Successful First Round Results of a Turkish Breast Cancer Screening Program with Mammography in Bahcesehir, Istanbul

Background: The Bahcesehir Breast Cancer Screening Project is the first organized population basedbreast cancer mammographic screening project in Turkey. The objective of this prospective observationalstudy was to demonstrate the feasibility of a screening program in a developing country and to determine theappropriate age (40 or 50 years old) to start with screening in Turkish women. Materials and
Methods: BetweenJanuary 2009 to December 2010, a total of 3,758 women aged 40-69 years were recruited in this prospectivestudy. Screening was conducted biannually, and five rounds were planned. After clinical breast examination(CBE), two-view mammograms were obtained. True positivity, false positivity, positive predictive values (PPV)according to ACR, cancer detection rate, minimal cancer detection rate, axillary node positivity and recall ratewere calculated. Breast ultrasound and biopsy were performed in suspicious cases.
Results: Breast biopsy wasperformed in 55 patients, and 18 cancers were detected in the first round. The overall cancer detection rate was4.8 per 1,000 women. Most of the screened women (54%) and detected cancers (56%) were in women aged 40-49. Ductal carcinoma in situ (DCIS) and stage I cancer and axillary node positivity rates were 22%, 61%, and16.6%, respectively. The positive predictivity for biopsy was 32.7%, whereas the overall recall rate was 18.4 %.
Conclusions: Preliminary results of the study suggest that population based organized screening are feasibleand age of onset of mammographic screening should be 40 years in Turkey.