Avoidable surgical consultations in women with a positive screening mammogram: experience from a southern region of the Dutch breast screening programme.

Autor: Schreutelkamp JL; Department of Radiology, Atrium Medical Center Parkstad, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands. Electronic address: schreutelkamp@home.nl., Kwee RM; Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. Electronic address: rmkwee@gmail.com., de Booij M; Department of Radiology, Atrium Medical Center Parkstad, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands. Electronic address: machiel_de_booij@hotmail.com., Adriaensen ME; Department of Radiology, Atrium Medical Center Parkstad, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands. Electronic address: miraude@gmail.com.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2014 Mar; Vol. 83 (3), pp. 520-3. Date of Electronic Publication: 2013 Dec 17.
DOI: 10.1016/j.ejrad.2013.12.009
Abstrakt: Introduction: According to current Dutch guidelines, all women with a positive screening mammogram are referred for a full hospital assessment, which includes surgical consultation and radiological assessment. Surgical consultation may be unnecessary for many patients. Our objective was to determine how often surgical consultations can be avoided by radiological pre-assessment.
Materials and Methods: All women with a positive screening mammogram, referred to our radiology department between 2002 and 2007, were included (n=1014). Percentage of women that was downstaged to BI-RADS category 1 or 2 by radiological pre-assessment was calculated. Negative predictive value (NPV) for malignancy was estimated from the in-hospital follow-up, which was available up to September 2012.
Results: 423 of 1014 women (42%) were downstaged to BI-RADS category 1 or 2 by radiological pre-assessment. During follow-up, 8 of these 423 women (2%) developed a malignancy in the same breast. At least 6 of these malignancies were located at a different location as the original screening findings which led to the initial referral. The estimated NPV for malignancy was 99.5% (95%CI, 98.3-99.9).
Conclusion: By referring women with a positive screening mammogram to the radiology department for pre-assessment, a surgical consultation was avoided in 42%, with an estimated NPV of 99.5% for malignancy.
(Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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