title: [Analysis of the results of mammography screening in Dubrovnik-Neretva County in the 2006-2009 period].
abstract: OBJECTIVE
  To analyze the results of the first cycle of mammography screening during implementation of the National Program for Early Breast Cancer Detection (National Program) for women aged 50-69 in the Dubrovnik-Neretva County (DNC) in the 2006-2009 period, and to present new cases of breast cancer among women undergoing screening.
  
  
  METHODS
  Data were collected from the DNC Institute of Public Health database. Mammography results were classified according to the Breast Imaging Reporting and Data System (BI-RADS classification). Descriptive method was used to analyze the results of mammography screening.
  
  
  RESULTS
  A total of 19,475 women aged 50-69 were invited to the first cycle of mammography screening for early breast cancer detection, conducted from October 2006 to October 2009 in DNC. The overall turnout in mammography screening was 59.5%; according to age groups, it was 61.8%, 60.6%, 58.5% and 56.8% for 50-54, 55-59, 60-64 and 65-69 age group, respectively. According to BI-RADS classification, BI-RADS 0 was recorded in 886 (10.0%), BI-RADS 1 in 2993 (33.8%), BI-RADS 2 in 4023 (45.4%), BI-RADS 3 in 864 (9.8%), BI-RADS 4 in 87 (1.0%) and BI-RADS 5 in eight (0.1%) women. Fifty-seven new cases of breast cancer were diagnosed in the first cycle of mammography screening. Among newly diagnosed cases of breast cancer, in the category of BI-RADS 0, 4 and 5 malignancy was confirmed in 55.6%, 13.9% and 30.6% within 45 days, 46-90 days and more than 3 months of mammography.
  
  
  CONCLUSIONS
  Study results indicated a total turnout on mammography screening of 59.5%, which was below the goal set in the National Program of 70%, and also below the acceptable response rate of 70% or more according to the European guidelines for quality assurance in breast cancer screening. Comparison of our rate of newly diagnosed cancer cases (6.3/1000 screened women) with the rates from other countries (range, 1.8 to 10.1/1000) published in the literature, our rate of mammography screening was in the middle of other countries' range. The "recall rate" in DNC was 11.1%, which is higher than acceptable (acceptable, <7%). The National Program specifies that diagnostic evaluation of all women with suspect findings should be completed within one month, however, in DNC 48.5% of women with newly diagnosed breast cancer of the BI-RADS 4 or 5 group were processed within a month. Diagnostic evaluation of all women with suspect findings was difficult to achieve due to the lack of necessary equipment and experts.
  
  
  CONCLUSIONS
  It is crucial to ensure quality and systematic promotion of the importance of mammography screening, to improve the level of cooperation between all holders of program activities, and to shorten the time interval between mammography recording and additional diagnostic and therapeutic procedures for women with lesions suspect of malignancy (to provide appropriate diagnostic and therapeutic care).
authors.affiliation: Institute of Public Health of Dubrovnik-Neretva County, Duvrovnik, Croatia.
authors.forename: Ankica
authors.initials: A
authors.lastname: Dzono-Boban
authors.forename: Matija Cale
authors.initials: MC
authors.lastname: Mratović
authors.forename: Marija
authors.initials: M
authors.lastname: Masanović
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged