Organized Breast Cancer Screening Programs in Canada - Report on Program Performance in 2001 and 2002
Appendix 3
Glossary
Asymptomatic
A woman who does not report symptoms and appears without
signs of disease at screening.
Breast self-examination (BSE)
An examination of the breasts performed by the woman herself in
order to learn what is normal for her own breasts and to recognize
when something may be wrong.
Cancer
Includes malignant and ductal carcinoma in situ (DCIS) of the
breast.
Clinical breast examination (CBE)
A physical examination of the breasts performed by a trained
health professional.
Diagnosis
The first pathologic or cytologic diagnosis of cancer, last known
biopsy for benign cases, or last intervention before a recommendation
to return to screening or return for early recall1.
Ductal carcinoma in situ
(DCIS) a non-invasive tumour of the breast, arising from cells
that involve only the lining of a breast duct. The cells have not
spread outside the duct to other tissues in the breast.
Fine-needle aspiration biopsy
A technique used to differentiate cystic from solid lesions in the
breast. A needle is inserted into the lesion and material drawn out
using a syringe. If the material is solid, it can be stained and the
cells examined in a laboratory to determine whether or not they
are benign or malignant.
Incident cancer
Cancer detected by a program screen after the initial screen.
In situ
Refers specifically to ductal carcinoma in situ (DCIS): a noninvasive
tumour of the breast, arising from cells that involve only
the lining of a breast duct. The cells have not spread outside the
duct to other tissues in the breast.
Initial screen
The first Canadian screening program screen provided to a woman.
Interval cancer
Any invasive breast cancer diagnosed in the interval after a “normal”
screening result and before the next scheduled screening examination.
Invasive cancer
Cancer cells invading beyond the basement membrane of the
milk duct or lobule. A ductal carcinoma in situ component may
also be present in cases of invasive cancer.
Negative screening episode
A screening episode that concludes with normal findings, including
program-initiated work-up that did not reveal any cancer.
Open biopsy
Surgical removal of a breast mass under local anesthesia for
subsequent microscopic examination by a pathologist.
Post-screen cancer
A cancer detected outside the program within 24 months of a
negative screening episode.
Prevalent cancer
The proportion of the population with cancer at a given point in
time.
Rescreening
Subsequent screening, according to policy, after initial screening
under the program. This includes women who miss a scheduled
round of screening.
Screen
Can comprise mammography, or both clinical breast examination
and mammography, delivered by a program.
Screening episode (completed)
Defined for normal screens as the date of the last screen; for
abnormal screens, the date of tissue diagnosis if biopsy is performed,
the date of the last test before a return to screening or before the
recommendation for repeat diagnostic imaging. A “negative
screening episode” can include all follow-up, provided that the
end result is negative.
Screen-detected cancer
Cancer detected as a result of a positive test with histologic
confirmation attributed to the screening findings of the program.
Total person-years at risk
Within a 12 or 24-month period after a negative screening episode,
women are considered at risk for post-screen detected cancer.
Women contribute a count in the denominator for each year or
fraction of a year within the period of interest before a post-screen
detected cancer or the next regular program screen.
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