BreastCheck Programme Statistics 2003
The figures reported relate to those women contacted by BreastCheck between 1st January and 31st December 2003. Programme standards, against which performance is measured, are based on European Guidelines for Quality Assurance in Mammography Screening (3rd Edition).
In 2003 we saw many women return to BreastCheck for their second screening, and the results are presented by first and subsequent screening as appropriate.
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 2003 we saw a marked increase in screening activity, with a large rise in the number of women invited for screening (from 49,408 in 2002 to 70,241 in 2003), and a corresponding growth in the numbers screened (from 38,242 to 52,831 relating to 2002 and 2003 respectively). We do not expect to find as many cancers at subsequent screening as at first screening, which explains the overall slightly lower cancer detection rate than last year, when almost all women were attending for the first time. The overall standardised detection ratio (SDR), a measure of general programme performance, remains well in excess of the target.
Of the 52,831 women contacted in 2003 who were screened by the Programme, 379 were diagnosed with breast cancer. A further two women were diagnosed with other non-breast cancers as a result of their attendance for screening.
| Performance Parameter | 2003 |
| Number of women who deconsented following receipt of consent form | 289 |
| Number of women invited | 70,241 |
| Number of eligible women invited | 66,493 |
| Number of women attending for screening | 52,831 |
| Eligible women acceptance rate (includes deconsented women) * | 79.5% |
| Known target population acceptance rate | 75.2% |
| Number of women recalled for assessment | 2,147 |
| Number of benign biopsies | 91 |
| Number of cancers detected | 379 |
| Cancers detected per 1,000 women screened | 7.17 |
| Number of in situ cancers | 57 |
| Number of invasive cancers < 15mm | 166 |
| Standardised Detection Ratio | 1.14 |
* Details of the ineligible categories
Excluded in follow up care for breast cancer; An Post not contactable; physically/mentally incapacitated; terminally ill. Suspended - extended vacation / working abroad; previous mammogram < 1 year; wait until next round; woman wished to defer appointment; unwilling to reschedule.
Screening Activity By Type Of Screen
In 2003 a greater percentage (91.1%) of those women invited back for a second screening appointment took up that invitation and attended than in 2002 (87.2%). The percentage of eligible women who attended for the first time was above the target of 70%, but the known target acceptance rate was somewhat lower in this group. As seen in Table 1 the overall uptake was well in excess of the target of 70%.
| Performance Parameter | First Invited Population | Previous Non-Attenders | Subsequent Population |
| Number of women who deconsented | 289 | n/a | 590* |
| Number of women invited | 37,232 | 4,834 | 28,175 |
| Number of eligible women invited | 34,465 | 4,834 | 28,073 |
| Number of women screened | 25,693 | 1,574 | 25,564 |
| Eligible women acceptance rate (including deconsents) | 74.5% | 32.6% | 91.1% |
| Known target population acceptance rate | 68.5% | 32.6% | 88.9% |
* Deconsented in previous round of screening, but remain within target age group of 50-64 years.
Screening Activity By Type Of Screen And Age Group
Table 3(i) First Invited Population
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of women who deconsented | 91 | 95 | 102 |
| Number of women invited | 16,985 | 11,184 | 8,470 |
| Number of eligible women invited | 15,981 | 10,233 | 7,735 |
| Number of women screened | 12,641 | 7,336 | 5,301 |
| Eligible women acceptance rate (including deconsents) | 79.1% | 71.7% | 68.5% |
| Known target population acceptance rate | 74.0% | 65.0% | 61.8% |
Among women invited for the first time, the acceptance rate remains highest among the younger women, and falls with increasing age. This has been observed in other screening programmes.
Table 3(ii) Previous Non-Attenders
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of previous non-attenders invited | 854 | 2,160 | 1,737 |
| Number of women screened | 347 | 725 | 452 |
| Known target population acceptance rate | 40.6% | 33.6% | 26.0% |
Women who had not attended their appointments in the previous round of screening but remained within the target age group were re-invited for screening in 2003. Almost one third accepted, with the rates higher in the younger age group. Although these acceptance rates appear low they are higher than those typically observed for previous non-attenders in other programmes.
Table 3(iii) Subsequent Invite
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of women who deconsented in previous round* | 94 | 205 | 291 |
| Number of ineligible women** | 131 | 291 | 255 |
| Number of eligible women invited | 5,263 | 12,588 | 9,922 |
| Number of women screened | 4,705 | 11,575 | 8,950 |
| Eligible women acceptance rate (including deconsents) | 89.4% | 92.0% | 90.2% |
| Known target population acceptance rate | 87.2% | 89.9% | 87.9% |
* 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
With greater numbers of women invited for repeat screening the rates are more meaningful than in 2002 when subsequent screening was just commencing. A high percentage of women in all age groups took up the invitation to return for repeat screening two years after their first screen. This reflects well the satisfaction of women who attend for screening with the service offered by BreastCheck.
Screening Quality: First Screen
The Table relates to those women invited for breast screening by BreastCheck for the first time in 2003. The recall rate was a little higher than in 2002 but remains within the standard of 7%. The benign open biopsy rate is within the standard. The cancer detection rate remains satisfactory, with 8.5 women diagnosed with cancer per 1,000 women attending for their first breast screening. More women were found to have invasive cancer, with a corresponding fall in the percentage of in situ cancer from 20.3% in 2002 to 15.5% in 2003. The standardised detection ratio remains high and well in excess of the target.
| Performance Parameter | 2003 | Standard |
| Number of women screened for first time | 27,267 | - |
| Number of women recalled for assessment | 1,422 | - |
| Recall rate | 5.2% | <7% |
| Number of benign open biopsies | 74 | - |
| Benign open biopsy rate per 1,000 women screened | 2.7 | <3.6 |
| Number of women diagnosed with cancer | 232 | - |
| Cancer detection rate per 1,000 women screened | 8.5 | ≥7 |
| Number of women with in situ cancer (DCIS) | 36 | - |
| Pure DCIS detection rate per 1,000 women screened | 1.3 | - |
| Number of women diagnosed with DCIS as % of all women diagnosed with cancer | 15.5% | 10-20% |
| Number of women diagnosed with invasive cancer* | 196 | - |
| Invasive cancer detection rate per 1,000 women screened | 7.2 | - |
| Number of women with invasive cancers <15 mm | 86 | - |
| Number of women with invasive cancers <15 mm as % of all women with invasive cancers | 43.9% | ≥40% |
| Standardised Detection Ratio | 1.10 | >0.75 |
Screening Quality: Subsequent Screen
Women were invited back for their second screening in much greater numbers in 2003. The recall rate and benign biopsy rate remain low and well within the standards. The overall cancer detection rate is similar to last year, but as for the women invited for first screening, a greater percentage of these cancers were invasive in nature. Fortunately over 63% of these cancers were very small (<15mm).
The standardised detection ratio for subsequent screening in 2002 was based on a small number of women screened; the standardised detection ratio for 2003 is based on greater numbers, remains well in excess of the standard, and is a more accurate reflection of the Programme.
| Performance Parameter | 2003 | Standard |
| Number of women screened for second time | 25,564 | - |
| Number of women recalled for assessment | 725 | - |
| Recall rate | 2.8% | <5% |
| Number of benign open biopsies | 17 | - |
| Benign open biopsy rate per 1,000 women screened | 0.7 | <2 |
| Number of women diagnosed with cancer | 147 | - |
| Cancer detection rate per 1,000 women screened | 5.8 | ≥3.5 |
| Number of women with in situ cancer (DCIS) | 21 | - |
| Pure DCIS detection rate per 1,000 women screened | 0.8 | - |
| Number of women diagnosed with DCIS as % of all women diagnosed with cancer | 14.3% | 10-20% |
| Number of women diagnosed with invasive cancer | 126 | - |
| Invasive cancer detection rate per 1,000 women screened | 4.9 | - |
| Number of women with invasive cancers <15mm | 80 | - |
| Number of women with invasive cancers <15 mm as % of all women with invasive cancers | 63.5% | ≥40% |
| Standardised detection ratio | 1.25 | >0.75 |
Screening Outcome: First Screen by Age Group
For women in each of the age groups 50-54, 55-59 and 60-64 years screened for the first time, the percentage recalled for further assessment was again well within the standard of <7%. The benign open biopsy rate remains low in all age groups. As found in previous years, the cancer detection rate rises with increasing age.
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of women screened | 12,988 | 8,061 | 5,753 |
| Percentage of women recalled for assessment | 5.6% | 4.9% | 4.8% |
| Benign open biopsy rate per 1,000 women screened | 2.8 | 2.4 | 2.8 |
| Overall cancer detection rate per 1,000 women screened | 6.6 | 9.3 | 11.3 |
Screening Outcome: First Screen by Age Group
With greater numbers in each age group attending for subsequent screening than in 2002, rates are more likely to reflect the prevailing picture. The percentage recalled for assessment and the benign open biopsy rate were low in all age groups and within the standards. As expected, for these women the cancer detection rate rose with increasing age.
| Performance Parameter | 50-54 | 55-59 | 60-64 |
| Number of women screened | 4,705 | 11,575 | 8,950 |
| Percentage of women recalled for assessment | 3.6% | 2.8% | 2.4% |
| Benign open biopsy rate per 1,000 women screened | 0.21 | 1.0 | 0.6 |
| Overall cancer detection rate per 1,000 women screened | 3.8 | 5.4 | 6.7 |
Cancers With Non-Operative Diagnosis
The percentage of women with cancer who were diagnosed without an operation remains high and surpasses the standard. The rate has improved each year since the start of the Programme. The figures are similar for women screened for the first and subsequent times. Non-operative diagnosis allows informed decision making about treatment prior to any surgical intervention.
| Performance Parameter | Initial Screening | Subsequent Screening | Overall | Standard |
| Percentage of women with non-operative diagnosis of cancer | 95.2% | 93.2% | 94.4% | ≥70% |
Lymph Node Status
Almost all 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 previous years.
| Performance Parameter | Initial Screening | Subsequent Screening | Overall | Standard |
| Number of women with invasive cancer | 188 | 121 | 309 | - |
| Percentage of women with invasive cancer where nodal status known | 98.9% | 98.4% | 98.7% | 100% |
Outcome of First Screens by Region
Phase One of the National Breast Screening Programme involved the invitation of women resident in three regions – the Eastern Regional Health Authority, the Midland Health Board and the North Eastern Health Board. The cancer detection rate is above the standard of 7 per 1,000 women screened among women resident in each area. The higher rate of cancer detection in the North Eastern Health Board is based on a relatively 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 | 19,335 | 68.1% | 62.8% | 152 | 7.9 |
| Midland Health Board | 7,094 | 72.0% | 67.8% | 171 | 10.0 |
| North-Eastern Health Board | 9,992 | 838 | 84.6% | 80.7 9 | 10.7 |
| Total | 27,267 | 69.4% | 64.4% | 232 | 8.5 |
Outcome of Subsequent Screens by Region
In 2003 the uptake for screening was high among women resident in all regions invited for subsequent screening. With greater numbers of women reinvited for screening, cancer detection rates become more meaningful. The cancer detection rates are above the standard of 3.5 per 1,000 women screened in all three regions.
| 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 | 17,202 | 91.8% | 89.5% | 99 | 5.8 |
| Midland Health Board | 3,509 | 89.8% | 87.2% | 17 | 4.8 |
| North-Eastern Health Board | 4,852 | 92.0% | 90.4% | 31 | 6.4 |
| Total | 25,563 | 91.5% | 89.3% | 147 | 5.8 |
| Performance Parameter | 2003 | Standard |
| % women who received 7 days notice of appointment | 98% | ≥90% |
| % women who were sent results of mammogram within 3 weeks | 97.1% | ≥90% |
| % women offered an appointment for Assessment Clinic within 2 weeks of notification of abnormal mammographic result | 91.3% | ≥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 | 85.6% | ≥90% |
| % women re-invited for screening within 21-27 months of invitation at previous round | 60% | ≥90% |
In 2003 BreastCheck maintained good results on most of our Charter parameters. Well in excess of 90% of women received seven days notice of their appointment, received their mammogram results within three weeks, were offered an appointment within two weeks if required to return for assessment and were given the results of that assessment within one week.
BreastCheck also strives to offer hospital admission for surgical treatment within three weeks of diagnosis of breast cancer to at least 90% of patients who require surgery. Although the proportion of women offered admission to hospital within three weeks of diagnosis fell just short of our target, 94.5% of women were offered hospital admission within four weeks of diagnosis, which is similar to our figure for 2002. Although we fall short of the target for re-invitation within 27 months, 93.8% of women reinvited to the programme received that invitation within 31 months.
Download full Annual Report 2003: bc_areport03.pdf (.pdf file 1.2Mb, 46 pages)