The demands of screening mammography on surgical inpatient services of breast cancer

A nationwide mammographic screening of women ages 50 to 59 years commenced in Finland in January 1987, We studied the demands of screening on surgical inpatient services by comparing the treatment strategy, volume of breast b iopsies, and hospital stay before and after implementation of mass screenin g of women age 50 to 59. Approximately 20 patients per 100,000 inhabitants were referred annually from mass screening for surgical biopsies, in half o f which cancer was detected. In 1985 through 1986 (before screening) we ope rated on 134 patients suspected of having breast cancer. After the first (i n 1990) and the second (in 1995) round of mammographic screening we operate d on 161 patients in 2 years suspected of having breast cancer. Concurrentl y 25 of 92 cancers (27%) were found only because of the screening. Before t he screening period clinical symptoms and palpable tumors were cause for re ferral to surgery in 84 per cent of the cases and abnormal mammography in o nly 16 per cent. During screening these ratios were 34 and 61 per cent, res pectively. The number of T-is-1 cancers (<2 cm) increased from 44 per cent before screening to 70 per cent during screening. In contrast the number of T-2 cancers (2-4 cm) decreased from 40 to 20 per cent. The mammographic sc reening did not increase the hospital stay of patients. We conclude that th e mammographic screening program of all women age 50 to 59 years increased the number of surgical biopsies in our hospital by only 30 per cent. Breast cancer was found at an earlier stage during screening. More than one-fourt h of breast cancers are currently found through the mass screening program in Finland.