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Changes in breast cancer detection and mammography recall rates after the introduction of a computer-aided detection system.

BACKGROUND: Computer-aided mammography is rapidly gaining clinical acceptance, but few data demonstrate its actual benefit in the clinical environment. We assessed changes in mammography recall and cancer detection rates after the introduction of a computer-aided detection system into a clinical radiology practice in an academic setting. METHODS: We used verified practice- and outcome-related databases to compute recall rates and cancer detection rates for 24 Mammography Quality Standards Act-certified academic radiologists in our practice who interpreted 115,571 screening mammograms with (n = 59,139) or without (n = 56,432) the use of a computer-aided detection system. All statistical tests were two-sided. RESULTS: For the entire group of 24 radiologists, recall rates were similar for mammograms interpreted without and with computer-aided detection (11.39% versus 11.40%; percent difference = 0.09, 95% confidence interval [CI] = -11 to 11; P =.96) as were the breast cancer detection rates for mammograms interpreted without and with computer-aided detection (3.49% versus 3.55% per 1000 screening examinations; percent difference = 1.7, 95% CI = -11 to 19; P =.68). For the seven high-volume radiologists (i.e., those who interpreted more than 8000 screening mammograms each over a 3-year period), the recall rates were similar for mammograms interpreted without and with computer-aided detection (11.62% versus 11.05%; percent difference = -4.9, 95% CI = -21 to 4; P =.16), as were the breast cancer detection rates for mammograms interpreted without and with computer-aided detection (3.61% versus 3.49% per 1000 screening examinations; percent difference = -3.2, 95% CI = -15 to 9; P =.54). CONCLUSION: The introduction of computer-aided detection into this practice was not associated with statistically significant changes in recall and breast cancer detection rates, both for the entire group of radiologists and for the subset of radiologists who interpreted high volumes of mammograms.

Breast Neoplasms↗

Profile of a cancer detection camp.

The organisation and management of a cancer detection camp in rural area of Andhra Pradesh with the help of Lions Club and medical college staff were described. People with any one of the seven warning signals of cancer were asked to attend the camp. More women, most of them in reproductive age, attended the camp with unusual vaginal bleeding and lump in the breast. Among men, a large group complained of chronic cough. Smear for Papanicolaou's stain was used as a tool for screening of cervical cancer. Ten patients (2.5%) had malignant lesions and 16 patients (4.0%) had premalignant lesions. The programme of prevention, public health education and early detection of cancer can be put into action, successfully through cancer detection camps organised in rural areas.

Adult↗

Mammographic parenchymal features and breast cancer in the breast cancer detection demonstration project.

The Breast Cancer Detection Demonstration Project (BCDDP) screened 283,222 U.S. women for breast cancer by use of mammography and breast palpation. A sample of participants was followed up to determine the subsequent occurrence of breast cancer cases and deaths. We have used information from the BCDDP to evaluate the relation of mammographic parenchymal features to the incidence of and mortality from breast cancer, and to examine changes in this relation with duration of follow-up. We also reevaluated the relations of age, body weight, height, menopause, parity, and age at birth of first child to mammographic features of breast tissue. Among women 35-49 years of age at entry, those whose mammographic features were "glandular" or "homogeneously dense" had a 2.8-fold increase in risk of breast cancer compared to women whose mammographic features were "atrophic or fatty". The increased risk was observed up to 9 years after entry. Among women 50-74 years of age at entry, the risk of breast cancer was elevated by a factor of 1.7 for women with glandular or dense breast parenchyma compared to those with atrophic or fatty breasts. The increase in risk, however, diminished with increasing follow-up. The percentage of women with glandular or dense parenchymal features decreased as age, body weight, and parity increased. The percentage with glandular or dense features increased as height increased, and the percentage decreased with menopause. Mammographic parenchymal features were not associated with age at birth of first child.

Adult↗

Comparison of recall and cancer detection rates for immediate versus batch interpretation of screening mammograms.

PURPOSE: To retrospectively compare recall and cancer detection rates between immediate and subsequent batch methods for interpretation of screening mammograms. MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was waived. Retrospective analysis was performed for 8698 screening mammograms obtained between January 1 and October 31, 2001, which were interpreted either immediately (n = 4113) or subsequently with batch method (n = 4585). Data were collected from data reporting system and patient billing records. Patients with high risk factors were excluded; 3441 patients were in the immediate group, and 3932 were in the batch group. The two groups were compared with respect to age, breast density, and availability of comparison films with Wilcoxon rank sum test. Recall rates and cancer detection rates for each group were determined and compared with Pearson chi(2) test; false-negative rates were compared with Fischer exact test. RESULTS: A significant difference (P < .001) was noted in recall rates between immediate (18%) and batch (14%) groups; however, no significant difference (P = .7) was noted in cancer detection rates (immediate, 0.5%; batch, 0.4%). Mean age of patients was 56.8 years (age range, 21-96 years) in the immediate group and 56.2 years (age range 24-98 years) in the batch group (P = .02). Comparison of breast densities between groups indicates no statistically significant difference (P = .4). The batch group had significantly fewer comparison mammograms (3106 [79%]) available than the immediate group (2856 [83%]) (P < .001). There was no significant difference in false-negative rates between the immediate group (0.1%) and the batch group (0.1%) (P > .99). CONCLUSION: Immediate interpretation of screening mammograms resulted in a statistically significant increase in recalls and additional clinical work-ups of perceived abnormalities; however, no significant difference in cancer detection rate was detected between groups.

Adult↗

Cancer detection; a county medical society program, Riverside, California.

Cancer detection examinations by physicians in their private offices were performed as a county medical society project for a period of one year.In a series of 6,765 patients examined, approximately 600 were found to have lesions clinically suspect for tumor. The total number of proven cancers discovered was 280 and the number of lesions classified as precancerous was 87. This percentage of tumors discovered compares favorably with reports from special cancer detection centers formerly utilized in other parts of the country. The Cancer Commission believes that periodic health examinations of persons over the age of 40 in the offices of private physicians is a practical approach to the problem of earlier detection of tumors at accessible sites-the tumors that are the most readily curable by current surgical and radiotherapeutic techniques.

California↗

Influence of stricture dilation and repeat brushing on the cancer detection rate of brush cytology in the evaluation of malignant biliary obstruction.

BACKGROUND: The sensitivity for cancer detection of brush cytology at ERCP is relatively low. Manipulation of the stricture and repeated tissue sampling may increase the yield. This study compared the cancer detection rate of brush cytology before and after biliary stricture dilation. METHODS: In patients with a biliary stricture at ERCP of suspected malignant origin, the stricture was sampled with a cytology brush and then dilated with either a graduated dilating catheter or a dilating balloon (4-8 mm). Brushing was then repeated in all patients. Specimens were interpreted as normal, atypical (benign), highly atypical (suspicious for cancer), and malignant. Final diagnoses were based on cytology plus surgery, EUS, percutaneous biopsy, autopsy, or clinical follow-up. RESULTS: A total of 139 patients with suspected malignant obstructive jaundice underwent 143 ERCPs (116 ultimately found to have malignant obstruction, and 27 benign disease). Dilation was performed with a catheter in 68 cases, balloon in 73, and both in 2. Brush cytology had a sensitivity of 34.5% (40/116) before dilation and 31% (36/116) after dilation (p = NS). However, sensitivity with predilation and postdilation brushing specimens combined was 44% (51/116), which was higher than that for either the predilation or postdilation brush cytology (p = 0.001). Cancer detection rates were 34.7% (17/49) after dilation with the catheter and 27.7% (18/65) after balloon dilation (p = NS). CONCLUSIONS: Stricture dilation does not improve the sensitivity of brush cytology for the detection of cancer, which remains relatively low. However, repeat brushing increases the diagnostic yield and should be performed when sampling biliary strictures with a cytology brush at ERCP.

Bile Duct Neoplasms↗

Breast cancer detection practices of south Asian women: knowledge, attitudes, and beliefs.

PURPOSE/OBJECTIVES: To explore knowledge, attitudes, beliefs, and practices regarding breast cancer detection practices among South Asian women. DESIGN: Descriptive exploratory design. SETTING: Toronto, Ontario, Canada. SAMPLE: 57 South Asian women, age 40 and over, who are first generation immigrants from India and Pakistan and speak one of the four languages identified for the study--Hindi, Punjabi, Gujarati, or Urdu. METHODS: An interview guide was designed specifically for this study. It contained questions regarding knowledge, attitudes, beliefs, and practices about breast self-examination (BSE), clinical breast examination (CBE), and mammogram. In addition, questions assessing the variables of the Health Belief Model and health motivations also were included. The data were obtained during face-to-face interviews in the primary language of the participating woman. The interviews were transcribed and translated into English. FINDINGS: 12% of the participants practiced BSE monthly, 49% had undergone at least one CBE during their lives, and 47% had never had a mammogram. The majority (54%) said they did not know very much about breast cancer. While 21% of the women said detecting cancer early was important, only 5% reported that cancer could be cured. Age, education, or mother tongue showed no statistically significant relationship with the breast health practice scores. However, proficiency with the English language (p = 0.009) and number of years in Canada (p = 0.009) had a significant relationship with the breast health practice scores. The significant explanatory factor for the variable breast health practices was a cue to action (p = 0.009). CONCLUSIONS: South Asian women with minimal knowledge of breast cancer did not engage in breast cancer detection practices. IMPLICATIONS FOR NURSING PRACTICE: This segment of the population of immigrant women needs to be better informed about breast cancer and the benefits of breast cancer detection practices.

Adult↗

Extensive biopsy using a combined transperineal and transrectal approach to improve prostate cancer detection.

PURPOSE: Previous studies have indicated that 6-core transrectal prostate biopsy misses a considerable number of cancers. We performed an extensive biopsy protocol of 12-core sampling using both transperineal and transrectal approaches to determine the impact on the cancer detection rate. MATERIALS AND METHODS: We prospectively evaluated 402 men who underwent 6-core transperineal and 6-core transrectal biopsies simultaneously due to abnormal digital rectal examination (DRE) and/or elevated prostate-specific antigen (PSA) levels of 4.0 ng/mL or greater. Using the transperineal approach we obtained four cores from the bilateral peripheral zone targeting the lateral and parasagittal areas and two cores from the bilateral transition zone. The following transrectal biopsy was performed traditionally. We compared cancer detection rate between the extended 12-core procedure and conventional 6-core transperineal and transrectal groups in terms of total PSA and DRE findings. RESULTS: Using the extensive combined method, prostate cancer was detected in 195 cases (48.5%) and the detection rate significantly increased 7.2% and 8.5% compared to the transperineal and transrectal groups, respectively. According to PSA levels and DRE findings, the cancer detection rate by the combined method was significantly improved in patients with PSA levels of 4-10 ng/mL and negative DRE: 10.3% and 11.6% compared to the transperineal and transrectal groups, respectively. CONCLUSIONS: The extensive 12-core method significantly improved the overall cancer detection rate and was especially efficient for men with PSA levels of 4-10 ng/mL accompanied by a negative DRE finding.

Adult↗

Breast cancer incidence and mortality in the breast cancer detection demonstration project [published errtum appears in J Natl Cancer Inst 1989 Oct 4;81(19):1513].

The Breast Cancer Detection Demonstration Project (BCDDP) was a program of five annual screening examinations for breast cancer that was conducted at 29 centers in the United States. This report presents data on breast cancer incidence and mortality among the participants. A total of 283,222 women were enrolled. Our analysis is based on 55,053 white women who were 35-74 years of age at entry and who were selected for follow-up. For the first 9 years after entry, the cumulative incidence of breast cancer was estimated as 243.6 per 10,000, which is 1.34 times the expected incidence derived by use of data from the Surveillance, Epidemiology, and End Results (SEER) program. In contrast, 9-year cumulative mortality from breast cancer was only 79.6% of that expected in women with the age distribution of BCDDP participants who did not have diagnosed breast cancer at the start of observation. The ratio of observed to expected breast cancer mortality was 0.89 for women 35-49 years of age at entry, 0.76 for women 50-59 years of age at entry, and 0.74 for women 60-74 years of age at entry. Breast cancer incidence and mortality were lower for women who entered the BCDDP for routine screening than they were for women who entered for a reason such as concern about breast disease, family history of breast cancer, or a physician's recommendation. Among cases diagnosed within 5 years of entry, the 5-year case fatality attributed to breast cancer was 8.5%. Case fatality for all stages combined was greater than 50% lower for cases that were screen-detected than it was for cases that were not screen-detected. Case fatality was lower for cases diagnosed within the first 5 years of entry (which encompassed the period of screening) than it was for cases diagnosed in the sixth or seventh years.

Adult↗

Individualization of the biopsy protocol according to the prostate gland volume for prostate cancer detection.

PURPOSE: In this study we assessed the relative yield of 10 core biopsy, and the whole range of alternative 8 and 6 core biopsy protocols over that of the classic sextant biopsy protocol. We determined the optimum number of cores per biopsy according to prostate volume in patients who experienced prostate biopsy for the first time. MATERIALS AND METHODS: A total of 503 men with the indications of abnormal digital rectal examination and/or serum prostate specific antigen greater than 2.5 ng/ml were included in the study. All patients underwent a 10 core biopsy protocol with an additional 1 core from each suspicious area detected by transrectal ultrasound. Prostate volume was divided into quartiles, namely 14.9 to 35, 35.1 to 50, 50.1 to 65 and 65.1 to 150 cc. The optimum number of biopsy cores was determined in patients with different prostate volumes. RESULTS: Median age was 63 years and prostate specific antigen was 7.4 ng/ml in the whole group. Of 503 patients 159 (31.6%) were positive for prostate cancer. Cancer detection rates decreased significantly from 49.6% to 20.8% as prostate volume increased in preset quartiles. Lesion biopsies revealed the lowest unique cancer detection rates for all prostate volume quartiles (0% to 3%). There was an obvious positive trend in cancer detection rates in favor of the 10 core biopsy protocol over sextant biopsies in all patient groups. Classic sextant biopsy protocol proved to be inadequate for all prostate volumes. Among sextant biopsy protocols laterally placed cores including the apex, lateral mid gland and lateral base had the best cancer detection rates (81% to 95%). The 8 core biopsy scheme consisting of the apex, mid gland, lateral mid gland and lateral base resulted in an only 1% lower detection rate (97%) than the 10 core biopsy protocol in the lowest quartile. The yield of the 10 core biopsy protocol in patients with a prostate volume of between 35.1 and 150 cc outscored that of the optimal 8 core biopsy scheme including the apex, base, lateral mid gland and lateral base with 3% to 8% differences in the cancer detection rate. CONCLUSIONS: The 10 core biopsy protocol must be used in all group of patients except patients with a prostate volume of 14.9 to 35 cc. In patients with a prostate volume of 14.9 to 35 cc the 8 core biopsy protocol consisting of the apex, mid gland, lateral mid gland and lateral base can be used since it revealed results similar to those of the 10 core biopsy protocol. The classic sextant biopsy protocol seemed inadequate for all prostate volumes. Patients with a larger prostate had lower cancer detection rates. Transrectal ultrasound directed lesion biopsies may be omitted when using 10 core biopsy protocols since the yield of these biopsies was less than 2%.

Adult↗

A review of electrical impedance techniques for breast cancer detection.

Some evidence has been found that malignant breast tumors have lower electrical impedance than surrounding normal tissues. Although the separation of malignant tumors from benign lesions based on impedance measurements needs further investigation, electrical impedance could be used as an indicator for breast cancer detection. In this paper, we provide a systematic technical review of the existing electrical impedance techniques proposed for breast cancer detection, with an emphasis on noninvasive impedance imaging techniques. The electrical impedance of human breast tissue is first introduced, with tabulation of previous in vitro impedance measurement results on cancerous and normal breast tissues, and a brief description on the limited in vivo impedance measurements completed with invasive, or noninvasive, non-imaging techniques. A detailed review on noninvasive impedance imaging techniques for breast cancer detection, such as electrical impedance tomography (EIT) and electrical impedance mapping (EIM), is then presented. We suggest that for better breast cancer detection, an invasive impedance technique may be enhanced by combination with other cancer indicators. 3D EIT should be improved through collective efforts. EIM using a pair of electrode arrays is a viable method with great potential. Magnetic induction tomography and other magnetic induction based impedance imaging for breast cancer detection are promising and merit further exploration as well.

Breast↗

Free prostate-specific antigen improves prostate cancer detection in a high-risk population of men with a normal total PSA and digitalrectal examination.

OBJECTIVES: Uncertainty exists regarding optimal prostate cancer screening parameters for high-risk populations. The purpose of this study is to report the use of percent free prostate-specific antigen (PSA) as an indication for biopsy in men at increased risk for developing prostate cancer who have a normal digital rectal examination (DRE) and total PSA level between 2 and 4 ng/mL. METHODS: African-American men and men with at least one first-degree relative with prostate cancer are eligible for enrollment into the Prostate Cancer Risk Assessment Program (PRAP) at our institution. Between October 1996 and April 2002, 310 asymptomatic high-risk men with no history of prostate cancer, benign prostatic hyperplasia (BPH), or prostatic intraepithelial neoplasia (PIN) were screened in the PRAP with DRE and total PSA. Percent free PSA was obtained in men with a total PSA between 2 and 10 ng/mL. Men with a normal DRE and total PSA between 2 and 4 ng/mL were advised to undergo transrectal ultrasound-guided (TRUS) biopsies of the prostate if the percent free PSA was less than 27%. Other indications for biopsy included an abnormal DRE or a total PSA greater than 4 ng/mL. The primary endpoint evaluated was prostate cancer detection in high-risk men with a benign prostate examination, a normal total PSA between 2 and 4 ng/mL, and percent free PSA less than 27%. RESULTS: Of the 310 men, 174 (56%) were African American and 202 (65%) had at least one first-degree relative with prostate cancer. Sixty-two of the 310 men were referred for prostate biopsy, and 40 of 62 had biopsy performed. Twenty-one of 40 men were diagnosed with prostate cancer for a cancer detection rate of 53% in all men undergoing biopsy and an overall cancer detection rate of 6.8% in this high-risk population. Thirty-seven high-risk men (median age 54 years) with a total PSA level between 2 and 4 ng/mL (median 2.7 ng/mL) and a normal DRE were found to have a percent free PSA level of less than 27% (median 16%, range 8% to 25%). Twenty-three of these 37 men (62%) proceeded with the recommended prostate biopsy. Prostatic adenocarcinoma was diagnosed in 12 of 23 men for a cancer detection rate of 52% in men undergoing biopsy and 32% in all men with a normal DRE, a total PSA between 2 and 4 ng/mL, and a percent free PSA less than 27%. All positive biopsies demonstrated clinically significant Gleason score 6 or 7 disease. In all men electing radical prostatectomy, bilateral organ-confined disease (pT2bN0M0) was confirmed. CONCLUSIONS: In this unique population of men at high risk for prostate cancer, a percent free PSA of less than 27% was found to be useful for detecting early-stage but clinically significant cancers in men with a total PSA value between 2 and 4 ng/mL and normal DRE findings.

Biopsy, Needle↗

The planning, execution, and evaluation of a breast cancer detection awareness program.

A Breast Cancer Detection Awareness Program (BCDAP) was conducted in Western New York during the spring of 1987 in conjunction with a national effort by the American Cancer Society. The importance of screening mammography was promoted by public education through the media combined with promotion of breast cancer screening services available from 26 health care providers. Women were instructed to call a hot line to receive a coupon for a low-cost mammogram, if eligible to participate. A provider directory was included to facilitate scheduling appointments. The program resulted in 6,355 women requesting a coupon. From this population 3,178 women utilized the coupon to receive a mammogram. Although the screening rate of 50% was encouraging, approximately half of the callers to the hot line did not receive a mammogram. To increase the screening rate in future programs, it would be useful to determine why some women did not take advantage of the discount coupon.

Adult↗

Improved prostate cancer detection using systematic 14-core biopsy for large prostate glands with normal digital rectal examination findings.

OBJECTIVES: To evaluate in a retrospective study the improvements in prostate cancer detection rates for patients with a prostate gland larger than 30 cm3 using a systematic 14-core biopsy strategy compared with a systematic 8-core biopsy. METHODS: We retrospectively assessed 273 patients with screened prostate-specific antigen (PSA) levels of 3.0 to 50.0 ng/mL. A total of 204 patients with a prostate volume of 30 cm3 or larger and with normal digital rectal examination findings were enrolled in this study. Of the 204 patients, 110 underwent 8-core biopsy and 94 underwent 14-core biopsy of the prostate. We compared the cancer detection rates of prostate biopsy between the 8 and 14-core groups using total PSA, free/total PSA ratio, PSA density, and PSA density adjusted by transition zone volume. We also analyzed the Gleason grade of the biopsy core and the radical prostatectomy specimens. RESULTS: Of the 204 patients, 40 (19.5%) were identified as having prostate adenocarcinoma. The cancer detection rate for the 8 and 14-core groups was 14.5% (16 of 110 patients) and 24.5% (23 of 94 patients), respectively. The 14-core biopsy had a statistically significant greater cancer detection rate than did the 8-core group in patients with a prostate volume of 30 to 40 cm3 (36.7% versus 11.8%, respectively, P<0.05) and a PSA density adjusted by transition zone volume of 0.38 ng/mL/cm3 or greater (47.8% versus 20.0%, respectively, P <0.05). The difference in tumor grade between the 8 and 14-core biopsy samples was not statistically significant. CONCLUSIONS: The 14-core prostate needle biopsy is a recommended method for detecting prostate cancer in a large-volume prostate gland without increasing the risk of complications.

Adenocarcinoma↗

Tumor markers and screening tools in cancer detection.

The ideal cancer screening tool would be one that is sufficiently sensitive to detect early malignancy, specific to only cancer and not a host of other conditions, specific for the type of cancer, specific for the location of the cancer, commensurate to the tumor bulk, cost-effective, easy to use, safe, acceptable to the general population, and acceptable to the medical community. No one laboratory test or radiograph meets all of the preceding criteria. Great strides have been made, however, in the early diagnosis of cancer. For example, breast cancer is being diagnosed at much earlier stages because of mammography. Just a few years ago, safety was a major issue because of the high level of radiation exposure connected with mammography. Today, radiation exposure is minimal, and the benefits far outweigh the potential harm. Research must continue to perfect the existing screening tools and develop new tools that will enable the early detection of malignant disease.

Adult↗

The pulse wash instrument. A new sampling method for uterine cervical cancer detection.

A new sampling method for uterine cervical cancer detection is described. In this method, sampling of cytologic material is done by using a pulse wash instrument. Liquid jets with a diameter of 0.2 mm at a speed of 20 m/s create a successful rinsing effect of cervical epithelial cells due to the high kinetic energy produced. Because cells are suspended in the flushing liquid it is possible to collect material for additional cytochemical, immunocytochemical, and microbiologic diagnostic techniques in addition to a conventional smear technique. Compared to a conventional Papanicolaou smear technique performed in 75 women at two cervical atypia clinics at the Karolinska Hospital, the pulse wash technique is suggested to result in a more representative cellular sample, thus offering a method to decrease false negative diagnoses in uterine cervical cancer detection.

Adolescent↗

Prostate cancer detection in Black and White men with abnormal digital rectal examination and prostate specific antigen less then 4 ng./ml.

PURPOSE: Prostate cancer is more common in black than in white American men. Experience in a longitudinal prostate cancer screening program implies that cancer detection is greater in black than in white men with an abnormal digital rectal examination and prostate specific antigen (PSA) less than 4 ng./ml. We investigated potential racial differences in cancer detection in men treated in clinical practice who had an abnormal digital rectal examination and PSA less than 4 ng./ml. MATERIALS AND METHODS: Between January 1992 and December 1999 prostate biopsy was done at a Veterans Affairs Medical Center in 179 black and 357 white men with an abnormal digital rectal examination, PSA less than 4 ng./ml. and no history of prostate surgery. Significant racial differences in demographic and clinical parameters were limited to PSA, which was higher in black men (p = 0.01). RESULTS: Cancer was detected in 38 black (21%) and 65 white (18%) men (p = 0.42). There were no significant racial differences in the PSA adjusted cancer detection rate or in the Gleason score of detected disease. In men with PSA less than 1.0, 1.0 to 1.9, 2.0 to 2.9 and 3.0 to 3.9 ng./ml. the detection rate was 4%, 15%, 27% and 29%, respectively. CONCLUSIONS: In clinical practice prostate cancer detection appears to be equivalent in black and white men when an abnormal digital rectal examination is the only indication of malignancy.

Black or African American↗

The effect of changing from one to two views at incident (subsequent) screens in the NHS breast screening programme in England: impact on cancer detection and recall rates.

AIM: To assess the effect on cancer detection and recall rates of changing from one to two views for incident (subsequent) screens. METHODS: Controlled, comparative, observational study of programmes in NHS breast screening programme in England. SUBJECTS: women aged 50-64 years were screened by the NHSBSP between 1 April 2001 and 31 March 2003. RESULTS: The effect of changing to two-view mammography was a 20% increase in overall incident screen cancer detection rate, with the biggest effect seen for small (<15 mm) invasive cancers. This increased detection rate was achieved with an 11% drop-in recall rate. CONCLUSION: The introduction of two-view mammography for incident screens has resulted in considerable improvements in overall NHS breast screening performance.

Aged↗