The dilemma of recalling well-circumscribed masses in a screening population: A narrative literature review and exploration of Dutch screening practice.

Autor: Geertse TD; Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands. Electronic address: tanya.geertse@radboudumc.nl., van der Waal D; Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands., Vreuls W; Canisius Wilhelmina Hospital, Department of Radiology Weg Door, Jonkerbos 100, 6532 SZ, Nijmegen, the Netherlands., Tetteroo E; Amphia Hospital, Department of Radiology Molengracht 21, 4818 CK, Breda, the Netherlands., Duijm LEM; Canisius Wilhelmina Hospital, Department of Radiology Weg Door, Jonkerbos 100, 6532 SZ, Nijmegen, the Netherlands., Pijnappel RM; Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; University Medical Centre Utrecht, Utrecht UniversityDepartment of Radiology, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands., Broeders MJM; Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; Radboud University Medical CenterDepartment for Health Evidence Geert Grooteplein 21, 6525 EZ, Nijmegen, the Netherlands.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2023 Jun; Vol. 69, pp. 431-440. Date of Electronic Publication: 2023 May 03.
DOI: 10.1016/j.breast.2023.05.001
Abstrakt: Background: In Dutch breast cancer screening, solitary, new or growing well-circumscribed masses should be recalled for further assessment. This results in cancers detected but also in false positive recalls, especially at initial screening. The aim of this study was to determine characteristics of well-circumscribed masses at mammography and identify potential methods to improve the recall strategy.
Methods: A systematic literature search was performed using PubMed. In addition, follow-up data were retrieved on all 8860 recalled women in a Dutch screening region from 2014 to 2019.
Results: Based on 15 articles identified in the literature search, we found that probably benign well-circumscribed masses that were kept under surveillance had a positive predictive value (PPV) of 0-2%. New or enlarging solitary well-circumscribed masses had a PPV of 10-12%. In general the detected carcinomas had a favorable prognosis. In our exploration of screening practice, 25% of recalls (2133/8860) were triggered by a well-circumscribed mass. Those recalls had a PPV of 2.0% for initial and 10.6% for subsequent screening. Most detected carcinomas had a favorable prognosis as well.
Conclusion: To recognize malignancies presenting as well-circumscribed masses, identifying solitary, new or growing lesions is key. This information is missing at initial screening since prior examinations are not available, leading to a low PPV. Access to prior clinical examinations may therefore improve this PPV. In addition, given the generally favorable prognosis of screen-detected malignant well-circumscribed masses, one may opt to recall these lesions at subsequent screening, if grown, rather than at initial screening.
Competing Interests: Declaration of competing interest The authors of this manuscript certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. This study was performed under the national permit for breast cancer screening issued by the Ministry of Health, Welfare and Sports and did not require additional approval by a local institutional review board.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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