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Randomized mammographic screening for breast cancer in Stockholm

Design, first round results and comparisons

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Abstract

In March 1981 a randomized single-view mammographic screening for breast cancer was started in the south of Stockholm. The screened population in the first round numbered 40,318 women, and 20,000 women served as a well-defined control group. The age groups represented were 40–64 years, and 80.7% of the invited women participated in the study. The first round disclosed 128 breast cancers (113 invasive and 15 noninvasive), or 4.0 per 1,000 women. Mean tumour size was 14.1 mm and axillary lymph node metastases were found in 21.8%. Fifty-five per cent of the tumours were small (⩽10 mm) or non-invasive, and 71% were stage I.

Participation rates are high in all Swedish trials. The present results differ only slightly from other screening programs; the percentages of patients with axillary metastases and stage II tumours are similar in the Stockholm, Malmö and Kopparberg/Östergötland studies. Comparisons of cancer prevalence in the various Swedish screening trials show that, in comparable age groups, there are some differences, even when the differences in the natural cancer incidence are taken into account.

A decreased mortality was found recently in a Swedish trial in ages above 50 years but not below. In the Stockholm study more than one-third of the participants were aged 40–49 years.

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References

  1. Cancer Incidence in Sweden, 1980. National board of health and welfare. The Cancer registry, Stockholm 1984

  2. Rutqvist LE: The increasing incidence and constant mortality rates of breast cancer. Aspects on time trends in Stockholm County, 1961–1973. Breast Cancer Res Treat 4: 233–243, 1984

    PubMed  Google Scholar 

  3. Cancer. SOU 1984: 67. Liber 1984

  4. Adair F, Berg J, Joubert L, Robbins GF: Long-term follow-up of breast cancer patients: the 30-years report. Cancer 33: 1145–1150, 1974

    PubMed  Google Scholar 

  5. Wallgren A, Silfverswärd C, Eklund G: Prognostic factors in mammary carcinoma. Acta Radiol Ther Phys Biol 15: 1–6, 1976

    PubMed  Google Scholar 

  6. Langlands AO, Kerr GR: Prognosis in breast cancer: the relevance of clinical staging. Clin Radiol 29: 599–606, 1978

    PubMed  Google Scholar 

  7. Langeland P: Population screening for female breast tumours. Acta Radiol (Stockh) Suppl 297, 1970

  8. Gästrin G: New techniques for increasing the efficiency of self-examination in early diagnosis of breast cancer. Br Med J 2: 745, 1976

    PubMed  Google Scholar 

  9. Gästrin G: The mama method-health information program for diagnosing breast cancer. Läkartidningen 77: 449–451, 1980

    Google Scholar 

  10. Jakobsson S, Lundgren B, Melander O, Norin T: Mass screening of a female population for detection of early carcinoma of the breast. Acta Radiol Ther Phys Biol 14: 424–432, 1975

    PubMed  Google Scholar 

  11. Moskowitz M: Screening for breast cancer: How effective are our tests? A critical review. Cancer J Clin 33: 26–39, 1983

    Google Scholar 

  12. Shapiro S, Strax P, Venet L: Periodic breast cancer screening in reducing mortality from breast cancer. JAMA 215: 1777–1785, 1971

    PubMed  Google Scholar 

  13. Shapiro S: Evidence on screening for breast cancer from a randomized trial. Cancer 39: 2772–2782, 1977

    PubMed  Google Scholar 

  14. Shapiro S, Venet W, Strax P, Venet L, Roeser R: Tento-fourteen year effect of screening on breast cancer mortality. JNCI 60: 349–355, 1982

    Google Scholar 

  15. Beahrs OH, Smart CR: Diagnosis of minimal breast cancers in the BCDDP. The 66 questionable cases. Cancer 43: 848–850, 1979

    PubMed  Google Scholar 

  16. Miller AB: Screening for breast cancer. Breast Cancer Res Treat 3: 143–156, 1983

    PubMed  Google Scholar 

  17. Rombach JJ: Breast cancer screening. Results and implications for diagnostic decision-making. Stafleu's Scientific Publishing Company, Alphen aan den Rijn, Brussels, 1980

    Google Scholar 

  18. de Waard F, Rombach JJ, Colette HJA: The DOM-project for the early diagnosis of breast cancer in the city of Utrecht, the Netherlands. In: Miller AB (ed): Screening in cancer. UICC Technical Report Series, Vol 40. Geneva, 1978, pp 183–200

  19. Colette HJA, Day NE, Rombach JJ, de Waard F: Evaluation of screening for breast cancer in a non-randomized study (the DOM-project) by means of a case-control study. Lancet 2: 1224–1226, 1984

    PubMed  Google Scholar 

  20. Verbeek ALM, Holland R, Sturmans F, Hendriks JHCL, Mravunac M, Day NE: Reduction of breast cancer mortality through mass screening with modern mammography. Lancet 2: 1222–1224, 1984

    PubMed  Google Scholar 

  21. UK Trial of Early Detection of Breast Cancer Group: Trial of early detection of breast cancer: Description of method. Br J Cancer 44: 618–627, 1981

    Google Scholar 

  22. Thomas BA: Population screening for breast cancer using single view mammography and clinical examination. Cancer Detect Prev 3: 454, 1980

    Google Scholar 

  23. Thomas BA, Price JL, Boulter PS: The Guildford breast screening project. Clin Oncol 9: 121–129, 1983

    PubMed  Google Scholar 

  24. Lundgren B: The oblique view at mammography. Br J Radiol 50: 626–628, 1977

    PubMed  Google Scholar 

  25. Lundgren B, Jakobsson S: Single-view mammography, a simple and efficient approach to breast cancer screening. Cancer 38: 1124–1129, 1976

    PubMed  Google Scholar 

  26. Lundgren B: Single oblique-view mammography, an efficient method for breast cancer screening. Thesis, Gävle, 1980

  27. Lundgren B: Population screening for breast cancer by single-view mammography in a geographic region in Sweden. JNCI 62: 1373–1379, 1979

    PubMed  Google Scholar 

  28. Andersson I: Radiographic screening for breast carcinoma. Program and primary findings in 45–69 year old women. Acta Radiol Diagn (Stockh) 22: 185–194, 1981

    Google Scholar 

  29. Andersson I: Mammographic screening for breast carcinoma. A cross-sectional randomized study of 45–69 year old women. Thesis, Malmö, 1980

  30. Tabar L, Gad A: Screening for breast cancer: The Swedish trial. Radiology 138: 219–222, 1981

    PubMed  Google Scholar 

  31. Tabar L, Åkerlund E, Gad A: Five-year experience with single-view mammography randomized controlled screening in Sweden. Recent Results Cancer Res 90: 105–113, 1984

    PubMed  Google Scholar 

  32. Tabar L, Gad A et al.: Reduction in mortality from breast cancer after mass screening with mammography. Lancet 13: 829–832, 1985

    Google Scholar 

  33. Love R, Camilli AE: The value of screening. Cancer 48: 489–494, 1981

    PubMed  Google Scholar 

  34. Feinstein AR: On the sensitivity, specificity and discrimination of diagnostic tests. Clin Pharmacol Ther 17: 104–116, 1975

    PubMed  Google Scholar 

  35. Moskowitz M: The predictive value of certain mammographic signs in screening for breast cancer. Cancer 51: 1007–1011, 1983

    PubMed  Google Scholar 

  36. Moskowitz M: Screening is not diagnosis. Radiology 133: 265–268, 1979

    PubMed  Google Scholar 

  37. Moskowitz M: Mammography to screen asymptomatic women for breast cancer. Am J Roentgenol 143: 457–459, 1984

    Google Scholar 

  38. Gad A, Thomas BA, Moskowitz M: Screening for breast cancer in Europe: achievements, problems and future. Recent Results Cancer Res 90: 179–194, 1984

    PubMed  Google Scholar 

  39. Andersson I: Breast cancer screening in Malmö. Recent Results Cancer Res 90: 114–116, 1984

    PubMed  Google Scholar 

  40. Lundgren B: Diagnosis and screening in breast cancer: A review. Eur J Cancer Clin Oncol 19: 1709–1710, 1983

    PubMed  Google Scholar 

  41. Wallberg H, Alveryd A, Bergvall U, Nasiell K, Sundelin P, Troell S: Diaphanography in breast cancer — correlation with clinical examination and the mammography, cytological and histological findings. Acta Radiol Diagn (Stockh) 26: 33–34, 1985

    Google Scholar 

  42. Andersson I, Bjurstam N, Fagerberg G, Hellström L, Lundgren B, Tabar L: Bröstcancerscreening med mammografi i Sverige (Socialstyrelsen PM 33/82). Läkartidningen 25: 2559–2562, 1983

    Google Scholar 

  43. Andersson I: What can we learn from interval carcinomas? Recent Results Cancer Res 90: 161–163, 1984

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Dept. of Surgery, Karolinska Institute, Södersjukhuset, S-100 64, Stockholm, Sweden

    J. Frisell M.D. & A. Somell

  2. Dept. of Oncology, Karolinska Institute, Södersjukhuset, Stockholm, Sweden

    U. Glas

  3. Dept. of Radiology, Karolinska Institute, Södersjukhuset, Stockholm, Sweden

    L. Hellström

Authors
  1. J. Frisell M.D.
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  2. U. Glas
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  3. L. Hellström
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  4. A. Somell
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Frisell, J., Glas, U., Hellström, L. et al. Randomized mammographic screening for breast cancer in Stockholm. Breast Cancer Res Tr 8, 45–54 (1986). https://doi.org/10.1007/BF01805924

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