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Radiological surveillance of interval breast cancers in screening programmes.

Houssami N, Irwig L, Ciatto S

Screening and Test Evaluation Program (STEP), School of Public Health, University of Sydney, New South Wales, Australia. nehmath@health.usyd.edu.au

Interval breast cancers-those diagnosed after a negative mammographic screen and before the next scheduled screen-are an important indicator of the potential effectiveness of population screening for breast cancer. Although the incidence of interval cancers is usually monitored, radiological surveillance is not undertaken routinely in most screening programmes. Here, we describe radiological surveillance of interval breast cancers and discuss methodological difficulties in the radiological review process and in the categorisation of interval cancers as false-negative, true, or occult. Furthermore, we identify methods that affect whether an interval cancer is classified as a false-negative (missed) or a true interval cancer. For all radiological categories of interval cancers, we outline possible changes to screening programmes that might improve cancer detection. Standardised radiological surveillance of interval cancers might allow within-programme comparisons and has the potential to guide practice and improve quality.

Published 2 March 2006 in Lancet Oncol, 7(3): 259-65.
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