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Master Thesis

Comparaison des résultats des mammographies effectuées par dépistage individuel et dépistage organisé dans le cadre du cancer du sein

Abstract : Context: the coexistence of individual screening (IS) and organized screening (OS) for breast cancer is a French particularity. Interregional disparities show the difficulty for primary care physicians to position themselves between IS and OS. Objective: this study aimed to compare the risk of breast cancer on mammograms between patients who performed mammograms as part of an individual screening and those who did it as part of organized screening. Methods: a cross-sectional multicenter study included women aged 50 to 74, with no personal history of breast cancer, performing mammograms in 3 radiology centers in Paris. The nature of the screening (OS or IS), mammographic outcome (high risk: ACR 4, 5 or low risk: ACR 1, 2, 3), breast cancer risk factors and clinical breast examination (CBE) abnormalities were collected. Patients in the IS and OS group were matched on age, breast density, history of benign lesions and family history of breast cancer with a propensity score. The association between the nature of screening and the risk of malignancy was evaluated by conditional logistic regression. Results: the mean age was 59.7 (+/-6.7) years old for the 2190 included patients. Those who performed IS mammography represented 77% of the population and had significantly more CBE abnormalities (23% vs 11%), a history of benign lesion (15% vs 11%) and a family history (42% vs 29%). After pairing 503 OS patients with 941 IS patients, the high risk of malignancy on mammography and the nature of the screening were not associated (OR = 0,72 [0.35-1.47], p=0.50). Conclusion: the risk of malignancy was the same whether the mammography was performed as part of the OS or IS. The use of an intermediate endpoint to assess cancer risk is one of the main limitations, but it seems relevant because it is the result of mammography that is decisive in further exploration.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03199413
Contributor : Université Paris Descartes - Scd Connect in order to contact the contributor
Submitted on : Thursday, April 15, 2021 - 3:54:05 PM
Last modification on : Saturday, September 4, 2021 - 3:26:07 AM

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Arthur Tron. Comparaison des résultats des mammographies effectuées par dépistage individuel et dépistage organisé dans le cadre du cancer du sein. Médecine humaine et pathologie. 2019. ⟨dumas-03199413⟩

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