Diagnostik und Therapie des Mammakarzinoms seit Einführung des mammographischen Screenings in der flächendeckenden, ambulanten Versorgung des Großherzogtums Luxemburg*
| Autor: | R. Scheiden, M. Stieber, I Tossounidis, Werner Schmidt, D. Mink |
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| Rok vydání: | 1999 |
| Předmět: | |
| Zdroj: | Geburtshilfe und Frauenheilkunde. 59:150-156 |
| ISSN: | 1438-8804 0016-5751 |
| Popis: | Introduction: The efficiency of mammography screening in highly specialized diagnostic centres has been well proven for the age group 50-64 years. Few data is available concerning the value of such a screening under decentralised, population-wide conditions. Since 1992, a mammography screening program (LMSP) organised in this way is being offered in Luxembourg to the age group 50-64 years. Materials and methods: The early outcome indicators of this screening programme were evaluated retrospectively. The pathological characteristics of all the diagnosed breast cancers, their diagnosis and their therapy before (1989) and after (1993) the introduction of the mammography screening programme were compared and analysed. Results: The early outcome indicators of Luxembourg's mammography screening programme were just below the comparable values of other specialised centres. Since the introduction of this programme one notes a significant increase in the number of open breast biopsies in comparison to the period before the screening programme (p = 0.0001), with a highly significant increase in benign biospies (p=0.00001). The ratio cancer/all biopsies dropped non-significantly from 0.35 to 0.28 (p = 0.09). Atypical proliferative hyperplasias and in situ carcinomas increased significantly in number (p = 0.01) as did the number of early invasive cancers (p=0.0015). The lymph node status did not change significantly although there was an increase in node-negative tumours (p=0.11). The number of conservative surgical procedures increased significantly (p = 0.00001). In the age group analysis these changes were significant only in the age group 50-64 years (p=0.0002). All these changes were not only due to the evolution within the screening cohort, but also to the changes among the tumour patients diagnosed outside the screening programme. Conclusion: The early outcome indicators of this mammography screening prove a possible efficiency even under population-wide, non-specialised screening conditions. Nevertheless, studies over a longer period of time will be necessary to analyse the evolution of cancer-specific mortality. |
| Databáze: | OpenAIRE |
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