Breast Cancer Screening

Breast cancer screening

In Tuscany breast cancer screening, ongoing since the 90ies, is addressed to asymptomatic 50-69 years old women. Women are invited by a personal letter every 2 years. Organizational and diagnostic protocols are adopted according to European guidelines for Quality Assurance in Breast Cancer Screening: two view mammography, performed by a radiographer, is assessed by double reading and women are recalled to further diagnostic assessment because of technical reasons, doubtful/positive images and suspicious symptoms. In 2017 Tuscany Regional Government decided to expand invitation form 45 to 74 years old women. Differently from older women, those younger than 50 are invited every one year. Till now this implementation covers only the Florence health district.

Data concerning screening activity in 2014-2016 period are shown in table 1 where standard from GISMa (Italian group for screening mammography) are also reported.

Table 1 – Main indicators of mammography screening programmes performance in Tuscany Region and standard proposed by GISMa – Years 2014- 2016

 

Years

Standard GISMa

Indicators

2014§

2015

2016

Acceptable

Desirable

Adjusted extension (%)

95.8

93.7

95.7

 

 

Adjusted participation (%)

72.5

74.2

72.9

 

 

Recall rate at first screening (%)

13.9

14.0

15.9

< 7

< 5

Recall rate at repeat screening (%)

5.5

6.0

5.9

< 5

< 3

Crude detection rate (х 1.000) at first screening

6.5

5.8

6.3

No standard

Crude detection rate (х 1.000) at repeat screening

5.0

4.7

4.7

Benign/malignant ratio at first screening

0.3

0.4

0.3

≤ 1:1

≤ 0.5:1

Benign/malignant ratio at repeat screening

0.1

0.1

0.1

≤ 0.5:1

≤ 0.25:1

Detection rate for cancers ≤10 mm (х 1.000) at first screening

1.5

1.4

1.5

 

 

Detection rate for cancers ≤10 mm (х 1.000) at repeat screening

1.8

1.5

1.7

 

 

Tn situ carcinoma at first screening (%)

19.6

17.9

23.7

10

10-20

Tn situ carcinoma at repeat screening (%)

14.3

14.7

16.7

10

10-20

Stages II+ at first screening (%)

25.2

27.9

24.1

≤ 30

≤ 30

Unknown stages at first screening (%)

11.7

12.3

9.8

 

 

Stages II+ at repeat screening (%)

26.1

22.6

29.7

≤ 25

≤ 25

Unknown stages at repeat screening (%)

9.1

9.5

16.8

 

 

§Local Health Unit 12 Viareggio did not provided 2015 results concerning assessment screening phase