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Ricardo Jimenez-Lee, MD; Selene G. Oslak, MPH; Katrina Hedberg, MD, MPH; John T. Vetto, MD

Arch Surg. 2003;138:884-890.

Hypothesis  Surgical outcomes from a breast cancer–screening program of low-income women are similar to those of other screening programs.

Design  Prospective cohort.

Setting  Federally funded screening program.

Patients  A total of 15 730 women.

Interventions  A total of 23 149 mammograms, 20 396 with concomitant clinical breast examination, from January 1, 1997, through December 31, 2001.

Outcome Measures  American College of Radiology scores; associated surgery consultations, biopsies, operations, and pathology results.

Results  Most (20 868) of the 21 296 mammograms assigned an American College of Radiology score were benign; only 428 (2%) were suspicious. Resulting from suspicious clinical breast examinations, the group with American College of Radiology scores of 1 to 3 accounted for 45%, 18%, and 10% of recommended surgical consultations, biopsies, and cancers detected, respectively. A rate of 12.3 cancers per 1000 women was found, greater than with other screening programs. Compliance with therapy was 97%.

Conclusions  This screening program had a higher rate of advanced cancers. Clinical breast examination was an important component, and compliance with surgical recommendations was excellent.

From the Section of Surgical Oncology, Department of Surgery, Oregon Health & Science University (Drs Jimenez-Lee and Vetto), and the Oregon Breast and Cervical Cancer Program, Oregon Department of Human Services (Ms Oslak and Dr Hedberg), Portland.

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