-
Journal of the National Cancer Institute Apr 2020We examined the association between annual mammographic density change (MDC) and breast cancer (BC) risk, and how annual MDC influences the association between baseline...
BACKGROUND
We examined the association between annual mammographic density change (MDC) and breast cancer (BC) risk, and how annual MDC influences the association between baseline mammographic density (MD) and BC risk.
METHODS
We used the Karolinska Mammography Project for Risk Prediction of Breast Cancer cohort of Swedish women (N = 43 810) aged 30-79 years with full access to BC risk factors and mammograms. MD was measured as dense area (cm2) and percent MD using the STRATUS method. We used the contralateral mammogram for women with BC and randomly selected a mammogram from either left or right breast for healthy women. We calculated relative area MDC between repeated examinations. Relative area MDC was categorized as decreased (>10% decrease per year), stable (no change), or increased (>10% increase per year). We used Cox proportional hazards regression to estimate the association of BC with MDC and interaction analysis to investigate how MDC modified the association between baseline MD and BC risk. All tests of statistical significance were two-sided.
RESULTS
In all, 563 women were diagnosed with BC. Compared with women with a decreased MD over time, no statistically significant difference in BC risk was seen for women with either stable MD or increasing MD (hazard ratio = 1.01, 95% confidence interval = 0.82 to 1.23, P = .90; and hazard ratio = 0.98, 95% confidence interval = 0.80 to 1.22, P = .90, respectively). Categorizing baseline MD and subsequently adding MDC did not seem to influence the association between baseline MD and BC risk.
CONCLUSIONS
Our results suggest that annual MDC does not influence BC risk. Furthermore, MDC does not seem to influence the association between baseline MD and BC risk.
Topics: Adult; Aged; Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography; Middle Aged; Proportional Hazards Models; Prospective Studies; Sweden
PubMed: 31298705
DOI: 10.1093/jnci/djz149 -
Journal of Digital Imaging Apr 2017Nowadays, the optimization in digital mammography is one of the most important challenges in diagnostic radiology. The new digital technology has introduced additional...
Nowadays, the optimization in digital mammography is one of the most important challenges in diagnostic radiology. The new digital technology has introduced additional elements to be considered in this scenario. A major goal of mammography is related to the detection of structures on the order of micrometers (μm) and the need to distinguish the different types of tissues, with very close density values. The diagnosis in mammography faces the difficulty that the breast tissues and pathological findings have very close linear attenuation coefficients within the energy range used in mammography. The aim of this study was to develop a methodology for optimizing exposure parameters of digital mammography based on a new Figure of Merit: FOM ≡ (IQF)/AGD, considering the image quality and dose. The study was conducted using the digital mammography Senographe DS/GE, and CDMAM and TORMAM phantoms. The characterization of clinical practice, carried out in the mammography system under study, was performed considering different breast thicknesses, the technical parameters of exposure, and processing options of images used by the equipment's automatic exposure system. The results showed a difference between the values of the optimized parameters and those ones chosen by the automatic system of the mammography unit, specifically for small breast. The optimized exposure parameters showed better results than those obtained by the automatic system of the mammography, for the image quality parameters and its impact on detection of breast structures when analyzed by radiologists.
Topics: Adult; Breast; Female; Humans; Mammography; Middle Aged; Organ Size; Phantoms, Imaging; Radiation Dosage; Radiographic Image Enhancement
PubMed: 27896452
DOI: 10.1007/s10278-016-9928-3 -
Scientific Data Mar 2023Breast carcinoma is the second largest cancer in the world among women. Early detection of breast cancer has been shown to increase the survival rate, thereby...
Breast carcinoma is the second largest cancer in the world among women. Early detection of breast cancer has been shown to increase the survival rate, thereby significantly increasing patients' lifespan. Mammography, a noninvasive imaging tool with low cost, is widely used to diagnose breast disease at an early stage due to its high sensitivity. Although some public mammography datasets are useful, there is still a lack of open access datasets that expand beyond the white population as well as missing biopsy confirmation or with unknown molecular subtypes. To fill this gap, we build a database containing two online breast mammographies. The dataset named by Chinese Mammography Database (CMMD) contains 3712 mammographies involved 1775 patients, which is divided into two branches. The first dataset CMMD1 contains 1026 cases (2214 mammographies) with biopsy confirmed type of benign or malignant tumors. The second dataset CMMD2 includes 1498 mammographies for 749 patients with known molecular subtypes. Our database is constructed to enrich the diversity of mammography data and promote the development of relevant fields.
Topics: Female; Humans; Biopsy; Breast Diseases; Breast Neoplasms; Mammography
PubMed: 36882402
DOI: 10.1038/s41597-023-02025-1 -
Health Expectations : An International... Aug 2017There is substantial expert disagreement about the use of mammography to screen for breast cancer, and this disagreement routinely plays out in the media. Evidence...
BACKGROUND
There is substantial expert disagreement about the use of mammography to screen for breast cancer, and this disagreement routinely plays out in the media. Evidence suggests that some women are aware of the controversy over mammography, but less is known about whether immigrant and other underserved women have heard about it and, if so, how they react to it.
OBJECTIVE
To explore immigrant women's awareness of and reactions to mammography controversy.
DESIGN
Community-engaged qualitative study: we conducted six focus groups with 53 women aged 35-55 from three immigrant communities (Somali, Latina and Hmong) in a major US metropolitan area. A grounded theory approach was used to identify themes; NVivo 10 was used to enhance analyses.
RESULTS
Several themes emerged: (i) low awareness of mammography controversy across groups, despite self-reported attention to health information; (ii) high intentions to be screened, even after being told about the controversy; (iii) few reported discussions of mammography's risks and benefits with clinicians; (iv) substantial interest in learning more about mammography and breast cancer, but some low self-efficacy to obtain such information; and (v) questions about whether health recommendations matter and what qualifies as evidence.
CONCLUSION
Given on-going expert disagreement about mammography screening, it is important for clinicians to help women understand mammography's risks and benefits so they can make an informed choice. This is particularly critical for immigrant and other underserved women, who may be less able to access, attend to, process, retain and act on health information (a phenomenon known as communication inequality).
Topics: Adult; Awareness; Breast Neoplasms; Early Detection of Cancer; Emigrants and Immigrants; Ethnicity; Female; Focus Groups; Health Knowledge, Attitudes, Practice; Humans; Mammography; Middle Aged; Socioeconomic Factors; United States
PubMed: 27561593
DOI: 10.1111/hex.12494 -
Gaceta Medica de Mexico 2021Promoting breast cancer (BC) detection in women by means of mammography is a viable strategy to reduce the number of diagnoses at clinically advanced stages and...
INTRODUCTION
Promoting breast cancer (BC) detection in women by means of mammography is a viable strategy to reduce the number of diagnoses at clinically advanced stages and mortality.
OBJECTIVES
To describe the results reported by mammography studies in women, carried out nationally during 2013-2017, and to analyze the spatiotemporal trend of Breast Imaging Reporting and Data System (BIRADS) categories suggestive of malignancy by State.
METHOD
Longitudinal, analytical design that included information on mammography studies of women according to age group (< 40 and ≥ 40), evaluated in units of the Ministry of Health of Mexico during 2013-2017. The frequency of BIRADS categories and a standardized rate suggestive of malignancy (categories 4 and 5) were estimated in women aged ≥ 40 years, and spatial statistics were used to analyze the trend by State.
RESULTS
A total of 3,659,151 mammograms were analyzed, 98.5 % in women aged ≥ 40 years. The malignancy-suggestive rate decreased from 38.3 (2013) to 31 (2017) per 100,000 women aged ≥ 40 years; however, the risk of detection increased up to 13 times in ten States.
CONCLUSIONS
Although the risk of detection in categories suggestive of malignancy decreased at the national level, some States need to reinforce the application of BC detection programs through mammography and increase the participation of the target population.
Topics: Adult; Age Factors; Aged; Breast Neoplasms; Female; Humans; Linear Models; Mammography; Mexico; Middle Aged; Patient Participation; Space-Time Clustering; Spatio-Temporal Analysis
PubMed: 34270528
DOI: 10.24875/GMM.M21000541 -
Asian Pacific Journal of Cancer... 2016Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs,...
Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs, and no regular visits to a physician. Thus research is needed to explore factors associated with repeated mammography participation. Applying the concept of perceived risk as the guiding model, this study aimed to test the fit and strength of the relationship between perceived risk and physician recommendation in explaining repeat mammography. A total of 601 women, aged 50 years and older referred to mammography centers in region 6, were recruited via a convenience sampling method. Using path analysis, family history of breast cancer and other types of cancer were modeled as antecedent perceived risk, and physician recommendation and knowledge were modeled as an antecedent of the number of mammography visits. The model explained 49% of the variance in repeat mammography. The two factors of physician recommendation and breast self-examination had significant direct effects (P < 0.05) on repeat mammography. Perceived risk, knowledge, and family history of breast cancer had significant indirect effects on repeat mammography through physician recommendation. The results of this study provide a background for further research and interventions not only on Iranian women but also on similar cultural groups and immigrants who have been neglected to date in the mammography literature.
Topics: Breast Neoplasms; Early Detection of Cancer; Female; Follow-Up Studies; Genetic Predisposition to Disease; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Iran; Mammography; Middle Aged; Patient Acceptance of Health Care; Physician's Role; Physician-Patient Relations; Prognosis; Risk Factors
PubMed: 27165251
DOI: 10.7314/apjcp.2016.17.s3.161 -
Korean Journal of Radiology May 2023
Review
Topics: Humans; Female; Breast Neoplasms; Early Detection of Cancer; Mammography
PubMed: 37056158
DOI: 10.3348/kjr.2023.0012 -
BMC Cancer Feb 2022The aim of this systematic review was to evaluate the evidence and clinical outcomes of screening interventions and implementation trials in sub-Saharan Africa (SSA) and...
BACKGROUND
The aim of this systematic review was to evaluate the evidence and clinical outcomes of screening interventions and implementation trials in sub-Saharan Africa (SSA) and also appraise some ethical issues related to screening in the region through quantitative and qualitative narrative synthesis of the literature.
METHODS
We searched Pubmed, OvidMEDLINE, Embase, and Web of Science to identify studies published on breast cancer screening interventions and outcomes in SSA. Descriptive statistics were used to summarize the frequency and proportions of extracted variables, and narrative syntheses was used to evaluate the clinical outcomes of the different screening modalities. The mixed methods appraisal tool was used to assess the quality of studies included in the review.
RESULTS
Fifteen studies were included, which consisted of 72,572 women in ten countries in SSA. 63% (8/15) of the included publications evaluated Clinical Breast Examination (CBE), 47% (7/15) evaluated mammography and 7% (1/15) evaluated ultrasound screening. The cancer detection rate was < 1/1000 to 3.3/1000 and 3.3/100 to 56/1000 for CBE and mammography screening respectively. There was a lot of heterogeneity in CBE methods, target age for screening and no clear documentation of screening interval. Cost-effective analyses showed that CBE screening linked to comprehensive cancer care is most cost effective. There was limited discussion of the ethics of screening, including the possible harms of screening in the absence of linkage to care. The gap between conducting good screening program and the appropriate follow-up with diagnosis and treatment remains one of the major challenges of screening in SSA.
DISCUSSION
There is insufficient real-world data to support the systematic implementation of national breast cancer screening in SSA. Further research is needed to answer important questions about screening, and national and international partnerships are needed to ensure that appropriate diagnostic and treatment modalities are available to patients who screen positive.
Topics: Adolescent; Adult; Africa South of the Sahara; Breast Neoplasms; Early Detection of Cancer; Ethics, Medical; Female; Health Plan Implementation; Humans; Mammography; Middle Aged; Patient Acceptance of Health Care; Qualitative Research; Young Adult
PubMed: 35197002
DOI: 10.1186/s12885-022-09299-5 -
Radiology. Imaging Cancer Sep 2019To apply previously published benefit-to-risk ratio methods for mammography and molecular breast imaging (MBI) risk estimates to an expanded range of mammographic...
Comparative Benefit-to-Radiation Risk Ratio of Molecular Breast Imaging, Two-Dimensional Full-Field Digital Mammography with and without Tomosynthesis, and Synthetic Mammography with Tomosynthesis.
PURPOSE
To apply previously published benefit-to-risk ratio methods for mammography and molecular breast imaging (MBI) risk estimates to an expanded range of mammographic screening techniques, compressed breast thicknesses, and screening views.
MATERIALS AND METHODS
Only previously published estimates were used; therefore, this study was exempt from the requirement to obtain institutional review board approval. Benefit-to-risk ratios were calculated as the ratio of breast cancer deaths averted and lives lost to screening over 10-year intervals starting at age 40 years for MBI, two-dimensional (2D) full-field digital mammography (FFDM) alone, 2D FFDM with synthetic mammography, and 2D FFDM with tomosynthesis for two-, four-, and five-view screening mammography and compressed breast thicknesses of 20-29 mm, 50-59 mm, and 80-89 mm.
RESULTS
Central estimates of the benefit-to-risk ratios ranged from 3 to 179 for screening mammography and from 5 to 9 for MBI. Benefit-to-risk ratios for MBI were inferior to those for mammography for most scenarios, but MBI may be performed at an equal or superior benefit-to-risk ratio for women aged 40-59 years with a compressed breast thickness of at least 80 mm and for those undergoing mammographic screening examinations with four or five views per breast. The benefit-to-risk ratios across all ages with use of tomosynthesis plus 2D FFDM as a screening examination were 45% lower than those for tomosynthesis plus synthetic mammography.
CONCLUSION
Benefit-to-risk ratios for MBI are within the lower range of those for mammography when accounting for variation in mammography technique, compressed breast thickness, and age. Benefit-to-risk ratios of synthetic mammography plus tomosynthesis are superior to those of tomosynthesis plus 2D FFDM. Breast, Mammography, Molecular Imaging, Molecular Imaging-Cancer, Radiation Safety, Radionuclide Studies, Screening, Tomosynthesis© RSNA, 2019See also the commentary by Hruska in this issue.
Topics: Adult; Breast; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Middle Aged; Odds Ratio; Risk Assessment
PubMed: 33778669
DOI: 10.1148/rycan.2019190005 -
European Journal of Radiology Jun 2024This review provides an overview of the current state of artificial intelligence (AI) technology for automated detection of breast cancer in digital mammography (DM) and... (Review)
Review
PURPOSE
This review provides an overview of the current state of artificial intelligence (AI) technology for automated detection of breast cancer in digital mammography (DM) and digital breast tomosynthesis (DBT). It aims to discuss the technology, available AI systems, and the challenges faced by AI in breast cancer screening.
METHODS
The review examines the development of AI technology in breast cancer detection, focusing on deep learning (DL) techniques and their differences from traditional computer-aided detection (CAD) systems. It discusses data pre-processing, learning paradigms, and the need for independent validation approaches.
RESULTS
DL-based AI systems have shown significant improvements in breast cancer detection. They have the potential to enhance screening outcomes, reduce false negatives and positives, and detect subtle abnormalities missed by human observers. However, challenges like the lack of standardised datasets, potential bias in training data, and regulatory approval hinder their widespread adoption.
CONCLUSIONS
AI technology has the potential to improve breast cancer screening by increasing accuracy and reducing radiologist workload. DL-based AI systems show promise in enhancing detection performance and eliminating variability among observers. Standardised guidelines and trustworthy AI practices are necessary to ensure fairness, traceability, and robustness. Further research and validation are needed to establish clinical trust in AI. Collaboration between researchers, clinicians, and regulatory bodies is crucial to address challenges and promote AI implementation in breast cancer screening.
Topics: Breast Neoplasms; Humans; Female; Artificial Intelligence; Mammography; Radiographic Image Interpretation, Computer-Assisted; Early Detection of Cancer
PubMed: 38640824
DOI: 10.1016/j.ejrad.2024.111457