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Jiménez T, Domínguez-Castillo A, Fernández de Larrea-Baz N, Lucas P, Sierra MÁ, Salas-Trejo D, Llobet R, Martínez I, Pino MN, Martínez-Cortés M, Pérez-Gómez B, Pollán M, Lope V, García-Pérez J. Residential exposure to traffic pollution and mammographic density in premenopausal women. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172463. [PMID: 38615764 DOI: 10.1016/j.scitotenv.2024.172463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Mammographic density (MD) is the most important breast cancer biomarker. Ambient pollution is a carcinogen, and its relationship with MD is unclear. This study aims to explore the association between exposure to traffic pollution and MD in premenopausal women. METHODOLOGY This Spanish cross-sectional study involved 769 women attending gynecological examinations in Madrid. Annual Average Daily Traffic (AADT), extracted from 1944 measurement road points provided by the City Council of Madrid, was weighted by distances (d) between road points and women's addresses to develop a Weighted Traffic Exposure Index (WTEI). Three methods were employed: method-1 (1dAADT), method-2 (1dAADT), and method-3 (e1dAADT). Multiple linear regression models, considering both log-transformed percentage of MD and untransformed MD, were used to estimate MD differences by WTEI quartiles, through two strategies: "exposed (exposure buffers between 50 and 200 m) vs. not exposed (>200 m)"; and "degree of traffic exposure". RESULTS Results showed no association between MD and traffic pollution according to buffers of exposure to the WTEI (first strategy) for the three methods. The highest reductions in MD, although not statistically significant, were detected in the quartile with the highest traffic exposure. For instance, method-3 revealed a suggestive inverse trend (eβQ1 = 1.23, eβQ2 = 0.96, eβQ3 = 0.85, eβQ4 = 0.85, p-trend = 0.099) in the case of 75 m buffer. Similar non-statistically significant trends were observed with Methods-1 and -2. When we examined the effect of traffic exposure considering all the 1944 measurement road points in every participant (second strategy), results showed no association for any of the three methods. A slightly decreased MD, although not significant, was observed only in the quartile with the highest traffic exposure: eβQ4 = 0.98 (method-1), and eβQ4 = 0.95 (methods-2 and -3). CONCLUSIONS Our results showed no association between exposure to traffic pollution and MD in premenopausal women. Further research is needed to validate these findings.
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Affiliation(s)
- Tamara Jiménez
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid (UAM), Madrid, Spain; HM CINAC (Centro Integral de Neurociencias AC), Hospital Universitario Puerta del Sur, Fundación HM Hospitales, Móstoles, Spain
| | - Alejandro Domínguez-Castillo
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain.
| | - Nerea Fernández de Larrea-Baz
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Pilar Lucas
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain.
| | - María Ángeles Sierra
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Dolores Salas-Trejo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Valencian Breast Cancer Screening Program, General Directorate of Public Health, Valencia, Spain; Center for Public Health Research CSISP, FISABIO, Valencia, Spain.
| | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, Valencia, Spain.
| | - Inmaculada Martínez
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, Valencia, Spain; Center for Public Health Research CSISP, FISABIO, Valencia, Spain.
| | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain.
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain.
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health (Instituto de Salud Carlos III), Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
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Pattacini P, Nitrosi A, Giorgi Rossi P, Duffy SW, Iotti V, Ginocchi V, Ravaioli S, Vacondio R, Mancuso P, Ragazzi M, Campari C. A Randomized Trial Comparing Breast Cancer Incidence and Interval Cancers after Tomosynthesis Plus Mammography versus Mammography Alone. Radiology 2022; 303:256-266. [PMID: 35103537 DOI: 10.1148/radiol.211132] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Adding digital breast tomosynthesis (DBT) to digital mammography (DM) improves breast cancer screening sensitivity, but how this impacts mortality and other end points is unknown. Purpose To compare interval and overall breast cancer incidence after screening with DBT plus DM versus DM alone. Materials and Methods In this prospective trial (RETomo), women attending screening were randomized to one round of DBT plus DM (experimental arm) or to DM (control arm). All were then rescreened with DM after 12 months (women aged 45-49 years) or after 24 months (50-69 years). The primary outcome was interval cancer incidence. Cumulative incidence up to the subsequent screening round plus 9 months (21- and 33-month follow-up for women aged 45-49 and 50-69, respectively) was also reported. Ductal carcinomas in situ are included. Subgroup analyses by age and breast density were conducted; 95% CIs computed according to binomial distribution are reported. Results Baseline cancer detection was higher in the DBT plu DM arm than DM arm (101 of 13 356 women vs 61 of 13 521 women; relative detection, 1.7 [95% CI: 1.2, 2.3]). The mean age ± standard deviation for the women in both arms was 55 years ± 7. Interval cancer incidence was similar in the two arms (21 vs 22 cancers; relative incidence, 0.97 [95% CI: 0.53, 1.8]). Cumulative incidence remained higher in the DBT plus DM arm in women over 50 (153 vs 124 cancers; relative incidence, 1.2 [95% CI: 0.99, 1.6]), while it was similar in the two arms in women aged 45-49 (36 vs 41 cancers; relative incidence, 0.89 [95% CI: 0.57, 1.4]). Conclusion In women younger than 50 years, the benefit of early diagnosis seemed to be appreciable, while for women over age 50, the higher sensitivity of tomosynthesis plus mammography was not matched by a subsequent reduction in cancers at the next screening examination or in the intervening interval. Clinical trial registration no. NCT02698202 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Lee and Ray in this issue.
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Affiliation(s)
- Pierpaolo Pattacini
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Andrea Nitrosi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Paolo Giorgi Rossi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Stephen W Duffy
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Valentina Iotti
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Vladimiro Ginocchi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Sara Ravaioli
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Rita Vacondio
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Pamela Mancuso
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Moira Ragazzi
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
| | - Cinzia Campari
- From the Radiology Unit (P.P., V.I., V.G., S.R., R.V.), Medical Physics Unit (A.N.), Epidemiology Unit (P.G.R., P.M.), Pathology Unit (M.R.), and Screening Coordinating Centre (C.C.), Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia 42122, Italy; and Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England (S.W.D.)
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Wang G, Shi D, Guo Q, Zhang H, Wang S, Ren K. Radiomics Based on Digital Mammography Helps to Identify Mammographic Masses Suspicious for Cancer. Front Oncol 2022; 12:843436. [PMID: 35433437 PMCID: PMC9012139 DOI: 10.3389/fonc.2022.843436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/04/2022] [Indexed: 12/11/2022] Open
Abstract
Objectives This study aims to build radiomics model of Breast Imaging Reporting and Data System (BI-RADS) category 4 and 5 mammographic masses extracted from digital mammography (DM) for mammographic masses characterization by using a sensitivity threshold similar to that of biopsy. Materials and Methods This retrospective study included 288 female patients (age, 52.41 ± 10.31) who had BI-RADS category 4 or 5 mammographic masses with an indication for biopsy. The patients were divided into two temporal set (training set, 82 malignancies and 110 benign lesions; independent test set, 48 malignancies and 48 benign lesions). A total of 188 radiomics features were extracted from mammographic masses on the combination of craniocaudal (CC) position images and mediolateral oblique (MLO) position images. For the training set, Pearson’s correlation and the least absolute shrinkage and selection operator (LASSO) were used to select non-redundant radiomics features and useful radiomics features, respectively, and support vector machine (SVM) was applied to construct a radiomics model. The receiver operating characteristic curve (ROC) analysis was used to evaluate the classification performance of the radiomics model and to determine a threshold value with a sensitivity higher than 98% to predict the mammographic masses malignancy. For independent test set, identical threshold value was used to validate the classification performance of the radiomics model. The stability of the radiomics model was evaluated by using a fivefold cross-validation method, and two breast radiologists assessed the diagnostic agreement of the radiomics model. Results In the training set, the radiomics model obtained an area under the receiver operating characteristic curve (AUC) of 0.934 [95% confidence intervals (95% CI), 0.898–0.971], a sensitivity of 98.8% (81/82), a threshold of 0.22, and a specificity of 60% (66/110). In the test set, the radiomics model obtained an AUC of 0.901 (95% CI, 0.835–0.961), a sensitivity of 95.8% (46/48), and a specificity of 66.7% (32/48). The radiomics model had relatively stable sensitivities in fivefold cross-validation (training set, 97.39% ± 3.9%; test set, 98.7% ± 4%). Conclusion The radiomics method based on DM may help reduce the temporarily unnecessary invasive biopsies for benign mammographic masses over-classified in BI-RADS category 4 and 5 while providing similar diagnostic performance for malignant mammographic masses as biopsies.
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Affiliation(s)
| | - Dafa Shi
- Xiang’an Hospital, Xiamen University, Xiamen, China
| | - Qiu Guo
- Xiang’an Hospital, Xiamen University, Xiamen, China
| | - Haoran Zhang
- Xiang’an Hospital, Xiamen University, Xiamen, China
| | - Siyuan Wang
- Xiang’an Hospital, Xiamen University, Xiamen, China
| | - Ke Ren
- Xiang’an Hospital, Xiamen University, Xiamen, China
- Xiamen Key Laboratory of Endocrine-Related Cancer Precision Medicine, Xiamen, China
- *Correspondence: Ke Ren,
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4
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Saghatchian M, Abehsera M, Yamgnane A, Geyl C, Gauthier E, Hélin V, Bazire M, Villoing-Gaudé L, Reyes C, Gentien D, Golmard L, Stoppa-Lyonnet D. Feasibility of personalized screening and prevention recommendations in the general population through breast cancer risk assessment: results from a dedicated risk clinic. Breast Cancer Res Treat 2022; 192:375-383. [PMID: 34994879 PMCID: PMC8739506 DOI: 10.1007/s10549-021-06445-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/08/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE A personalized approach to prevention and early detection based on known risk factors should contribute to early diagnosis and treatment of breast cancer. We initiated a risk assessment clinic for all women wishing to undergo an individual breast cancer risk assessment. METHODS Women underwent a complete breast cancer assessment including a questionnaire, mammogram with evaluation of breast density, collection of saliva sample, consultation with a radiologist, and a breast cancer specialist. Women aged 40 or older, with 0 or 1 first-degree relative with breast cancer diagnosed after the age of 40 were eligible for risk assessment using MammoRisk, a machine learning-based tool that provides an individual 5-year estimated risk of developing breast cancer based on the patient's clinical data and breast density, with or without polygenic risk scores (PRSs). DNA was extracted from saliva samples for genotyping of 76 single-nucleotide polymorphisms. The individual risk was communicated to the patient, with individualized screening and prevention recommendations. RESULTS A total of 290 women underwent breast cancer assessment, among which 196 women (68%) were eligible for risk assessment using MammoRisk (median age 52, range 40-72). When PRS was added to MammoRisk, 40% (n = 78) of patients were assigned a different risk category, with 28% (n = 55) of patients changing from intermediate to moderate or high risk. CONCLUSION Individual risk assessment is feasible in the general population. Screening recommendations could be given based on individual risk. The use of PRS changed the risk score and screening recommendations in 40% of women.
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Affiliation(s)
- Mahasti Saghatchian
- American Hospital of Paris, Neuilly-sur-Seine, France. .,Paris-Descartes University, Paris, France.
| | - Marc Abehsera
- American Hospital of Paris, Neuilly-sur-Seine, France
| | | | - Caroline Geyl
- American Hospital of Paris, Neuilly-sur-Seine, France
| | | | | | | | | | | | | | - Lisa Golmard
- INSERM U830 D.R.U.M. Team, Institut Curie Hospital, Paris-University, Paris, France
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Paris, France.,INSERM U830 D.R.U.M. Team, Institut Curie Hospital, Paris-University, Paris, France
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5
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Giorgi Rossi P, Djuric O, Hélin V, Astley S, Mantellini P, Nitrosi A, Harkness EF, Gauthier E, Puliti D, Balleyguier C, Baron C, Gilbert FJ, Grivegnée A, Pattacini P, Michiels S, Delaloge S. Validation of a new fully automated software for 2D digital mammographic breast density evaluation in predicting breast cancer risk. Sci Rep 2021; 11:19884. [PMID: 34615978 PMCID: PMC8494838 DOI: 10.1038/s41598-021-99433-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/22/2021] [Indexed: 11/09/2022] Open
Abstract
We compared accuracy for breast cancer (BC) risk stratification of a new fully automated system (DenSeeMammo-DSM) for breast density (BD) assessment to a non-inferiority threshold based on radiologists' visual assessment. Pooled analysis was performed on 14,267 2D mammograms collected from women aged 48-55 years who underwent BC screening within three studies: RETomo, Florence study and PROCAS. BD was expressed through clinical Breast Imaging Reporting and Data System (BI-RADS) density classification. Women in BI-RADS D category had a 2.6 (95% CI 1.5-4.4) and a 3.6 (95% CI 1.4-9.3) times higher risk of incident and interval cancer, respectively, than women in the two lowest BD categories. The ability of DSM to predict risk of incident cancer was non-inferior to radiologists' visual assessment as both point estimate and lower bound of 95% CI (AUC 0.589; 95% CI 0.580-0.597) were above the predefined visual assessment threshold (AUC 0.571). AUC for interval (AUC 0.631; 95% CI 0.623-0.639) cancers was even higher. BD assessed with new fully automated method is positively associated with BC risk and is not inferior to radiologists' visual assessment. It is an even stronger marker of interval cancer, confirming an appreciable masking effect of BD that reduces mammography sensitivity.
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Affiliation(s)
- Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy.
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, Center for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), University of Modena and Reggio Emilia, Via Università 4, 41121, Modena, Italy.
| | - Valerie Hélin
- Predlife, Espace Maurice Tubiana, 39 rue Camille Desmoulins, 94800, Villejuif, France
| | - Susan Astley
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, UK
- Prevent Breast Cancer and Nightingale Breast Screening Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK
| | - Paola Mantellini
- Screening Unit, ISPRO - Oncological Network, Prevention and Research Institute, via Cosimo il Vecchio 2, 50139, Florence, Italy
| | - Andrea Nitrosi
- Medical Physics Unit, Department of Oncology and Advanced Technologies, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Elaine F Harkness
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, UK
- Prevent Breast Cancer and Nightingale Breast Screening Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK
| | - Emilien Gauthier
- Predlife, Espace Maurice Tubiana, 39 rue Camille Desmoulins, 94800, Villejuif, France
| | - Donella Puliti
- Clinical Epidemiology Unit, ISPRO - Oncological Network, Prevention and Research Institute, via Cosimo il Vecchio 2, 50139, Florence, Italy
| | - Corinne Balleyguier
- Department of Radiology, Institut Gustave-Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - Camille Baron
- UNICANCER, Institut Bergonié, 229, cours de l'Argonne CS 61283, 33076, Bordeaux Cedex, France
| | - Fiona J Gilbert
- Department of Radiology, NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, CB2 0QQ, UK
| | - André Grivegnée
- Senology Unit, Institute Jules Bordet, Boulevard de Waterloo 121, 1000, Brussels, Belgium
| | - Pierpaolo Pattacini
- Department of Diagnostic Imaging, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Stefan Michiels
- Biostatistics and Epidemiology Service, Centre de Recherche en Epidémiologie et Santé des Populations, Gustave Roussy, Université Paris-Sud, 114, rue Edouard-Vaillant, 94805, Villejuif, France
| | - Suzette Delaloge
- Department of Radiology, Institut Gustave-Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
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Youk JH, Gweon HM, Son EJ, Eun NL, Kim JA. Fully automated measurements of volumetric breast density adapted for BIRADS 5th edition: a comparison with visual assessment. Acta Radiol 2021; 62:1148-1154. [PMID: 32910685 DOI: 10.1177/0284185120956309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since the 5th edition of BI-RADS was released, prior studies have compared BI-RADS and quantitative fully automated volumetric assessment, but with software packages that were not recalibrated according to the 5th edition. PURPOSE To investigate mammographic density assessment of automated volumetric measurements recalibrated according to the BI-RADS 5th edition compared with visual assessment. MATERIAL AND METHODS A total of 4000 full-field digital mammographic examinations were reviewed by three radiologists for the BI-RADS 5th edition density category by consensus after individual assessments. Volumetric density data obtained using Quantra and Volpara software were collected. The comparison of visual and volumetric density assessments was performed in total and according to the presence of cancer. RESULTS Among 4000 examinations, 129 were mammograms of breast cancer. Compared to visual assessment, volumetric measurements showed higher category B (40.6% vs. 19.8%) in Quantra, and higher category D (40.4% vs. 14.7%) and lower category A (0.2% vs. 5.0%) in Volpara (P < 0.0001). All volumetric data showed a difference according to visually assessed categories and were correlated between the two volumetric measurements (P < 0.0001). The group with cancer showed a lower proportion of fatty breast than that without cancer: 17.8% vs. 46.9% for Quantra (P < 0.0001) and 9.3% vs. 21.5% for Volpara (P = 0.003). Both measurements showed significantly higher mean density data in the group with cancer than without cancer (P < 0.005 for all). CONCLUSION Automated volumetric measurements adapted for the BI-RADS 5th edition showed different but correlated results with visual assessment and each other. Recalibration of volumetric measurement has not completely reflected the visual assessment.
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Affiliation(s)
- Ji Hyun Youk
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Mi Gweon
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Ju Son
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Na Lae Eun
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Ah Kim
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Uzan C, Ndiaye-Guèye D, Nikpayam M, Oueld Es Cheikh E, Lebègue G, Canlorbe G, Azais H, Gonthier C, Belghiti J, Benusiglio PR, Séroussi B, Gligorov J, Uzan S. [First results of a breast cancer risk assessment and management consultation]. Bull Cancer 2020; 107:972-981. [PMID: 32977936 DOI: 10.1016/j.bulcan.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/09/2020] [Accepted: 08/08/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In France, participation in the organized breast cancer screening program remains insufficient. A personalized approach adapted to the risk factors for breast cancer (RBC) should make screening more efficient. A RBC evaluation consultation would therefore make it possible to personalize this screening. Here we report our initial experience. MATERIAL AND METHOD This is a prospective study on women who were seen at the RBC evaluation consultation and analyzing: their profile, their risk assessed according to Tyrer Cuzick model (TC)±Mammorisk© (MMR), the existence of an indication of oncogenetic consultation (Eisinger and Manchester score), their satisfaction and the recommended monitoring. RESULTS Among the women who had had a TCS and/or MMR evaluation of SCR (n=153), 76 (50%) had a high risk (n=67) or a very high risk (n=9). Almost half (47%) had a possible (15%) or certain (32%) indication to an oncogenetic consultation. Regarding this consultation, 98% of women were satisfied or very satisfied. In total, 60% of women had a change in screening methods. CONCLUSION This RBC evaluation consultation satisfies women and for a majority of them, modifies their methods of breast cancer screening.
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Affiliation(s)
- Catherine Uzan
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm UMR S938 « Biologie et thérapeutique des cancers », Paris, France; AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France.
| | - Diaretou Ndiaye-Guèye
- AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France
| | - Marianne Nikpayam
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France; AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France
| | - Eva Oueld Es Cheikh
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France; AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France
| | - Geraldine Lebègue
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France; AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France
| | - Geoffroy Canlorbe
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm UMR S938 « Biologie et thérapeutique des cancers », Paris, France; AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France
| | - Henri Azais
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Clementine Gonthier
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Jeremie Belghiti
- AP-HP, hôpital Pitié-Salpêtrière, Sorbonne Université, service de chirurgie et cancérologie gynécologique et mammaire, 47-83, boulevard de l'Hôpital, 75013 Paris, France; AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France
| | - Patrick R Benusiglio
- AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France; AP-HP, groupe hospitalier Pitié-Salpêtrière, Sorbonne Université, département de génétique, UF d'oncogénétique, Paris, France
| | - Brigitte Séroussi
- AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France; Département de santé publique, Tenon, France; Sorbonne Université, université Sorbonne Paris Nord, Inserm, UMR S_1142, LIMICS, Paris, France
| | - Joseph Gligorov
- Inserm UMR S938 « Biologie et thérapeutique des cancers », Paris, France; AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France; AP-HP Tenon, Sorbonne Université, oncologie médicale, Paris, France
| | - Serge Uzan
- AP-HP, institut universitaire de cancérologie, Sorbonne Université (IUC AP-HP.SU), Paris, France
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Comparison of breast density assessment between human eye and automated software on digital and synthetic mammography: Impact on breast cancer risk. Diagn Interv Imaging 2020; 101:811-819. [PMID: 32819886 DOI: 10.1016/j.diii.2020.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/07/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the agreement between automatic assessment software of breast density based on artificial intelligence (AI) and visual assessment by a senior and a junior radiologist, as well as the impact on the assessment of breast cancer risk (BCR) at 5 years. MATERIALS AND METHODS We retrospectively included 311 consecutive women (mean age, 55.6±8.5 [SD]; range: 40-74 years) without a personal history of breast cancer who underwent routine mammography between January 1, 2019 and February 28, 2019. Mammographic breast density (MBD) was independently evaluated by a junior and a senior reader on digital mammography (DM) and synthetic mammography (SM) using BI-RADS (5th edition) and by an AI software. For each MBD, BCR at 5 years was estimated per woman by the AI software. Interobserver agreement for MBD between the two readers and the AI software were evaluated by quadratic κ coefficients. Reproducibility of BCR was assessed by intraclass correlation coefficient (ICC). RESULTS Agreement for MBD assessment on DM and SM was almost perfect between senior and junior radiologists (κ=0.88 [95% CI: 0.84-0.92] and κ=0.86 [95% CI: 0.82-0.90], respectively) and substantial between the senior radiologist and AI (κ=0.79; 95% CI: 0.73-0.84). There was substantial agreement between DM and SM for the senior radiologist (κ=0.79; 95% CI: 0.74-0.84). BCR evaluation at 5 years was highly reproducible between the two radiologists on DM and SM (ICC=0.98 [95% CI: 0.97-0.98] for both), between BCR evaluation based on DM and SM evaluated by the senior (ICC=0.96; 95% CI: 0.95-0.97) or junior radiologist (ICC=0.97; 95% CI: 0.96-0.98) and between the senior radiologist and AI (ICC=0.96; 95% CI: 0.95-0.97). CONCLUSION This preliminary study demonstrates a very good agreement for BCR evaluation based on the evaluation of MBD by a senior radiologist, junior radiologist and AI software.
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Artificial intelligence and breast screening: French Radiology Community position paper. Diagn Interv Imaging 2019; 100:553-566. [DOI: 10.1016/j.diii.2019.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/20/2019] [Accepted: 08/26/2019] [Indexed: 01/02/2023]
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