Breast screening has resulted in earlier diagnosis - study

Compared to 10 years ago, breast cancer is being diagnosed at an earlier stage.

Breast cancer is being diagnosed at an earlier stage than 10 years ago and statistics also show an increase in breast conservation surgery.

This shows that current initiatives and programmes aiming to increase breast cancer awareness are paying off a study by Mandy Caruana and Gordon Caruana Dingli published in the Malta Medical Journal shows.

The study compares the records of 456 patients operated for breast cancer in the year 2000 and 2010.

The study attributes the improvement over the past decade to the introduction of a number of programmes and initiatives aiming to raise risk and symptom awareness on breast cancer and promoting early presentation.

There includes the national Breast Screening Programme (BSP) was started in October 2009.

The study shows a shift from mastectomy towards breast conserving surgery. In the year 2000, mastectomy with axillary surgery was the commonest type of operation performed but in 2010, the commonest type of operation performed was lumpectomy/WLE with axillary surgery.

A decline in the mean tumour size of more than 5mm was also detected. The mean tumour size of the invasive type decreased from 28.2mm in the year 2000, to 22.9mm in the year.

This decline can be partially attributed to the introduction of Breast Screening. Out of the 291 tumours studied for the year 2010, 43 were detected through the screening programme, and 33 of these were of the invasive type. The mean tumour size of these 33 tumours was 16.2 mm, while the mean tumour size of the other 209  tumours of the year 2010 was 23.9mm.

The median age of patients with breast cancer decreased from 64 years in 2000 to 59 years in 2010.

In 2010, patients aged less than 80 years reported a smaller breast tumour than in 2001. But older patients did not follow this pattern reporting a number of large breast tumours. This shows that that breast cancer awareness in older age groups is poor, and thus they are more likely to delay diagnosis.

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I do not think this study adds much to what is already known in the existing literature on Breast Cancer screening! I must say these two authors have found similar findings to those seen in the UK and other countries were breast cancer screening is being adopted. Certainly I would not carry out such a study for a PhD as there is nothing novel however it would generally make the Maltese public more aware of breast cancer screening!