CARACTERÍSTICAS CLINICOPATOLÓGICAS DOS CANCROS DA MAMA DIAGNOSTICADOS EM PARTICIPANTES, NÃO PARTICIPANTES E NÃO CONVIDADOS AO PROGRAMA DE RASTREIO DE CANCRO DA MAMA NO NORTE DE PORTUGAL EM (2003-2008): PARTE UM – AVALIAÇÃO
Resumo
O objetivo deste estudo foi avaliar as características clínicas e patológicas dos cancros invasivos da mama, diagnosticados em mulheres participantes no programa de rastreio do cancro da mama, em comparação com os cancros detetados em não participantes e em mulheres não convidadas. Os dados foram obtidos do Registo Oncológico Regional do Norte, registo de base populacional, e do Programa de Rastreio de Cancro da Mama (PRCM), organizado, de base populacional da região norte de Portugal; foi avaliada a correspondência entre os dados para selecionar os três grupos para comparação. Em 125 participantes de rastreio, 75.8% dos cancros da mama invasivos eram ≤ 20 mm, 67.7% não tinham metástases nos gânglios linfáticos axilares e 58.1% eram estadio I. Estas características eram significativamente mais favoráveis do que as encontradas em cancros da mama detetados em não participantes (57 mulheres) ou não convidadas (314 mulheres). Após análise multivariável, o tamanho permaneceu a única característica distintiva dos cancros da mama detetados no âmbito do programa de rastreio em comparação com os outros dois grupos em estudo. Os cancros da mama detetados nas participantes do rastreio foram significativamente menores, o que é consistente com achados de outros autores. As características prognósticas mais favoráveis dos cancros da mama detetados numa população exposta ao rastreio (incluindo cancros de intervalo) indicam uma possível redução da mortalidade no futuro.
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Referências
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prognosis between screen-detected and symptomatic breast cancers. British Journal of Cancer 104, 1680-1685.
Baré M., Bonfill X., Andreu X. & On Behalf of the Breast Cancer Screening Programme of Sabadell-Cerdanyola Research Group
(2006) Relationship between the method of detection and prognostic factors for breast cancer in a community with a screening
programme. Journal of Medical Screening 13, 183-191.
Bento M. J., Goncalves G., Aguiar A., Castro C., Veloso V. & Rodrigues V. (2015) Performance indicators evaluation of the populationbased
breast cancer screening programme in Northern Portugal using the European Guidelines. Cancer Epidemiology 39, 783-789.
Berry D. A., Cronin K. A., Plevritis S. K., Fryback D. G., Clarke L., Zelen M., Mandelblatt J. S., Yakovlev A. Y., Habbema J. D., Feuer E.
J., Cancer I. & Surveillance Modeling Network C. (2005) Effect of screening and adjuvant therapy on mortality from breast cancer.
New England Journal of Medicine 353, 1784-1792.
Bucchi L., Barchielli A., Ravaioli A., Federico M., De Lisi V., Ferretti S., Paci E., Vettorazzi M., Patriarca S., Frigerio A. & Buiatti E. (2005)
Screen-detected vs clinical breast cancer: the advantage in the relative risk of lymph node metastases decreases with increasing
tumour size. British Journal of Cancer 92, 156-161.
Bucchi L., Puliti D., Ravaioli A., Cortesi L., De Lisi V., Falcini F., Ferretti S., Frigerio A., Mangone L., Petrella M., Petrucci C., Sassoli
De Bianchi P., Traina A., Tumino R., Zanetti R., Zorzi M. & Paci E. (2008) Breast screening: axillary lymph node status of interval
cancers by interval year. Breast 17, 477-483.
Bulliard J. L., Ducros C., Jemelin C., Arzel B., Fioretta G. & Levi F. (2009) Effectiveness of organised versus opportunistic mammography
screening. Annals of Oncology 20, 1199-1202.
Burke J. P., Power C., Gorey T. F., Flanagan F., Kerin M. J. & Kell M. R. (2008) A comparative study of risk factors and prognostic features
between symptomatic and screen detected breast cancer. European Journal of Surgical Oncology 34, 149-153.
Castro C., Bento M. J., Lunet N. & Campos P. (2012) Assessing the completeness of cancer registration using suboptimal death certificate
information. European Journal of Cancer Prevention 21, 478-479.
Day N. E., Williams D. R. & Khaw K. T. (1989) Breast cancer screening programmes: the development of a monitoring and evaluation
system. British Journal of Cancer 59, 954-958.
Dijck J. & Schouten L. (2000) Use of cancer registry data: prerequesites, limitations and solutions. In: Evaluation and monitoring of
screening programmes (eds. Sankila, R., Démaret, E., Hakama, M., Lynge, E., Schouten, L. & Parkin, D. M.), pp. 43-57. Europe
Against Cancer Programme, Brussels, Luxembourg.
Domingo L., Jacobsen K. K., Von Euler-Chelpin M., Vejborg I., Schwartz W., Sala M. & Lynge E. (2013) Seventeen-years overview of
breast cancer inside and outside screening in Denmark. Acta Oncologica 52, 48-56.
Duffy S. W., Tabar L., Fagerberg G., Gad A., Grontoft O., South M. C. & Day N. E. (1991) Breast screening, prognostic factors and
survival--results from the Swedish two county study. British Journal of Cancer 64, 1133-1138.
Elston C. W. & Ellis I. O. (1991) Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer:
experience from a large study with long-term follow-up. Histopathology 19, 403-410.
Giordano L., Von Karsa L., Tomatis M., Majek O., De Wolf C., Lancucki L., Hofvind S., Nystrom L., Segnan N., Ponti A., Van Hal G.,
Martens P., Majek O., Danes J., Von Euler-Chelpin M., Aasmaa A., Anttila A., Becker N., Pentek Z., Budai A., Madai S., Fitzpatrick
P., Mooney T., Zappa M., Ventura L., Scharpantgen A., Hofvind S., Seroczynski P., Morais A., Rodrigues V., Bento M. J., Gomes
De Carvalho J., Natal C., Prieto M., Sanchez-Contador Escudero C., Zubizarreta Alberti R., Fernandez Llanes S. B., Ascunce N.,
Ederra Sanza M., Sarriugarte Irigoien G., Salas Trejo D., Ibanez Cabanell J., Wiege M., Ohlsson G., Tornberg S., Korzeniewska
M., De Wolf C., Fracheboud J., Patnick J. J., Lancucki L., Ducarroz S. & Suonio E. (2012) Mammographic screening programmes
in Europe: organization, coverage and participation. Journal of Medical Screening 19 (Suppl 1), 72-82.
Greene F. L., Page D. L. & Fleming I. D. (2002) AJCC Cancer Staging Handbook, 6th edn, Springer, New York, NY.
Hakama M., Holli K., Isola J., Kallioniemi O. P., Karkkainen A., Visakorpi T., Pukkala E., Saarenmaa I., Geiger U., Ikkala J. & Et Al.
(1995) Aggressiveness of screen-detected breast cancers. Lancet 345, 221-224.
Hoff S. R., Klepp O. & Hofvind S. (2012) Asymptomatic breast cancer in non-participants of the national screening programme in
Norway: a confounding factor in evaluation? Journal of Medical Screening 19, 177-183.
Hofvind S., Lee C. I. & Elmore J. G. (2012) Stage-specific breast cancer incidence rates among participants and non-participants of a
population-based mammographic screening program. Breast Cancer Research and Treatment 135, 291-299.
Hofvind S., Sorum R. & Thoresen S. (2008) Incidence and tumor characteristics of breast cancer diagnosed before and after implementation
of a population-based screening-program. Acta Oncologica 47, 225-231.
Kalager M., Haldorsen T., Bretthauer M., Hoff G., Thoresen S. O. & Adami H. O. (2009) Improved breast cancer survival following
introduction of an organized mammography screening program among both screened and unscreened women: a populationbased
cohort study. Breast Cancer Research 11, R44.
Kim J., Lee S., Bae S., Choi M. Y., Lee J., Jung S. P., Kim S., Choe J. H., Kim J. H., Kim J. S., Lee J. E., Nam S. J. & Yang J. H. (2012)
Comparison between screen-detected and symptomatic breast cancers according to molecular subtypes. Breast Cancer Research
and Treatment 131, 527-540.
Lynge E., Tornberg S., Von Karsa L., Segnan N. & Van Delden J. J. (2012) Determinants of successful implementation of populationbased
cancer screening programmes. European Journal of Cancer 48, 743-748.
Mccann J., Stockton D. & Day N. (1998) Breast cancer in East Anglia: the impact of the breast screening programme on stage at diagnosis.
Journal of Medical Screening 5, 42-48.
Mook S., Van ‘T Veer L. J., Rutgers E. J., Ravdin P. M., Van De Velde A. O., Van Leeuwen F. E., Visser O. & Schmidt M. K. (2011)
Independent prognostic value of screen detection in invasive breast cancer. Journal of the National Cancer Institute 103, 585-597.
Nagtegaal I. D., Allgood P. C., Duffy S. W., Kearins O., Sullivan E. O., Tappenden N., Wallis M. & Lawrence G. (2011) Prognosis and
pathology of screen-detected carcinomas: how different are they? Cancer 117, 1360-1368.
Nagtegaal I. D. & Duffy S. W. (2013) Reduction in rate of node metastases with breast screening: consistency of association with tumor
size. Breast Cancer Research and Treatment 137, 653-663.
Narod S. A. (2012) Tumour size predicts long-term survival among women with lymph node-positive breast cancer. Current Oncology
(Toronto, Ont.) 19, 249-253.
Perry N., Broeders M., De Wolf C., Tornberg S., Holland R. & Von Karsa L. (2006) European guidelines for quality assurance in breast
cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxembourg.
Roreno (2002). Mapas – comparações efectuadas entre cada distrito e a restante região. [Access Date: 2015/03/01 ]. Available from:
http://www.roreno.com.pt/pt/estatisticas/mapas.html.
Segnan N., Rosso S. & Ponti A. (2012) Is the breast cancer mortality decrease in Sweden due to screening or treatment? Not the right
question. Journal of the National Cancer Institute 104, 1040-1041.
Shen Y., Yang Y., Inoue L. Y., Munsell M. F., Miller A. B. & Berry D. A. (2005) Role of detection method in predicting breast cancer
survival: analysis of randomized screening trials. Journal of the National Cancer Institute 97, 1195-1203.
Stockton D. & Mccann J. (2001) Cancer registries in monitoring, evaluating and planning breast cancer screening programmes. In:
Evaluation and Monitoring of Screening Programmes (eds. Sankila, R., Démaret, E., Hakama, M., Lynge, E., Shouten, L. J. & Parkin,
D. M.), pp. 181-194. Office for Official Publications of the European Communities, Luxembourg.
Vanier A., Leux C., Allioux C., Billon-Delacour S., Lombrail P. & Molinie F. (2013) Are prognostic factors more favorable for breast
cancer detected by organized screening than by opportunistic screening or clinical diagnosis? A study in Loire-Atlantique (France).
Cancer Epidemiology 37, 683-687.
Welch H. G. (2010) Screening mammography--a long run for a short slide? New England Journal of Medicine 363, 1276-1278.
prognosis between screen-detected and symptomatic breast cancers. British Journal of Cancer 104, 1680-1685.
Baré M., Bonfill X., Andreu X. & On Behalf of the Breast Cancer Screening Programme of Sabadell-Cerdanyola Research Group
(2006) Relationship between the method of detection and prognostic factors for breast cancer in a community with a screening
programme. Journal of Medical Screening 13, 183-191.
Bento M. J., Goncalves G., Aguiar A., Castro C., Veloso V. & Rodrigues V. (2015) Performance indicators evaluation of the populationbased
breast cancer screening programme in Northern Portugal using the European Guidelines. Cancer Epidemiology 39, 783-789.
Berry D. A., Cronin K. A., Plevritis S. K., Fryback D. G., Clarke L., Zelen M., Mandelblatt J. S., Yakovlev A. Y., Habbema J. D., Feuer E.
J., Cancer I. & Surveillance Modeling Network C. (2005) Effect of screening and adjuvant therapy on mortality from breast cancer.
New England Journal of Medicine 353, 1784-1792.
Bucchi L., Barchielli A., Ravaioli A., Federico M., De Lisi V., Ferretti S., Paci E., Vettorazzi M., Patriarca S., Frigerio A. & Buiatti E. (2005)
Screen-detected vs clinical breast cancer: the advantage in the relative risk of lymph node metastases decreases with increasing
tumour size. British Journal of Cancer 92, 156-161.
Bucchi L., Puliti D., Ravaioli A., Cortesi L., De Lisi V., Falcini F., Ferretti S., Frigerio A., Mangone L., Petrella M., Petrucci C., Sassoli
De Bianchi P., Traina A., Tumino R., Zanetti R., Zorzi M. & Paci E. (2008) Breast screening: axillary lymph node status of interval
cancers by interval year. Breast 17, 477-483.
Bulliard J. L., Ducros C., Jemelin C., Arzel B., Fioretta G. & Levi F. (2009) Effectiveness of organised versus opportunistic mammography
screening. Annals of Oncology 20, 1199-1202.
Burke J. P., Power C., Gorey T. F., Flanagan F., Kerin M. J. & Kell M. R. (2008) A comparative study of risk factors and prognostic features
between symptomatic and screen detected breast cancer. European Journal of Surgical Oncology 34, 149-153.
Castro C., Bento M. J., Lunet N. & Campos P. (2012) Assessing the completeness of cancer registration using suboptimal death certificate
information. European Journal of Cancer Prevention 21, 478-479.
Day N. E., Williams D. R. & Khaw K. T. (1989) Breast cancer screening programmes: the development of a monitoring and evaluation
system. British Journal of Cancer 59, 954-958.
Dijck J. & Schouten L. (2000) Use of cancer registry data: prerequesites, limitations and solutions. In: Evaluation and monitoring of
screening programmes (eds. Sankila, R., Démaret, E., Hakama, M., Lynge, E., Schouten, L. & Parkin, D. M.), pp. 43-57. Europe
Against Cancer Programme, Brussels, Luxembourg.
Domingo L., Jacobsen K. K., Von Euler-Chelpin M., Vejborg I., Schwartz W., Sala M. & Lynge E. (2013) Seventeen-years overview of
breast cancer inside and outside screening in Denmark. Acta Oncologica 52, 48-56.
Duffy S. W., Tabar L., Fagerberg G., Gad A., Grontoft O., South M. C. & Day N. E. (1991) Breast screening, prognostic factors and
survival--results from the Swedish two county study. British Journal of Cancer 64, 1133-1138.
Elston C. W. & Ellis I. O. (1991) Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer:
experience from a large study with long-term follow-up. Histopathology 19, 403-410.
Giordano L., Von Karsa L., Tomatis M., Majek O., De Wolf C., Lancucki L., Hofvind S., Nystrom L., Segnan N., Ponti A., Van Hal G.,
Martens P., Majek O., Danes J., Von Euler-Chelpin M., Aasmaa A., Anttila A., Becker N., Pentek Z., Budai A., Madai S., Fitzpatrick
P., Mooney T., Zappa M., Ventura L., Scharpantgen A., Hofvind S., Seroczynski P., Morais A., Rodrigues V., Bento M. J., Gomes
De Carvalho J., Natal C., Prieto M., Sanchez-Contador Escudero C., Zubizarreta Alberti R., Fernandez Llanes S. B., Ascunce N.,
Ederra Sanza M., Sarriugarte Irigoien G., Salas Trejo D., Ibanez Cabanell J., Wiege M., Ohlsson G., Tornberg S., Korzeniewska
M., De Wolf C., Fracheboud J., Patnick J. J., Lancucki L., Ducarroz S. & Suonio E. (2012) Mammographic screening programmes
in Europe: organization, coverage and participation. Journal of Medical Screening 19 (Suppl 1), 72-82.
Greene F. L., Page D. L. & Fleming I. D. (2002) AJCC Cancer Staging Handbook, 6th edn, Springer, New York, NY.
Hakama M., Holli K., Isola J., Kallioniemi O. P., Karkkainen A., Visakorpi T., Pukkala E., Saarenmaa I., Geiger U., Ikkala J. & Et Al.
(1995) Aggressiveness of screen-detected breast cancers. Lancet 345, 221-224.
Hoff S. R., Klepp O. & Hofvind S. (2012) Asymptomatic breast cancer in non-participants of the national screening programme in
Norway: a confounding factor in evaluation? Journal of Medical Screening 19, 177-183.
Hofvind S., Lee C. I. & Elmore J. G. (2012) Stage-specific breast cancer incidence rates among participants and non-participants of a
population-based mammographic screening program. Breast Cancer Research and Treatment 135, 291-299.
Hofvind S., Sorum R. & Thoresen S. (2008) Incidence and tumor characteristics of breast cancer diagnosed before and after implementation
of a population-based screening-program. Acta Oncologica 47, 225-231.
Kalager M., Haldorsen T., Bretthauer M., Hoff G., Thoresen S. O. & Adami H. O. (2009) Improved breast cancer survival following
introduction of an organized mammography screening program among both screened and unscreened women: a populationbased
cohort study. Breast Cancer Research 11, R44.
Kim J., Lee S., Bae S., Choi M. Y., Lee J., Jung S. P., Kim S., Choe J. H., Kim J. H., Kim J. S., Lee J. E., Nam S. J. & Yang J. H. (2012)
Comparison between screen-detected and symptomatic breast cancers according to molecular subtypes. Breast Cancer Research
and Treatment 131, 527-540.
Lynge E., Tornberg S., Von Karsa L., Segnan N. & Van Delden J. J. (2012) Determinants of successful implementation of populationbased
cancer screening programmes. European Journal of Cancer 48, 743-748.
Mccann J., Stockton D. & Day N. (1998) Breast cancer in East Anglia: the impact of the breast screening programme on stage at diagnosis.
Journal of Medical Screening 5, 42-48.
Mook S., Van ‘T Veer L. J., Rutgers E. J., Ravdin P. M., Van De Velde A. O., Van Leeuwen F. E., Visser O. & Schmidt M. K. (2011)
Independent prognostic value of screen detection in invasive breast cancer. Journal of the National Cancer Institute 103, 585-597.
Nagtegaal I. D., Allgood P. C., Duffy S. W., Kearins O., Sullivan E. O., Tappenden N., Wallis M. & Lawrence G. (2011) Prognosis and
pathology of screen-detected carcinomas: how different are they? Cancer 117, 1360-1368.
Nagtegaal I. D. & Duffy S. W. (2013) Reduction in rate of node metastases with breast screening: consistency of association with tumor
size. Breast Cancer Research and Treatment 137, 653-663.
Narod S. A. (2012) Tumour size predicts long-term survival among women with lymph node-positive breast cancer. Current Oncology
(Toronto, Ont.) 19, 249-253.
Perry N., Broeders M., De Wolf C., Tornberg S., Holland R. & Von Karsa L. (2006) European guidelines for quality assurance in breast
cancer screening and diagnosis, 4th edn. Office for Official Publications of the European Communities, Luxembourg.
Roreno (2002). Mapas – comparações efectuadas entre cada distrito e a restante região. [Access Date: 2015/03/01 ]. Available from:
http://www.roreno.com.pt/pt/estatisticas/mapas.html.
Segnan N., Rosso S. & Ponti A. (2012) Is the breast cancer mortality decrease in Sweden due to screening or treatment? Not the right
question. Journal of the National Cancer Institute 104, 1040-1041.
Shen Y., Yang Y., Inoue L. Y., Munsell M. F., Miller A. B. & Berry D. A. (2005) Role of detection method in predicting breast cancer
survival: analysis of randomized screening trials. Journal of the National Cancer Institute 97, 1195-1203.
Stockton D. & Mccann J. (2001) Cancer registries in monitoring, evaluating and planning breast cancer screening programmes. In:
Evaluation and Monitoring of Screening Programmes (eds. Sankila, R., Démaret, E., Hakama, M., Lynge, E., Shouten, L. J. & Parkin,
D. M.), pp. 181-194. Office for Official Publications of the European Communities, Luxembourg.
Vanier A., Leux C., Allioux C., Billon-Delacour S., Lombrail P. & Molinie F. (2013) Are prognostic factors more favorable for breast
cancer detected by organized screening than by opportunistic screening or clinical diagnosis? A study in Loire-Atlantique (France).
Cancer Epidemiology 37, 683-687.
Welch H. G. (2010) Screening mammography--a long run for a short slide? New England Journal of Medicine 363, 1276-1278.
Publicado
2020-07-02
Como Citar
BENTO, Maria José et al.
CARACTERÍSTICAS CLINICOPATOLÓGICAS DOS CANCROS DA MAMA DIAGNOSTICADOS EM PARTICIPANTES, NÃO PARTICIPANTES E NÃO CONVIDADOS AO PROGRAMA DE RASTREIO DE CANCRO DA MAMA NO NORTE DE PORTUGAL EM (2003-2008): PARTE UM – AVALIAÇÃO.
Revista Portuguesa de Cirurgia, [S.l.], n. 47, p. 31-40, july 2020.
ISSN 2183-1165.
Disponível em: <https://revista.spcir.com/index.php/spcir/article/view/807>. Acesso em: 30 mar. 2023.
doi: https://doi.org/10.34635/rpc.807.
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