Jacky Luiten

76 | Chapter 5 Table 5.3 Suspicious calcifications at screening mammography: trends in positive predictive value of recall, DCIS detection rate, grading and surgical treatment. Screening year 97/98 99/00 01/02 03/04 05/06 07/08 09/10 11/12 13/14 15/16 Total Cancer 26 (51.0) 49 (72.1) 34 (44.2) 78 (36.6) 64 (38.8) 70 (41.9) 153 (23.4) 196 (25.8) 219 (30.4) 222 (32.6) 1,111 (31.2) Type of cancer , (%) DCIS Invasive cancer 17 (65.4) 9 (34.6) 33 (67.3) 16 (32.7) 22 (64.7) 12 (35.3) 47 (60.3) 31 (39.7) 40 (62.5) 24 (37.5) 44 (62.9) 26 (37.1) 104 (68.0) 49 (32.0) 145 (74.0) 51 (26.0) 148 (67.6) 71 (32.4) 147 (66.2) 75 (33.8) 747 (67.2) 364 (32.8) DCIS, mean size (mm, range) 18 (4‐60) 16 (2‐35) 21 (4‐70) 20 (3‐40) 25 (2‐80) 21 (4‐85) 15 (1‐90) 15 (1‐130) 22 (2‐114) 21 (2‐100) 19 (1‐130) PPV for recall , % 51.0 72.1 44.2 36.6 38.8 41.9 23.4 25.8 30.4 32.6 31.2 Initial, % 29.4 68.2 53.3 25.6 43.8 27.0 18.9 17.2 17.4 20.1 21.8 [95%CI] [7.8‐51.1] [48.7‐87.6] [28.1‐78.6] [12.5‐38.6] [26.6‐60.9] [12.7‐41.3] [12.6‐25.2] [12.1‐22.3] [12.4‐22.4] [14.2‐26.0] [19.2‐24.5] Subsequent, % 61.8 73.9 41.9 39.4 37.6 46.2 24.8 29.0 36.2 37.1 34.6 [95%CI] [45.4‐78.1] [61.2‐86.6] [29.7‐54.2] [32.1‐46.8] [29.4‐45.8] [37.6‐54.7] [21.0‐28.5] [25.2‐32.8] 32.0‐40.4] [32.9‐41.4] [32.7‐36.4] DCIS detection rate * 0.3 0.6 0.4 0.8 0.6 0.7 1.2 1.3 1.1 1.1 0.9 Initial* 0.4 1.1 0.9 1.1 1.2 1.0 2.4 2.3 1.8 1.9 1.5 Subsequent* 0.3 0.5 0.3 0.7 0.5 0.6 1.0 1.1 1.0 1.0 0.8 DCIS grading , (%) Low Intermediate High Unknown 3 (17.6) 1 (5.9) 10 (58.8) 3 (17.6) 2 (6.1) 8 (24.2) 21 (63.6) 2 (6.1) 3 (13.6) 2 (9.1) 17 (77.3) 0 7 (14.9) 10 (21.3) 30 (63.8) 0 3 (7.5) 8 (20.0) 29 (72.5) 0 5 (11.4) 10 (22.7) 29 (65.9) 0 24 (23.1) 37 (35.6) 43 (41.3) 0 32 (22.1) 48 (33.1) 65 (44.8) 0 23 (15.5) 52 (35.1) 73 (49.3) 0 14 (9.5) 57 (38.8) 76 (51.7) 0 116 (15.5) 233 (31.2) 393 (52.6) 5 (0.7) Surgical treatment DCIS , (%) None BCS Mastectomy 0 10 (58.8) 7 (41.2) 0 24 (72.7) 9 (27.3) 0 16 (72.7) 6 (27.3) 0 38 (80.9) 9 (19.1) 1 (2.5) 28 (70.0) 11 (27.5) 1 (2.2) 31 (70.5) 12 (27.3) 2 (1.9) 80 (76.9) 22 (21.2) 4 (2.8) 110 (75.9) 31 (21.4) 2 (1.4) 114 (70.0) 32 (21.6) 3 (2.0) 110 (74.8) 34 (23.1) 13 (1.7) 561 (75.1) 173 (23.2) Preoperative DCIS confirmation, (%) 1 (5.9) 3 (9.1) 11 (50.0) 40 (85.1) 36 (90.0) 43 (97.7) 102 (98.1) 135 (93.1) 139 (93.9) 135 (91.8) 645 (86.3) *Per 1,000 screens. DCIS = ductal carcinoma in‐situ. PPV = positive predictive value. BCS = breast conserving surgery.