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The UK national breast cancer screening programme for survivors of Hodgkin lymphoma detects breast cancer at an early stage.

Howell SJ, Searle C, Goode V, Gardener T, Linton K, Cowan RA, Harris MA, Hopwood P, Swindell R, Norman A, Kennedy J, Howell A, Wardley AM, Radford JA - Br. J. Cancer (2009)

Bottom Line: Of these 417 women, 23 (5.5%) have been diagnosed with BC, a standardised incidence ratio of 2.9 compared with the age-matched general population.Of five invasive BCs diagnosed within the NRASP, none involved axillary lymph nodes compared with 7 of 13 (54%) diagnosed outside the programme (P<0.10).Determination of NRASP results on a national basis is required for the accurate evaluation of screening efficacy in women previously treated with SRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. Showell@picr.man.ac.uk

ABSTRACT

Background: Supradiaphragmatic radiotherapy (SRT) to treat Hodgkin's lymphoma (HL) at a young age increases the risk of breast cancer (BC). A national notification risk assessment and screening programme (NRASP) for women who were treated with SRT before the age of 36 years was instituted in the United Kingdom in 2003. In this study, we report the implementation and screening results from the largest English Cancer Network.

Methods: A total of 417 eligible women were identified through cancer registry/hospital databases and from follow-up (FU) clinics. Screening results were collated retrospectively, and registry searches were used to capture BC cases.

Results: Of the 417 women invited for clinical review, 243 (58%) attended. Of these 417 women, 23 (5.5%) have been diagnosed with BC, a standardised incidence ratio of 2.9 compared with the age-matched general population. Of five invasive BCs diagnosed within the NRASP, none involved axillary lymph nodes compared with 7 of 13 (54%) diagnosed outside the programme (P<0.10). The mean latency for BC cases was 19.5+/-8.35 years and the mean FU duration for those unaffected by BC was 14.6+/-9.11 years (P<0.01), suggesting that those unaffected by BC remain at high risk. Recall and negative biopsy rates were acceptable (10.5 and 0.8%, respectively).

Conclusions: The NRASP appears to detect BC at an early stage with acceptable biopsy rates, although numbers are small. Determination of NRASP results on a national basis is required for the accurate evaluation of screening efficacy in women previously treated with SRT.

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Related in: MedlinePlus

Flow diagram depicting the inclusion process for NRASP, the proportion of women requiring screening and the number of women for whom screening reports were available. FU, follow-up; NHSBSP, National Health Service Breast Screening Programme.
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fig1: Flow diagram depicting the inclusion process for NRASP, the proportion of women requiring screening and the number of women for whom screening reports were available. FU, follow-up; NHSBSP, National Health Service Breast Screening Programme.

Mentions: Database searches revealed 405 eligible women and a further 15 were identified through the telephone helpline or FU clinics, having received SRT at another institution but now residing in the GMCCN. The processing of these women is described in Figure 1 and, out of a total of 417 eligible patients, 243 (58%) were reviewed, counselled and referred for screening if required.


The UK national breast cancer screening programme for survivors of Hodgkin lymphoma detects breast cancer at an early stage.

Howell SJ, Searle C, Goode V, Gardener T, Linton K, Cowan RA, Harris MA, Hopwood P, Swindell R, Norman A, Kennedy J, Howell A, Wardley AM, Radford JA - Br. J. Cancer (2009)

Flow diagram depicting the inclusion process for NRASP, the proportion of women requiring screening and the number of women for whom screening reports were available. FU, follow-up; NHSBSP, National Health Service Breast Screening Programme.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2736813&req=5

fig1: Flow diagram depicting the inclusion process for NRASP, the proportion of women requiring screening and the number of women for whom screening reports were available. FU, follow-up; NHSBSP, National Health Service Breast Screening Programme.
Mentions: Database searches revealed 405 eligible women and a further 15 were identified through the telephone helpline or FU clinics, having received SRT at another institution but now residing in the GMCCN. The processing of these women is described in Figure 1 and, out of a total of 417 eligible patients, 243 (58%) were reviewed, counselled and referred for screening if required.

Bottom Line: Of these 417 women, 23 (5.5%) have been diagnosed with BC, a standardised incidence ratio of 2.9 compared with the age-matched general population.Of five invasive BCs diagnosed within the NRASP, none involved axillary lymph nodes compared with 7 of 13 (54%) diagnosed outside the programme (P<0.10).Determination of NRASP results on a national basis is required for the accurate evaluation of screening efficacy in women previously treated with SRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. Showell@picr.man.ac.uk

ABSTRACT

Background: Supradiaphragmatic radiotherapy (SRT) to treat Hodgkin's lymphoma (HL) at a young age increases the risk of breast cancer (BC). A national notification risk assessment and screening programme (NRASP) for women who were treated with SRT before the age of 36 years was instituted in the United Kingdom in 2003. In this study, we report the implementation and screening results from the largest English Cancer Network.

Methods: A total of 417 eligible women were identified through cancer registry/hospital databases and from follow-up (FU) clinics. Screening results were collated retrospectively, and registry searches were used to capture BC cases.

Results: Of the 417 women invited for clinical review, 243 (58%) attended. Of these 417 women, 23 (5.5%) have been diagnosed with BC, a standardised incidence ratio of 2.9 compared with the age-matched general population. Of five invasive BCs diagnosed within the NRASP, none involved axillary lymph nodes compared with 7 of 13 (54%) diagnosed outside the programme (P<0.10). The mean latency for BC cases was 19.5+/-8.35 years and the mean FU duration for those unaffected by BC was 14.6+/-9.11 years (P<0.01), suggesting that those unaffected by BC remain at high risk. Recall and negative biopsy rates were acceptable (10.5 and 0.8%, respectively).

Conclusions: The NRASP appears to detect BC at an early stage with acceptable biopsy rates, although numbers are small. Determination of NRASP results on a national basis is required for the accurate evaluation of screening efficacy in women previously treated with SRT.

Show MeSH
Related in: MedlinePlus