Journal articles on the topic 'Breast cancer; mammography screening; over-diagnosis'
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1
Łuczyńska, Elżbieta, Marta Pawlak, Tadeusz Popiela, and Wojciech Rudnicki. "The role of ABUS in the diagnosis of breast cancer." Journal of Ultrasonography 22, no. 89 (April 13, 2022): 76–85. http://dx.doi.org/10.15557/jou.2022.0014.
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Breast cancer, which is the most common cancer in women, is a major problem both in Poland and worldwide. Mammography remains the primary screening method. However, the sensitivity of mammographic screening is lower in women with dense glandular breasts due to tissue overlap and the effect of the glandular tissue obscuring the tumor and the fact that tumors and glandular tissue show similar X-ray absorption. Consequently, other methods are being sought to increase breast cancer detection rates. Currently, the most common and used methods are ultrasonography, magnetic resonance imaging and advanced mammographic methods (digital breast tomosynthesis and contrast-enhanced spectral mammography). Despite many advantages and superiority over mammography in dense breasts, they also have many disadvantages. Ultrasound is operator-dependent and the other techniques are expensive or not widely available. The Automated Breast Ultrasound Service (ABUS) technique appears to be a good option in terms of both effectiveness and lower cost.
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Kuhl, Christiane K., Heribert Bieling, Kevin Strobel, Claudia Leutner, Hans H. Schild, and Simone Schrading. "Breast MRI screening of women at average risk of breast cancer: An observational cohort study." Journal of Clinical Oncology 33, no. 28_suppl (October 1, 2015): 1. http://dx.doi.org/10.1200/jco.2015.33.28_suppl.1.
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1 Background: Breast-MRI is currently recommended for screening women at high-risk of breast-cancer only. However, despite decades of mammographic-screening, breast-cancer continues to represent a major cause of cancer-death also for women at average-risk – suggesting a need for improved methods for early diagnosis also for these women. Therefore, we investigated the utility of supplemental MRI-screening of women who carry an average-risk of breast-cancer. Methods: Prospective observational cohort-study conducted in two academic breast-centers on asymptomatic women at average-risk in the usual age range for screening-mammography (40 to 70). Women underwent DCE-breast-MRI in addition to mammography every 12, 24, or 36 months, plus follow-up of 2 years to establish a standard-of-reference. We report on the supplemental-cancer-yield, interval-cancer-rate, diagnostic accuracy of screening-MRI, and biologic profiles of additional, MRI-detected breast-cancers. Results: 2120 women underwent a total 3861 MRI-studies covering 7007 women-years. Breast-cancer was diagnosed in 61/2120 women (DCIS: 20, invasive: 41), and ADH/LIN in another 21. Interval-cancer-rate was 0%, irrespective of screening interval. Forty-eight women were diagnosed with breast-cancer at prevalence-screening by MRI alone (supplemental cancer-detection-rate: 22.6 per 1000); 13 women were diagnosed with breast-cancer in 1741 incidence-screening-rounds collected over 4887 women-years. A total 12 of these 13 incident cancers were diagnosed by screening-MRI alone (supplemental-cancer-detection-rate: 6.9 per 1000), one by MRI and mammography, none by mammography alone. Supplemental-cancer-detection-rate was independent of mammographic breast-density. Invasive cancers were small (mean size: 8mm), node-negative in 93.4%, ER/PR-negative in 32.8%, and de-differentiated in 41.7% at prevalence, and 46.0% at incidence-screening. Specificity of MRI-screening was 97.1%, False-Positive-Rate 2.9%. Conclusions: MRI-screening improves detection of biologically relevant breast-cancer in women at average-risk, and reduces the interval-cancer-rate down to 0%, at a low false-positive rate.
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Kosar, Sumreen. "Harms and Benefits of Mammography Screening." YMER Digital 21, no. 05 (May 2, 2022): 7–16. http://dx.doi.org/10.37896/ymer21.05/02.
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Mammography is one of the most technically challenging areas of radiography, required high spatial resolution, excellent soft tissue contrast and low radiation dose. Mammography screening for breast cancer is worldwide available. Early detection of breast cancer through screening can lower breast cancer mortality rate and reduce the burden of this disease in the population, the benefits and harms of mammography screening have been debated in the past years. This review discuss the benefits and harms of mammography screening in light of findings from randomized trials and more recent observational studies performed in the era of modern diagnosis. The main benefit for mammography screening is reduces the risk of dying from breast cancer. Reduction vary from 15 to 20% in randomized trials to more recent estimates of 13 to 17% in analyses of observational studies. UK data of 2007 shows that for 1,000 women invited to biennial mammography screening for 20years to 50years age, 2-3 women’s are prevented from breast cancer. Main harm of mammography screening is the over diagnosis of breast cancer. 15 women’s over diagnosis for every 1000 women invited to biennial screening for 20 years from 50 years age. In an era of limiting health care services, screening services need to scrutinized and compared with each other regard to effectiveness, cost effectiveness and harms.
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Allison, Kimberly H., Linn A. Abraham, Donald L. Weaver, Anna NA Tosteson, Tracy Onega, Berta M. Geller, Karla Kerlikowske, et al. "Tissue sampling frequency and breast pathology diagnoses following mammography: Time trends and age group analysis from the Breast Cancer Surveillance Consortium (BCSC)." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 559. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.559.
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559 Background: Pathology diagnoses in a well-characterized population of women can be used to identify tissue sampling and diagnosis trends following mammography. Methods: Screening and diagnostic mammography, patient characteristics, and pathology reports from the BCSC performed from 1996-2008 were identified. Diagnosis was based on the most severe pathology interpretation in the same breast within 60 days of a post-mammogram tissue sample. Age, mammogram year and type, breast density, and family history of breast cancer were evaluated for associations with tissue sampling and most severe pathology diagnosis. Results: 4,022,506 mammograms (88.5% screening; 11.5% diagnostic) were performed in 1,288,886 women; 76,567 (1.9%) were followed by tissue sampling (1.2% screening; 7.1% diagnostic). Tissue sampling frequency following diagnostic mammography increased over time in women over 50 but remained stable following screening mammography. The frequency of invasive cancer increased with age and was more common following a diagnostic (29.3%) vs screening (19.8%) mammogram; the frequency of high risk lesions (ADH; lobular neoplasia) was highest in women aged 50-59. For tissue sampling following screening mammograms, the frequency of DCIS increased over time while benign diagnoses decreased. No significant time trends were noted for diagnoses associated with diagnostic mammograms. Women aged 40-59 with dense breasts and a tissue sampling following screening mammogram had a significantly higher frequency of DCIS (40-49: 4.8% vs 3.2%, P< 0.001; 50-59: 7.0% vs 5.7%, P=0.007). Women aged 40-59 with > 1first degree relative with breast cancer vs none that had a tissue sampling following screening mammogram had a significantly higher frequency of invasive cancer (40-49: 11.4% vs 9.4%, p=0.008; 50-59: 19.8% vs 18.2%, p =0.086) and DCIS (40-49: 6.2% vs 4.0%, p< 0.001; 50-59: 8.2% vs 6.2%, p< 0.001). Conclusions: There was an increase in DCIS and a decrease in benign diagnoses in tissues samples after screening mammography over time. No trends were seen following diagnostic mammography. DCIS was also more frequent in women with dense breasts.
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Sener, Stephen F., David J. Winchester, David P. Winchester, Raffael Kurek, Gary Motykie, Carole H. Martz, and Sarah Rabbitt. "Spectrum of Mammographically Detected Breast Cancers." American Surgeon 65, no. 8 (August 1999): 731–36. http://dx.doi.org/10.1177/000313489906500807.
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Mammographic screening of women at both ends of the age spectrum presents a number of challenges. The purpose of this study was to characterize experience with mammographic detection of breast cancer. The two goals were 1) to establish the cancer detection rate of screening mammography and 2) to compare the tumor size of cancers found by mammography, physical examination, or both modalities. From January 1994 through June 1997, data on 609 consecutive female primary breast cancer patients were collected concurrent with definitive surgical therapy. The method of detection was determined by the surgeon, after reviewing mammogram and physical examination. Screening ultrasound was not used. For the 184 patients under 50 years of age, 53 (29%) cancers were detected by mammography only and 48 (26%) by physical examination only. Women under 50 years of age had fewer cancers detected by mammography only (P < 0.001) and more cancers detected by physical examination only (P = 0.0014) than those over 50. With increasing age, the proportion of women with ductal carcinoma in situ decreased (P = 0.004), and the proportion with T1c or T2 tumors increased (P = 0.006). We conclude that 1) when examining women under 50 years of age, the surgeon must be clearly focused on the double-edged sword of screening mammography in this age group, and 2) community cancer programs should encourage annual screening of women over 40 years of age but focus on those over 70, without an arbitrary upper age limit.
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Bancej, C., K. Decker, A. Chiarelli, M. Harrison, D. Turner, and J. Brisson. "Original Paper: Contribution of clinical breast examination to mammography screening in the early detection of breast cancer." Journal of Medical Screening 10, no. 1 (March 1, 2003): 16–21. http://dx.doi.org/10.1258/096914103321610761.
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Objectives: As the benefit of clinical breast examination (CBE) over that of screening mammography alone in reducing breast cancer mortality is uncertain, it is informative to monitor its contribution to interim measures of effectiveness of a screening programme. Here, the contribution of CBE to screening mammography in the early detection of breast cancer was evaluated. Setting: Four Canadian organised breast cancer screening programmes. Methods: Women aged 50-69 receiving dual screening (CBE and mammography) (n=300,303) between 1996 and 1998 were followed up between screen and diagnosis. Outcomes assessed by mode of detection (CBE alone, mammography alone, or both CBE and mammography) included referral rate, positive predictive value, pathological features of tumours (size, nodal status, morphology), and cancer detection rates overall and for small cancers (≤10 mm or node-negative). Heterogeneity in findings across programmes was also assessed. Results: On first versus subsequent screen, CBE alone resulted in 28.5-36.7% of referrals, and 4.6-5.9% of cancers compared with 52.6-60.1% of referrals and 60.0-64.3% of cancers for mammography alone. Among cancers detected by CBE, 83.6-88.6% were also detected by mammography, whereas for mammographically detected cancers only 31.7-37.2% were also detected by CBE. On average, CBE increased the rate of detection of small invasive cancers by 2-6% over rates if mammography was the sole detection method. Without CBE, programmes would be missing three cancers for every 10,000 screens and 3-10 small invasive cancers in every 100,000 screens. Conclusions: Inclusion of CBE in an organised programme contributes minimally to early detection.
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Liu, Ying, Aliza Gordon, Michael Eleff, John Barron, and Winnie Chi. "Improved outcomes among breast cancer patients with more frequent mammography screening." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e19146-e19146. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19146.
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e19146 Background: Guidelines for optimal frequency of screening mammography (annual, biennial, never/choice of patient) vary by professional society, due to mixed or insufficient evidence regarding its benefits and harms. Little evidence exists on the impact of screening frequency, rather than any screening, on health outcomes. In this study, we measured differences in cancer stage at diagnosis, treatment rendered, mortality, and cost of treatment for women with different numbers of screenings prior to breast cancer diagnosis. Methods: Utilizing administrative claims, we identified 25,492 women aged 44 or older with various numbers of mammographic screening ≥ 11 months apart during the four years prior to their incident breast cancer diagnosis from 2010 to 2018. Outcomes were assessed during the six months following diagnosis. Regression models were used to compare women with differing numbers of mammograms (0, 1, 2, 3, or 4/5), adjusting for demographic characteristics and baseline comorbidities. Results: More screenings were associated with less advanced cancer at diagnosis, higher rates in lumpectomy and radiation, lower rates in mastectomy and chemotherapy, lower costs and mortality within 6 months post diagnosis (Table). Results were similar in a subgroup with only women aged 44-49 at diagnosis (not shown). Conclusions: Increased frequency of screening mammography is associated with earlier breast cancer stage at diagnosis, less toxic and invasive treatment, lower mortality, and lower cost, including for women under age 50. [Table: see text]
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Calinescu, Gina, Corina Grigoriu, Athir Eddan, Nicolae Bacalbasa, Irina Balescu, Bianca-Margareta Mihai, Roxana Elena Bohiltea, and Claudia Stoica. "Breast density and breast cancer." Romanian Journal of Medical Practice 16, S7 (December 30, 2021): 29–32. http://dx.doi.org/10.37897/rjmp.2021.s7.9.
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Breast density is increasingly recognized as an independent risk factor for the development of breast cancer. It has been shown to be associated with a four-to sixfold increase a woman's risk of malignant breast disease. Increased breast density, as identified on mammography, is known to decrease the diagnostic sensitivity of the examination, which is of great concern to women at increased risk for breast cancer. Dense tissue has generally been associated with younger age and premenopausal status, with the assumption that breast density gradually decreases after menopause. However, the actual proportion of older women with dense breasts is unknown. Unfortunately, mammography is less accurate on dense breast tissue compared to fattier breast tissue. Multiple studies suggest a solution to this by demonstrating the ability of supplemental screening ultrasound to detect additional malignant lesions in women with dense breast tissue but with negative mammography. Improved screening methods for women with dense breasts are needed due to their increased risk of breast cancer and of failed early diagnosis by screening mammography.
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Scott, Anthony M., Madison G. Lashley, Nicholas B. Drury, and Paul S. Dale. "Comparison of Call-Back Rates between Digital Mammography and Digital Breast Tomosynthesis." American Surgeon 85, no. 8 (August 2019): 855–57. http://dx.doi.org/10.1177/000313481908500837.
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The effect of mammographic screening on the natural history and evolution of breast cancer treatment cannot be overstated; however, despite intensive and resource consuming screening, advanced breast cancer is still diagnosed frequently. The development of three-dimensional mammography or digital breast tomosynthesis (DBT) has already demonstrated greater sensitivity in the diagnosis of breast pathology and effectiveness in identifying early breast cancers. In addition to being a more sensitive screening tool, other studies indicate DBT has a lower call-back rate when compared with traditional DM. This study compares call-back rates between these two screening tools. A single institution, retrospective review was conducted of almost 20,000 patient records who underwent digital mammography or DBTin the years 2016 to 2018. These charts were analyzed for documentation of imaging type, Breast Imaging Reporting and Data System 0 status, call-back status, and type of further imaging that was required. Charts for 19,863 patients were reviewed, 17,899 digital mammography examinations were conducted compared with 11,331 DBT examinations resulting in 1,066 and 689 Breast Imaging Reporting and Data System 0 studies, respectively. Of the DM call-backs, 82.08 per cent were recommended for additional radiographic imaging and 17.82 per cent for ultrasound imaging. In the DBT group, only 39.77 per cent of callbacks were recommended for additional radiographic imaging and 60.09 per cent for ultrasound imaging. Our data suggest that DBT results in less call-back for additional mammographic images as compared with digital mammography. DBT may offer benefits over DM, including less imaging before biopsy, less time before biopsy, quicker diagnosis, and improved patient satisfaction.
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Walsh, Elaine, Michael P. Farrell, Fergal Gallagher, Roisin Clarke, Carmel Nolan, M. John Kennedy, Peter Daly, et al. "Breast cancer detection among Irish BRCA1 and BRCA2 mutation carriers." Journal of Clinical Oncology 30, no. 27_suppl (September 20, 2012): 59. http://dx.doi.org/10.1200/jco.2012.30.27_suppl.59.
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59 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical breast exam, mammography and MRI have sensitivities approaching 100%. Even with intensive screening BRCA mutation carriers can present with self-detected interval cancers. We investigate screening practices and presentation among a cohort of Irish BRCA1/2 mutation carriers. Methods: Females with breast cancer belonging to kindreds now known to harbour BRCA1/2 mutations were retrospectively identified. Records were reviewed for BRCA mutation, demographics, breast cancer diagnosis, stage, histology and screening. We assessed screening modalities and whether breast cancers were diagnosed at screening or as interval cancers. Results: 53 cases of breast cancer were diagnosed from 1968-2010 among 53 Irish hereditary breast ovarian cancer kindreds. BRCA mutation status was unknown at time of diagnosis but subsequently confirmed. Detection method was identified in 50% of patients: 84% by clinical breast exam (CBE), 4% mammography, 4% MRI and 8% by a combination of CBE and mammography. Fifteen women (28%) developed second breast cancer; 9(60%) were undergoing screening, 2 were not and 27% were unknown. 22% were detected by CBE alone; 34% mammography; 22% a combination of mammography and CBE and 22% by MRI. In 41%, histology changed between first and second diagnosis. Two women developed a third breast cancer. In one, her second was an interval cancer despite being in a screening programme. Her third was radiologically detected. Conclusions: In this cohort of Irish BRCA1/2 mutation carriers almost 25% of second breast cancers were not detected by screening. 4% of cases were phenocopies and in 41% histology changed between first and second diagnosis. [Table: see text]
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Walsh, Elaine, Michael P. Farrell, Fergal Gallagher, Roisin Clarke, Carmel Nolan, M. John Kennedy, Peter Daly, et al. "Breast cancer detection among Irish BRCA1 and BRCA2 mutation carriers." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e12038-e12038. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e12038.
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e12038 Background: High-risk breast cancer screening for BRCA1/2 mutations carriers with clinical breast exam, mammography and MRI have sensitivities approaching 100%. Even with intensive screening BRCA mutation carriers can present with self-detected interval cancers. We investigate screening practices and presentation among a cohort of Irish BRCA1/2 mutation carriers. Methods: Females with breast cancer belonging to kindreds now known to harbour BRCA1/2 mutations were retrospectively identified. Records were reviewed for BRCA mutation, demographics, breast cancer diagnosis, stage, histology and screening. We assessed screening modalities and whether breast cancers were diagnosed at screening or as interval cancers. Results: 53 cases of breast cancer were diagnosed from 1968-2010 among 53 Irish hereditary breast ovarian cancer kindreds. BRCA mutation status was unknown at time of diagnosis but subsequently confirmed. Detection method was identified in 50% of patients: 84% by clinical breast exam (CBE), 4% mammography, 4% MRI and 8% by a combination of CBE and mammography. Fifteen women (28%) developed second breast cancer; 9(60%) were undergoing screening, 2 were not and 27% were unknown. 22% were detected by CBE alone; 34% mammography; 22% a combination of mammography and CBE and 22% by MRI. In 41%, histology changed between first and second diagnosis. Two women developed a third breast cancer. In one, her second was an interval cancer despite being in a screening programme. Her third was radiologically detected. Conclusions: In this cohort of Irish BRCA1/2 mutation carriers almost 25% of second breast cancers were not detected by screening. 4% of cases were phenocopies and in 41% histology changed between first and second diagnosis. [Table: see text]
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Aurora, Habiba, and Yuyun Yueniwati. "Mammographic and Sonographic Findings in Breast Cancer Screening." International Journal of Radiology and Imaging 1, no. 01 (June 29, 2022): 27–32. http://dx.doi.org/10.21776/ub.ijri.2022.001.01.6.
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Breast cancer in the most common malignancy in woman. Screening is very important to identify precancerous lesions. The use of diagnostic imaging is one of the first steps in cancer diagnosis. Mammography is one of detection tool, which able to detect breast abnormality in early stage, while breast sonography is more helpful in cases with dense breast. In this study we compared the finding on mammography and ultrasonography among woman 40 to 60 years undergoing breast cancer screening.
This study included 30 asymptomatic woman aged over 40 years, which have no history of reast cancer. All were assigned to undergo screening by either mammography and ultrasonography. The diagnoses were scored due to ultrasound BI-RADS, the finding from mammography and breast ultrasound were compared to analyze the difference between both examination.
From the result of mammography and ultrasound were shown that at the same BIRADS scale, different images could be obtained. Further studies are needed to demonstrate the significance of the differences in examination findings on the same BIRADS scale.
Keywords: Breast Cancer, Mammography, Screening, Sonography
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Gordon, Paula B. "The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening." Current Oncology 29, no. 5 (May 17, 2022): 3595–636. http://dx.doi.org/10.3390/curroncol29050291.
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The purpose of breast cancer screening is to find cancers early to reduce mortality and to allow successful treatment with less aggressive therapy. Mammography is the gold standard for breast cancer screening. Its efficacy in reducing mortality from breast cancer was proven in randomized controlled trials (RCTs) conducted from the early 1960s to the mid 1990s. Panels that recommend breast cancer screening guidelines have traditionally relied on the old RCTs, which did not include considerations of breast density, race/ethnicity, current hormone therapy, and other risk factors. Women do not all benefit equally from mammography. Mortality reduction is significantly lower in women with dense breasts because normal dense tissue can mask cancers on mammograms. Moreover, women with dense breasts are known to be at increased risk. To provide equity, breast cancer screening guidelines should be created with the goal of maximizing mortality reduction and allowing less aggressive therapy, which may include decreasing the interval between screening mammograms and recommending consideration of supplemental screening for women with dense breasts. This review will address the issue of dense breasts and the impact on the stage of breast cancer at the time of diagnosis, and discuss options for supplemental screening.
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Barrajon, E., A. Lopez, and E. Adrover. "Screening mammography in old women saves lives: A simulation model." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 10561. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.10561.
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10561 Background: Screening mammography has shown to decrease breast cancer specific death rate by 20–25% and has been recommended in women aged 40 and above, nevertheless, some country service screen programs stop screening in women older than 69, even though the sensitivity and specificity of screening mammography is highest in older women, especially those older than 80 years. The size of the older population is growing exponentially and old women have the highest incidence of breast cancer; one third of breast cancer diagnosis and half the deaths of breast cancer in USA occurred in women aged 70 and above in the year 2000. The aim of this study is to estimate the impact of mammographic screening in women aged 70 and above on breast cancer mortality. Methods: US Census, SEER, CISNET, CDC, HMD, ULTD databases were searched to obtain population data and rates of incidence and mortality of breast cancer by age. In addition, mammography screening bibliography from randomized clinical trials, meta-analysis, and service health programs publications were reviewed to estimate the impact of screening mammography on results for different strata. Analytical and simulation methods were applied for modeling the data with the aid of Mathematica to calculate breast cancer reduction rate. Results: A reduction in breast cancer mortality was observed with a magnitude proportional to age, even after taking into account competing risks of death by other causes in the aging population. Simulation of different scenarios revealed a decrease in breast cancer mortality in the range of 5 to15% for women younger than 50 years, 15 to 25% in the group of women aged 50 to 69, and 25 to 35% in women older than 69. Factors such as population life expectancy, breast cancer incidence, attrition rate in screening or cross-over, overall specificity of mammographic detection, interval of screening, impact the estimations, explaining in part some of the negative results of prevention trials. Conclusions: Reduction of breast cancer mortality by mammographic screening is proportional to age. Women aged 70 and above benefit more from mammographic screening than younger women. No significant financial relationships to disclose.
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Pisano, Etta. "Issues in Breast Cancer Screening." Technology in Cancer Research & Treatment 4, no. 1 (February 2005): 5–9. http://dx.doi.org/10.1177/153303460500400102.
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This paper will review the use of screening mammography in the United States, with an emphasis on its limitations as currently practiced. It will then emphasize several areas where breast cancer imaging practice can be improved, namely in reducing overtreatment of potentially nonlethal cancers, in monitoring the effectiveness of nonsurgical therapies, and in guiding noninvasive therapies. Any new modality that is to have an impact on breast cancer mortality must perform comparably to screening mammography to become widely utilized. While mammography is not perfect, it has set a high threshold that other modalities must reach before they will be widely utilized for screening or diagnosis.
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Hegar, Veronica, Kristin Oliveira, Bharat Kakarala, Alicia Mangram, and Ernest Dunn. "Annual Mammography Screening: Is it Necessary?" American Surgeon 78, no. 1 (January 2012): 104–6. http://dx.doi.org/10.1177/000313481207800145.
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Recent recommendations from the U.S. Preventative Services Task Force suggest that screening mammography for women should be biennial starting at age 50 years and continue to age 74 years. With these recommendations in mind, we proposed a study to evaluate women at our institution in whom breast cancer is diagnosed within 1 year of a previously benign mammogram. A retrospective chart review was performed over a 4-year period. Only patients who had both diagnostic mammograms and previous mammograms performed at our institution and a pathologic diagnosis of breast cancer were included. Benign mammograms were defined as either Breast Imaging Reporting And Data System 1 or 2. Analysis of the time elapse between benign mammogram and subsequent mammogram indicative of the diagnosis of breast cancer was performed. A total of 205 patients were included. The average age was 64 years. From our results, 48 patients, 23 per cent of the total, had a documented benign mammogram at 12 months or less before a breast cancer diagnosis. One hundred forty-three (70%) patients had a benign mammogram at 18 months or less prior. This study raises concern that 2 years between screening mammograms may delay diagnosis and possible treatment options for many women.
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Singh, Shamy. "Imaging Technologies in Breast Cancer Screening Beyond Mammography." Journal of Advance Research in Computer Science & Engineering (ISSN: 2456-3552) 3, no. 5 (May 31, 2016): 01–06. http://dx.doi.org/10.53555/nncse.v3i5.416.
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Still there is a passionate debate in medical world about the best screening method for Breast Cancer. Early detection is an effective way to diagnose and manage breast cancer. Mammography is the most widely used screening modality, with solid evidence of benefit for women aged 40 to 74 years. Even then it has also undergone increased scrutiny for False-Positives with additional testing which increase radiation dose, cost and anxiety. False-Negatives with false sense of security and potential delay in cancer diagnosis. To overcome these challenges, new imaging technologies for breast cancer screening have been developed, including; X- ray Mammography, Contrast Enhanced Mammography, Digital Mammography, Ultrasound, Automated Whole Breast Ultrasound (AWBU), and Magnetic Resonance Imaging (MRI) are being evaluated. The purpose of this paper is to provide an overview of different medical imaging techniques used in the diagnosis of breast cancer. We compare their effectiveness, advantages, and disadvantages for detecting early-stage breast cancer. We mainly focusing on the comparison of these technologies with mammography for the diagnosis of breast cancer. Here we recommend Digital Mammography is the best available screening method for the early detection of Breast Cancer. Even though the optimal screening will ultimately require a personalized approach. It based on the metrics of cancer risk with selective application of specific screening technologies best suited to the individual’s age, risk, and breast density.
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Singh, Shamy, and J. Dheeba. "Imaging Technologies in Breast Cancer Screening Beyond Mammography." Journal of Advance Research in Computer Science & Engineering (ISSN: 2456-3552) 2, no. 4 (April 30, 2015): 01–06. http://dx.doi.org/10.53555/nncse.v2i4.412.
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Still there is a passionate debate in medical world about the best screening method for Breast Cancer. Early detection is an effective way to diagnose and manage breast cancer. Mammography is the most widely used screening modality, with solid evidence of benefit for women aged 40 to 74 years. Even then it has also undergone increased scrutiny for False-Positives with additional testing which increase radiation dose, cost and anxiety. False-Negatives with false sense of security and potential delay in cancer diagnosis. To overcome these challenges, new imaging technologies for breast cancer screening have been developed, including; X- ray Mammography, Contrast Enhanced Mammography, Digital Mammography, Ultrasound, Automated Whole Breast Ultrasound (AWBU), and Magnetic Resonance Imaging (MRI) are being evaluated. The purpose of this paper is to provide an overview of different medical imaging techniques used in the diagnosis of breast cancer. We compare their effectiveness, advantages, and disadvantages for detecting early-stage breast cancer. We mainly focusing on the comparison of these technologies with mammography for the diagnosis of breast cancer. Here we recommend Digital Mammography is the best available screening method for the early detection of Breast Cancer. Even though the optimal screening will ultimately require a personalized approach. It based on the metrics of cancer risk with selective application of specific screening technologies best suited to the individual’s age, risk, and breast density.
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Morrell, Stephen, Richard Taylor, David Roder, and Annette Dobson. "Mammography screening and breast cancer mortality in Australia: an aggregate cohort study." Journal of Medical Screening 19, no. 1 (February 18, 2012): 26–34. http://dx.doi.org/10.1258/jms.2012.011127.
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Background Evidence that mammography screening reduces breast cancer mortality derives from trials, with observational studies broadly supporting trial findings. The purpose of this study was to evaluate the national mammographic screening programme, BreastScreen Australia, using aggregate screening and breast cancer mortality data. Methods Breast cancer mortality from 1990 to 2004 in the whole Australian population was assessed in relation to screening exposure in the target of women aged 50–69 years. Population cohorts were defined by year of screening (and diagnosis), five-year age group at screening (and diagnosis), and local area of residence at screening (and diagnosis). Biennial screening data for BreastScreen Australia were related to cumulated mortality from breast cancer in an event analysis using Poisson regression, and in a time-to-event analysis using Cox proportional hazards regression. Results were adjusted for repeated measures and the potential effects of mammography outside BreastScreen Australia, regionality, and area socio-economic status. Results From the adjusted Poisson regression model, a 22% (95% CI:12–31%) reduction in six-year cumulated mortality from breast cancer was predicted for screening participation of approximately 60%, compared with no screening; 21% (95% CI:11–30%) for the most recently reported screening participation of 56%; and 25% (95% CI:15–35%) for the programme target of 70% biennial screening participation. Corresponding estimates from the Cox proportional hazard regression model were 30% (95% CI:17–41%), 28% (95% CI:16–38%) and 34% (95% CI:20–46%). Conclusions Despite data limitations, the results of this nationwide study are consistent with the trial evidence, and with results of other service studies of mammography screening. With sufficient participation, mammography screening substantially reduces mortality from breast cancer.
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Morrell, Stephen, Marli Gregory, Kerry Sexton, Jessica Wharton, Nisha Sharma, and Richard Taylor. "Absence of sustained breast cancer incidence inflation in a national mammography screening programme." Journal of Medical Screening 26, no. 1 (June 27, 2018): 26–34. http://dx.doi.org/10.1177/0969141318775766.
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Objective To investigate the impact of population mammography screening on breast cancer incidence trends in New Zealand. Methods Trends in age-specific rates of invasive breast cancer incidence (1994–2014) were assessed in relation to screening in women aged 50–64 from 1999 and 45–69 following the programme age extension in mid-2004. Results Breast cancer incidence increased significantly by 18% in women aged 50–64 compared with 1994–98 (p<0.0001), coinciding with the 1999 introduction of mammography screening, and remained elevated for four years, before declining to pre-screening levels. Increases over 1994–99 incidence occurred in the 45–49 (21%) and 65–69 (19%) age groups following the 2004 age extension (p<0.0001). Following establishment of screening (2006–10), elevated incidence in the screening target age groups was compensated for by lower incidence in the post-screening ⩾70 age groups than in 1994–98. Incidence in women aged ⩾45 was not significantly higher (+5%) after 2006 than in 1994–98. The cumulated risk of breast cancer in women aged 45–84 for 1994–98 was 10.7% compared with 10.8% in 2006–10. Conclusions Increases in breast cancer incidence following introduction of mammography screening in women aged 50–64 did not persist. Incidence inflation also occurred after introduction of screening for age groups 45–49 and 65–69. The cumulated incidence for women aged 45–84 over 2006–10 after screening was well established, compared with 1994–98 prior to screening, shows no increase in diagnosis. Over-diagnosis is not inevitable in population mammography screening programmes.
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Kuczyńska, Angelika, Łukasz Kwietniewski, Wiktor Kupisz, Joanna Kruk-Bachonko, and Witold Krupski. "Digital breast tomosynthesis (DBT) value in breast mass detection." Polish Journal of Public Health 130, no. 1 (January 1, 2021): 1–4. http://dx.doi.org/10.2478/pjph-2020-0001.
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Abstract Epidemiologically, breast cancer is the most common cancer in middle-aged women and it is one of the leading causes of cancer-related deaths. Middle-aged patients are covered by screening tests – digital mammography, often supplemented with ultrasound (US) breast examination. Other radiological tests in the diagnosis of breast cancer include such techniques as tomosynthesis, spectral mammography and magnetic resonance imaging (MRI). Many research groups around the world have demonstrated superiority of tomosynthesis in detecting focal lesions in breasts when compared to conventional mammography. Tomosynthesis usage was proposed for screening studies as a test of choice and for radiologically-guided tissue biopsies of suspicious tissue lesions.
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Ruddy, Kathryn Jean, Lindsey R. Sangaralingham, Heather B. Neuman, Caprice Christian Greenberg, Rachel A. Freedman, Ahmedin Jemal, Sarah Schellhorn Mougalian, et al. "Mammography use in breast cancer survivors: An administrative claims study." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 6531. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.6531.
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6531 Background: Annual mammography is recommended to screen residual breast tissue for new cancers and recurrent disease after treatment for early stage breast cancer. This study aimed to assess mammography rates over time in breast cancer survivors. Methods: We used administrative claims data from a large U.S. commercial insurance database, OptumLabs, to retrospectively identify privately- and Medicare Advantage-insured women with operable breast cancer who had residual breast tissue after definitive breast surgery between 2006 and 2015. We required coverage for at least 13 months following surgery. For each subsequent 13-month time period, we only included women without a loss of coverage, bilateral mastectomy, metastatic breast cancer diagnosis, or non-breast cancer diagnosis. We calculated the proportion of patients who had a mammogram during each 13-month period following breast surgery. We used multivariable logistic regression to test for factors associated with mammography in the first 13 months. Results: The cohort included 26,011 women followed for a median of 2.9 years (IQR 1.9-4.6) after surgery; 63.1% were less than 65 years of age, and 74.4% were white. In their first year of follow-up, 86% underwent mammography, but by year 7, this decreased to 73%. Fewer than 1% underwent MRI instead of mammography. In multivariable analysis, mammograms were less likely during the first year after surgery among women aged < 50 years (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6 to 0.8), African Americans (OR, 0.7; 95% CI, 0.7 to 0.8), patients who underwent mastectomy (OR, 0.7; 95% CI, 0.6 to 0.7), and patients residing in the Western part of the country (OR, 0.9; 95% CI, 0.7 to 0.9). Those with 1-2 comorbidities were more likely (OR, 1.1; 95% CI 1.1-1.2) than those with none to have a mammogram during that period. Mammography use did not differ significantly by year of diagnosis (2006-2015). Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance mammography. Mammography use falls as the time from the early stage breast cancer diagnosis increases. Understanding factors associated with lack of mammographic screening may help improve survivorship care.
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Chiarelli, Anna M., Kristina M. Blackmore, Lucia Mirea, Susan J. Done, Vicky Majpruz, Ashini Weerasinghe, Linda Rabeneck, and Derek Muradali. "Annual vs Biennial Screening: Diagnostic Accuracy Among Concurrent Cohorts Within the Ontario Breast Screening Program." JNCI: Journal of the National Cancer Institute 112, no. 4 (June 24, 2019): 400–409. http://dx.doi.org/10.1093/jnci/djz131.
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Abstract Background The Ontario Breast Screening Program recommends annual mammography to women age 50–74 years at increased risk because of family history of breast or ovarian cancer or personal history of ovarian cancer or mammographic density 75% or greater. Few studies have examined the diagnostic accuracy of recommendations based on risk factors and included screen film as well as digital mammography. Methods A retrospective design identified concurrent cohorts of women age 50–74 years screened annually or biennially with digital mammography only between 2011 and 2014 and followed until 2016 or breast cancer diagnosis. Diagnostic accuracy measures were compared between women screened annually because of first-degree relative of breast or ovarian cancer or personal history of ovarian cancer (n = 67 795 women), mammographic density 75% or greater (n = 51 956), or both (n = 3758) and those screened biennially (n = 526 815). The association between recommendation and sensitivity and specificity was assessed using generalized estimating equation models. All P values are two-sided. Results For annual screening because of family or personal history vs biennial, sensitivity was statistically significantly higher (81.7% vs 70.6%; OR = 1.86, 95% CI = 1.48 to 2.34), particularly for invasive cancers and postmenopausal women. Although there was no statistically significant difference in sensitivity for annual screening for mammographic density 75% or greater, specificity was statistically significantly lower (91.3%; OR = 0.87, 95% CI = 0.80 to 0.96) vs biennial (92.3%), particularly for women age 50–59 years. Conclusion Compared with biennial screening, annual screening improved detection for women with a family or personal history of breast and/or ovarian cancer, supporting screening that is more frequent. The benefit for annual screening for women with higher mammographic density must be weighed against possible harms of increased false positives.
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Roberto Eduardo Guerra Estrada, Andrés Felipe Díaz Muñoz, Fred David Delgado Ricardo, Astrid Carolina Saavedra Andrade, María Morera-Esquivel, Angela María Piamba Valencia, Omar Avendaño Solano, and Oscar Ivan Avendaño Solano. "Use of mammography with contrast for the diagnosis of breast cancer." World Journal of Advanced Research and Reviews 14, no. 1 (April 30, 2022): 277–83. http://dx.doi.org/10.30574/wjarr.2022.14.1.0315.
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Breast cancer is a heterogeneous disease, caused by the progressive accumulation of mutations and chromosomal abnormalities. Currently, breast cancer is considered the neoplasm with the highest incidence and mortality in women worldwide, so much so that every year in the world, one million breast cancers are discovered and around 400,000 women die from it. The search for diagnostic techniques that allow the detection of this pathology in an effective way has become essential and that is where mammography emerges, as a screening method, which has been shown to reduce mortality by detecting breast cancer early; however, in very dense breasts detection is difficult, so they have been modified, and thus generating new screening and diagnostic methods such as contrast-enhanced mammography, which is the newest and most promising imaging technique based on neovascularization of breast tumors in a similar way and may even be better than MRI.
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Ding, Rui, Yi Xiao, Miao Mo, Ying Zheng, Yi-Zhou Jiang, and Zhi-Ming Shao. "Breast cancer screening and early diagnosis in Chinese women." Cancer Biology & Medicine 19, no. 4 (April 5, 2022): 450–67. http://dx.doi.org/10.20892/j.issn.2095-3941.2021.0676.
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Breast cancer is the most common malignant tumor in Chinese women, and its incidence is increasing. Regular screening is an effective method for early tumor detection and improving patient prognosis. In this review, we analyze the epidemiological changes and risk factors associated with breast cancer in China and describe the establishment of a screening strategy suitable for Chinese women. Chinese patients with breast cancer tend to be younger than Western patients and to have denser breasts. Therefore, the age of initial screening in Chinese women should be earlier, and the importance of screening with a combination of ultrasound and mammography is stressed. Moreover, Chinese patients with breast cancers have several ancestry-specific genetic features, and aiding in the determination of genetic screening strategies for identifying high-risk populations. On the basis of current studies, we summarize the development of risk-stratified breast cancer screening guidelines for Chinese women and describe the significant improvement in the prognosis of patients with breast cancer in China.
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Singh, Shamy, and J. Dheeba. "Imaging Technologies in Breast Cancer Screening Beyond Mammography." Journal of Advance Research in Computer Science & Engineering (ISSN: 2456-3552) 2, no. 5 (May 31, 2015): 01–06. http://dx.doi.org/10.53555/nncse.v2i5.407.
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Still there is a passionate debate in medical world about the best screening method for Breast Cancer. Early detection is an effective way to diagnose and manage breast cancer. Mammography is the most widely used screening modality, with solid evidence of benefit for women aged 40 to 74 years. Even then it has also undergone increased scrutiny for False-Positives with additional testing which increase radiation dose, cost and anxiety. False-Negatives with false sense of security and potential delay in cancer diagnosis. To overcome these challenges, new imaging technologies for breast cancer screening have been developed, including; X- ray Mammography, Contrast Enhanced Mammography, Digital Mammography, Ultrasound, Automated Whole Breast Ultrasound (AWBU), and Magnetic Resonance Imaging (MRI) are being evaluated. The purpose of this paper is to provide an overview of different medical imaging techniques used in thediagnosis of breast cancer. We compare their effectiveness, advantages, and disadvantages for detecting early-stage breast cancer. We mainly focusing on the comparison of these technologies with mammography for the diagnosis of breast cancer. Here we recommend early detection of Breast Cancer. Even though the optimal screening will ultimately require a personalized approach. It based on the metrics of cancer risk with selective application of specific screening technologies best suited to the individual’s age, risk, and breast density.
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Weinstock, Chana, Cristina Campassi, Olga G. Goloubeva, Saranya Chumsri, Ting Bao, Susan Kesmodel, Steven J. Feigenberg, Kathleen Wooten, Olga B. Ioffe, and Katherine Hanna Tkaczuk. "The effect on detection rate of second cancers after the addition of MRI to conventional screening mammography in patients with a history of breast cancer." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 10572. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.10572.
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10572 Background: Mammography is currently used in the surveillance of breast cancer survivors, who are at increased risk of developing ipsilateral and contralateral breast cancers regardless of age at diagnosis or time since diagnosis. Several prospective studies have shown the utility of breast MRI in other high risk populations; however, little data exists on the use of MRI for surveillance of breast cancer survivors. We aimed to compare the outcome of surveillance breast MRI vs. mammography in this population. Methods: We identified women <65 with non-metastatic breast cancer or DCIS with at least one MRI performed at our center >11 months after initial diagnosis, along with a mammogram done within 6 months of the MRI. We compared the outcome of MRI and mammography in terms of biopsies performed as well as in detection of new cancers. Results: Of 512 consecutive charts reviewed, 204 patients met inclusion criteria, 105 (51.4%) of whom were African-American. The average number of MRIs per patient was 2.3 (range 2-7), with a total of 474 MRIs performed between 2005 and 2011. MRI resulted in BIRADS scores of 1 or 2 in 73.5% of studies vs. 84.4% for mammography. There were 19 biopsies performed due to MRI findings alone, 7 done due to mammographic findings alone, and 6 biopsies done based on abnormalities seen on both MRI and mammography. There were 7 malignancies identified based on an abnormal MRI, 3 seen on both MRI and mammography, and none identified via mammography alone. The malignancies identified via MRI alone included 1 patient with DCIS, 5 with stage I disease, and 1 with isolated lung metastases. Of the 10 recurrences detected, 5 (50%) were in African Americans. Two patients developed interval cancers within 6 months of normal screening MRI and mammography. Sensitivity and specificity for MRI were 83.3% (95% CI 0.51-0.97) and 92.2% (95% CI 0.87-0.95), vs. 25% (95% CI 0.05-0.57) and 94.8% (95% CI 0.90-0.97) for mammography. Positive and negative predictive values were 40% and 98.9% for MRI vs. 25% and 95.2% for mammography. Conclusions: Gadolinium-enhanced breast MRI is a useful surveillance modality in breast cancer survivors < age 65. Prospective studies are needed in this population.
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Anderson, William F., Anne S. Reiner, Rayna K. Matsuno, and Ruth M. Pfeiffer. "Shifting Breast Cancer Trends in the United States." Journal of Clinical Oncology 25, no. 25 (September 1, 2007): 3923–29. http://dx.doi.org/10.1200/jco.2007.11.6079.
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Purpose United States breast cancer incidence rates declined during the years 1999 to 2003, and then reached a plateau. These recent trends are impressive and may indicate an end to decades of increasing incidence. Methods To put emerging incidence trends into a broader context, we examined age incidence patterns (frequency and rates) during five decades. We used age density plots, two-component mixture models, and age-period-cohort (APC) models to analyze changes in the United States breast cancer population over time. Results The National Cancer Institute's Connecticut Historical Database and Surveillance, Epidemiology, and End Results program collected 600,000+ in situ and invasive female breast cancers during the years 1950 to 2003. Before widespread screening mammography in the early 1980s, breast cancer age-at-onset distributions were bimodal, with dominant peak frequency (or mode) near age 50 years and smaller mode near age 70 years. With widespread screening mammography, bimodal age distributions shifted to predominant older ages at diagnosis. From 2000 to 2003, the bimodal age distribution returned to dominant younger ages at onset, similar to patterns before mammography screening. APC models confirmed statistically significant calendar-period (screening) effects before and after 1983 to 1987. Conclusion Breast cancer in the general United States population has a bimodal age at onset distribution, with modal ages near 50 and 70 years. Amid a background of previously increasing and recently decreasing incidence rates, breast cancer populations shifted from younger to older ages at diagnosis, and then back again. These dynamic fluctuations between early-onset and late-onset breast cancer types probably reflect a complex interaction between age-related biologic, risk factor, and screening phenomena.
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Belaya, Ju A., N. A. Zakharova, and A. R. Brentnall. "Realisation of mammography screening in Khanty-Mansiysk Autonomous State – Yugra." Tumors of female reproductive system 16, no. 3 (January 12, 2021): 32–36. http://dx.doi.org/10.17650/1994-4098-2020-16-3-32-36.
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Objective: to perform a retrospective analysis of the quality of mammography screening in Khanty-Mansiysk State Region – Yugra from its beginning to 2018 inclusive.Materials and methods. During this investigation a throughout analysis of epidemiological indicators (breast cancer mortality and morbidity), quality indicators (coverage of the target population, cancer detection in general and early detection, sensitivity and morbidity) and mammographic screening performance indicators (projected and observed morbidity and mortality) was carried out.Results and conclusions. During this period, 572,348 women were screened, 9.7 % of whom were recommended for further screening. The coverage of the target population for one round was 33 %. Screening test sensitivity for the specified period was 80 %. The observed number of women with newly detected breast cancer cases of stage I in 2018 made 42 % (53 cases) higher in comparison with expected numbers, and in stage T2+ it made 21 % (62 cases) less. The observed number of deaths in 2018 was 23.7 % lower than expected. The above-mentioned demonstrates once again that mammography screening in Khanty-Mansiysk State Region – Yugra has led to the improvement of early diagnosis of breast cancer. This, in turn, leads to a steady decline in breast cancer mortality among women over 40 years of age.
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Maurer, Stephen M., Robin Berton Leopold, Alexander W. Thomas, Kyle Francis Concannon, Alissa Dorothy Correll, Catherine M. LaPenta, Brian L. Sprague, Sally D. Herschorn, and Claire F. Verschraegen. "Breast cancer screening in patients with cancers other than breast." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e13095-e13095. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e13095.
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e13095 Background: Screening mammography can detect early breast cancers and reduce subsequent cancer mortality. However, there is a lack of consensus as to what should trigger screening discontinuation. This absence of clear-cut guidelines means that many patients with advanced malignancies continue screening despite unclear benefit. Methods: We performed a retrospective cohort study of female patients diagnosed with a non-breast malignancy to explore the incidence and effects of screening mammography. Female patients, who were diagnosed between 2007 and 2012 with a non-breast malignancy stage II or higher, were cross-referenced with the Vermont mammography screening logs from January 1, 2007 to September 30, 2014. Additional data was collected through chart reviews, in May 2016. Results: Of 1501 women, 398 (26%) who met the above criteria had a screening mammogram within first 5 years of their cancer diagnosis. Of these 398 women, 193 (48.5%) were alive without cancer, 132 (33.2%) had died, and 73 (18.3%) were alive with cancer at the time of chart review. Of those who died, 84 (63.6%) had a stage III or IV cancer. Eighteen (4.5%) had a breast biopsy following a suspicious screening mammogram, resulting in 13 (3.3%) benign diagnoses and 5 (1.3%) breast cancer diagnoses. No patient died of breast cancer. Conclusions: Female patients diagnosed with an advanced non-breast malignancy have a mortality risk that outweighs the known breast cancer mortality benefit from screening mammography. [Table: see text]
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Semprini, Jason, and Mary Vaughan-Sarrazin. "Breast density notification with adjunctive digital breast tomosynthesis (DBT): A cost-effectiveness analysis." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 7072. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.7072.
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7072 Background: Dense breasts increase a woman's risk of developing cancer while also raising the likelihood of a missed diagnosis from traditional mammography screening. Digital Breast Tomosynthesis (DBT) has been shown to identify positive breast cancer more accurately in women with dense breasts, but no study has estimated the cost-effectiveness of this screening mode under a notification requirement. Methods: Taking the perspective of a healthcare system, we estimated the incremental cost-effectiveness ratio (ICER) of providing DBT as an alternative to mammography for 40-year old women. Model parameters reflecting risk of breast cancer, detection rates, and costs were estimated from recent meta analyses, Tufts’ CEA registry, and Medicare Fee Schedules. We used probabilistic Markov Models to estimate the ICER under uncertainty, and a time-variant model in which breast density and cancer risk change over time. Additionally, a heterogeneity analysis included all women between the ages of 40-65, while also using 1st and 2nd degree family history to calculate cancer risk. Results: In the probabilistic model, adjunctive DBT has a cost differential of $12,203, with an increase of 0.0382 quality-adjusted life years (ICER = $319,491/QALY) compared to mammography. This result was most sensitive to the probability of a missed diagnosis for women with dense breasts. At a willing-ness to pay of $50,000, adjunctive DBT had a 57% chance of being more costly and less effective than standard mammography. Conversely, DBT only had a 20% chance of being cost-effective and a 9.9% chance of being less costly and more effective. The time-variant model reported an ICER of $174,218, but adjunctive DBT became even more cost-effective after expanding the population and including family history of cancer (ICER_All Ages = $157,146; ICER_FamHist = $153,388). Conclusions: Breast density notification laws which provide additional screening via DBT are not cost-effective at a willingness to pay of $50,000. Policymakers, however, should note that many modern cancer therapeutics also exceed this threshold. As an adjunctive screening technique, DBT would result in fewer deaths and increase quality of life, but the effect is minimal and carries a high cost. Including breast density within greater risk stratification protocols, however, may prove highly cost-effective, especially for older women with a family history of cancer.
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Hellgren, Roxanna, Paul Dickman, Karin Leifland, Ariel Saracco, Per Hall, and Fuat Celebioglu. "Comparison of handheld ultrasound and automated breast ultrasound in women recalled after mammography screening." Acta Radiologica 58, no. 5 (September 30, 2016): 515–20. http://dx.doi.org/10.1177/0284185116665421.
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Background Automated breast volume scanner (ABVS) is an ultrasound (US) device with a wide scanner that sweeps over a large area of the breast and the acquired transverse images are sent to a workstation for reconstruction and review. Whether ABVS is as reliable as handheld US is, however, still not established. Purpose To compare the sensitivity and specificity of ABVS to handheld breast US for detection of breast cancer, in the situation of recall after mammography screening. Material and Methods A total of 113 women, five with bilateral suspicious findings, undergoing handheld breast US due to a suspicious mammographic finding in screening, underwent additional ABVS. The methods were assessed for each breast and each detected lesion separately and classified into two categories: breasts with mammographic suspicion of malignancy and breasts with a negative mammogram. Results Twenty-six cancers were found in 25 women. In the category of breasts with a suspicious mammographic finding (n = 118), the sensitivity of both handheld US and ABVS was 88% (22/25). The specificity of handheld US was 93.5% (87/93) and ABVS was 89.2% (83/93). In the category of breasts with a negative mammography (n = 103), the sensitivity of handheld US and ABVS was 100% (1/1). The specificity of handheld US was 100% (102/102) and ABVS was 94.1% (96/102). Conclusion ABVS can potentially replace handheld US in the investigation of women recalled from mammography screening due to a suspicious finding. Due to the small size of our study population, further investigation with larger study populations is necessary before the implementation of such practice.
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Loizidou, Kosmia, Galateia Skouroumouni, Christos Nikolaou, and Costas Pitris. "A Review of Computer-Aided Breast Cancer Diagnosis Using Sequential Mammograms." Tomography 8, no. 6 (December 6, 2022): 2874–92. http://dx.doi.org/10.3390/tomography8060241.
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Radiologists assess the results of mammography, the key screening tool for the detection of breast cancer, to determine the presence of malignancy. They, routinely, compare recent and prior mammographic views to identify changes between the screenings. In case a new lesion appears in a mammogram, or a region is changing rapidly, it is more likely to be suspicious, compared to a lesion that remains unchanged and it is usually benign. However, visual evaluation of mammograms is challenging even for expert radiologists. For this reason, various Computer-Aided Diagnosis (CAD) algorithms are being developed to assist in the diagnosis of abnormal breast findings using mammograms. Most of the current CAD systems do so using only the most recent mammogram. This paper provides a review of the development of methods to emulate the radiological approach and perform automatic segmentation and/or classification of breast abnormalities using sequential mammogram pairs. It begins with demonstrating the importance of utilizing prior views in mammography, through the review of studies where the performance of expert and less-trained radiologists was compared. Following, image registration techniques and their application to mammography are presented. Subsequently, studies that implemented temporal analysis or subtraction of temporally sequential mammograms are summarized. Finally, a description of the open access mammography datasets is provided. This comprehensive review can serve as a thorough introduction to the use of prior information in breast cancer CAD systems but also provides indicative directions to guide future applications.
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Trivedi, Usha, Toma S. Omofoye, Cindy Marquez, Callie R. Sullivan, Diane M. Benson, and Gary J. Whitman. "Mobile Mammography Services and Underserved Women." Diagnostics 12, no. 4 (April 5, 2022): 902. http://dx.doi.org/10.3390/diagnostics12040902.
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Breast cancer, the second most common cause of cancer in women, affects people across different ages, ethnicities, and incomes. However, while all women have some risk of breast cancer, studies have found that some populations are more vulnerable to poor breast cancer outcomes. Specifically, women with lower socioeconomic status and of Black and Hispanic ethnicity have been found to have more advanced stages of cancer upon diagnosis. These findings correlate with studies that have found decreased use of screening mammography services in these underserved populations. To alleviate these healthcare disparities, mobile mammography units are well positioned to provide convenient screening services to enable earlier detection of breast cancer. Mobile mammography services have been operating since the 1970s, and, in the current pandemic, they may be extremely helpful. The COVID-19 pandemic has significantly disrupted necessary screening services, and reinstatement and implementation of accessible mobile screenings may help to alleviate the impact of missed screenings. This review discusses the history and benefits of mobile mammography, especially for underserved women.
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Bae, Min Sun, Janice S. Sung, Wonshik Han, Blanca Bernard-Davila, Filipe R. Bara, Elizabeth J. Sutton, Christopher Comstock, Maxine S. Jochelson, and Elizabeth Ann Morris. "Survival outcomes of screening with breast MRI in high-risk women." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 1508. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.1508.
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1508 Background: Mammography is the only imaging modality proven to reduce mortality from breast cancer. Over the past decade, magnetic resonance imaging (MRI) screening of women with increased risk of breast cancer ( > 20% cumulative life time risk) has been recommended. However, there is little evidence that supplemental screening with MRI improves survival. The purpose of this study was to compare survival outcomes of combined screening with MRI and mammography to screening mammography alone in women at increased risk for breast cancer. Methods: A total of 3,002 women at increased risk underwent at least two screening rounds between 2001 and 2005, with at least 5 years of follow-up. 1,534 women had combined screening (MRI and mammography), and 1,468 had screening mammography alone. Cancer detection yield and survival were determined in the two groups. Results: 60 women were diagnosed with breast cancer, 38 patients in the combined screening group and 22 in the mammography-only group. Cancer yield was 24.8 per 1000 (95% CI, 17.6-33.8) combined screening and 15.0 per 1000 (95% CI, 9.4-22.6) mammography-only. No interval cancers occurred in women undergoing combined screening, while 9 interval cancers were found in women undergoing only mammography screening. During a median follow-up of 10.8 years (range, 0.7-15.2), a total of 11 recurrences and 5 deaths (4 breast cancer cause and 1 unknown cause) were found. Of the 11 recurrences, 6 were in the combined screening group and 5 were in the mammography-only group. All deaths were in the mammography-only group. The Kaplan-Meier estimate for disease-free survival showed no statistically significant difference between the two groups ( P = .325). However, patients in the combined screening group had a significantly better overall survival compared with patients in the mammography-only group ( P = .002). Conclusions: Combined screening with MRI and mammography in women with increased risk of breast cancer resulted in not only a higher cancer detection yield but also better overall survival.
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Franchini, Michela, Stefania Pieroni, Edgardo Montrucchio, Jacopo Nori Cucchiari, Cosimo Di Maggio, Enrico Cassano, Brunella Di Nubila, et al. "The P.I.N.K. Study Approach for Supporting Personalized Risk Assessment and Early Diagnosis of Breast Cancer." International Journal of Environmental Research and Public Health 18, no. 5 (March 2, 2021): 2456. http://dx.doi.org/10.3390/ijerph18052456.
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Breast cancer is a clear example of excellent survival when it is detected and properly treated in the early stage. Currently, screening of this cancer relies on mammography, which may be integrated by new imaging techniques for more exhaustive evaluation. The Personalized, Integrated, Network, Knowledge (P.I.N.K.) study is a longitudinal multicentric study involving several diagnostic centres across Italy, co-ordinated by the Italian National Research Council and co-funded by the Umberto Veronesi Foundation. Aim of the study is to evaluate the increased diagnostic accuracy in detecting cancers obtained with different combinations of imaging technologies, and find the most effective diagnostic pathway matching the characteristics of an individual patient. The study foresees the enrolment of 50,000 women over the age of 40 years presenting for breast examination and providing informed consent to data handling. So far, the 15 participating centres across Italy have recruited a total of 22,848 patients. Based on the analyses of the first 175 histopathological-proven breast cancers, mammographic sensitivity was estimated to be 61.7% (n = 108 cancers), whereas diagnostic accuracy increased by 35.5% (n = 44 cancers) when mammography was integrated with other imaging modalities (ultrasound and/or digital breast tomosynthesis). Increase was mainly determined by ultrasound alone. Given the ongoing data collection and recruitment, the number of cancers detected is too low to allow any further in-depth analysis to explore links to patient characteristics. Past studies show that the uniform approach of population screening guidelines should be revised in favour of more personalised regimens, where known standards are integrated by imaging techniques most suitable for the individual’s characteristics. With the ultimate goal of identifying early breast cancer detection strategies, our preliminary results suggest that integrated diagnostic approach could lead to a paradigm shift from an age-based regimen toward more specific and effective risk-based personalised screening regimens, in order to reduce mortality from breast cancer.
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Webb, Matthew L., Blake Cady, and James S. Michaelson. "Buckle Up for Breast Cancer—Deaths from Breast Cancer Can Be Analyzed in the Same Way as Deaths in Automobile Accidents." Oncology & Hematology Review (US) 06 (2010): 36. http://dx.doi.org/10.17925/ohr.2010.06.0.36.
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Background:Randomized population mammographic screening trials demonstrated a statistically significant mortality reduction in screened women. Studies in Sweden and The Netherlands show that screening is the main reason that the death rate has decreased in the general population, but ony limited data are available to assess this in the US. In a previous report, 75% of breast cancer deaths occurred in the small proportion of unscreened women. This conclusion needs confirmation.Methods:In a large hospital consortium, 6,997 invasive breast cancer diagnoses occurred between 1990 and 1999. Among all subsequent deaths through 2007, breast cancer deaths in Massachusetts women were documented by review of hospital and outpatient records. Regular screening was defined as two or more screening mammograms at intervals of two years or less in asymptomatic women.Results:After 12.5 (range: eight to 17) years of median follow-up, 461 deaths from breast cancer were confirmed. Seventy-two deaths (15.6%) resulted from non-palpable screen-detected cancers, 44 deaths (9.6%) resulted from palpable interval cancers, and a total of 116 deaths (25.2%) occurred in regularly screened women. Three hundred and twenty-two deaths (69.9%) occurred in women who had never had screening mammography, and 23 deaths (5%) occurred after one or more previous mammograms, none within two years of diagnosis. Thus, 345 breast cancer deaths (74.8%) occurred in women who were not regularly screened.Conclusion:The most effective method of avoiding death from breast cancer is for women to participate in regular screening mammography.
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Jha, Anamika, and Ranjit Kumar Chaudhary. "Mammography Trends in a Tertiary Care Hospital in Nepal." Journal of Nepal Health Research Council 18, no. 4 (January 21, 2021): 667–71. http://dx.doi.org/10.33314/jnhrc.v18i4.2268.
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Background: Mammography is an established screening tool for early detection of breast cancer, with several protocols used worldwide. Such screening programs and related data are lacking in less developed countries. We documented and analyzed the mammographic trends at Tribhuvan University Teaching Hospital, a tertiary care referral center, in Kathmandu, Nepal, to develop baseline data which may be helpful in further researches.Methods: In this descriptive study, imaging findings of consecutive patients who had undergone mammography between July 2016 and March 2018 were reviewed after obtaining ethical clearance from the Institutional Review Committee. Ultrasonography and histopathological examination were done as needed. Demographics, presenting complaints, breast density, Breast Imaging, Reporting, Assessment and Data System category and final diagnosis were recorded and analyzed using appropriate statistical methods.Results: There were more diagnostic mammograms (62%) than screening with mastalgia the most common presenting complaint. Breast density was less in screening group. Overall, there were more benign lesions with incidence of breast cancer being 4.4% more in the diagnostic group. The age range varied from 22 to 86 years, with 15% (n=219) below 40 years age accounting for one-third of the cases of extremely dense breast and one-fourth of the suspicious lesions. Nearly 50% of breast cancers were seen in patients less than 50 years of age.Conclusions: The study showed greater number of diagnostic than screening mammograms, with malignancies detected more often in the diagnostic group and younger age. Fewer screening studies suggest a lack of breast cancer awareness in our population who seek medical help only when symptomatic. Keywords: BIRADS; Breast Cancer; Mammography
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Ali, Kalthum Abdullah Sofi, and Salah Muhammed Fateh. "Mammographic breast density status in women aged more than 40 years in Sulaimaniyah, Iraq: a cross-sectional study." Journal of International Medical Research 50, no. 12 (December 2022): 030006052211397. http://dx.doi.org/10.1177/03000605221139712.
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Objective Mammography is the gold standard screening procedure for the early diagnosis of breast cancer. This study aimed to determine the distribution of breast density among women older than 40 years in Sulaimaniyah, Iraq, and to examine the correlations between breast density and various risk factors. Methods This cross-sectional study included 750 women who received routine mammographic breast screening at Sulaimaniyah Breast Center. Bilateral standard two-view mammographic images (craniocaudal and mediolateral oblique projections) were acquired and reported using a picture archiving and communication system. American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) assessment categories C and D were considered as dense. Results A total of 54.3% of breasts were classified as dense, with ACR-BI-RADS categories C or D. Breast density was significantly associated with age, body mass index, a family history of breast cancer, and pre-menopause, and women with no history of breastfeeding were more likely to have dense breasts than those with partial or complete breastfeeding. Conclusions This study revealed that women from Sulaimaniyah with a distinct breast-density profile at mammographic screening may have a significantly increased risk of breast cancer.
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Román, Marta, Javier Louro, Margarita Posso, Carmen Vidal, Xavier Bargalló, Ivonne Vázquez, María Jesús Quintana, et al. "Long-Term Risk of Breast Cancer after Diagnosis of Benign Breast Disease by Screening Mammography." International Journal of Environmental Research and Public Health 19, no. 5 (February 24, 2022): 2625. http://dx.doi.org/10.3390/ijerph19052625.
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Assessing the long-term risk of breast cancer after diagnosis of benign breast disease by mammography is of utmost importance to design personalised screening strategies. We analysed individual-level data from 778,306 women aged 50–69 years with at least one mammographic screening participation in any of ten breast cancer screening centers in Spain from 1996 to 2015, and followed-up until 2017. We used Poisson regression to compare the rates of incident breast cancer among women with and without benign breast disease. During a median follow-up of 7.6 years, 11,708 (1.5%) women had an incident of breast cancer and 17,827 (2.3%) had a benign breast disease. The risk of breast cancer was 1.77 times higher among women with benign breast disease than among those without (95% CI: 1.61 to 1.95). The relative risk increased to 1.99 among women followed for less than four years, and remained elevated for two decades, with relative risk 1.96 (95% CI: 1.32 to 2.92) for those followed from 12 to 20 years. Benign breast disease is a long-term risk factor for breast cancer. Women with benign breast disease could benefit from closer surveillance and personalized screening strategies.
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Clanahan, Julie M., Sanjana Reddy, Robyn B. Broach, Anne F. Rositch, Benjamin O. Anderson, E. Paul Wileyto, Brian S. Englander, and Ari D. Brooks. "Clinical Utility of a Hand-Held Scanner for Breast Cancer Early Detection and Patient Triage." JCO Global Oncology, no. 6 (September 2020): 27–34. http://dx.doi.org/10.1200/jgo.19.00205.
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PURPOSE Globally, breast cancer represents the most common cause of cancer death among women. Early cancer diagnosis is difficult in low- and middle-income countries, most of which are unable to support population-based mammographic screening. Triage on the basis of clinical breast examination (CBE) alone can be difficult to implement. In contrast, piezo-electric palpation (intelligent Breast Exam [iBE]) may improve triage because it is portable, low cost, has a short learning curve, and provides electronic documentation for additional diagnostic workup. We compared iBE and CBE performance in a screening patient cohort from a Western mammography center. METHODS Women presenting for screening or diagnostic workup were enrolled and underwent iBE then CBE, followed by mammography. Mammography was classified as negative (BI-RADS 1 or 2) or positive (BI-RADS 3, 4, or 5). Measures of accuracy and κ score were calculated. RESULTS Between April 2015 and May 2017, 516 women were enrolled. Of these patients, 486 completed iBE, CBE, and mammography. There were 101 positive iBE results, 66 positive CBE results, and 35 positive mammograms. iBE and CBE demonstrated moderate agreement on categorization (κ = 0.53), but minimal agreement with mammography (κ = 0.08). iBE had a specificity of 80.3% and a negative predictive value of 94%. In this cohort, only five of 486 patients had a malignancy; iBE and CBE identified three of these five. The two cancers missed by both modalities were small—a 3-mm retro-areolar and a 1-cm axillary tail. CONCLUSION iBE performs comparably to CBE as a triage tool. Only minimal cancers detected through mammographic screening were missed on iBE. Ultimately, our data suggest that iBE and CBE can synergize as triage tools to significantly reduce the numbers of patients who need additional diagnostic imaging in resource-limited areas.
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Ermakova, M. S., S. M. Demidov, and D. A. Demidov. "Overhaul of Radiological Mammography Check-ups for Early Malignancy Diagnosis during COVID-19 Pandemic." Creative surgery and oncology 11, no. 4 (December 21, 2021): 316–22. http://dx.doi.org/10.24060/2076-3093-2021-11-4-316-322.
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Background. The article reports the number of examinations with stationary mammography systems, in outpatient screenings, as well as in a mobile mammography survey across the Sverdlovsk Region.Aim. A study of expedience and design of radiological breast check-ups (exemplified by mammography) for early cancer diagnosis under the COVID-19 pandemic situation.Materials and methods. A survey based at the Sverdlovsk Regional Oncology Dispensary’s Department of Diagnostic Radiology analysed the expedience and design of non-invasive diagnostic procedures in a case study of breast X-ray checkups (mammography) in the Sverdlovsk Region during 2019—2020. Th e survey used the Sverdlovsk Region population statistics on breast malignancy incidence for 2019—2020.Results. According to reports, the number of outpatient screening surveys significantly decreased in 2020 vs. 2019 due to the coronavirus pandemic and effective ban on screenings and medical check-ups. Th e mobile mammography screening numbers increased more than twice in 2020 vs. 2019.Discussion. Screening measures continued during the COVID-19 pandemic. Clinicians adhered to local guidelines, while fully complying with the recommendations to contain SARS-CoV-2 infection. Th e growth of mobile mammography screenings enabled completion of the annual check-up plan, however, the breast malignancy detection rate slightly dropped in 2020 compared to 2019.Conclusion. Mammography screenings at the Sverdlovsk Regional Oncology Dispensary in 2019--2020 demonstrate the expedience and good organisation of breast radiological check-ups (mammography) in Sverdlovsk Region. Accounting for the epidemiological state of coronavirus infection, a positive trend is evident towards growing examinations and improved breast malignancy detection, which lowers mortality accordingly among the female population of Sverdlovsk Region.
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Šalát, Dušan, Denisa Nikodemová, Andrej Klepanec, Viera Lehotská, and Anna Šalátová. "DIAGNOSTIC REFERENCE LEVELS IN SCREENING MAMMOGRAPHY CENTERS IN SLOVAKIA." Radiation Protection Dosimetry 198, no. 9-11 (August 2022): 537–39. http://dx.doi.org/10.1093/rpd/ncac095.
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Abstract Optimization in mammography remains the most important tool in practice. In the optimization process, we look for a balanced relationship between image quality and patient dose. For mammographic examinations, the diagnostic reference levels (DRLs) are expressed as the average glandular dose (AGD) based on the thickness of the compressed breast. The aim of this study was to analyse DRL compliance in diagnostic mammography at 16 mammography screening centres using an automated system for tracking patient doses during the period between January 2020 and December 2020 and to subsequently propose new DRLs for the screening mammography centres in Slovakia. The new DRLs were ~20% lower than the existing national DRLs in diagnostic mammography in Slovakia and significantly lower than the achievable AGD levels published in the fourth edition of the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis.
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Thurfjell, E., M. Gelig Thurfjell, E. Egge, and N. Bjurstam. "Sensitivity and specificity of computer-assisted breast cancer detection in mammography screening." Acta Radiologica 39, no. 4 (July 1998): 384–88. http://dx.doi.org/10.1080/02841859809172450.
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Purpose: To evaluate a system of computer-assisted diagnosis (CAD) in mammography. Material and Methods: A sample of 120 sets of two-view mammograms was examined by an expert screener, a screening radiologist, a clinical radiologist, and a CAD system. The screening and clinical radiologists examined the mammograms twice, first without and then with the help of CAD. The sample consisted of first-round screening films from a two-round population-based screening, and comprised: 32 women in whom breast cancer was detected at the first screening; 10 with cancer detected during the screening interval; 32 with cancer detected at the second screening; and 46 with normal mammograms at both screenings. Results: The expert screener, the screening radiologist, the clinical radiologist, and the CAD system detected respectively 44, 41, 34 and 37 cancers. Their respective specificities were 80%, 83%, 100% and 22%. With the help of CAD, the screening radiologist detected 1 additional cancer and the clinical radiologist detected 3; their respective specificities were 80% and 100%. Conclusion: The sensitivity of the CAD system was satisfactory. The two radiologists helped by CAD achieved a modest increase in sensitivity with unaffected specificity. However, the CAD system by itself had a very low specificity and it needs improvement before it can be useful in mammographic screening.
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Evans, J. A. "Screening mammography breast cancer diagnosis in asymptomatic women." Breast 3, no. 2 (June 1994): 132–33. http://dx.doi.org/10.1016/0960-9776(94)90022-1.
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Petrić, Mirko, Adnan Šehić, and Ismira Čatović. "The significance of mammography and ultrasound examination in the diagnosis of breast cancer." Radiološke tehnologije 11, no. 1 (November 7, 2020): 23–29. http://dx.doi.org/10.48026/isnn.26373297.2020.11.1.4.
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Introduction: Mammography represents a very accessible diagnostic method that has been accepted as the initial method of examining women over the age of 40 worldwide. It is a method with a high percentage of accuracy (80-90%) in the detection of breast cancer in patients without symptoms. However, there may be a significant overlap of mammographic presentation of benign and malignant changes in the structural tissue of the breast. The ultrasound method of breast examination is invaluable in breaking down between solid and cystic changes, as well as for clarifying palpable lumps in the breast. In almost 98% of cases, ultrasound examination can distinguish whether it is a benign or malignant change. The aim of this study is to prove the correlation between mammography and ultrasound methods of breast examination.Material and methods: The examination was performed as a retrospective - prospective descriptive study in the Department for radiological and ultrasound diagnostics of the Derventa Health Center. The study included 80 female respondents who consented to the recording. Based on the performed ultrasound and mammography images, a qualitative analysis was made. A comparison of the sensitivity of the breast imaging between mammography and ultrasound imaging was performed.Results: Comparing mammography and ultrasound examination according to BI-RADS classification, based on Pearson's correlation coefficient, we concluded that there is a strong correlation between these two tests (r = 0.743), which is statistically significant (p <0.005). The correlation, in addition to having a strong connection, moves in a positive direction, that is, by increasing the value of BI-RADS of one diagnostic procedure, there is an increase in another.Conclusion: By analyzing the obtained results, we can conclude that mammography and ultrasound methods of breast examination are complementary methods, which complement each other, and which are not perfect. However, these two methods certainly have their place in breast cancer screening.
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Bruce, Laura, Jessica Kerns, W. Bradford Carter, and Thomas G. Frazier. "Five-year longitudinal mammographic follow-up after breast cancer." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 37. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.37.
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37 Background: Breast Cancer recurrences following radiation are seen in the first three to five years after treatment. As part of our Survivorship Program, annual screening mammography is a guideline following treatment with the exception of those patients who undergo bilateral mastectomy. To evaluate compliance with this guideline, we followed patients treated in 2012 for breast cancer at our institution, over the five-year period through 2017. Methods: A retrospective chart review of patients diagnosed with breast cancer in 2012 was conducted and annual mammography was assessed for compliance for a period of five-years. Compliance was defined as having annual mammography screening for five years, until recurrence or until death. Results: 252 patients were treated for Breast Cancer in 2012. Of these, 15 patients had follow-up elsewhere. 4 patients had metastatic disease at the time of diagnosis and were not included. 3 patients with male breast cancer had no mammographic follow-up. 5 patients had bilateral mastectomies and were excluded leaving 225 patients followed for compliance. Of the 225 evaluable patients, 134 (59.5%) were compliant with mammography. 126 (56.0%) had a full five years of follow-up and had no recurrent breast cancer. 158 (70.2%) had four years of follow-up. 168 patients (74.7%) had three years of follow-up. 178 (79.1%) had two years of follow-up. 190 (84.4%) had at least one year of follow-up. 14 (6.2%) died before the five year follow-up of causes not related to breast cancer. 7 (3.1%) developed metastatic disease during follow-up and no additional mammography was carried out. 7 had ipsilateral recurrence, 3 had contralateral recurrence (4.4%). Conclusions: In an upper-middle class population that is well insured and should be compliant, only 59.5% of eligible patients were compliant with mammography for five-years, until recurrence or death. Since almost 5% of patients in this cohort recurred in the breast, follow-up with annual mammography is critical. The Survivorship Care Plan (SCP) discussion with the patient is a strategy to address compliance with annual follow-up. Future studies are planned to re-evaluate compliance with annual mammography.
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Gioia, S., C. Torres, J. Cavalcanti, and A. Heringer. "Brazil Needs Organized Breast Cancer Screening: Pilot Project in Rio De Janeiro." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 31s. http://dx.doi.org/10.1200/jgo.18.54900.
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Background: In Rio de Janeiro there is only the opportunistic screening program for women with breast cancer who arrive at health facilities and with a 14% rate of mammography coverage. In countries that have implemented effective screening programs, with coverage of the target population, quality of screening, and adequate treatment, breast cancer mortality has declined. Evidence of the impact of screening on mortality by this neoplasm justifies its adoption as a public health policy, as recommended by WHO. 80% of the population use the public health system (Sistema Unico de Saude - SUS), provided by the government. This system mainly provides conventional mammography. The private insurance system covers the remaining 20%, who have access to modern technologies such as digital mammography or MRI. Aim: The breast cancer organized screening program in the community of the Andaraí, RJ is committed in assisting women asymptomatic 50-69 years from SUS. Methods: The program foresees the participation of these women for an indefinite period, free of charge, and the accomplishment of biennial digital mammography, going through the stages of early detection and diagnosis. In case of positivity for malignant disease, it will be treated properly. Results: Since April 2014 have been 350 women with an average age of 54 years. 100% of them were asymptomatic and 49% had never done before mammography. Only 1 woman presented clinical suspect aged 44 years. The screening program organized by breast cancer in the community of Andaraí, RJ presented a mammographic coverage rate of 70%. The program is contemplated in the healthcare plan of the SUS. Conclusion: Preliminary results of the study suggest that population based organized screening are feasible and age of onset mammography screening should be 50 years in Rio de Janeiro.
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Fancher, Crystal E., Anthony Scott, Ahkeel Allen, and Paul Dale. "Mammographic Screening at Age 40 or 45? What Difference Does it Make? the Potential Impact of American Cancer Society Mammography Screening Guidelines." American Surgeon 83, no. 8 (August 2017): 847–49. http://dx.doi.org/10.1177/000313481708300834.
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This is a 10-year retrospective chart review evaluating the potential impact of the most recent American Cancer Society mammography screening guidelines which excludes female patients aged 40 to 44 years from routine annual screening mammography. Instead they recommend screening mammography starting at age 45 with the option to begin screening earlier if the patient desires. The institutional cancer registry was systematically searched to identify all women aged 40 to 44 years treated for breast cancer over a 10-year period. These women were separated into two cohorts: screening mammography detected cancer (SMDC) and nonscreening mammography detected cancer (NSMDC). Statistical analysis of the cohorts was performed for lymph node status (SLN), five-year disease-free survival, and five-year overall survival. Women with SMDC had a significantly lower incidence of SLN positive cancer than the NSMDC group, 9 of 63 (14.3%) versus 36 of 81 (44 %; P < 0.001). The five-year disease-free survival for both groups was 84 per cent for SMDC and 80 per cent for NSMDC; this was not statistically significant. The five-year overall survival was statistically significant at 94 per cent for the SMDC group and 80 per cent for the NSMDC group (P < 0.05). This review demonstrates the significance of mammographic screening for early detection and treatment of breast cancer. Mammographic screening in women aged 40 to 44 detected tumors with fewer nodal metastases, resulting in improved survival and reaffirming the need for annual mammographic screening in this age group.
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Mert, Tuba. "Evaluation of knowledge and practice regarding mammography among a group of Turkish women attending a tertiary hospital." Turkish Journal of Surgery 38, no. 3 (September 1, 2022): 230–36. http://dx.doi.org/10.47717/turkjsurg.2022.5672.
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Objective: Early detection is the most important cornerstone of breast cancer in determining treatment outcome and survival. In this study, it was aimed to investigate the level of knowledge, attitude, and practice of mammography in the early diagnosis of breast cancer in a group of women. Material and Methods: Data of this descriptive study were collected under observation with the help of a questionnaire. Female patients over 40 years of age or over 30 years of age with a family history of breast cancer admitted to our general surgery outpatient clinic for a health problem other than breast were included. Results: A total of 300 female patients with a mean age of 48.7 ± 10.9 years (min-max, 33-83 years) were included. Median frequency of correct answers among the women participating in the study was 83.7% (76.0-92.0). Mean score obtained by the participants from the questionnaire was 75.7 ± 15.8 (the median score 80; 25th-75th centiles, 73.3-86.7). Slightly more than half of the patients (159 patients, 53%) had at least one mammography scan before. The level of mammography knowledge was negatively correlated with age and the number of previous mammographies, and positively correlated with education level (r= -0.700, p< 0.001; r= -0.419, p< 0.001 and r= 0.643, p< 0.001, respectively). Conclusion: Although the level of knowledge about breast cancer and early diagnosis methods in women was at a satisfactory level, it is obvious that mammography screening practice of women without any breast symptoms is very low. Therefore, it should be aimed to increase women’s awareness of cancer prevention and compliance with early diagnosis methods and to promote participation in mammography screening.