BreastCheck Programme Statistics 2002
In 2002 the programme began inviting women for follow up/subsequent screening, and we present the figures by first and subsequent screening separately where appropriate.Overall, BreastCheck is maintaining or surpassing the high standard set in its first reported screening period of 2000/2001.
The Board and staff of BreastCheck would like to express their thanks to the National Cancer Registry for provision of national breast cancer statistics necessary for completion of this Report.
The Following Statistics' tables are available:
- Screening Activity Overall
- Screening Activity by Type Of Screen
- Screening Activity by Type of Screen And Age Group
- Screening Quality: First Screen
- Screening Quality: Subsequent Screen
- Screening Outcome: First Screen by Age Group
- Screening Outcome: Subsequent Screen by Age Group
- Cancers with Non-Operative Diagnosis
- Lymph Node Status
- Outcome of First Screens by Region
- Outcome of Subsequent Screens by Region
- Women's Charter Parameters
Screening Activity Overall
In this table we present two acceptance/uptake rates, the first based on the eligible women in the population, and the second based on all women known to the programme (the known target population). The known target population includes women who are ineligible for screening for certain reasons, as itemised in the table below. The uptake for screening overall (including first and subsequent screening) exceeds the standard of ≥70% for both the eligible and known target population rates.
At the time of the 2002 Census the number of women aged 50-64 in the Phase One area (i.e. Eastern Regional Health Authority,Midland Health Board and North Eastern Health Board) known to the Population Register was within 2% of the Census figure.Work is ongoing in the examination of discrepancies at a smaller area level.
The overall Standardised Detection Ratio (SDR), a measure of general programme performance, at 1.22 is in excess of the standard of 0.75.Of the 38,242 women screened by the programme, 306 were diagnosed with breast cancer. A further three women were diagnosed with other non-breast cancers as a result of their attendance for screening.
| Performance Parameter | 2002 |
| Number of women sent consent forms for first screening or invited for susequent screening | 50,128 |
| Number of women who deconsented following receipt of consent form | 720 |
| Number of women invited | 49,408 |
| Number of eligible women invited | 48,051 |
| Number of women attending for screening | 38,242 |
| Eligible women acceptance rate (includes deconsented women) | 78.4% |
| Known target population acceptance rate | 76.3% |
| Number of women recalled for assessment | 1,613 |
| Number of benign biopsies | 57 |
| Number of cancers detected | 306 |
| Cancers detected per 1,000 women screened | 8.0 |
| Number of in situ cancers | 64 |
| Number of invasive cancers < 15mm | 114 |
| Standardised Detection Ratio | 1.22 |
Details of the ineligible categories
Excluded - in follow up care for breast cancer/previous bilateral mastectomy: 121
Excluded - An Post not contactable: 676
Excluded - physically/mentally incapacitated: 17
Excluded - terminally ill: 2
Excluded - other: 34
Suspended - wait until next round: 296
Suspended - mammogram within previous 12 months: 206
Suspended - unwilling to reschedule: 5
Screening Activity By Type Of Screen
Looking at first screening alone, the eligible women acceptance rate for 2002 is 77.1%, an improvement on the first reported screening period (2000/2001) where it was 73%.The known target population rate also surpasses the standard of 70%.
Of the previous non-attenders (women who had not attended their two appointments in the previous round of screening), a small number remained within the target age group and over 90% responded to the re-invitation.
In the first three months of the second round of screening (October to December 2002), 89% of women who had attended previously (i.e.women screened as a percentage of the 5,995 eligible invited) responded positively to their invitation for subsequent screening.
This rate will be closely monitored.
| Performance Parameter | First Invited Population | Previous Non-Attenders | Subsequent Population |
| Consented | 43,725 | n/a | n/a |
| Number of women who deconsented | 591 | n/a | 129* |
| Number of women invited | 43,134 | 53 | 5,995 |
| Number of eligible women invited | 42,003 | 53 | 5,995 |
| Number of women screened | 32,852 | 50 | 5,340 |
| Eligible women acceptance rate (including deconsents) | 77.1% | 94.3% | 87.2% |
| Known target population acceptance rate | 75.1% | 94.3% | 84.1%** |
* deconsented in previous round, but remain in the target population
** includes 226 women identified as ineligible in previous round of screening or in this round, but remain in the target population.
Screening Activity By Type Of Screen And Age Group
There has been an improvement in the eligible women acceptance rate compared to the first reported screening period (2000/2001) for all age groups. Again, the acceptance rate is highest among younger women.
The known target population acceptance rate also surpasses the standard of 70% for each of these age groups.
Table 3(i) First Invited Population
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Consented | 16,309 | 15,203 | 11,599 |
| Number of women who deconsented | 169 | 191 | 228 |
| Number of women invited | 16,140 | 15,012 | 11,371 |
| Number of eligible women invited | 15,735 | 14,619 | 11,055 |
| Number of women screened | 12,585 | 11,495 | 8,302 |
| Eligible women acceptance rate (including deconsents) | 79.1% | 77.6% | 73.6% |
| Known target population acceptance rate | 77.1% | 75.6% | 71.6% |
Table 3(ii) Previous Non-Attenders
Of the women who had not attended their two appointments in the previous round of screening, the response to a further invitation in the next round of screening was high in all age groups.
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of previous non-attenders invited | 16 | 29 | 7 |
| Number of women screened | 14 | 28 | 7 |
| Known target population acceptance rate | 87.5% | 96.6% | 100.0% |
Table 3(iii) Subsequent Invite
The acceptance rates for subsequent screening were over 80% in all age groups. However, in the period reported the numbers of women invited in each age group was still relatively small; these rates will be followed as the number of women invited for subsequent screening grows.
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of women who deconsented in previous round* | 28 | 47 | 54 |
| Number of ineligible women** | 54 | 96 | 74 |
| Number of eligible women invited | 1,368 | 2,732 | 1,888 |
| Number of women screened | 1,187 | 2,446 | 1,700 |
| Eligible women acceptance rate (including deconsents) | 85.0% | 88.0% | 87.5% |
| Known target population acceptance rate | 81.9% | 85.1 | 84.3% |
* deconsented in previous round, but remain in the target population
** identified as ineligible in previous round of screening or in this round, but remain in the target population
Screening Quality: First Screen
This Table gives the results for the main screening quality parameters for women attending for their first screening with BreastCheck. All performance indicators continue to be achieved or surpassed. The Standardised Detection Ratio has increased from 0.95-1.01 for the period 2000/2001 to 1.20 in 2002.
| Performance Parameter | 2002 | Standard |
| Number of women screened for first time | 32,902 | - |
| Number of women recalled for assessment | 1,477 | - |
| Recall rate | 4.5% | <7% |
| Number of benign open biopsies | 53 | - |
| Benign open biopsy rate per 1,000 women screened | 1.6 | <3.6 |
| Number of women diagnosed with cancer | 276 | - |
| Cancer detection rate per 1,000 women screened | 8.4 | ≥7 |
| Number of women with in situ cancer (DCIS) | 56 | - |
| Pure DCIS detection rate per 1,000 women screened | 1.7 | - |
| Number of women diagnosed with DCIS as % of all women diagnosed with cancer | 20.3% | 10-20% |
| Number of women diagnosed with invasive cancer* | 220 | - |
| Invasive cancer detection rate per 1,000 women screened | 6.7 | - |
| Number of women with invasive cancers <15 mm | 102 | - |
| Number of women with invasive cancers <15 mm as % of all women with invasive cancers | 46.8% | ≥40% |
| Standardised Detection Ratio | 1.20 | >0.75 |
* Includes two women who had invasive cancer diagnosed (i.e. from core biopsy) but did not have primary surgical treatment (no size available, not included in calculation of % invasive <15mm)
Screening Quality: Subsequent Screen
In October 2002 BreastCheck began to invite women back for a second screening examination.
The performance standards for this subsequent screening differ from those for first screening. While a smaller absolute number of cancers was detected in this group, the cancer detection rate far exceeds the standard of 3.5 per 1,000 women screened.
The number of women with DCIS only, as a percentage of malignancies detected, is slightly over the expected standard.This is based on small numbers and the rate will be monitored over the coming years.The remaining performance parameters are surpassed.
| Performance Parameter | 2002 | Standard |
| Number of women screened for second time | 5,340 | - |
| Number of women recalled for assessment | 136 | - |
| Recall rate | 2.5% | <5% |
| Number of benign open biopsies | 4 | - |
| Benign open biopsy rate per 1,000 women screened | 0.7 | <2 |
| Number of women diagnosed with cancer | 30 | - |
| Cancer detection rate per 1,000 women screened | 5.6 | ≥3.5 |
| Number of women with in situ cancer (DCIS) | 8 | - |
| Pure DCIS detection rate per 1,000 women screened | 1.5 | - |
| Number of women diagnosed with DCIS as % of all women diagnosed with cancer | 26.7% | 10-20% |
| Number of women diagnosed with invasive cancer | 22 | - |
| Invasive cancer detection rate per 1,000 women screened | 4.1 | - |
| Number of women with invasive cancers <15mm | 12 | - |
| Number of women with invasive cancers <15 mm as % of all women with invasive cancers | 54.5% | ≥40% |
| Standardised detection ratio | 1.49 | >0.75 |
Screening Outcome: First Screen by Age Group
For women in the target age group of 50-64, the percentage recalled for assessment was again well within the standard of <7% for those screened for the first time.The benign open biopsy rate remains low in all age groups (standard <3.6 per 1,000 women screened).The cancer detection rate continues to rise steadily with increasing age (standard ≥7 per 1,000 women screened).
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of women screened | 12,599 | 11,523 | 8,309 |
| Percentage of women recalled for assessment | 4.8% | 4.5% | 4.0% |
| Benign open biopsy rate per 1,000 women screened | 2.0 | 1.6 | 1.2 |
| Overall cancer detection rate per 1,000 women screened | 6.0 | 9.4 | 10.6 |
Screening Outcome: First Screen by Age Group
For women who attended a second or subsequent screening the percentage recalled for assessment in all age groups was well within the standard of <5%. The benign open biopsy rate was similarly low, all age groups were within the standard of <2 per 1,000 women screened.The cancer detection rate for women aged 50-54 was low, but the overall rate was above the standard of 3.5 per 1,000 women screened.
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of women screened | 1,187 | 2,446 | 1,700 |
| Percentage of women recalled for assessment | 2.3% | 2.8% | 2.4% |
| Benign open biopsy rate per 1,000 women screened | 0.0 | 1.2 | 0.6 |
| Overall cancer detection rate per 1,000 women screened | 0.8 | 6.5 | 7.6 |
Cancers With Non-Operative Diagnosis
Overall 99.6% of women with invasive cancer detected and treated by BreastCheck had a surgical procedure to determine their nodal status.This percentage is similar to that achieved in the first 22-month period of the programme.
| Performance Parameter | First Screening | Subsequent Screening | Standard |
| Percentage of women with non-operative diagnosis of cancer | 92.3% | 85.7% | ≥70% |
Lymph Node Status
Overall 99.6% of women with invasive cancer detected and treated by BreasCheck had a surgical procedure to determine their nodal status. This percentage is similar to that achieved in the first 22-month period of the programme.
| Performance Parameter | First Screening | Subsequent Screening | Standard |
| Number of women with invasive cancer | 215 | 19 | - |
| Percentage of women with invasive cancer where nodal status known | 100% | 94.7% | 100% |
Outcome of First Screens by Region
Phase One of the National Breast Screening Programme involves the invitation of women resident in three regions – the Eastern Regional Health Authority, the Midland Health Board and the North Eastern Health Board.
The results for women from each region first invited to the programme are presented in the Table below.
The cancer detection rate is above the standard of 7 per 1,000 women screened among women resident in the Eastern Regional Health Authority and the North Eastern Health Board. The uptake rates and cancer detection rate in the Midland Health Board area are based on a very small number of women invited/screened in the period; these rates will be monitored but are unlikely to reflect the overall picture for that region as a whole.
| Region of Residence | Number of women screened | Acceptance rate: Eligible | Acceptance rate: Known Target Pop | Number of cancers detected | Cancers detected per 1,000 women |
| Eastern Regional Health Authority | 22,731 | 77.2% | 75.0% | 189 | 8.3 |
| Midland Health Board | 166 | 78.7% | 78.7% | 1 | 6.0 |
| North-Eastern Health Board | 9,992 | 77.0% | 75.5% | 86 | 8.6 |
| Outside Phase One area* | 13 | 92.9% | 92.9% | 0 | 0.0 |
| Total | 32,902 | 77.1% | 75.2% | 276 | 8.4 |
* A number of women may have moved their area of residence to a location outside the target area of the programme in the time between receipt of initial consent and screening.These women remained part of the programme activity for the period reported.
Outcome of Subsequent Screens by Region
In 2002 women invited for subsequent screening were resident in the Eastern Regional Health Authority and the North Eastern Health Board. No women from the Midland Health Board were invited for subsequent screening in the period.
In the two areas screened the cancer detection rates are above the standard of 3.5 per 1,000 women screened.The lower cancer detection rate in the North Eastern Health Board is based on a very small number of women screened.
| Region of Residence | Number of women screened | Acceptance rate: Eligible | Acceptance rate: Known Target Pop | Number of cancers detected | Cancers detected per 1,000 women |
| Eastern Regional Health Authority | 4,612 | 87.1% | 83.9% | 27 | 5.9 |
| Midland Health Board | - | - | - | - | - |
| North-Eastern Health Board | 728 | 87.6% | 85.1% | 3 | 4.1 |
| Total | 5,340 | 87.2% | 84.1% | 30 | 5.6 |
Women’s Charter Parameters
A Women’s Charter was established at the initiation of the programme to ensure that women are informed about what to expect from the screening process.
| Performance Parameter | 2002 | Standard |
| % women who received 7 days notice of appointment | 97.3% | ≥90% |
| % women who were sent results of mammogram within 3 weeks | 97.8% | ≥90% |
| % women offered an appointment for Assessment Clinic within 2 weeks of notification of abnormal mammographic result | 94.2% | ≥90% |
| % women given results from Assessment Clinic within 1 week | 92.4% | ≥90% |
| % women offered hospital admission for treatment within 3 weeks of diagnosis of breast cancer | 89.5% | ≥90% |
| % women re-invited for screening within 21-27 months of invitation at previous round | 60.1% | ≥90% |
In 2002 the programme improved on each of the Women’s Charter parameters comparable to the initial 22-month period of the programme.The percentages of women sent appointments, given results of a normal mammogram, recalled to assessment and given results after the assessment within the desired timeframe have increased, and each of these parameters easily surpassed the standard of 90%.The proportion of women offered admission to hospital within three weeks of diagnosis only just failed to reach the target, and represents an improvement in this parameter.
Overall 96.5% of women were offered hospital admission within four weeks of diagnosis. With the progress to subsequent screening in late 2002, a new Charter parameter examined on this occasion is the proportion of women re-invited within 21-27 months of their appointment in the previous screening round. This falls short of the desired standard, reflecting delays at the commencement of the programme. A further 1.1% of women were re-invited before 21 months and 38.2% re-invited within 28-30 months of the previous round, giving a total re-invited within 30 months of 99.4%.
Download Annual Report 2002 (.pdf file 640Kb, 48 pages): bc_areport02.pdf