-
Insights Into Imaging Dec 2023Calcifications on mammography can be indicative of breast cancer, but the prognostic value of their appearance remains unclear. This systematic review and meta-analysis... (Review)
Review
BACKGROUND
Calcifications on mammography can be indicative of breast cancer, but the prognostic value of their appearance remains unclear. This systematic review and meta-analysis aimed to evaluate the association between mammographic calcification morphology descriptors (CMDs) and clinicopathological factors.
METHODS
A comprehensive literature search in Medline via Ovid, Embase.com, and Web of Science was conducted for articles published between 2000 and January 2022 that assessed the relationship between CMDs and clinicopathological factors, excluding case reports and review articles. The risk of bias and overall quality of evidence were evaluated using the QUIPS tool and GRADE. A random-effects model was used to synthesize the extracted data. This systematic review is reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
RESULTS
Among the 4715 articles reviewed, 29 met the inclusion criteria, reporting on 17 different clinicopathological factors in relation to CMDs. Heterogeneity between studies was present and the overall risk of bias was high, primarily due to small, inadequately described study populations. Meta-analysis demonstrated significant associations between fine linear calcifications and high-grade DCIS [pooled odds ratio (pOR), 4.92; 95% confidence interval (CI), 2.64-9.17], (comedo)necrosis (pOR, 3.46; 95% CI, 1.29-9.30), (micro)invasion (pOR, 1.53; 95% CI, 1.03-2.27), and a negative association with estrogen receptor positivity (pOR, 0.33; 95% CI, 0.12-0.89).
CONCLUSIONS
CMDs detected on mammography have prognostic value, but there is a high level of bias and variability between current studies. In order for CMDs to achieve clinical utility, standardization in reporting of CMDs is necessary.
CRITICAL RELEVANCE STATEMENT
Mammographic calcification morphology descriptors (CMDs) have prognostic value, but in order for CMDs to achieve clinical utility, standardization in reporting of CMDs is necessary.
SYSTEMATIC REVIEW REGISTRATION
CRD42022341599 KEY POINTS: • Mammographic calcifications can be indicative of breast cancer. • The prognostic value of mammographic calcifications is still unclear. • Specific mammographic calcification morphologies are related to lesion aggressiveness. • Variability between studies necessitates standardization in calcification evaluation to achieve clinical utility.
PubMed: 38051355
DOI: 10.1186/s13244-023-01529-z -
British Journal of Cancer Feb 2024There is little evidence on the balance between potential benefits and harms of mammography screening in women 75 years and older. The aim of this systematic review was...
BACKGROUND
There is little evidence on the balance between potential benefits and harms of mammography screening in women 75 years and older. The aim of this systematic review was to synthesise the evidence on the outcomes of mammography screening in women aged 75 years and older.
METHODS
A systematic review of mammography screening studies in women aged 75 years and over.
RESULTS
Thirty-six studies were included in this review: 27 observational studies and 9 modelling studies. Many of the included studies used no or uninformative comparison groups resulting in a potential bias towards the benefits of screening. Despite this, there was mixed evidence about the benefits and harms of continuing mammography screening beyond the age of 75 years. Some studies showed a beneficial effect on breast cancer mortality, and other studies showed no effect on mortality. Some studies showed some harms (false positive tests and recalls) being comparable to those in younger age-groups, with other studies showing increase in false positive screens and biopsies in older age-group. Although reported in fewer studies, there was consistent evidence of increased overdiagnosis in older age-groups.
CONCLUSION
There is limited evidence available to make a recommendation for/against continuing breast screening beyond the age of 75 years. Future studies should use more informative comparisons and should estimate overdiagnosis given potentially substantial harm in this age-group due to competing causes of death. This review was prospectively registered with PROSPERO (CRD42020203131).
Topics: Aged; Female; Humans; Age Factors; Breast; Breast Neoplasms; Mammography; Mass Screening
PubMed: 38030747
DOI: 10.1038/s41416-023-02504-7 -
Cureus Nov 2023Breast cancer is a prevalent global health concern, necessitating accurate diagnostic tools for effective management. Diagnostic imaging plays a pivotal role in breast... (Review)
Review
Breast cancer is a prevalent global health concern, necessitating accurate diagnostic tools for effective management. Diagnostic imaging plays a pivotal role in breast cancer diagnosis, staging, treatment planning, and outcome evaluation. Radiomics is an emerging field of study in medical imaging that contains a broad set of computational methods to extract quantitative features from radiographic images. This can be utilized to guide diagnosis, treatment response, and prognosis in clinical settings. A systematic review was performed in concordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Quality was assessed using the radiomics quality score. Diagnostic sensitivity and specificity of radiomics analysis, with 95% confidence intervals (CIs), were included for meta-analysis. The area under the curve analysis was recorded. An extensive statistical analysis was performed following the Cochrane guidelines. Statistical significance was determined if p-values were less than 0.05. Statistical analyses were conducted using Review Manager (RevMan), Version 5.4.1. A total of 31 manuscripts involving 8,773 patients were included, with 17 contributing to the meta-analysis. The cohort comprised 56.2% malignant breast cancers and 43.8% benign breast lesions. MRI demonstrated a sensitivity of 0.91 (95% CI: 0.89-0.92) and a specificity of 0.84 (95% CI: 0.82-0.86) in differentiating between benign and malignant breast cancers. Mammography-based radiomic features predicted breast cancer subtype with a sensitivity of 0.79 (95% CI: 0.76-0.82) and a specificity of 0.81 (95% CI: 0.79-0.84). Ultrasound-based analysis yielded a sensitivity of 0.92 (95% CI: 0.90-0.94) and a specificity of 0.85 (95% CI: 0.83-0.88). Only one study reported the results of radiomic evaluation from CT, which had a sensitivity of 0.95 (95% CI: 0.88-0.99) and a specificity of 0.56 (95% CI: 0.45-0.67). Across different imaging modalities, radiomics exhibited robust diagnostic accuracy in differentiating benign and malignant breast lesions. The results underscore the potential of radiomic assessment as a minimally invasive alternative or adjunctive diagnostic tool for breast cancer. This is pioneering data that reports on a novel diagnostic approach that is understudied and underreported. However, due to study limitations, the complexity of this technology, and the need for future development, biopsy still remains the current gold standard method of determining breast cancer type.
PubMed: 38024014
DOI: 10.7759/cureus.49015 -
Gland Surgery Oct 2023Cone-beam breast computed tomography (CBBCT) is a new breast imaging technique, however, CBBCT is not yet widely used, and its future application will depend on its...
Diagnostic accuracy of cone-beam breast computed tomography and head-to-head comparison of digital mammography, magnetic resonance imaging and cone-beam breast computed tomography for breast cancer: a systematic review and meta-analysis.
BACKGROUND
Cone-beam breast computed tomography (CBBCT) is a new breast imaging technique, however, CBBCT is not yet widely used, and its future application will depend on its diagnostic potential and application value. Therefore, it is of great clinical significance to systematically review and analyze the diagnostic accuracy of CBBCT for breast cancer detection in existing studies and compare it with other traditional imaging methods for the diagnosis of breast lesions.
METHODS
We searched PubMed, Embase, Web of Science, and Chinese databases until August 2022 for relevant papers. Studies evaluating the diagnostic accuracy of CBBCT in women with suspected breast cancer were included. Each study's quality was evaluated using the Quality Assessment of Diagnostic Performance Studies-2 (QUADAS-2) instrument.
RESULTS
Eighteen studies with a total of 1,792 patients were included in the analysis. The overall pooled sensitivity and specificity of CBBCT in diagnosing breast cancer were 0.95 [95% confidence interval (CI): 0.91-0.97] and 0.72 (95% CI: 0.62-0.80), respectively. The area under the curve (AUC) for CBBCT was 0.92 (95% CI: 0.90-0.94). In a head-to-head comparison of CBBCT and digital mammography (DM), eight trials with 992 patients were included in the study, and the AUCs for CBBCT and DM were 0.94 (95% CI: 0.92-0.96) and 0.83 (95% CI: 0.80-0.83), respectively. In a head-to-head comparison of CBBCT and magnetic resonance imaging (MRI), four trials with 203 patients were included in the analysis; the AUC for CBBCT and MRI were 0.88 (95% CI: 0.85-0.91) and 0.96 (95% CI: 0.94-0.97), respectively.
CONCLUSIONS
This meta-analysis of CBBCT test accuracy indicated encouraging diagnostic performance. In the summary of head-to-head comparative studies, there is a tendency for CBBCT to have greater diagnostic accuracy than DM, although its diagnostic performance is marginally inferior to that of MRI. However, the meta-analysis results were derived from studies with limited sample sizes. There is a need for more extensive research in this setting.
PubMed: 38021193
DOI: 10.21037/gs-23-153 -
Cureus Sep 2023Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are...
Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are treated by surgical excision. The diagnosis of MFB is made through immunohistochemical (IHC) analysis, with the most common biomarkers being CD34+, desmin+, smooth muscle actin+, and vimentin+. In this article, we describe a case of an MFB in a premenopausal female with variance from classic IHC findings. We also performed a systemic review of the MFB of the breast. The systemic review compiles the most common IHC findings of MFB, patient demographics, treatment methods, lesion size, and the presence or absence of pain associated with the lesion. As MFB can share many features with other breast lesions, including potentially malignant ones, this article sought to underline the most common IHC findings and characteristics of MFB to aid in the proper diagnosis of MFB.
PubMed: 37900540
DOI: 10.7759/cureus.46125 -
BMC Bioinformatics Oct 2023Recent advancements in computing power and state-of-the-art algorithms have helped in more accessible and accurate diagnosis of numerous diseases. In addition, the...
BACKGROUND
Recent advancements in computing power and state-of-the-art algorithms have helped in more accessible and accurate diagnosis of numerous diseases. In addition, the development of de novo areas in imaging science, such as radiomics and radiogenomics, have been adding more to personalize healthcare to stratify patients better. These techniques associate imaging phenotypes with the related disease genes. Various imaging modalities have been used for years to diagnose breast cancer. Nonetheless, digital breast tomosynthesis (DBT), a state-of-the-art technique, has produced promising results comparatively. DBT, a 3D mammography, is replacing conventional 2D mammography rapidly. This technological advancement is key to AI algorithms for accurately interpreting medical images.
OBJECTIVE AND METHODS
This paper presents a comprehensive review of deep learning (DL), radiomics and radiogenomics in breast image analysis. This review focuses on DBT, its extracted synthetic mammography (SM), and full-field digital mammography (FFDM). Furthermore, this survey provides systematic knowledge about DL, radiomics, and radiogenomics for beginners and advanced-level researchers.
RESULTS
A total of 500 articles were identified, with 30 studies included as the set criteria. Parallel benchmarking of radiomics, radiogenomics, and DL models applied to the DBT images could allow clinicians and researchers alike to have greater awareness as they consider clinical deployment or development of new models. This review provides a comprehensive guide to understanding the current state of early breast cancer detection using DBT images.
CONCLUSION
Using this survey, investigators with various backgrounds can easily seek interdisciplinary science and new DL, radiomics, and radiogenomics directions towards DBT.
Topics: Humans; Female; Deep Learning; Radiographic Image Enhancement; Breast; Breast Neoplasms; Mammography
PubMed: 37884877
DOI: 10.1186/s12859-023-05515-6 -
Medical Journal of the Islamic Republic... 2023Breast cancer is a non-communicable and common disease that accounts for a high percentage of deaths. Early diagnosis of this disease reduces the death rate. Screening... (Review)
Review
BACKGROUND
Breast cancer is a non-communicable and common disease that accounts for a high percentage of deaths. Early diagnosis of this disease reduces the death rate. Screening methods such as digital mammography can help prevent or identify the disease earlier. Therefore, this study aims to analyze the cost-benefit of breast cancer using digital mammography.
METHODS
This systematic review was conducted based on PRISMA 2020 checklist. PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, and Google Scholar were searched without any time limitation on June 2022. The quality of the studies was evaluated with the CHEERS checklist. After data extraction, the results were synthesized by thematic content analysis.
RESULTS
During the search, 3468 records were identified, of which 1061 were duplicates. 2407 titles and abstracts screened in terms of inclusion criteria. Finally, after studying 20 fulltexts, three of them were included in the study. The quality of these articles was scored between 10 and 16. These studies were from Spain, Denmark, and the United States from 2000 to 2019. Two studies showed that digital mammography is not as effective as other screening methods.
CONCLUSION
The results of this study showed that digital mammography is not very cost-benefit for the health care system. An increase in its repetition frequency imposes more costs on the health system and doesn't have more benefits for it.
PubMed: 37750094
DOI: 10.47176/mjiri.37.89 -
ELife Sep 2023COVID-19 has strained population breast mammography screening programs that aim to diagnose and treat breast cancers earlier. As the pandemic has affected countries...
COVID-19 has strained population breast mammography screening programs that aim to diagnose and treat breast cancers earlier. As the pandemic has affected countries differently, we aimed to quantify changes in breast screening volume and uptake during the first year of COVID-19 . We systematically searched Medline, the World Health Organization (WHO) COVID-19 database, and governmental databases. Studies covering January 2020 to March 2022 were included. We extracted and analyzed data regarding study methodology, screening volume, and uptake. To assess for risk of bias, we used the Joanna Briggs Institute (JBI) Critical Appraisal Tool. Twenty-six cross-sectional descriptive studies (focusing on 13 countries/nations) were included out of 935 independent records. Reductions in screening volume and uptake rates were observed among eight countries. Changes in screening participation volume in five nations with national population-based screening ranged from -13 to -31%. Among two countries with limited population-based programs, the decline ranged from -61 to -41%. Within the USA, population participation volumes varied ranging from +18 to -39%, with suggestion of differences by insurance status (HMO, Medicare, and low-income programs). Almost all studies had high risk of bias due to insufficient statistical analysis and confounding factors. The extent of COVID-19-induced reduction in breast screening participation volume differed by region and data suggested potential differences by healthcare setting (e.g., national health insurance vs. private healthcare). Recovery efforts should monitor access to screening and early diagnosis to determine whether prevention services need strengthening to increase the coverage of disadvantaged groups and reduce disparities.
Topics: Aged; Female; Humans; Breast Neoplasms; COVID-19; Cross-Sectional Studies; Early Detection of Cancer; Medicare; United States
PubMed: 37698273
DOI: 10.7554/eLife.85680 -
Canadian Association of Radiologists... Feb 2024Preoperative breast magnetic resonance imaging (MRI) is known to detect additional cancers that are occult on mammography and ultrasound. There is debate as to whether... (Meta-Analysis)
Meta-Analysis
Preoperative breast magnetic resonance imaging (MRI) is known to detect additional cancers that are occult on mammography and ultrasound. There is debate as to whether these additional lesions affect clinical outcomes. The objective of this systematic review was to summarize the evidence on whether additional information on disease extent obtained with preoperative breast MRI in patients with newly diagnosed breast cancer affects surgical management, rates of recurrence, survival, re-excision, and early detection of bilateral cancer. Embase, MEDLINE, and Cochrane Central Register of Controlled Trials were searched until January 2021 (partial update July 2022) for studies comparing outcomes with versus without pre-operative MRI. Included were both randomized controlled trials and other comparative studies provided MRI and control groups had equivalent disease and patient characteristics or methods such as multivariable analysis or propensity score matching were used to control potential confounders. The search resulted in 26,399 citations, of which 8 randomized control trials, 1 prospective cohort study, and 42 retrospective studies met the inclusion criteria. Use of MRI resulted in decreased rates of reoperations (OR = 0.73, 95% CI = 0.63 to 0.85), re-excisions (OR = 0.63, 95% CI = 0.45 to 0.89), and recurrence (HR = 0.77, 95% CI = 0.65 to 0.90). Increased detection of synchronous contralateral breast cancers led to a reduction in metachronous contralateral breast cancer (HR = 0.71, 95% CI = 0.59 to 0.85). Hazard ratios for recurrence-free and overall survival were 0.77 (95% CI = 0.53 to 1.12) and 0.89 (95% CI = 0.74 to 1.07). This systematic review indicates substantial benefits of pre-operative breast MRI in decreasing reoperations and recurrence.
Topics: Humans; Female; Breast Neoplasms; Retrospective Studies; Prospective Studies; Breast; Magnetic Resonance Imaging
PubMed: 37593787
DOI: 10.1177/08465371231184769 -
Radiography (London, England : 1995) Aug 2023Mammography screening programs have been implemented in European countries as prevention tools aimed at reducing breast cancer mortality through early detection in... (Review)
Review
INTRODUCTION
Mammography screening programs have been implemented in European countries as prevention tools aimed at reducing breast cancer mortality through early detection in asymptomatic women. Nordic countries (Denmark, Finland, Iceland, Norway, Sweden, the Faroe Islands, and Greenland) demonstrated high participation rates; however, breast cancer mortality could be limited by further optimizing screening. This review aimed to explore factors that affect women's participation in mammography screening in Nordic countries.
METHOD
A systematic review of segregated mixed research synthesis using a deductive approach was conducted. The following databases and platforms were searched to identify relevant studies: CINAHL with Full Text (EBSCOHost), MEDLINE (EBSCOHost), PsycInfo (ProQuest), Scopus (Elsevier) and Web of Science Core Collection (SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, and ESCI). The Critical Appraisal Skills Program was used for quality assessment. The Health Promotion Model was applied to integrate findings from qualitative and qualitative research. All methodological steps followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
The final selection (16 articles) included studies from three Nordic countries: Denmark (four quantitative studies), Norway (one qualitative and four quantitative studies), and Sweden (three qualitative and seven quantitative studies). Sixty-three factors were identified as barriers, facilitators, or factors with no influence.
CONCLUSION
A substantial number of obtained factors, spread across a wide spectrum, describe (non-)participation in mammography screening as a versatile phenomenon.
IMPLICATIONS FOR PRACTICE
The findings of this review could benefit the mammography staff and providers regarding possible interventions aimed at improving screening participation rates.
Topics: Female; Humans; Mammography; Breast Neoplasms; Scandinavian and Nordic Countries; Qualitative Research; Norway
PubMed: 37421878
DOI: 10.1016/j.radi.2023.06.010