Selected breast cancer risk factors and early detection of the neoplasm in women from Lublin region attending screening program in St. John’s Cancer Center, years 2005–2006
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St. John’s Cancer Center, Lublin, Poland
Department of Oncology and Environmental Health, Medical University, Lublin, Poland
Department of Oncology, Medical University, Lublin, Poland
Dariusz Surdyka   

St. John’s Cancer Center, Lublin, Poland
Ann Agric Environ Med. 2014;21(4):792–798
introduction and objective:
In Poland, consulting is offered to women about risk factors of breast cancer, breast symptoms and early cancer detection. Study aims were to evaluate the correlation between some risk factors and women’s attendance to breast checkups, and to assess links between risk factors and detection of early breast cancer.

Material and Methods:
The study involved 8014 women aged 50–69 years, participating in breast cancer screening program. The frequency of breast checkups (mammography, CBE and BSE) and occurrence of breast cancer risk factors in studied women were evaluated as well as clinical stage of detected tumors. Odds ratios were used to compare relative odds of breast cancer with exposure to risk factors.

47.11% studied women had regularly undergone MMG, 30.82% had CBE within the previous year, 14.26% regularly performed BSE. The incidence of risk factors varied from 2.94% (menarche at ≤ 11 years) to 12.38% (current use of HRT). In 47.82% women, no evidence of studied risk factors was found. Women with history of breast biopsies and current users of HRT had MMG, CBE and BSE significantly more often ( p<0.0001). 29.27% early breast cancers (pTis, pT1abN0) were found among 82 detected tumors. Relative odds of breast cancer occurrence in women without the risk factors were significantly lower (OR = 0.55, 95% CI [0.35; 0.86]). Only nulliparous women had significantly higher odds of early breast cancer (OR = 7.37, 95% CI [1.32; 41.17]).

]Women using HRT and women after breast biopsy were significantly more likely to attend breast checkups. There were no significant links between most risk factors and odds of early stages of breast cancer. Women should have preventive checkups irrespective of their breast cancer risk factors.

Wronkowski Z. Wczesne wykrywanie nowotworów. Polski Komitet Zwalczania Raka. Warszawa, 2000 (in Polish).
Wronkowski Z, Zwierko M. Zasady i wyniki „Programu modelowego skryningu raka piersi i raka szyjki macicy w Polsce, 1999–2000”. Nowotwory. Journal of Oncology 2002; 52(suppl.2) (in Polish).
Ustawa z dnia 1 lipca 2005 r. o ustanowieniu programu wieloletniego “Narodowy program zwalczania chorób nowotworowych”. Dz.U.05.143.1200 (in Polish).
Narodowy Fundusz Zdrowia. Program profilaktyki raka piersi. Załącznik nr 4 do zarządzenia Nr 86/2005 Prezesa Narodowego Funduszu Zdrowia. Warszawa, 2005(in Polish).
Perry N, Broeders M, de Wolf C, et al. Europejskie zalecenia dotyczące jakości badań przesiewowych i rozpoznawania raka piersi. Czwarta edycja – streszczenie dokumentu. Onkologia w Praktyce Klinicznej 2008; 4(2): 74–86 (in Polish).
Yager JD, Davidson NE. Estrogen carcinogenesis in breast cancer. N Engl J Med. 2006; 354(3): 270–282.
Beiki O, Hall P, Ekbom A, Moradi T. Breast cancer incidence and case fatality among 4.7 million women in relation to social and ethnic background: a population-based cohort study. Breast Cancer Research 2012; 14: 5. doi:10.1186/bcr3086.
Gareth D, Evans R, Howell A. Breast cancer risk-assessment models. Breast Cancer Research 2007; 9: 213. doi:10.1186/bcr1750.
Amir E, Freedman OC, Seruga B, Evans DG. Assessing Women at High Risk of Breast Cancer: A Review of Risk Assessment Models. J Natl Cancer Inst. 2010; 102: 680–691.
Gaudet MM, Gapstur SM, Sun J, et al. Active Smoking and Breast Cancer Risk: Original Cohort Data and Meta-Analysis. JNCI J Natl Cancer Inst. 2013; 105(8): 515–525.
Pięta B, Chmaj-Wierzchowska K, Opala T. Life style and risk of development of breast and ovarian cancer. Ann Agric Environ Med. 2012; 19(3): 379–384.
Meads C, Ahmed I, Riley RD. A systematic review of breast cancer incidence risk prediction models with meta-analysis of their performance. Breast Cancer Research and Treatment 2012; 132(2): 365–377.
Lee IM, Shiroma EJ, Lobelo F et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012; 380: 219–229.
Lacey Jr JV, Kreimer AR, Buys SS, et al. Breast cancer epidemiology according to recognized breast cancer risk factors in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Cohort. BMC Cancer. 2009; 9: 84. doi:10.1186/1471-2407-9-84.
Evans DGR, Warwick J, Astley MS, et al. Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention. Cancer Prev Res. 2012; 5: 943–951.
Visvanathan K, Hurley P, Bantug E, et al. Use of Pharmacologic Interventions for Breast Cancer Risk Reduction: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2009; 31: 2942–2962.
Narod SA, Offit K. Prevention and Management of Hereditary Breast Cancer. J Clin Oncol. 2005; 23: 1656–1663.
Mainiero MB, Lourenco A, Mahoney MC, et al. ACR Appropriateness Criteria Breast Cancer Screening. Journal of the American College of Radiology 2013; 10(1): 11–14.
Pfeiffer RM, Park Y, Kreimer AR, Lacey JV Jr, Pee D, et al. Risk Prediction for Breast, Endometrial, and Ovarian Cancer in White Women Aged 50 y or Older: Derivation and Validation from PopulationBased Cohort Studies. PLoS Med. 2013; 10(7): e1001492. doi:10.1371/ journal.pmed.1001492.
Główny Urząd Statystyczny. Portal informacyjny. Ludność. Stan i struktura w przekroju terytorialnym. Stan w dniu 31 XII 2005 r. www. (access: 2013.09.01) (in Polish).
Greene FL, Page DL, Fleming ID, et al. AJCC Cancer Staging Manual. 6th ed. New York, Springer, 2002.
European Network of Cancer Registries (ENCR). ENCR Recommendations. Condensed TNM for Coding the Extent of Disease. 2002. (access: 2013.09.05).
Gareth D, Evans R, Howell A. Assessing Women at High Risk of Breast Cancer: A Review of Risk Assessment Models. J Natl Cancer Inst. 2010; 102: 680–691.
Kaczmarek M. Określenie wieku menopauzy naturalnej w populacji polskich kobiet. Prz Menopauz. 2007; 2: 77–82 (in Polish).
Bińkowska M, Pietrzak B, Dębski R. Hormonalna terapia zastępcza w grupie kobiet polskich w wieku 45–54 lat. Wiedza, opinie, stosowanie. Prz Menopauz. 2005; 2: 19–27 (in Polish).
Garcia–Closas M, Brinton LA, Lissowska J, et al. Established breast cancer risk factors by clinically important tumour characteristics. British Journal of Cancer 2006; 95(1): 123–129.
Wiedza o nowotworach i profilaktyce. Raport tabelaryczny. Województwo Wielkopolskie. Populacja. Warszawa/Sopot 2007. http:// (access: 2010.09.05) (in Polish).
Jassem J, Krzakowski M. Rak piersi. W: Krzakowski M, Warzocha W, et al. Zalecenia postępowania diagnostyczno-teraputycznego w nowotworach złośliwych – 2013 rok. Via Medica Gdańsk, 2013.p.211–264 (in Polish).
Kaczmarek M. Zróżnicowanie wieku menopauzy naturalnej wśród polskich kobiet ze względu na historie okresu rozrodczego. Prz Menopauz. 2007; 2: 69–76 (in Polish).
Romundstad P, Janszky I, Vatten L, et al. Cancer risk factors in Poland: the PONS Study. Ann Agric Environ Med. 2011; 18(2):251–254.
Bińkowska M, Dębski R. Przesiewowe badania mammograficzne w populacji kobiet polskich w wieku od 45 do 54 lat. Gin Pol. 2005; 76(11): 871–878 (in Polish).
Chlebowski RT, Anderson GL. Changing Concepts: Menopausal Hormone Therapy and Breast Cancer. J Natl Cancer Inst. 2012; 104: 517–527.
Buist DSM, Rod Walker, Erin J. Aiello Bowles, et al. Screening Mammography Use among Current, Former, and Never Hormone Therapy Users May Not Explain Recent Declines in Breast Cancer Incidence. Cancer Epidemiol Biomarkers Prev. 2012; 21: 720–727.
Maślach D, Krzyżak M, Szpak A, et al. Differences in results of breast cancer curative treatment between urban/rural female population in Podlaskie Voivodship of Poland before introduction of the National Cancer Control Programme. Ann Agric Environ Med. 2013; 20(1): 68–71.
Tabár L, Vitak B, Chen TH, et al. Swedish Two-County Trial: Impact of Mammographic Screening on Breast Cancer Mortality during 3 Decades. Radiology 2011; 260(3): 658–663.
Walters S, Maringe C, Butler J, et al. Breast cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK, 2000–2007: a population-based study. British Journal of Cancer 2013; 108: 1195–1208. doi:10.1038/bjc.2013.6.