The Efficiency of Breast Cancer Screening in Tbilisi

Abstract

We have analyzed 67,710 cases of screening-diagnostics conducted in 2010-2014 by National Screening Centre, in which 1,197 patients were diagnosed with breast cancer. The prevalence of breast cancer per 1,000 women was 17.7%0. The prevalence of breast cancer cases increases with age and reaches its peak in age group 65-69 (46.7%0). 53% of breast cancer cases were detected at I clinical stage, 35% - at the II, and 12% - at the III-IV clinical stages. With age, the detection of the disease at I stage decreases, while at the II clinical stage it increases. Breast cancer prevalence per 1,000 women (%0) at all clinical stages reaches its peak in age group 60-69. In order to evaluate the diagnostic efficiency of tests during breast cancer screening and estimate the diagnostic value and role of ultrasonography research, we studied the following indicators of diagnostic efficiency of breast physical examination, mammography, ultrasonography and punctate cytological research based on Screening National Centre. While evaluating diagnostic efficiency, we paid attention to the value of tests in differentiating diagnostics between breast cancer and other benign tumors. In order to evaluate the diagnostic efficiency and role of ultrasonography during breast cancer screening, we have additionally compared mammographic and ultrasonography results in cases of breast cancer and other benign tumors. During breast benign tumors, hyper diagnostics occurred in 39.2% of all cases according to mammographic research and only in 15.3% according to ultrasonography research. In other words, ultrasonography research in cases of benign tumors reduces the number of cases of screening hyper diagnostics by 23.9%. During breast cancer, hypo diagnostics occurred in 7.1% according to mammographic research and only in 2.7% according to ultrasonography research. In other words, ultrasonography research in cases of breast cancer reduces the number of cases of screening hypo diagnostics by 4.4% which is very important. It is very important that ultrasonography research at the age of 40-49 increases cases of early diagnostics of breast cancer in I clinical stage.