomy than those with invasive cancer.