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British Journal of Cancer Jan 2003Compared with triple assessment for symptomatic and occult breast disease, magnetic resonance mammography (MRM) offers higher sensitivity for the detection of multifocal... (Review)
Review
Compared with triple assessment for symptomatic and occult breast disease, magnetic resonance mammography (MRM) offers higher sensitivity for the detection of multifocal cancer, which is important in selecting patients appropriately for breast-conserving surgery. It is an ideal tool for the screening of patients with a high risk of breast cancer or where there is axillary disease or nipple discharge and conventional imaging has not revealed the primary focus. Techniques are now available to biopsy lesions only apparent on MRM. MRM can differentiate scar tissue from tumour; therefore, it is useful in patients in which there is possible recurrent disease. Clinical and X-ray mammographic assessment of response to neoadjuvant chemotherapy may be unreliable because of replacement of the tumour with scar tissue. MRM can identify responders and nonresponders with more accuracy. It is the modality of choice for the assessment of breast implants for rupture with accuracy higher than X-ray mammography and ultrasound. Advances in both spatial and temporal resolutions, the imaging sequences employed, pharmacokinetic modelling of contrast uptake, the use of dedicated and now phased-array breast coils, and gadolinium-based contrast agents have all played their part in the advancement of this imaging technique. Despite the limitations of patient compliance, scan-time and cost, this review describes how MRM has become a valuable tool in breast disease, especially in cases of diagnostic uncertainty. However, MRM must make the transition from research institutions into routine clinical practice.
Topics: Breast Diseases; Breast Implants; Drug Therapy; Female; Forecasting; Humans; Magnetic Resonance Spectroscopy; Mammography; Nipples; Recurrence; Sensitivity and Specificity
PubMed: 12556951
DOI: 10.1038/sj.bjc.6600713 -
Scientific Data May 2023Mammography, or breast X-ray imaging, is the most widely used imaging modality to detect cancer and other breast diseases. Recent studies have shown that deep...
Mammography, or breast X-ray imaging, is the most widely used imaging modality to detect cancer and other breast diseases. Recent studies have shown that deep learning-based computer-assisted detection and diagnosis (CADe/x) tools have been developed to support physicians and improve the accuracy of interpreting mammography. A number of large-scale mammography datasets from different populations with various associated annotations and clinical data have been introduced to study the potential of learning-based methods in the field of breast radiology. With the aim to develop more robust and more interpretable support systems in breast imaging, we introduce VinDr-Mammo, a Vietnamese dataset of digital mammography with breast-level assessment and extensive lesion-level annotations, enhancing the diversity of the publicly available mammography data. The dataset consists of 5,000 mammography exams, each of which has four standard views and is double read with disagreement (if any) being resolved by arbitration. The purpose of this dataset is to assess Breast Imaging Reporting and Data System (BI-RADS) and breast density at the individual breast level. In addition, the dataset also provides the category, location, and BI-RADS assessment of non-benign findings. We make VinDr-Mammo publicly available as a new imaging resource to promote advances in developing CADe/x tools for mammography interpretation.
Topics: Humans; Benchmarking; Breast; Breast Diseases; Computers; Mammography
PubMed: 37173336
DOI: 10.1038/s41597-023-02100-7 -
Journal of the National Cancer Institute Jul 2012
Topics: Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Population Surveillance; Risk Assessment
PubMed: 22811440
DOI: 10.1093/jnci/djs289 -
Journal of General Internal Medicine Nov 2018Decades of persuasive messages have reinforced the importance of traditional screening mammography at regular intervals. A potential new paradigm, risk-based screening,...
BACKGROUND
Decades of persuasive messages have reinforced the importance of traditional screening mammography at regular intervals. A potential new paradigm, risk-based screening, adjusts mammography frequency based on a woman's estimated breast cancer risk in order to maximize mortality reduction while minimizing false positives and overdiagnosis. Women's views of risk-based screening are unknown.
OBJECTIVE
To explore women's views and personal acceptability of a potential risk-based mammography screening paradigm.
DESIGN
Four semi-structured focus group discussions about screening mammography and surveys before provision of information about risk-based screening. We analyzed coded focus group transcripts using a mixed deductive (content analysis) and inductive (grounded theory) approach.
PARTICIPANTS
Convenience sample of 29 women (40-74 years old) with no personal history of breast cancer recruited by print and online media in New Hampshire and Vermont.
RESULTS
Twenty-seven out of 29 women reported having undergone mammography screening. All participants were white and most were highly educated. Some women accepted the idea that early cancer detection with traditional screening was beneficial-although many also reported hearing inconsistent recommendations from clinicians and mixed messages from media reports about mammography. Some women were familiar with a risk-based screening paradigm (primarily related to cervical cancer, n = 8) and thought matching screening mammography frequency to personal risk made sense (n = 8). Personal acceptability of risk-based screening was mixed. Some believed risk-based screening could reduce the harms of false positives and overdiagnosis (n = 7). Others thought screening less often might result in missing a dangerous diagnosis (n = 14). Many (n = 18) expressed concerns about the feasibility of risk-based screening and questioned whether breast cancer risk estimates could be accurate. Some suspected that risk-based mammography was motivated by a desire to save money (n = 6).
CONCLUSION
Some women thought risk-based screening made sense. Willingness to abandon traditional screening for the new paradigm was mixed. Broad acceptability of risk-based screening will require clearer communication about its rationale and feasibility and consistent messages from the health care team.
Topics: Adult; Aged; Breast Neoplasms; Early Detection of Cancer; False Positive Reactions; Female; Focus Groups; Humans; Mammography; Medical Overuse; Middle Aged; Qualitative Research
PubMed: 30066118
DOI: 10.1007/s11606-018-4601-9 -
Journal of Digital Imaging Aug 1997Mammography is the most effective method for early detection of breast cancer and yet, 10% to 30% of women who have breast cancer and undergo mammography have negative...
Mammography is the most effective method for early detection of breast cancer and yet, 10% to 30% of women who have breast cancer and undergo mammography have negative mammograms. Furthermore, of the women who are sent to biopsy, only 20% to 40% actually have breast cancer. Quantitative analysis of the radiographic features of microcalcifications and masses may help radiologists improve their specificity.
Topics: Breast Neoplasms; Female; Humans; Mammography; Mass Screening; Radiographic Image Enhancement
PubMed: 9268858
DOI: 10.1007/BF03168676 -
Korean Journal of Radiology 2014To compare new full-field digital mammography (FFDM) with and without use of an advanced post-processing algorithm to improve image quality, lesion detection, diagnostic... (Comparative Study)
Comparative Study
OBJECTIVE
To compare new full-field digital mammography (FFDM) with and without use of an advanced post-processing algorithm to improve image quality, lesion detection, diagnostic performance, and priority rank.
MATERIALS AND METHODS
During a 22-month period, we prospectively enrolled 100 cases of specimen FFDM mammography (Brestige®), which was performed alone or in combination with a post-processing algorithm developed by the manufacturer: group A (SMA), specimen mammography without application of "Mammogram enhancement ver. 2.0"; group B (SMB), specimen mammography with application of "Mammogram enhancement ver. 2.0". Two sets of specimen mammographies were randomly reviewed by five experienced radiologists. Image quality, lesion detection, diagnostic performance, and priority rank with regard to image preference were evaluated.
RESULTS
Three aspects of image quality (overall quality, contrast, and noise) of the SMB were significantly superior to those of SMA (p < 0.05). SMB was significantly superior to SMA for visualizing calcifications (p < 0.05). Diagnostic performance, as evaluated by cancer score, was similar between SMA and SMB. SMB was preferred to SMA by four of the five reviewers.
CONCLUSION
The post-processing algorithm may improve image quality with better image preference in FFDM than without use of the software.
Topics: Adult; Aged; Algorithms; Breast Neoplasms; Calcinosis; Female; Humans; Mammography; Middle Aged; Prospective Studies; Radiographic Image Enhancement; Sensitivity and Specificity; Software
PubMed: 24843234
DOI: 10.3348/kjr.2014.15.3.305 -
Canadian Association of Radiologists... Feb 2022The Covid pandemic has taught many lessons, including the importance of mental health. The value of the radiologist in holistic patient care may be underestimated and... (Review)
Review
The Covid pandemic has taught many lessons, including the importance of mental health. The value of the radiologist in holistic patient care may be underestimated and underresearched. Barriers to the acceptance of imaging as an important component in reassurance may be rooted in old ideas minimizing the importance of mental health.
Topics: Anxiety; Breast Neoplasms; Clinical Decision-Making; Female; Humans; Mammography; Paternalism; Patient Participation
PubMed: 34227431
DOI: 10.1177/08465371211021996 -
PloS One 2017To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and...
OBJECTIVES
To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study.
METHODS
We retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35-80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs.
RESULTS
Compression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (p<0.0001). Compression parameters including compression force, compression pressure, CBT and breast contact area were widely variable between [relative standard deviation (RSD)≥21.0%] and within (p<0.0001) Asian women. The median compression force should be about 8.1 daN compared to the current 12.0 daN. Decreasing compression force from 12.0 daN to 9.0 daN increased CBT by 3.3±1.4 mm, MGD by 6.2-11.0%, and caused no significant effects on image quality (p>0.05).
CONCLUSIONS
Force-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD.
Topics: Adult; Aged; Aged, 80 and over; Asia; Asian People; Breast; Breast Density; Female; Humans; Mammography; Middle Aged; Phantoms, Imaging; Retrospective Studies; Software
PubMed: 28419125
DOI: 10.1371/journal.pone.0175781 -
Cleveland Clinic Journal of Medicine Mar 2009The finding of a palpable breast mass on physical examination often warrants a radiologic workup including directed ultrasonography, diagnostic mammography, and, at... (Review)
Review
The finding of a palpable breast mass on physical examination often warrants a radiologic workup including directed ultrasonography, diagnostic mammography, and, at times, biopsy with ultrasonographic guidance. The choice of initial imaging study is most often guided by the patient's age at presentation. Communicating the clinical findings to both the patient and the radiologist helps ensure the selection of the most appropriate imaging studies and helps in the interpretation of those studies. Every woman with a palpable breast mass, regardless of her age, should undergo imaging to exclude or establish the diagnosis of cancer.
Topics: Breast Neoplasms; Diagnosis, Differential; Female; Humans; Mammography; Palpation; Reproducibility of Results
PubMed: 19258464
DOI: 10.3949/ccjm.76a.08015 -
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