Breast cancer diagnosis from screening in Trinidad and Tobago: Opportunities for cancer prevention

Trinidad and Tobago (TT) experiences the highest breast cancer mortality in the Caribbean; the distribution of traditional breast cancer risk factors in this population has not been analyzed. Data onwomen who underwent breast cancer screening at the TT Cancer Society between January 2009-December 2011(N = 2,689) were retrospectively collected. The screening detected 131 incident breast cancers; variables significantly associated with breast cancer diagnosis were, a positive family history of breast cancer (adjusted odds ratio [OR _adj]: 1.55; 95 % CI 1.00-2.41), presence of symptoms (OR _adj: 1.91; 95 % CI 1.25-2.92), and previous breast surgery (OR _adj: 1.67; 95 % CI 0.97-2.88). Breast cancer was significantly associated with increased breast density. Among healthy women, breast density was positively associated with nulliparity (OR_adj: 1.46, 1.37, 2.52 respectively for density level 2, 3 and 4 vs. 1) and previous breast surgeries (OR_adj: 2.27, 3.09 and 4.13 respectively for density level 2, 3 and 4 vs. 1). This analysis confirms that breast density is an important predictor of newly diagnosed breast cancer in this Caribbean population. Screening is still a diagnostic tool rather than a preventive measure in TT.