Open Access Research

Performance of breast cancer screening methods and modality among Chinese women: a report from a society-based breast screening program (SBSP) in Shanghai

Miao Mo12, Guang-yu Liu13, Ying Zheng4, Lian-fang Di5, Ya-jie Ji13, Li-lang Lv13, Ying-yao Chen2, Wei-jun Peng13, Jie-ru Zhu5, Ping-ping Bao4, Jian-hui Ding13, Cai Chang13, Jian-feng Luo2, Zhi-gang Cao13, Wang-hong Xu2* and Zhi-min Shao13*

Author Affiliations

1 Shanghai Cancer Hospital, Fudan University, 270 Dong An Road, Shanghai 200032, China

2 Department of Epidemiology, School of Public Health, Fudan University; Key Laboratory of Public Health Safety, Ministry of Education (Fudan University), 138 Yi Xue Yuan Road, Shanghai 200032, China

3 Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong An Road, Shanghai 200032, China

4 Department of Cancer Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 Zhong Shan Xi Road, Shanghai 200336, China

5 Community Health Care Center of Qibao County, Minhang District, 94 Fu Qiang Road, Shanghai 201101, China

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SpringerPlus 2013, 2:276  doi:10.1186/2193-1801-2-276

Published: 24 June 2013

Abstract

To evaluate the screening performance of individual and combined use of clinical breast examination, ultrasonography and mammography in Chinese women, we conducted a biennial breast cancer screening program among 14,464 women aged 35 to 74 years old who lived in Qibao County, Minhang district of Shanghai, China, between May 2008 and Sept 2012. All participants were submitted to clinical breast examination, and then women with positive results and all women at age of 45-69 years old were preformed breast ultrasonography and mammography. The examination results were compared against pathological findings as the gold standard of reference. A total of 66 women were diagnosed with breast cancer in the two rounds of the screening, yielding an incident rate of 194 per 100,000 person-years. The sensitivity of clinical breast examination, ultrasonography and mammography alone were 61.4%, 53.7% and 67.3%, respectively. While mammography performed better in elder age groups and hormone receptor positive disease groups, ultrasonography had a higher sensitivity in younger age group and did not differ in sensitivity by estrogen receptor or progesterone receptor status. Combined use of the two imaging examinations increased the sensitivity in almost all age groups, but had a higher sensitivity in hormone receptor positive cancers than in those negative. Our results suggest that the Qibao modality is an effective strategy for breast cancer screening among Chinese women, especially for early detection of elder and hormone receptor positive breast cancer.

Keywords:
Breast cancer screening; Clinical breast examination; Mammography; Breast ultrasonography; Sensitivity; Specificity