Department of Surgery, Stellenbosch University, Stellenbosch, W. Cape, South Africa; Panorama, Western Cape, South Africa
Apffelstaedt, J.P., Department of Surgery, Stellenbosch University, Stellenbosch, W. Cape, South Africa; Steenkamp, V., Department of Surgery, Stellenbosch University, Stellenbosch, W. Cape, South Africa; Baatjes, K., Panorama, Western Cape, South Africa
Background. Mammographic screening has become part of routine health care. We present a first analysis of screening mammography in a dedicated breast health centre in Africa. Objective. To establish a performance benchmark and provide data for health care policy and funding decisions on screening mammography. Method. All mammography performed between January 2003 and August 2008 was entered into a prospective database. Mammography was performed exclusively by certified mammographers and double-read by experienced readers. Results. Outcomes were classified in a simplified classification system based on the Breast Imaging Reporting and Data System (BIRADS). In 40-49-year-old women, 3 192 mammograms led to a recall rate of 4.7%, a biopsy rate of 1.9% and a cancer diagnosis rate of 3.8 per 1000 examinations, for women of 50 years and older, the corresponding figures were 4 446, 5.4%, 2.6% and 9.7 per 1 000. Of the cancers detected, 31% were in situ and, of the invasive cancers, 81% were node-negative. These figures were established by a dedicated surgeon-led team and fall within the range expected in organised screening programmes in resource-rich environments, providing a first benchmark for screening mammography in Africa.
adult; Africa; age distribution; article; breast biopsy; breast cancer; cancer incidence; cancer invasion; cancer screening; carcinoma in situ; female; human; mammography; women's health; Adult; Breast Neoplasms; Female; Health Facilities; Humans; Mammography; Mass Screening; Middle Aged; Prospective Studies; Reproducibility of Results; South Africa