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Radiography (London, England : 1995) Jan 2024A positive experience in mammography is essential for increasing patient attendance and reattendance at these examinations, whether conducted for diagnostic or screening... (Review)
Review
INTRODUCTION
A positive experience in mammography is essential for increasing patient attendance and reattendance at these examinations, whether conducted for diagnostic or screening purposes. Mammograms indeed facilitate early disease detection, enhance the potential for cure, and consequently reduce breast cancer mortality. The main objective of this review was to identify and map the strategies aiming to improve the patient experience in diagnostic and screening mammography.
METHODS
This scoping review was performed following the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches were performed through databases of MEDLINE, Embase.com, CINAHL, APA PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, ProQuest Dissertation and Theses, and three clinical trial registries. This review considered studies evaluating the effect of interventions, occurring within the mammography department, on the patient experience.
RESULTS
The literature search yielded 8113 citations of which 60, matching the inclusion criteria, were included. The strategies were classified into eight categories. The most represented one was breast compression and positioning, followed by relaxation techniques and analgesic care, communication and information, screening equipment, examination procedures, patient-related factors, physical environment, and finally staff characteristics. The studied outcomes related to patient experience were mainly pain, anxiety, comfort, and satisfaction. Other types of outcomes were also considered in the studies such as image quality, technical parameters, or radiation dose. Most studies were conducted by radiographers, on female patients, and none mentioned the inclusion of male or transgender patients.
CONCLUSION
This review outlined a diversity of strategies to improve patient experience, although technique-based interventions were predominant. Further research is warranted, notably on psychological strategies, and on men and transgender people.
IMPLICATIONS FOR PRACTICE
This scoping review provides guidance to healthcare providers and services for better patient/client-centered care.
Topics: Female; Humans; Breast Neoplasms; Early Detection of Cancer; Mammography; Pain; Patient Satisfaction
PubMed: 38141428
DOI: 10.1016/j.radi.2023.11.016 -
Journal of Medical Radiation Sciences Sep 2020As an efficient, effective and moderately inexpensive modality, mammography has been implemented as a cancer screening tool and in diagnostic management. However,... (Review)
Review
INTRODUCTION
As an efficient, effective and moderately inexpensive modality, mammography has been implemented as a cancer screening tool and in diagnostic management. However, appropriate breast compression is necessary for optimal outcomes. Current key measures of compression force are subjective and variable, giving rise to the concept of a 'personalised' pressure-standardisation protocol.
METHODS
A scoping review of the literature was performed using the Arksey and O'Malley framework to explore the existing force- and pressure-standardisation protocols in clinical application. A comprehensive search strategy and standardised study selection and evaluation were completed. This synthesis of existing knowledge can lead to the implementation of mechanically standardised mammographic compression pressure as a feasible tailored approach to clinical practice. Four databases (PubMed, MEDLINE, Embase and Scopus) were searched from the databases' inception to 13 December 2019 for relevant information, and eighteen articles were selected for analysis.
RESULTS
In addition to current protocol comparison, emerging key concepts include the reasoning behind standardisation, the benefits of improved diagnostic outcomes/decreased pain with negligible change in image quality and average glandular dose (AGD), and the recommendation of a 10kPa (approximate) pressure-standardisation protocol. Research to date is largely based abroad (Netherlands), with a strong focus on screening practices. Consequently, several gaps in the current literature were identified as potential directions for future investigation.
CONCLUSIONS
As a suggested mammographic guideline, compression pressures of approximately 10kPa aid in image acquisition reproducibility both within and between women; pain levels decrease, with minimal variations to breast thickness, AGD and image quality.
Topics: Breast; Humans; Mammography; Pain; Pressure; Reference Standards
PubMed: 32420700
DOI: 10.1002/jmrs.400 -
Statistical Methods in Medical Research May 2023Screening mammography is the primary preventive strategy for early detection of breast cancer and an essential input to breast cancer risk prediction and application of...
Screening mammography is the primary preventive strategy for early detection of breast cancer and an essential input to breast cancer risk prediction and application of prevention/risk management guidelines. Identifying regions of interest within mammogram images that are associated with 5- or 10-year breast cancer risk is therefore clinically meaningful. The problem is complicated by the irregular boundary issue posed by the semi-circular domain of the breast area within mammograms. Accommodating the irregular domain is especially crucial when identifying regions of interest, as the true signal comes only from the semi-circular domain of the breast region, and noise elsewhere. We address these challenges by introducing a proportional hazards model with imaging predictors characterized by bivariate splines over triangulation. The model sparsity is enforced with the group lasso penalty function. We apply the proposed method to the motivating Joanne Knight Breast Health Cohort to illustrate important risk patterns and show that the proposed method is able to achieve higher discriminatory performance.
Topics: Humans; Female; Mammography; Breast Neoplasms; Early Detection of Cancer; Risk; Proportional Hazards Models
PubMed: 36951095
DOI: 10.1177/09622802231160551 -
The British Journal of Radiology Feb 2020In this article, we explore the evidence around the relative benefits and harms of breast cancer screening using a single radiologist to examine each female's mammograms... (Review)
Review
In this article, we explore the evidence around the relative benefits and harms of breast cancer screening using a single radiologist to examine each female's mammograms for signs of cancer (single reading), or two radiologists (double reading). First, we briefly explore the historical evidence using film-screen mammography, before providing an in-depth description of evidence using digital mammography. We classify studies according to which exact version of double reading they use, because the evidence suggests that effectiveness of double reading is contingent on whether the two radiologists are blinded to one another's decisions, and how the decisions of the two radiologists are integrated. Finally, we explore the implications for future mammography, including using artificial intelligence as the second reader, and applications to more complex three-dimensional imaging techniques such as tomosynthesis.
Topics: Aged; Aged, 80 and over; Breast Neoplasms; Early Detection of Cancer; Female; Forecasting; Humans; Mammography; Middle Aged
PubMed: 31617741
DOI: 10.1259/bjr.20190610 -
Tomography (Ann Arbor, Mich.) Jun 2023Breast cancer remains the leading cause of cancer-related deaths in women worldwide. Current screening regimens and clinical breast cancer risk assessment models use... (Review)
Review
Breast cancer remains the leading cause of cancer-related deaths in women worldwide. Current screening regimens and clinical breast cancer risk assessment models use risk factors such as demographics and patient history to guide policy and assess risk. Applications of artificial intelligence methods (AI) such as deep learning (DL) and convolutional neural networks (CNNs) to evaluate individual patient information and imaging showed promise as personalized risk models. We reviewed the current literature for studies related to deep learning and convolutional neural networks with digital mammography for assessing breast cancer risk. We discussed the literature and examined the ongoing and future applications of deep learning techniques in breast cancer risk modeling.
Topics: Female; Humans; Breast Neoplasms; Artificial Intelligence; Deep Learning; Mammography; Breast
PubMed: 37368543
DOI: 10.3390/tomography9030091 -
Preventing Chronic Disease Nov 2018Although breast cancer deaths have declined, the mortality rate among women from medically underserved communities is disproportionally high. Screening mammography is...
INTRODUCTION
Although breast cancer deaths have declined, the mortality rate among women from medically underserved communities is disproportionally high. Screening mammography is the most effective tool for detecting breast cancer in its early stages, yet many women from medically underserved communities do not have adequate access to screening mammograms. Mobile mammography may be able to bridge this gap by providing screening mammograms at no cost or low cost and delivering services to women in their own neighborhoods, thus eliminating cost and transportation barriers. The objective of this systematic review was to describe the scope and impact of mobile mammography programs in promoting mammographic screening participation among medically underserved women.
METHODS
We searched electronic databases for English-language articles published in the United States from January 2010 through March 2018 by using the terms "mobile health unit," "mammogram," "mammography," and "breast cancer screening." Of the 93 articles initially identified, we screened 55; 16 were eligible to be assessed and 10 qualified for full text review and data extraction. Each study was coded for study purpose, research design, data collection, population targeted, location, sample size, outcomes, predictors, analytical methods, and findings.
RESULTS
Of the 10 studies that qualified for review, 4 compared mobile mammography users with users of fixed units, and the other 6 characterized mobile mammography users only. All the mobile mammography units included reached underserved women. Most of the women screened in mobile units were African American or Latina, low income, and/or uninsured. Mobile mammography users reported low adherence to 1-year (12%-34%) and 2-year (40%-48%) screening guidelines. Some difficulties faced by mobile clinics were patient retention, patient follow-up of abnormal or inconclusive findings, and women inaccurately perceiving their breast cancer risk.
CONCLUSION
Mobile mammography clinics may be effective at reaching medically underserved women. Adding patient navigation to mobile mammography programs may promote attendance at mobile sites and increase follow-up adherence. Efforts to promote mammographic screening should target women from racial/ethnic minority groups, women from low-income households, and uninsured women. Future research is needed to understand how to best improve visits to mobile mammography clinics.
Topics: Age Distribution; Breast Neoplasms; Female; Health Behavior; Health Services Accessibility; Health Status Disparities; Humans; Mammography; Mass Screening; Medically Underserved Area; Mobile Health Units; Risk Assessment; United States; Vulnerable Populations
PubMed: 30447104
DOI: 10.5888/pcd15.180291 -
Breast Cancer Research : BCR Feb 2022Improved breast cancer risk assessment models are needed to enable personalized screening strategies that achieve better harm-to-benefit ratio based on earlier detection... (Review)
Review
BACKGROUND
Improved breast cancer risk assessment models are needed to enable personalized screening strategies that achieve better harm-to-benefit ratio based on earlier detection and better breast cancer outcomes than existing screening guidelines. Computational mammographic phenotypes have demonstrated a promising role in breast cancer risk prediction. With the recent exponential growth of computational efficiency, the artificial intelligence (AI) revolution, driven by the introduction of deep learning, has expanded the utility of imaging in predictive models. Consequently, AI-based imaging-derived data has led to some of the most promising tools for precision breast cancer screening.
MAIN BODY
This review aims to synthesize the current state-of-the-art applications of AI in mammographic phenotyping of breast cancer risk. We discuss the fundamentals of AI and explore the computing advancements that have made AI-based image analysis essential in refining breast cancer risk assessment. Specifically, we discuss the use of data derived from digital mammography as well as digital breast tomosynthesis. Different aspects of breast cancer risk assessment are targeted including (a) robust and reproducible evaluations of breast density, a well-established breast cancer risk factor, (b) assessment of a woman's inherent breast cancer risk, and (c) identification of women who are likely to be diagnosed with breast cancers after a negative or routine screen due to masking or the rapid and aggressive growth of a tumor. Lastly, we discuss AI challenges unique to the computational analysis of mammographic imaging as well as future directions for this promising research field.
CONCLUSIONS
We provide a useful reference for AI researchers investigating image-based breast cancer risk assessment while indicating key priorities and challenges that, if properly addressed, could accelerate the implementation of AI-assisted risk stratification to future refine and individualize breast cancer screening strategies.
Topics: Artificial Intelligence; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography
PubMed: 35184757
DOI: 10.1186/s13058-022-01509-z -
The British Journal of Radiology Apr 2022Contrast-enhanced spectral mammography (CESM) breast biopsy has been recently introduced into clinical practice. This short communication describes the technique and...
OBJECTIVE
Contrast-enhanced spectral mammography (CESM) breast biopsy has been recently introduced into clinical practice. This short communication describes the technique and potential as an alternative to MRI-guided biopsy.
METHODS AND MATERIALS
An additional abnormality was detected on a breast MRI examination in a patient with lobular carcinoma. The lesion was occult on conventional mammography, tomosynthesis and ultrasound and required histological diagnosis. Traditionally, this would have necessitated an MRI-guided breast biopsy, but was performed under CESM guidance.
RESULTS
A diagnostic CESM study was performed to ensure the lesion visibility with CESM and then targeted under CESM guidance. A limited diagnostic study, CESM scout and paired images for stereotactic targeting were obtained within a 10 min window following a single injection of iodinated contrast agent. The time from positioning in the biopsy device to releasing compression after biopsy and marker clip placement was 15 min. The biopsy confirmed the presence of multifocal breast cancer.
CONCLUSION
CESM-guided breast biopsy is a new technique that can be successfully used as an alternative to MRI-guided breast biopsy.
ADVANCES IN KNOWLEDGE
CESM-guided biopsy can be used to sample breast lesions which remain occult on standard mammography and ultrasound.
Topics: Breast Neoplasms; Contrast Media; Female; Humans; Image-Guided Biopsy; Magnetic Resonance Imaging; Mammography; Sensitivity and Specificity
PubMed: 35015574
DOI: 10.1259/bjr.20211287 -
Journal of Medical Radiation Sciences Sep 2020To investigate compliance to the '30% rule' and key factors which may influence visualisation of the pectoralis major muscle (PMM) on the craniocaudal (CC) view of the...
INTRODUCTION
To investigate compliance to the '30% rule' and key factors which may influence visualisation of the pectoralis major muscle (PMM) on the craniocaudal (CC) view of the breast.
METHODS
A retrospective review of 2688 paired full-field digital mammography (FFDM) CC view mammograms of women attending BreastScreen NSW between August and October 2015 was undertaken. PMM visualisation and measurements of PMM width and length, compressed breast thickness, the posterior nipple line (PNL) and age were recorded. Statistical analysis was performed using descriptive and inferential statistics to investigate associations between key breast measurements, age and PMM visualisation.
RESULTS
PMM visualisation was reported in 10.4% of images unilaterally (one breast, left or right only), 14.1% bilaterally (both left and right breasts) and 24.5% overall (unilateral and bilateral combined). There was little or no correlations between PMM length or width and age, breast compressed thickness or PNL. Multiple logistic regression analysis found that up to 15% of the variance in visualisation of the PMM was accounted for by the predictors overall. While some predictors provided a statistically significant contribution to the model, the contribution was small and the odds ratio for all predictors approximated 1.
CONCLUSION
This research could not replicate the '30% rule', and visualisation of the PMM was determined not to be influenced by the variables investigated. The significance of the 'rule' itself must be challenged where the vast majority of images (70-85%) do not comply, and there is no requirement for repeat imaging if the 'rule' is not met. Further research should be undertaken to validate this study including analysis of diagnostic images for comparison.
Topics: Breast; Humans; Image Processing, Computer-Assisted; Mammography; Pectoralis Muscles; Practice Guidelines as Topic
PubMed: 32567806
DOI: 10.1002/jmrs.404 -
Journal of Nuclear Medicine : Official... Feb 2016Breast-dedicated radionuclide imaging systems show promise for increasing clinical sensitivity for breast cancer while minimizing patient dose and cost. We present... (Review)
Review
Breast-dedicated radionuclide imaging systems show promise for increasing clinical sensitivity for breast cancer while minimizing patient dose and cost. We present several breast-dedicated coincidence-photon and single-photon camera designs that have been described in the literature and examine their intrinsic performance, clinical relevance, and impact. Recent tracer development is mentioned, results from recent clinical tests are summarized, and potential areas for improvement are highlighted.
Topics: Breast; Breast Neoplasms; Female; Humans; Mammography; Organ Specificity; Radionuclide Imaging; Radiopharmaceuticals
PubMed: 26834101
DOI: 10.2967/jnumed.115.157883