Surgical outcomes of a breast cancer-screening program for low-income women

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 23149 mammograms, 20396 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 21296 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.