PRELIMINARY RESULTS AND ANALYSIS OF FEASABILITY OF MAMMOGRAPHIC BREAST CANCER SCREENING IN WOMEN YOUNGER THAN 50 YEARS OF THE L’ARIANA STATE OF TUNISIA.

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Vol. 87 No. 7 (2009): Issue Jul 2009

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Zaanouni E
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie Unité de dépistage du cancer du sein par mammographie
Ben Abdallah M
Service d'Epidémiologie Biostatistique et Informatique Médicale Institut Salah Azaiz Tunis Tunisie
Bouchlaka A
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie
Ben Aissa R
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie
Kribi L
Division Recherche Biomédicale, Office National de la Famille et de la Population (ONFP), Tunis, Tunisie;Service de radiologie, hôpital Charles Nicolle - Tunis,unité de mammographie de l'office national de la famille et de la population
M'barek F
Ben Hamida A
Service de la Médecine Préventive Faculté de médecine Tunis Tunisie
Boussen H
Service d'oncologie médicale Institut Salah Azaiz Tunis TunisieService de la Médecine Préventive
Gueddana N
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie

Abstract

Objective: To report the preliminary results of the feasibility of breast cancer mammographic screening among women younger than 50 years from the l’Ariana state of Tunisia.
Material and methods: The National office of the Family and Population (ONFP) launched a protocol on feasibility of breast cancer mammographic screening targeting asymptomatic women aged 40-69 years, from the l’Ariana state in Tunisia. We practiced two oblique and face incidences at the mammography screening unit of the ONFP, whose equipment and control system of quality answered to the European Communitiy for breast cancer screening.
Results: We did 5325 mammograms between April 2004 and March 2006. Our targeted population had a 48,9 years mean age (CI 95% = [48.7 - 49.1]), 60,3% of them younger than 50 years. There were more young women with high breast denisty (8.2%) compared to the group from 50 to 69 years (2,1%). The women arising from the 40- 49 years cohort had a socio-economic and educational level higher. The complementary rate of examination/explorations was higher in this cohort(19.5%) vs 11.5% for the 50-69 years. The youngest women presented a more often positive test (7.0 vs 5.2%) than the oldest women (p<0.01).
Conclusion : The option to screen breast cancer by mammography in women younger than 40 years in Tunisia is partially justified by the relatively high frequency of this cancer in this age group. Our feasibility poorly useful in screening will be used to sensibilise females to the problematic of breast cancer to obtain a better compliance compared to the older age group of 50-59 years.

Keywords:

mammography, screening, age, young woman, Breast, cancer, feasability, density

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References

  1. Maalej M, Hentati D, Mesai T et al. Cancer du sein en Tunisie en 2004 : Etude comparative clinique et épidémiologique. Bull Cancer 2008 ;95 :E5-9.
  2. Titus-Emstoff L, Tosteson AS, Kasales AC et al. Breast cancer risk factors in relation to breast density(United States). Cancer Causes Control 2006;17:1281-90.
  3. Andersson I, Aspegren K, Janzon L et al. Mammographic screening and mortality from breast cancer : the Malmoe trial. Br Med J, 1988 ; 297 : 943-948.
  4. Miller AB, Baines CJ & Wall C. Breast cancer detection and death rates among women aged 40 to 49 years. C M A J, 1992;147:1459-1476.
  5. Primic Zakelj M. Screening mammography for early detection of breast cancer. Ann Oncol 1999;10:121-127.
  6. Smart CR, Hendrick RE, Rutledge JH & Smith RA. Benefit of mammography screening in women aged 40 to 49 years. Current evidence from randomized controlled trials. Cancer 1995;75:1619-1626.
  7. Sancho-Garnier H, Sasco A, Seradour B et al. Dépistage du cancer du sein par mammographie :Evaluation de la méta-analyse de Gotzsche et Olsen. Paris :Agence Nationale d'Accréditation et d'Evaluation en Santé, 2002.
  8. Ancelle-Park R, Arveux P, Barreau B et al. Opportunité d'étendre le programme national de dépistage du cancer du sein aux femmes âgées de 40 à 49 ans. Evaluation technologique et économique. Paris, Agence Nationale d'Accréditation et d'Evaluation en Santé: 2004.
  9. Armstrong K, Moye E, Williams S et al. Screening mammography in women 40 to 49 years : a systematic review for the American college of physicians. Ann Intern Med 2007;146:516-26.
  10. Stewart BW & Kleiheus P. Le Cancer dans le Monde. Lyon : Centre International de Recherche contre le Cancer, 2005 : 158- 161 ; 190-195.
  11. Perry N, Broeders M, Wolf C & al. European Guidelines for quality assurance in breast cancer screening and diagnosis (4th edition). Luxembourg : European Union Health & Consumer Protection Directorate, 2006.
  12. Paty AC, Ancelle-Park R, Julien M & al. Programme de dépistage du cancer du sein en France. Résultats 2004. Paris, Institut de Veille Sanitaire : 2006.
  13. Pisano ED, Gatsonis C, Hendrick E & al. Diagnostic performance of digital versus film mammography for breast cancer screening. N Engl J Med, 2005 ; 355:1773-1783.
  14. Ciatto S, Visioli C, Paci E & Zappa M. Breast density as a determinant of interval cancer at mammographic screening. Br J Cancer, 2004 ; 90 : 393-396.
  15. Taylor R, Page A, Bampton D & al. Age specific interval breast cancers. Meta-analysis of studies of women aged 40-49 years. J Med Screen, 2004 ; 11 : 199-206.
  16. Korvin D, Courtel ML, Bohec C & al. Analyse radiologique des cancers d'intervalle après 2 ans de dépistage organise du KS en Ile-et Vilaine. J Radiol, 1998 ; 79 : 1379-1386.
  17. Hsairi M, Fakhfakh R, Bellaaj R & Achour N. Connaissances et participation des médecins et sages-femmes de première ligne vis-Ã -vis du dépistage des cancers du col utérin et du sein. Eastern Mediterranean Health Journal, 2003 ; 9 : 353-363
  18. Agence Nationale d'Accréditation et d'Evaluation en Santé (ANAES). Synthèse des recommandations Cancer du sein. ANAES, Service des recommandations Professionnelles,Paris, Novembre 1998.
  19. Kopans DB. The positive predictive value of mammography. AJR 1992;158:521-526.
  20. Kerlikowske K,Grady D,Barclay J Sickles EA, Ernster V. Likelihood ratios for modern screening mammography. R of breast cancer based on age and mammographic interpretation. JAMA 1996;276:39-43.
  21. Ancelle-Park R, Paty AC, & Bloch J. Dépistage du cancer du sein. Rapport d'évaluation du suivi épidémiologique. Données 2001 et 2002. Paris : Institut de Veille Sanitaire, 2005.
  22. Office National de la Famille et de la Population. Evaluation de l'expérience pilote de dépistage de masse du cancer du sein par mammographie dans le gouvernorat de l'Ariana. Tunis : Office National de la Famille et de la Population, 2006.