Assessment of Recalled Patients in Population Based Screening Mammography

INTRODUCTION: This study assesses the results of patients referred by KETEM (Cancer Early Diagnosis Screening and Education Center) to our hospital as a result of a recall, providing the viewpoint of a secondary level center.
METHODS: The study included patients who underwent a mammography at KETEM and who were referred to our department through a recall between January 2016 and October 2019. The assessment parameters included the rates at which the patients bringing report and mammography images, US BIRADS category, true positives, false positives, ppv and cancer detection rates.
RESULTS: The average age of the 409 patients was 52 years. Of the patients, 94.4% underwent a US examination without previous access to mammography images. In the 21 BIRADS 4 and 5 patients with histopathological data, the true positivity rate was 16, the false positivity rate was 5, and PPV was 76%. The cancer detection rate was 16/409 (39.1‰); the detection rate for minimally invasive cancer was 4/16; the size of the malignant mass varied from 7 to 40 mm; and symptoms such as breast stiffness, palpable mass and skin retraction were noted in nine of the patients diagnosed with malignancy.
DISCUSSION AND CONCLUSION: The main issue experienced at a secondary level is the need to perform US without first accessing mammography images. The approach is used not only for screening at KETEM, but also for diagnostic purposes, and so the rates of detected cancer are higher than from screening programs. There is a need to revise the functioning of screening programs also in secondary level.

Toplum Tabanlý Tarama Mamografilerinde Geri Çaðýrýlan Hastalarýn Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Ýlimiz içerisindeki KETEM ikinci düzey merkezlerinden biri olan hastanemize geri çaðrýlma ile yönlendirilen hastalarýn bulgularýnýn ikinci basamak merkezin bakýþ açýsýndan deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: KETEM de mamografileri çekilen ve Ocak 2016- Ekim 2019 tarihleri arasýnda bölümümüze yönlendirilen hastalar çalýþmaya dahil edildi. Rapor ve filmi getirme oranlarý,US-BIRADS kategorisi, true pozitif, false pozitif, positive prediktif deðer (ppv) ve kanser saptama oranlarý deðerlendirildi.
BULGULAR: Yaþ ortalamasý 52 olan 409 hastanýn, %94,4 ünde filmleri görülmeden US incelemesi yapýldý. BIRADS 4-5 grubunda histopatolojik verilerine ulaþýlan 21 hasta için Gerçek pozitiflik 16, yalancý pozitiflik 5, ppd 76% idi. Kanser saptama oraný 16/409 (Binde 39,1) idi. 4/16 minimal invaziv kanser saptama oraný idi. Malign kitle boyutu 7-40 mm arasýnda deðiþmekte idi. Malign taný alan hastalarýn 9’unda memede sertlik, ele gelen kitle, ciltte çekinti gibi semptomlar mevcuttu.
TARTIÞMA ve SONUÇ: Ýkinci basamakta yaþanan öncelikli sorun mamografi filmleri görülmeden US yapýlmasýdýr. KETEM de sadece tarama amaçlý deðil tanýsal amaçlý da kullanýlmaktadýr. Bu nedenle saptanan kanser oranlarý tarama programlarýndan yüksek bulunmaktadýr. Tarama programýnýn iþleyiþinin ikinci basamakta da düzenlenmesine ihtiyaç duyulmaktadýr.