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\udBackground: Although well established, population based screening and family risk assessment\udfor breast cancer have come under increasing scrutiny. The concept of over diagnosis is increasingly\udcited in cancer publications. This study assessed the impact of failure to screen or risk assess\udpatients attending with a new diagnosis of breast cancer. Methods: A retrospective review was\udundertaken of 200 consecutive patients diagnosed with breast cancer between January 2010 and\udSeptember 2012 at Letterkenny Hospital. Appropriate screening was defined as biennial in those\udaged 50 - 66 and in those 40 - 49 with moderate/high family history risk (NICE criteria or IBIS criteria).\udPatient demographics, screening history, diagnosis date and stage (TNM) were documented.\udPatients with previous breast cancer were not included (n = 17). Results: 200 consecutive patients,\udwhose mean age was 61 (range 28 - 99), were studied. 112/200 (56%) met no criteria for screening\udor family history assessment, and 88/200 (44%) met criteria for either screening (in 56) or\udfamily history assessment (in 32). 61/88 (69.3%) meeting criteria did not have a mammogram or\udrisk assessment. The stage of breast cancer was significantly earlier in those screened appropriately,\udwith early stage cancer in n = 111/139 (79.9 %) and late in n = 28/139 (20.1%), compared\udwith 38/61 (62.3%) and 23/61 (37.7%) in those failing to be screened appropriately (p = 0.01 χ2\uddf1). Conclusion: Failure to engage in breast screening and risk assessment resulted in more advanced\udstage at diagnosis

Failure to Engage in Breast Screening and Risk Assessment Results in More Advanced Stage at Diagnosis