Weinig effect van borstkankerscreening op de trend in mammasparende chirurgie in Zuidoost-Nederland

To study the relationship between breast-cancer screening among women aged 50-69 years and trends in the use of breast-conserving surgery among women with an invasive mammary carcinoma.

Design

Descriptive.

Method

Trends in the use of breast-conserving surgery in the period 1990-1998 were studied by using data of the cancer registry of the Comprehensive Cancer Centre South concerning eight community hospitals in southeastern North Brabant and Northern Limburg.

Results

In the period 1990-1998, 4788 patients were diagnosed with invasive, operable mammary carcinoma, of whom 2341 were 50-69 years of age. Although upon screening a larger percentage of small tumours were found (diameter ≤ 2 cm) with prognostically favourable characteristics, no increase was observed in the use of breast-conserving surgery for patients aged 50-69 years in the period 1990-1998 (64 in 1990 and 1998). Patients with a tumour detected by screening, however, were more likely to have undergone breast conservation compared to those presenting clinically (68 vs. 54; p < 0.0001; χ²-test).

Conclusion

No increase in breast-conserving surgery was observed in the southeast of the Netherlands among patients aged 50-69 years in the period 1990-1998, despite the introduction of breast-cancer screening for this group. Screening, however, did coincide with a larger proportion of patients with tumours ≤ 2 cm with prognostically favourable characteristics.