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BMC Public Health Aug 2023In Germany, all women aged 50-69 have been invited to biennial mammography screening since 2009. We aimed to assess longitudinal adherence over ten years in women aged...
BACKGROUND
In Germany, all women aged 50-69 have been invited to biennial mammography screening since 2009. We aimed to assess longitudinal adherence over ten years in women aged 50 in 2009 and characterize the different adherence groups.
METHODS
Using the German Pharmacoepidemiological Research Database (GePaRD, ~ 20% of the German population), we included women aged 50 in 2009 (baseline) with continuous health insurance coverage and without breast cancer or in-situ-carcinoma. We followed them until age 59 and categorized them according to mammography screening participation into the following groups: never, 1-2, 3-4, 5-6 times. We characterized these groups, inter alia, regarding the use of other preventive measures, non-screening mammography (i.e., mammography outside the organized screening program) and menopausal hormone therapy.
RESULTS
Overall, 82,666 women were included. Of these, 27.6% never participated in the screening program, 15.1% participated 1-2 times, 31.7% participated 3-4 times and 25.6% participated regularly (5-6 times). Among regular participants, 91% utilized other preventive measures (e.g., cervical cancer screening, general health checkup) before baseline as compared to 66% among non-participants. Menopausal hormone therapy was least common among non-participants (11% vs. 18% among regular participants). Among non-participants, the proportions using ≥ 1, ≥ 2, and ≥ 3 non-screening mammographies between age 50-59 were 25%, 18%, and 15%, respectively.
CONCLUSIONS
Using a large cohort based on claims data, this study provides novel insights into longitudinal adherence to the mammography screening program and the use of mammography outside of the program in Germany. Between age 50-59, 57% of eligible women participated at least three times in the German mammography screening program and 28% (~ 3 in 10 women) never participated. Among non-participants, 15% had at least three non-screening mammographies during this period, indicating potential gray screening. Participants more often utilized other preventive measures as compared to non-participants.
Topics: Humans; Female; Early Detection of Cancer; Uterine Cervical Neoplasms; Mammography; Breast Neoplasms; Databases, Factual
PubMed: 37653487
DOI: 10.1186/s12889-023-16589-5 -
Radiology Mar 2022
Topics: Breast; Humans; Mammography
PubMed: 34904880
DOI: 10.1148/radiol.212856 -
Tomography (Ann Arbor, Mich.) Dec 2022Radiologists assess the results of mammography, the key screening tool for the detection of breast cancer, to determine the presence of malignancy. They, routinely,... (Review)
Review
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.
Topics: Humans; Female; Breast Neoplasms; Mammography; Diagnosis, Computer-Assisted; Breast; Computers
PubMed: 36548533
DOI: 10.3390/tomography8060241 -
Radiography (London, England : 1995) Aug 2022Breast cancer is the most common malignancy in women. Mammography and ultrasound are commonly used in a clinical environment as the first choice for breast cancer... (Review)
Review
Comparison of the diagnostic performance of Magnetic Resonance Imaging (MRI), ultrasound and mammography for detection of breast cancer based on tumor type, breast density and patient's history: A review.
OBJECTIVE
Breast cancer is the most common malignancy in women. Mammography and ultrasound are commonly used in a clinical environment as the first choice for breast cancer detection. Magnetic Resonance Imaging (MRI) has been reported to reveal additional information. In the following review MRI, Ultrasound (US) and Mammography (MM) are all compared in terms of their diagnostic performance on breast cancer detection, depending on tumor type, breast density and patient's history.
KEY FINDINGS
Evaluating each modality alone, MRI provided an overall sensitivity and specificity of 94.6% (range 85.7%-100%) and 74.2% (range 25%-100%) respectively, while mammography showed that the overall sensitivity was at 54.5% (range 27%-86.8%) and specificity was 85.5% (range 62.9%-98.8%). The overall sensitivity and specificity of ultrasound was 67.2% (range 26.9%-87.5%) and 76.8% (range 18.8%-96.9%). When combining the results of all three techniques, it resulted in a sensitivity of 97.7% (range 95%-100%) and a specificity of 63.3% (range 37.1%-87.5%). In addition, contrast-enhanced mammography (CE-MM) and MRI (CE-MRI) illustrated an overall sensitivity and specificity for CE-MM was 90.5% (range 80.9%-100%) and 52.6% (range 15%-76.1%) and for CE-MRI, the overall sensitivity and specificity was 91.5% (range 89.1%-93.8%) and 64.7% (range 43.7%-85.7%).
CONCLUSION
As modalities alone, the highest sensitivity has been observed for MRI and the lowest sensitivity for mammography regardless breast type, density, and history. Sensitivity is even more increased from the combination of US + MRI or MM + MRI or MRI + MM + US. The specificity seems to be affected by the size, type of the tumor and patient's history, however based on breast density, the highest specificity was observed by US alone.
IMPLICATIONS FOR PRACTICE
Breast cancer screening is of outmost importance and identifying the best technique will improve cancer management. Combining techniques increases diagnostic ability compared with using modalities alone. CE-MM can be a viable option in dense breast tissue when there are contraindications to MRI as it also has high sensitivity based on the type of breast cancer.
Topics: Breast Density; Breast Neoplasms; Female; Humans; Magnetic Resonance Imaging; Mammography; Ultrasonography, Mammary
PubMed: 35148941
DOI: 10.1016/j.radi.2022.01.006 -
Clinical Imaging Apr 2020Quality and patient safety are essential to the practice of radiology. "Quality is our image" is the slogan for the American College of Radiology (ACR), which has...
Quality and patient safety are essential to the practice of radiology. "Quality is our image" is the slogan for the American College of Radiology (ACR), which has embraced the quality and safety movement as a central tenet. The impact of advances in radiology on diagnosis and management of complex medical disorders cannot be understated. Nevertheless, these revolutionary technologies do come at a cost. Increasing utilization of advanced imaging in emergency departments throughout the country poses challenges both in terms of appropriate use and management of radiation dose. The indispensable place advanced imaging plays in diagnosis has necessitated guidelines and accountability to protect patients and radiology staff. In this series, we have created a concise discourse on what we have determined to be the essentials of the economics of quality and safety as it pertains to radiology. In this first article, we summarize the accreditation programs in radiology, their legislative background, and the associated financial and market responses that have subsequently resulted. We discuss the progression from historical predecessors to the passage of the Mammography Quality and Safety Act (MQSA), which served as a model for subsequent laws governing the quality and safety of other imaging modalities. These laws have had real economic implications for radiology practices seeking to meet new increasingly stringent guidelines. We also break down the costs of participation in the ACR accreditation and center of excellence programs.
Topics: Accreditation; Humans; Mammography; Radiology; United States
PubMed: 31812348
DOI: 10.1016/j.clinimag.2019.09.003 -
Acta Clinica Croatica Apr 2023Mammography is one of the gold standard screening tests for breast cancer. The effects of mammography procedure on blood parameters are not known. This study aimed to...
Mammography is one of the gold standard screening tests for breast cancer. The effects of mammography procedure on blood parameters are not known. This study aimed to investigate whether the procedure-associated breast compression affects the widely and simultaneously performed blood measurements of C-reactive protein (CRP), carcinoembryonic antigen (CEA), and cancer antigen (CA) 15-3. According to breast ultrasound examination results, participants were divided into 3 groups as follows: group 1 (participants with breast mass size ≥20.0 mm, n=48); group 2 (participants with breast mass size <20.0 mm, n=17); and group 3 (participants with no breast mass, n=23). In groups 1 and 2, on the day of the mammographic imaging study, serum CRP, CEA, and CA 15-3 levels were measured before and after the imaging study. Participants in group 3 had their blood parameters measured without mammography and/or any breast compression. Post-mammography blood measurements displayed a significant increase in serum CRP levels, and a significant decrease in serum CEA and CA 15-3 levels in group 1 (in comparison with the same day pre-mammography blood sampling levels; p<0.05 all). Although pre-mammography serum CEA levels in group 1 participants were significantly higher than those in group 2 and 3 participants, this significant elevation became nonsignificant at post-mammography measurements (p<0.05 and p>0.05, respectively). On the day of the mammographic imaging study, the optimal time of blood sampling for testing CRP, CEA and CA 15-3 levels in persons with a breast mass is before, but not after the mammographic imaging procedure. This issue requires additional detailed studies.
Topics: Humans; Female; Carcinoembryonic Antigen; Mammography; Breast Neoplasms; C-Reactive Protein
PubMed: 38304366
DOI: 10.20471/acc.2023.62.01.23 -
BMC Medical Imaging Sep 2022This study is aimed to explore the value of mammography-based radiomics signature for preoperative prediction of triple-negative breast cancer (TNBC).
OBJECTIVE
This study is aimed to explore the value of mammography-based radiomics signature for preoperative prediction of triple-negative breast cancer (TNBC).
MATERIALS AND METHODS
Initially, the clinical and X-ray data of patients (n = 319, age of 54 ± 14) with breast cancer (triple-negative-65, non-triple-negative-254) from the First Affiliated Hospital of Soochow University (n = 211, as a training set) and Suzhou Municipal Hospital (n = 108, as a verification set) from January 2018 to February 2021 are retrospectively analyzed. Comparing the mediolateral oblique (MLO) and cranial cauda (CC) mammography images, the mammography images with larger lesion areas are selected, and the image segmentation and radiomics feature extraction are then performed by the MaZda software. Further, the Fisher coefficients (Fisher), classification error probability combined average correlation coefficients (POE + ACC), and mutual information (MI) are used to select three sets of feature subsets. Moreover, the score of each patient's radiomics signature (Radscore) is calculated. Finally, the receiver operating characteristic curve (ROC) is analyzed to calculate the AUC, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of TNBC.
RESULTS
A significant difference in the mammography manifestation between the triple-negative and the non-triple-negative groups (P < 0.001) is observed. The (POE + ACC)-NDA method showed the highest accuracy of 88.39%. The Radscore of triple-negative and non-triple-negative groups in the training set includes - 0.678 (- 1.292, 0.088) and - 2.536 (- 3.496, - 1.324), respectively, with a statistically significant difference (Z = - 6.314, P < 0.001). In contrast, the Radscore in the validation set includes - 0.750 (- 1.332, - 0.054) and - 2.223 (- 2.963, - 1.256), with a statistically significant difference (Z = - 4.669, P < 0.001). In the training set, the AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TNBC include 0.821 (95% confidence interval 0.752-0.890), 74.4%, 82.5%, 72.5%, 41.2%, and 94.6%, respectively. In the validation set, the AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TNBC are of 0.809 (95% confidence interval 0.711-0.907), 80.6%, 72.0%, 80.7%, 55.5%, and 93.1%, respectively.
CONCLUSION
In summary, we firmly believe that this mammography-based radiomics signature could be useful in the preoperative prediction of TNBC due to its high value.
Topics: Humans; Mammography; Predictive Value of Tests; ROC Curve; Retrospective Studies; Triple Negative Breast Neoplasms
PubMed: 36104679
DOI: 10.1186/s12880-022-00875-6 -
European Journal of Radiology Feb 2024Contrast-enhanced breast MRI and recently also contrast-enhanced mammography (CEM) are available for breast imaging. The aim of the current overview is to explore... (Review)
Review
BACKGROUND
Contrast-enhanced breast MRI and recently also contrast-enhanced mammography (CEM) are available for breast imaging. The aim of the current overview is to explore existing evidence and ongoing challenges of contrast-enhanced breast imaging.
METHODS
This narrative provides an introduction to the contrast-enhanced breast imaging modalities breast MRI and CEM. Underlying principle, techniques and BI-RADS reporting of both techniques are described and compared, and the following indications and ongoing challenges are discussed: problem-solving, high-risk screening, supplemental screening in women with extremely dense breast tissue, breast implants, neoadjuvant systemic therapy (NST) response monitoring, MRI-guided and CEM- guided biopsy.
RESULTS
Technique and reporting for breast MRI are standardised, for the newer CEM standardisation is in progress. Similarly, compared to other modalities, breast MRI is well established as superior for problem-solving, screening women at high risk, screening women with extremely dense breast tissue or with implants; and for monitoring response to NST. Furthermore, MRI-guided biopsy is a reliable technique with low long-term false negative rates. For CEM, data is as yet either absent or limited, but existing results in these settings are promising.
CONCLUSION
Contrast-enhanced breast imaging achieves highest diagnostic performance and should be considered essential. Of the two contrast-enhanced modalities, evidence of breast MRI superiority is ample, and preliminary results on CEM are promising, yet CEM warrants further study.
Topics: Female; Humans; Breast; Breast Density; Breast Neoplasms; Contrast Media; Magnetic Resonance Imaging; Mammography
PubMed: 38237520
DOI: 10.1016/j.ejrad.2024.111312 -
BioMed Research International 2022In this study, the authors hope to demonstrate that when mammography is combined with intelligent segmentation techniques, it can become more effective in diagnosing... (Review)
Review
In this study, the authors hope to demonstrate that when mammography is combined with intelligent segmentation techniques, it can become more effective in diagnosing breast abnormalities and aiding in the early detection of breast cancer. In conjunction with intelligent segmentation techniques, mammography can be made more effective in diagnosing breast abnormalities and aiding in the early diagnosis of breast cancer, hence increasing its overall effectiveness. The methodology, which includes some concepts of digital imaging and machine learning techniques, will be described in the following section after a review of the literature on breast cancer (categories, prevention involving the environment and lifestyle, diagnosis, and tracking of the disease) has been completed (neural networks and random forests). It was possible to achieve these results by working with an image collection that previously had questionable regions (per the given technique). Fiji software extracted problematic candidate regions from mammography images, which were subsequently subjected to further examination. To categorize the results of the picture segmentation, they were sorted into three groups, which were as follows: random forest and neural networks both generated promising results in the segmentation of suspicious parts that were emphasized in the highlight of the image, and this was true for both algorithms. Detection of contours of the regions was carried out, indicating that cuts of these segmented sections may be created. Later on, automatic categorization of the targets can be carried out using a learning algorithm, as illustrated in the experiment.
Topics: Algorithms; Breast; Breast Neoplasms; Calcinosis; Female; Humans; Mammography
PubMed: 35692589
DOI: 10.1155/2022/2525433 -
Clinical Radiology Apr 2022To review and discuss the current published data on FUNCTIONAL DATA DERIVED FROM contrast-enhanced spectral mammography (CESM) for investigation of breast lesions. (Review)
Review
AIM
To review and discuss the current published data on FUNCTIONAL DATA DERIVED FROM contrast-enhanced spectral mammography (CESM) for investigation of breast lesions.
MATERIALS AND METHODS
Literature searches were conducted in MEDLINE and PUBMED. Due to the novel nature of CESM and sparsity of published literature pertaining to associated functional data, the Medical Subject Headings (MeSH) used were intentionally broad.
RESULTS
After inclusion and exclusion criteria, 23 papers were included; 13 pertained to assessment of intensity or pattern of lesion enhancement, and 10 considered textural analysis for lesion assessment, including those using computer-aided detection (CAD) software. Meta-analysis of data was not possible due to heterogeneity of methodology.
CONCLUSIONS
There is consistent evidence that benign lesions tend to demonstrate different enhancement characteristics to cancers, with benign lesions tending to demonstrate weaker, homogeneous contrast medium uptake. Limited evidence suggests malignant lesions exhibit "wash-out" or decreasing pattern of enhancement, and benign lesions a progressively enhancing one. The application of textural analysis and radiomics to CESM images shows promising results for differentiating benign and malignant lesions, with potential to predict immunohistological features. A large-scale multicentre study, ideally using multivendor CESM equipment, will be needed to confirm this.
Topics: Breast Neoplasms; Contrast Media; Female; Humans; Mammography; Multicenter Studies as Topic; Software
PubMed: 35090695
DOI: 10.1016/j.crad.2021.12.010