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Akwo JD, Trieu PDY, Barron ML, Reynolds T, Lewis SJ. Access to prior screening mammograms affects the specificity but not sensitivity of radiologists' performance. Clin Radiol 2024:S0009-9260(24)00512-9. [PMID: 39370324 DOI: 10.1016/j.crad.2024.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 09/05/2024] [Accepted: 09/12/2024] [Indexed: 10/08/2024]
Abstract
AIMS To establish the impact that access to prior mammograms has on radiologists' performance and the influence of radiologists' characteristics and breast density on their subsequent performance. METHODS Eight participants independently interpreted 72 digital screening mammograms in two reading sessions using the Royal Australian and New Zealand College of Radiologist's classification. In the first reading session, participants were given access to current and prior mammograms. In the second reading session six months later, participants only had access to the current mammograms. Radiologists' specificity, sensitivity, lesion sensitivity, Receiver Operating Characteristic (ROC) curve, and Jacknife Alternative Free-response ROC (JAFROC) were calculated. A Paired T-test was used to compare readings with and without prior mammograms, and to assess if breast density influenced participants performance. Independent Sample T-test was used to compare performance across radiologists' characteristics. A relative risk analysis was conducted to assess the probability of false positives and false negatives when prior mammograms were available. RESULTS Access to prior mammograms improved specificity in dense and non-dense breasts (p≤0.01) and reduced false positives (p = 0.01) but had no effect on sensitivity (p = 0.37), lesion sensitivity (p = 0.67), ROC (p = 0.16), and JAFROC (p = 0.24). Prior mammogram also reduced the probability of false positives (RR = 0.38; 95%CI:0.26-0.57, p<0.0001) without affecting the false negative rate (RR = 1.14; 95%CI:0.88-1.49, p = 0.30). The impact of prior mammograms on performance was not influenced by breast density or radiologists' characteristics. CONCLUSIONS Access to prior mammograms improves radiologists' specificity and reduces false positives without affecting sensitivity and the false negative rate regardless of radiologists' characteristics and breast density.
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Affiliation(s)
- J D Akwo
- Medical Image Optimisation and Perception Group, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
| | - P D Yun Trieu
- Medical Image Optimisation and Perception Group, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - M L Barron
- Medical Image Optimisation and Perception Group, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - T Reynolds
- Medical Image Optimisation and Perception Group, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - S J Lewis
- Medical Image Optimisation and Perception Group, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; School of Health Sciences, Western Sydney University, Campbelltown, Australia
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2
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Upadhyay N, Wolska J. Imaging the dense breast. J Surg Oncol 2024; 130:29-35. [PMID: 38685673 DOI: 10.1002/jso.27661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
The sensitivity of mammography reduces as breast density increases, which impacts breast screening and locoregional staging in breast cancer. Supplementary imaging with other modalities can offer improved cancer detection, but this often comes at the cost of more false positives. Magnetic resonance imaging and contrast-enhanced mammography, which assess tumour enhancement following contrast administration, are more sensitive than digital breast tomosynthesis and ultrasound, which predominantly rely on the assessment of tumour morphology.
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Affiliation(s)
- Neil Upadhyay
- Faculty of Medicine, Imperial College London, London, UK
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Joanna Wolska
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
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3
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Park-Simon TW, Müller V, Albert US, Banys Paluchowski M, Bauerfeind I, Blohmer JU, Budach W, Dall P, Ditsch N, Fallenberg EM, Fasching PA, Fehm T, Friedrich M, Gerber B, Gluz O, Harbeck N, Hartkopf AD, Heil J, Huober J, Jackisch C, Kolberg-Liedtke C, Kreipe HH, Krug D, Kühn T, Kümmel S, Loibl S, Lüftner D, Lux MP, Maass N, Mundhenke C, Reimer T, Rhiem K, Rody A, Schmidt M, Schneeweiss A, Schütz F, Sinn HP, Solbach C, Solomayer EF, Stickeler E, Thomssen C, Untch M, Witzel I, Wuerstlein R, Wöckel A, Janni W, Thill M. Arbeitsgemeinschaft Gynäkologische Onkologie Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2024. Breast Care (Basel) 2024; 19:165-182. [PMID: 38894952 PMCID: PMC11182637 DOI: 10.1159/000538596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction Each year the interdisciplinary AGO (Arbeitsgemeinschaft Gynäkologische Onkologie, German Gynecological Oncology Group) Breast Committee on Diagnosis and Treatment of Breast Cancer provides updated state-of-the-art recommendations for early and metastatic breast cancer. Methods The updated evidence-based treatment recommendations for early and metastatic breast cancer have been released in March 2024. Results and Conclusion This paper concisely captures the updated recommendations for early breast cancer chapter by chapter.
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Affiliation(s)
- Tjoung-Won Park-Simon
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover, Hanover, Germany
| | - Volkmar Müller
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Ute-Susann Albert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Maggie Banys Paluchowski
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Ingo Bauerfeind
- Frauenklinik und Brustzentrum Klinikum Landshut, AdöR, Landshut, Germany
| | - Jens-Uwe Blohmer
- Klinik für Gynäkologie und Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany
| | - Wilfried Budach
- Klinik für Strahlentherapie und Radioonkologie Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Peter Dall
- Klinik für Gynäkologie und Geburtshilfe, Städtisches Klinikum Lüneburg, Lüneburg, Germany
| | - Nina Ditsch
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Eva M. Fallenberg
- Institute of Diagnostic and Interventional Radiology, TUM School of Medicine & Health, Klinikum Rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Peter A. Fasching
- Universitätsfrauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Tanja Fehm
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Düsseldorf, CIO ABCD, Düsseldorf, Germany
| | - Michael Friedrich
- Klinik für Frauenheilkunde und Geburtshilfe, Helios Klinikum Krefeld GmbH, Krefeld, Germany
| | - Bernd Gerber
- Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt, Rostock, Germany
| | - Oleg Gluz
- Brustzentrum, Evang, Krankenhaus Bethesda, Mönchengladbach, Germany
| | - Nadia Harbeck
- Department of Obstetrics and Gynecology, Breast Center, BZKF, LMU University Hospital Munich and CCC Munich, Munich, Germany
| | - Andreas Daniel Hartkopf
- Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Jörg Heil
- Brustzentrum Heidelberg, Klinik St. Elisabeth und Klinik für Frauenheilkunde und Geburtshilfe, Sektion Senologie, Universitäts-Klinikum Heidelberg, Heidelberg, Germany
| | - Jens Huober
- Brustzentrum, Kantonspital St. Gallen, St. Gallen, Switzerland
| | | | | | | | - David Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thorsten Kühn
- Filderklinik, Filderstadt, Brustzentrum und Universitätsklinik Ulm, Ulm, Germany
| | - Sherko Kümmel
- Frauenheilkunde/Brustzentrum Evangelische Kliniken Essen Mitte, Essen, Germany
| | - Sibylle Loibl
- German Breast Group Forschungs GmbH, Frankfurt, Germany
| | - Diana Lüftner
- Immanuel Klinik Märkische Schweiz (Buckow) and Immanuel Klinik Rüdersdorf, Medizinische Hochschule Brandenburg Theodor Fontane (Rüdersdorf), Rüdersdorf, Germany
| | - Michael Patrick Lux
- Kooperatives Brustzentrum Paderborn, Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn und St. Josefs-Krankenhaus, Salzkotten, St. Vincenz-Krankenhaus GmbH, Paderborn, Germany
| | - Nicolai Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christoph Mundhenke
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Bayreuth, Bayreuth, Germany
| | - Toralf Reimer
- Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt, Rostock, Germany
| | - Kerstin Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs, Centrum für Integrierte Onkologie (CIO), Universitätsklinikum Köln, Köln, Germany
| | - Achim Rody
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Marcus Schmidt
- Klinik und Poliklinik für Geburtshilfe und Frauengesundheit Universitätsmedizin Mainz, Mainz, Germany
| | - Andreas Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum und Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Florian Schütz
- Klinik für Gynäkologie und Geburtshilfe, Diakonissen Krankenhaus Speyer, Speyer, Germany
| | - Hans-Peter Sinn
- Sektion Gynäkopathologie, Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Christine Solbach
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - Erich-Franz Solomayer
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Elmar Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Universitätsklinikum Aachen und CIO ABCD, Aachen, Germany
| | | | - Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Isabell Witzel
- Department of Gynecology, University Medical Center Zurich, University of Zurich, Zurich, Switzerland
| | - Rachel Wuerstlein
- Department of Obstetrics and Gynecology, Breast Center, BZKF, LMU University Hospital Munich and CCC Munich, Munich, Germany
| | - Achim Wöckel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Wolfgang Janni
- Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Marc Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt, Germany
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Gómez-Flores W, Gregorio-Calas MJ, Coelho de Albuquerque Pereira W. BUS-BRA: A breast ultrasound dataset for assessing computer-aided diagnosis systems. Med Phys 2024; 51:3110-3123. [PMID: 37937827 DOI: 10.1002/mp.16812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE Computer-aided diagnosis (CAD) systems on breast ultrasound (BUS) aim to increase the efficiency and effectiveness of breast screening, helping specialists to detect and classify breast lesions. CAD system development requires a set of annotated images, including lesion segmentation, biopsy results to specify benign and malignant cases, and BI-RADS categories to indicate the likelihood of malignancy. Besides, standardized partitions of training, validation, and test sets promote reproducibility and fair comparisons between different approaches. Thus, we present a publicly available BUS dataset whose novelty is the substantial increment of cases with the above-mentioned annotations and the inclusion of standardized partitions to objectively assess and compare CAD systems. ACQUISITION AND VALIDATION METHODS The BUS dataset comprises 1875 anonymized images from 1064 female patients acquired via four ultrasound scanners during systematic studies at the National Institute of Cancer (Rio de Janeiro, Brazil). The dataset includes biopsy-proven tumors divided into 722 benign and 342 malignant cases. Besides, a senior ultrasonographer performed a BI-RADS assessment in categories 2 to 5. Additionally, the ultrasonographer manually outlined the breast lesions to obtain ground truth segmentations. Furthermore, 5- and 10-fold cross-validation partitions are provided to standardize the training and test sets to evaluate and reproduce CAD systems. Finally, to validate the utility of the BUS dataset, an evaluation framework is implemented to assess the performance of deep neural networks for segmenting and classifying breast lesions. DATA FORMAT AND USAGE NOTES The BUS dataset is publicly available for academic and research purposes through an open-access repository under the name BUS-BRA: A Breast Ultrasound Dataset for Assessing CAD Systems. BUS images and reference segmentations are saved in Portable Network Graphic (PNG) format files, and the dataset information is stored in separate Comma-Separated Value (CSV) files. POTENTIAL APPLICATIONS The BUS-BRA dataset can be used to develop and assess artificial intelligence-based lesion detection and segmentation methods, and the classification of BUS images into pathological classes and BI-RADS categories. Other potential applications include developing image processing methods like despeckle filtering and contrast enhancement methods to improve image quality and feature engineering for image description.
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Affiliation(s)
- Wilfrido Gómez-Flores
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Tamaulipas, Mexico
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5
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Kerlikowske K, Zhu W, Su YR, Sprague BL, Stout NK, Onega T, O’Meara ES, Henderson LM, Tosteson ANA, Wernli K, Miglioretti DL. Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density. J Natl Cancer Inst 2024; 116:249-257. [PMID: 37897090 PMCID: PMC10852604 DOI: 10.1093/jnci/djad201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Examining screening outcomes by breast density for breast magnetic resonance imaging (MRI) with or without mammography could inform discussions about supplemental MRI in women with dense breasts. METHODS We evaluated 52 237 women aged 40-79 years who underwent 2611 screening MRIs alone and 6518 supplemental MRI plus mammography pairs propensity score-matched to 65 810 screening mammograms. Rates per 1000 examinations of interval, advanced, and screen-detected early stage invasive cancers and false-positive recall and biopsy recommendation were estimated by breast density (nondense = almost entirely fatty or scattered fibroglandular densities; dense = heterogeneously/extremely dense) adjusting for registry, examination year, age, race and ethnicity, family history of breast cancer, and prior breast biopsy. RESULTS Screen-detected early stage cancer rates were statistically higher for MRI plus mammography vs mammography for nondense (9.3 vs 2.9; difference = 6.4, 95% confidence interval [CI] = 2.5 to 10.3) and dense (7.5 vs 3.5; difference = 4.0, 95% CI = 1.4 to 6.7) breasts and for MRI vs MRI plus mammography for dense breasts (19.2 vs 7.5; difference = 11.7, 95% CI = 4.6 to 18.8). Interval rates were not statistically different for MRI plus mammography vs mammography for nondense (0.8 vs 0.5; difference = 0.4, 95% CI = -0.8 to 1.6) or dense breasts (1.5 vs 1.4; difference = 0.0, 95% CI = -1.2 to 1.3), nor were advanced cancer rates. Interval rates were not statistically different for MRI vs MRI plus mammography for nondense (2.6 vs 0.8; difference = 1.8 (95% CI = -2.0 to 5.5) or dense breasts (0.6 vs 1.5; difference = -0.9, 95% CI = -2.5 to 0.7), nor were advanced cancer rates. False-positive recall and biopsy recommendation rates were statistically higher for MRI groups than mammography alone. CONCLUSION MRI screening with or without mammography increased rates of screen-detected early stage cancer and false-positives for women with dense breasts without a concomitant decrease in advanced or interval cancers.
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Affiliation(s)
- Karla Kerlikowske
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, CA, USA
| | - Weiwei Zhu
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Yu-Ru Su
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Brian L Sprague
- Departments of Surgery and Radiology, University of Vermont, Burlington, VT, USA
| | - Natasha K Stout
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Tracy Onega
- Department of Population Health Sciences, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ellen S O’Meara
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Louise M Henderson
- Department of Radiology, University of North Carolina, Chapel Hill, NC, USA
| | - Anna N A Tosteson
- The Dartmouth Institute for Health Policy and Clinical Practice and Dartmouth Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Karen Wernli
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Diana L Miglioretti
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
- Department of Public Health Sciences, University of California, Davis, CA, USA
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Enogieru IE, Comstock CE, Grimm LJ. Breast Cancer Screening and Treatment Clinical Trials Updated for 2023. JOURNAL OF BREAST IMAGING 2024; 6:14-22. [PMID: 38243862 DOI: 10.1093/jbi/wbad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Indexed: 01/22/2024]
Abstract
There are many active or recently completed breast cancer screening and treatment trials in 2023 that have the potential to fundamentally change the way breast radiologists practice medicine. Breast cancer screening trials may provide evidence to support supplemental screening beyond mammography to include US, contrast-enhanced mammography, and breast MRI. Furthermore, there are multiple efforts to support risk-adaptive screening strategies that would personalize screening modalities, frequencies, and ages of initiation. For breast cancer treatment, aims to reduce overtreatment may provide nonsurgical treatment options for women with low-risk breast cancer. Breast radiologists must be familiar with the study designs, major inclusion and exclusion criteria, and principal endpoints in order to determine when and how the study results should influence clinical care. As multidisciplinary team members, breast radiologists will have major roles in the success or failure of these trials as they transition from research to actual clinical practice.
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Affiliation(s)
- Imarhia E Enogieru
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| | | | - Lars J Grimm
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
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Gómez-Flores W, Pereira WCDA. Gray-to-color image conversion in the classification of breast lesions on ultrasound using pre-trained deep neural networks. Med Biol Eng Comput 2023; 61:3193-3207. [PMID: 37713158 DOI: 10.1007/s11517-023-02928-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
Breast ultrasound (BUS) image classification in benign and malignant classes is often based on pre-trained convolutional neural networks (CNNs) to cope with small-sized training data. Nevertheless, BUS images are single-channel gray-level images, whereas pre-trained CNNs learned from color images with red, green, and blue (RGB) components. Thus, a gray-to-color conversion method is applied to fit the BUS image to the CNN's input layer size. This paper evaluates 13 gray-to-color conversion methods proposed in the literature that follow three strategies: replicating the gray-level image to all RGB channels, decomposing the image to enhance inherent information like the lesion's texture and morphology, and learning a matching layer. Besides, we introduce an image decomposition method based on the lesion's structural information to describe its inner and outer complexity. These gray-to-color conversion methods are evaluated under the same experimental framework using a pre-trained CNN architecture named ResNet-18 and a BUS dataset with more than 3000 images. In addition, the Matthews correlation coefficient (MCC), sensitivity (SEN), and specificity (SPE) measure the classification performance. The experimental results show that decomposition methods outperform replication and learning-based methods when using information from the lesion's binary mask (obtained from a segmentation method), reaching an MCC value greater than 0.70 and specificity up to 0.92, although the sensitivity is about 0.80. On the other hand, regarding the proposed method, the trade-off between sensitivity and specificity is better balanced, obtaining about 0.88 for both indices and an MCC of 0.73. This study contributes to the objective assessment of different gray-to-color conversion approaches in classifying breast lesions, revealing that mask-based decomposition methods improve classification performance. Besides, the proposed method based on structural information improves the sensitivity, obtaining more reliable classification results on malignant cases and potentially benefiting clinical practice.
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Affiliation(s)
- Wilfrido Gómez-Flores
- Centro de Investigación y de Estudios Avanzados del IPN, Unidad Tamaulipas, Ciudad Victoria, 87138, Tamaulipas, Mexico.
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8
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Ren W, Yan H, Zhao X, Jia M, Zhang S, Zhang J, Li Z, Ming L, Zhang Y, Li H, He L, Li X, Cheng X, Yue L, Zhou W, Qiao Y, Zhao F. Integration of Handheld Ultrasound or Automated Breast Ultrasound among Women with Negative Mammographic Screening Findings: A Multi-center Population-based Study in China. Acad Radiol 2023; 30 Suppl 2:S114-S126. [PMID: 37003874 DOI: 10.1016/j.acra.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 04/03/2023]
Abstract
RATIONALE AND OBJECTIVES This study assessed the role of second-look automated breast ultrasound (ABUS) adjunct to mammography (MAM) versus MAM alone in asymptomatic women and compared it with supplementing handheld ultrasound (HHUS). MATERIALS AND METHODS Women aged 45 to 64 underwent HHUS, ABUS, and MAM among six hospitals in China from 2018 to 2022. We compared the screening performance of three strategies (MAM alone, MAM plus HHUS, and MAM plus ABUS) stratified by age groups and breast density. McNemar's test was used to assess differences in the cancer detection rate (CDR), the false-positive biopsy rate, sensitivity, and specificity of different strategies. RESULTS Of 19,171 women analyzed (mean [SD] age, 51.54 [4.61] years), 72 cases of breast cancer (3.76 per 1000) were detected. The detection rates for both HHUS and ABUS combined with MAM were statistically higher than those for MAM alone (all p < 0.001). There was no significant difference in cancer yields between the two integration strategies. The increase in CRD of the integrated strategies was higher in women aged 45-54 years with denser breasts compared with MAM alone (all p < 0.0167). In addition, the false-positive biopsy rate of MAM plus ABUS was lower than that of MAM plus HHUS (p = 0.025). Moreover, the retraction in ABUS was more frequent in cases detected among MAM-negative results. CONCLUSION Integrated ABUS or HHUS into MAM provided similar CDRs that were significantly higher than those for MAM alone in younger women (45-54 years) with denser breasts. ABUS has the potential to avoid unnecessary biopsies and provides specific image features to distinguish malignant tumors from HHUS.
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Affiliation(s)
- Wenhui Ren
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijiao Yan
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuelian Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengmeng Jia
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, Henan, China
| | - Junpeng Zhang
- Department of Breast Surgery, Xinmi Maternal and Child Health Care Hospital, Xinmi, Henan, China
| | - Zhifang Li
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
| | - Lingling Ming
- Department of Breast Surgery, Zezhou Maternal and Child Health Care Hospital, Zezhou, Shanxi, China
| | - Yongdong Zhang
- Department of Ultrasound, Jungar Banner Maternal and Child Care Service Centre, Jungar, Inner Mongolia, China
| | - Huibing Li
- Department of Women Health, Chongzhou Maternal & Child Health Care Hospital, Chongzhou, Sichuan, China
| | - Lichun He
- Physical Examination Center, Mianyang Maternal & Child Health Care Hospital, Mianyang Children's Hospital, Mianyang, Sichuan, China
| | - Xiaofeng Li
- School of Public Health, Dalian Medical University, Dalian, Liaoning, China
| | - Xia Cheng
- Department of Women Health, Dalian Women and Children's Medical Group, Dalian, Liaoning, China
| | - Lu Yue
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wenjing Zhou
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Champendal M, Marmy L, Malamateniou C, Sá Dos Reis C. Artificial intelligence to support person-centred care in breast imaging - A scoping review. J Med Imaging Radiat Sci 2023; 54:511-544. [PMID: 37183076 DOI: 10.1016/j.jmir.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 05/16/2023]
Abstract
AIM To overview Artificial Intelligence (AI) developments and applications in breast imaging (BI) focused on providing person-centred care in diagnosis and treatment for breast pathologies. METHODS The scoping review was conducted in accordance with the Joanna Briggs Institute methodology. The search was conducted on MEDLINE, Embase, CINAHL, Web of science, IEEE explore and arxiv during July 2022 and included only studies published after 2016, in French and English. Combination of keywords and Medical Subject Headings terms (MeSH) related to breast imaging and AI were used. No keywords or MeSH terms related to patients, or the person-centred care (PCC) concept were included. Three independent reviewers screened all abstracts and titles, and all eligible full-text publications during a second stage. RESULTS 3417 results were identified by the search and 106 studies were included for meeting all criteria. Six themes relating to the AI-enabled PCC in BI were identified: individualised risk prediction/growth and prediction/false negative reduction (44.3%), treatment assessment (32.1%), tumour type prediction (11.3%), unnecessary biopsies reduction (5.7%), patients' preferences (2.8%) and other issues (3.8%). The main BI modalities explored in the included studies were magnetic resonance imaging (MRI) (31.1%), mammography (27.4%) and ultrasound (23.6%). The studies were predominantly retrospective, and some variations (age range, data source, race, medical imaging) were present in the datasets used. CONCLUSIONS The AI tools for person-centred care are mainly designed for risk and cancer prediction and disease management to identify the most suitable treatment. However, further studies are needed for image acquisition optimisation for different patient groups, improvement and customisation of patient experience and for communicating to patients the options and pathways of disease management.
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Affiliation(s)
- Mélanie Champendal
- School of Health Sciences HESAV, HES-SO; University of Applied Sciences Western Switzerland: Lausanne, CH.
| | - Laurent Marmy
- School of Health Sciences HESAV, HES-SO; University of Applied Sciences Western Switzerland: Lausanne, CH.
| | - Christina Malamateniou
- School of Health Sciences HESAV, HES-SO; University of Applied Sciences Western Switzerland: Lausanne, CH; Department of Radiography, Division of Midwifery and Radiography, School of Health Sciences, University of London, London, UK.
| | - Cláudia Sá Dos Reis
- School of Health Sciences HESAV, HES-SO; University of Applied Sciences Western Switzerland: Lausanne, CH.
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10
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Park-Simon TW, Müller V, Jackisch C, Albert US, Banys-Paluchowski M, Bauerfeind I, Blohmer JU, Budach W, Dall P, Ditsch N, Fallenberg EM, Fasching PA, Fehm T, Friedrich M, Gerber B, Gluz O, Harbeck N, Hartkopf AD, Heil J, Huober J, Kolberg-Liedtke C, Kreipe HH, Krug D, Kühn T, Kümmel S, Loibl S, Lüftner D, Lux MP, Maass N, Mundhenke C, Reimer T, Rhiem K, Rody A, Schmidt M, Schneeweiss A, Schütz F, Sinn HP, Solbach C, Solomayer EF, Stickeler E, Thomssen C, Untch M, Witzel I, Wöckel A, Wuerstlein R, Janni W, Thill M. Arbeitsgemeinschaft Gynäkologische Onkologie Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2023. Breast Care (Basel) 2023; 18:289-305. [PMID: 37900552 PMCID: PMC10601667 DOI: 10.1159/000531578] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 10/31/2023] Open
Abstract
Background Each year the interdisciplinary Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), German Gynecological Oncology Group Breast Committee on Diagnosis and Treatment of Breast Cancer provides updated state-of-the-art recommendations for early and metastatic breast cancer. Summary The updated evidence-based treatment recommendation for early and metastatic breast cancer has been released in March 2023. Key Messages This paper concisely captures the updated recommendations for early breast cancer chapter by chapter.
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Affiliation(s)
- Tjoung-Won Park-Simon
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover, Hannover, Germany
| | - Volkmar Müller
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach GmbH, Offenbach, Germany
| | - Ute-Susann Albert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Maggie Banys-Paluchowski
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Kiel, Germany
| | - Ingo Bauerfeind
- Frauenklinik, Klinikum Landshut gemeinnützige GmbH, Landshut, Germany
| | - Jens-Uwe Blohmer
- Klinik für Gynäkologie und Brustzentrum des Universitätsklinikums der Charite, Berlin, Germany
| | - Wilfried Budach
- Klinik für Strahlentherapie und Radioonkologie Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Peter Dall
- Klinik für Gynäkologie und Geburtshilfe, Städtisches Klinikum Lüneburg, Lüneburg, Germany
| | - Nina Ditsch
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Eva Maria Fallenberg
- Institut für diagnostische und Interventionelle Radiologie, Klinikum der Technischen Universität München, Rechts der Isar, Munich, Germany
| | - Peter A. Fasching
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Tanja Fehm
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Michael Friedrich
- Klinik für Frauenheilkunde und Geburtshilfe, Helios Klinikum Krefeld GmbH, Krefeld, Germany
| | - Bernd Gerber
- Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt, Rostock, Germany
| | - Oleg Gluz
- Brustzentrum, Evang. Krankenhaus Bethesda, Mönchengladbach, Germany
| | - Nadia Harbeck
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany
| | - Andreas D. Hartkopf
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Joerg Heil
- Brustzentrum Heidelberg, Klinik St. Elisabeth und Klinik für Frauenheilkunde und Geburtshilfe, Sektion Senologie, Universitäts-Klinikum Heidelberg, Heidelberg, Germany
| | - Jens Huober
- Brustzentrum, Kantonspital St. Gallen, St. Gallen, Switzerland
| | - Cornelia Kolberg-Liedtke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Essen, Phaon GmbH, Wiesbaden, Germany
| | - Hans H. Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - David Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thorsten Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Germany
| | - Sherko Kümmel
- Klinik für Senologie, Evangelische Kliniken Essen Mitte, Essen, Germany
| | - Sibylle Loibl
- German Breast Group Forschungs GmbH, Frankfurt, Germany
| | - Diana Lüftner
- Immanuel Klinik Märkische Schweiz (Buckow) & Immanuel Klinik Rüdersdorf/Medizinische Hochschule Brandenburg Theodor Fontane (Rüdersdorf), Rüdersdorf, Germany
| | - Michael Patrick Lux
- Kooperatives Brustzentrum Paderborn, Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn und St. Josefs-Krankenhaus, Salzkotten, St. Vincenz-Krankenhaus GmbH, Paderborn, Germany
| | - Nicolai Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Toralf Reimer
- Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt, Rostock, Germany
| | - Kerstin Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs, Centrum für Integrierte Onkologie (CIO), Universitätsklinikum Köln, Cologne, Germany
| | - Achim Rody
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Kiel, Germany
| | - Marcus Schmidt
- Klinik und Poliklinik für Geburtshilfe und Frauengesundheit der Johannes-Gutenberg-Universität Mainz, Mainz, Germany
| | - Andreas Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum und Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Florian Schütz
- Klinik für Gynäkologie und Geburtshilfe, Diakonissen Krankenhaus Speyer, Speyer, Germany
| | - Hans Peter Sinn
- Sektion Gynäkopathologie, Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Christine Solbach
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - Erich-Franz Solomayer
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Elmar Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Universitätsklinikum Aachen, Aachen, Germany
| | | | - Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Isabell Witzel
- Department of Gynecology, University Medical Center Zurich, University of Zurich, Zurich, Switzerland
| | - Achim Wöckel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Rachel Wuerstlein
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany
| | - Wolfgang Janni
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Marc Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt, Germany
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Urban LABD, Chala LF, Paula IBD, Bauab SDP, Schaefer MB, Oliveira ALK, Shimizu C, Oliveira TMGD, Moraes PDC, Miranda BMM, Aduan FE, Rego SDJF, Canella EDO, Couto HL, Badan GM, Francisco JLE, Moraes TP, Jakubiak RR, Peixoto JE. Recommendations for the Screening of Breast Cancer of the Brazilian College of Radiology and Diagnostic Imaging, Brazilian Society of Mastology and Brazilian Federation of Gynecology and Obstetrics Association. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:e480-e488. [PMID: 37683660 PMCID: PMC10491472 DOI: 10.1055/s-0043-1772498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE To present the update of the recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology and the Brazilian Federation of Associations of Gynecology and Obstetrics for breast cancer screening in Brazil. METHODS Scientific evidence published in Medline, EMBASE, Cochrane Library, EBSCO, CINAHL and Lilacs databases between January 2012 and July 2022 was searched. Recommendations were based on this evidence by consensus of the expert committee of the three entities. RECOMMENDATIONS Annual mammography screening is recommended for women at usual risk aged 40-74 years. Above 75 years, it should be reserved for those with a life expectancy greater than seven years. Women at higher than usual risk, including those with dense breasts, with a personal history of atypical lobular hyperplasia, classic lobular carcinoma in situ, atypical ductal hyperplasia, treatment for breast cancer or chest irradiation before age 30, or even, carriers of a genetic mutation or with a strong family history, benefit from complementary screening, and should be considered individually. Tomosynthesis is a form of mammography and should be considered in screening whenever accessible and available.
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Affiliation(s)
| | - Luciano Fernandes Chala
- National Mammography Commission, Brazilian College of Radiology and Diagnostic Imaging, São Paulo, SP, Brazil
| | - Ivie Braga de Paula
- Brazilian College of Radiology and Diagnostic Imaging, São Paulo, SP, Brazil
| | - Selma di Pace Bauab
- Brazilian College of Radiology and Diagnostic Imaging, São Paulo, SP, Brazil
| | | | | | - Carlos Shimizu
- Brazilian College of Radiology and Diagnostic Imaging, São Paulo, SP, Brazil
| | | | | | | | - Flávia Engel Aduan
- Brazilian College of Radiology and Diagnostic Imaging, São Paulo, SP, Brazil
| | | | | | - Henrique Lima Couto
- National Mammography Commission, Representative of the Brazilian Society of Mastology, São Paulo, SP, Brazil
| | - Gustavo Machado Badan
- National Mammography Commission, Representative of the Brazilian Society of Mastology, São Paulo, SP, Brazil
| | - José Luis Esteves Francisco
- National Mammography Commission, Representative of the Brazilian Federation of Associations of Gynecology and Obstetrics, São Paulo, SP, Brazil
| | - Thaís Paiva Moraes
- National Mammography Commission, Representative of the Brazilian Federation of Associations of Gynecology and Obstetrics, São Paulo, SP, Brazil
| | | | - João Emílio Peixoto
- Brazilian College of Radiology and Diagnostic Imaging, São Paulo, SP, Brazil
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12
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Urban LABD, Chala LF, de Paula IB, Bauab SDP, Schaefer MB, Oliveira ALK, Shimizu C, de Oliveira TMG, Moraes PDC, Miranda BMM, Aduan FE, Rego SDJF, Canella EDO, Couto HL, Badan GM, Francisco JLE, Moraes TP, Jakubiak RR, Peixoto JE. Recommendations for breast cancer screening in Brazil, from the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology, and the Brazilian Federation of Gynecology and Obstetrics Associations. Radiol Bras 2023; 56:207-214. [PMID: 37829583 PMCID: PMC10567087 DOI: 10.1590/0100-3984.2023.0064-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 10/14/2023] Open
Abstract
Objective To present an update of the recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology, and the Brazilian Federation of Gynecology and Obstetrics Associations for breast cancer screening in Brazil. Materials and Methods Scientific evidence published between January 2012 and July 2022 was gathered from the following databases: Medline (PubMed); Excerpta Medica (Embase); Cochrane Library; Ebsco; Cumulative Index to Nursing and Allied Health Literature (Cinahl); and Latin-American and Caribbean Health Sciences Literature (Lilacs). Recommendations were based on that evidence and were arrived at by consensus of a joint committee of experts from the three entities.Recommendations: Annual mammographic screening is recommended for women between 40 and 74 years of age. For women at or above the age of 75, screening should be reserved for those with a life expectancy greater than seven years. Women at higher than average risk are considered by category: those with dense breasts; those with a personal history of atypical lobular hyperplasia, classical lobular carcinoma in situ, or atypical ductal hyperplasia; those previously treated for breast cancer; those having undergone thoracic radiotherapy before age 30; and those with a relevant genetic mutation or a strong family history. The benefits of complementary screening are also addressed according to the subcategories above. The use of tomosynthesis, which is an evolved form of mammography, should be considered in screening, whenever accessible and available.
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Affiliation(s)
- Linei Augusta Brolini Delle Urban
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Luciano Fernandes Chala
- Coordinator of the National Mammography Commission of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Ivie Braga de Paula
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Selma di Pace Bauab
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Marcela Brisighelli Schaefer
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Ana Lúcia Kefalás Oliveira
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Carlos Shimizu
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Tatiane Mendes Gonçalves de Oliveira
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Paula de Camargo Moraes
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Beatriz Medicis Maranhão Miranda
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Flávia Engel Aduan
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Salete de Jesus Fonseca Rego
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Ellyete de Oliveira Canella
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - Henrique Lima Couto
- Members of the National Mammography Commission, Representatives of the Sociedade Brasileira de Mastologia (SBM), Rio de Janeiro, RJ, Brazil
| | - Gustavo Machado Badan
- Members of the National Mammography Commission, Representatives of the Sociedade Brasileira de Mastologia (SBM), Rio de Janeiro, RJ, Brazil
| | - José Luis Esteves Francisco
- Members of the National Mammography Commission, Representatives of the Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO), Rio de Janeiro, RJ, Brazil
| | - Thaís Paiva Moraes
- Members of the National Mammography Commission, Representatives of the Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO), Rio de Janeiro, RJ, Brazil
| | - Rosangela Requi Jakubiak
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
| | - João Emílio Peixoto
- Members of the National Mammography Commission, Representatives of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), São Paulo, SP, Brazil
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Lobig F, Caleyachetty A, Forrester L, Morris E, Newstead G, Harris J, Blankenburg M. Performance of Supplemental Imaging Modalities for Breast Cancer in Women With Dense Breasts: Findings From an Umbrella Review and Primary Studies Analysis. Clin Breast Cancer 2023:S1526-8209(23)00088-5. [PMID: 37202338 DOI: 10.1016/j.clbc.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/28/2023] [Accepted: 04/14/2023] [Indexed: 05/20/2023]
Abstract
Breast cancer screening performance of supplemental imaging modalities by breast density and breast cancer risk has not been widely studied, and the optimal choice of modality for women with dense breasts remains unclear in clinical practice and guidelines. This systematic review aimed to assess breast cancer screening performance of supplemental imaging modalities for women with dense breasts, by breast cancer risk. Systematic reviews (SRs) in 2000 to 2021, and primary studies in 2019 to 2021, on outcomes of supplemental screening modalities (digital breast tomography [DBT], MRI (full/abbreviated protocol), contrast enhanced mammography (CEM), ultrasound (hand-held [HHUS]/automated [ABUS]) in women with dense breasts (BI-RADS C&D) were identified. None of the SRs analyzed outcomes by cancer risk. Meta-analysis of the primary studies was not feasible due to lack of studies (MRI, CEM, DBT) or methodological heterogeneity (ultrasound); therefore, findings were summarized narratively. For average risk, a single MRI trial reported a superior screening performance (higher cancer detection rate [CDR] and lower interval cancer rate [ICR]) compared to HHUS, ABUS and DBT. For intermediate risk, ultrasound was the only modality assessed, but accuracy estimates ranged widely. For mixed risk, a single CEM study reported the highest CDR, but included a high proportion of women with intermediate risk. This systematic review does not allow a complete comparison of supplemental screening modalities for dense breast populations by breast cancer risk. However, the data suggest that MRI and CEM might generally offer superior screening performance versus other modalities. Further studies of screening modalities are urgently required.
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Affiliation(s)
| | | | | | - Elizabeth Morris
- University of California Davis, Department of Radiology, Sacramento, CA 95817, USA
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Tittmann J, Csanádi M, Ágh T, Széles G, Vokó Z, Kallai Á. Development of a breast cancer screening protocol to use automated breast ultrasound in a local setting. Front Public Health 2023; 10:1071317. [PMID: 36684917 PMCID: PMC9846565 DOI: 10.3389/fpubh.2022.1071317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction The sensitivity of mammography screening is lower in women with dense breast. Increasing the efficacy of breast cancer screening have received special attention recently. The automated breast ultrasound (ABUS) shows promising results to complement mammography. Our aim was to expand the existing breast cancer screening protocol with ABUS within a Hungarian pilot project. Methods First, we developed a protocol for the screening process focusing on integrating ABUS to the current practice. Consensus among clinical experts was achieved considering information from the literature and the actual opportunities of the hospital. Then we developed a protocol for evaluation that ensures systematic data collection and monitoring of screening with mammography and ABUS. We identified indicators based on international standards and adapted them to local setting. We considered their feasibility from the data source and timeframe perspective. The protocol was developed in a partnership of researchers, clinicians and hospital managers. Results The process of screening activity was described in a detailed flowchart. Human and technological resource requirements and communication activities were defined. We listed 23 monitoring indicators to evaluate the screening program and checked the feasibility to calculate these indicators based on local data collection and other sources. Partnership between researchers experienced in planning and evaluating screening programs, interested clinicians, and hospital managers resulted in a locally implementable, evidence-based screening protocol. Discussion The experience and knowledge gained on the implementation of the ABUS technology could generate real-world data to support the decision on using the technology at national level.
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Affiliation(s)
- Judit Tittmann
- Semmelweis University, Center for Health Technology Assessment, Budapest, Hungary
| | | | - Tamás Ágh
- Syreon Research Institute, Budapest, Hungary
| | | | - Zoltán Vokó
- Semmelweis University, Center for Health Technology Assessment, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - Árpád Kallai
- Csongrád-Csanád Regional Health Center, Hódmezovásárhely, Hungary
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15
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Madani M, Behzadi MM, Nabavi S. The Role of Deep Learning in Advancing Breast Cancer Detection Using Different Imaging Modalities: A Systematic Review. Cancers (Basel) 2022; 14:5334. [PMID: 36358753 PMCID: PMC9655692 DOI: 10.3390/cancers14215334] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 12/02/2022] Open
Abstract
Breast cancer is among the most common and fatal diseases for women, and no permanent treatment has been discovered. Thus, early detection is a crucial step to control and cure breast cancer that can save the lives of millions of women. For example, in 2020, more than 65% of breast cancer patients were diagnosed in an early stage of cancer, from which all survived. Although early detection is the most effective approach for cancer treatment, breast cancer screening conducted by radiologists is very expensive and time-consuming. More importantly, conventional methods of analyzing breast cancer images suffer from high false-detection rates. Different breast cancer imaging modalities are used to extract and analyze the key features affecting the diagnosis and treatment of breast cancer. These imaging modalities can be divided into subgroups such as mammograms, ultrasound, magnetic resonance imaging, histopathological images, or any combination of them. Radiologists or pathologists analyze images produced by these methods manually, which leads to an increase in the risk of wrong decisions for cancer detection. Thus, the utilization of new automatic methods to analyze all kinds of breast screening images to assist radiologists to interpret images is required. Recently, artificial intelligence (AI) has been widely utilized to automatically improve the early detection and treatment of different types of cancer, specifically breast cancer, thereby enhancing the survival chance of patients. Advances in AI algorithms, such as deep learning, and the availability of datasets obtained from various imaging modalities have opened an opportunity to surpass the limitations of current breast cancer analysis methods. In this article, we first review breast cancer imaging modalities, and their strengths and limitations. Then, we explore and summarize the most recent studies that employed AI in breast cancer detection using various breast imaging modalities. In addition, we report available datasets on the breast-cancer imaging modalities which are important in developing AI-based algorithms and training deep learning models. In conclusion, this review paper tries to provide a comprehensive resource to help researchers working in breast cancer imaging analysis.
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Affiliation(s)
- Mohammad Madani
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT 06269, USA
- Department of Computer Science and Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Mohammad Mahdi Behzadi
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT 06269, USA
- Department of Computer Science and Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Sheida Nabavi
- Department of Computer Science and Engineering, University of Connecticut, Storrs, CT 06269, USA
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16
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Diagnostic Efficacy across Dense and Non-Dense Breasts during Digital Breast Tomosynthesis and Ultrasound Assessment for Recalled Women. Diagnostics (Basel) 2022; 12:diagnostics12061477. [PMID: 35741287 PMCID: PMC9222054 DOI: 10.3390/diagnostics12061477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background: To compare the diagnostic efficacy of digital breast tomosynthesis (DBT) and ultrasound across breast densities in women recalled for assessment. Methods: A total of 482 women recalled for assessment from January 2017 to December 2019 were selected for the study. Women met the inclusion criteria if they had undergone DBT, ultrasound and had confirmed biopsy results. We calculated sensitivity, specificity, PPV, and AUC for DBT and ultrasound. Results: In dense breasts, DBT showed significantly higher sensitivity than ultrasound (98.2% vs. 80%; p < 0.001), but lower specificity (15.4% vs. 55%; p < 0.001), PPV (61.3% vs. 71%; p = 0.04) and AUC (0.568 vs. 0.671; p = 0.001). In non-dense breasts, DBT showed significantly higher sensitivity than ultrasound (99.2% vs. 84%; p < 0.001), but no differences in specificity (22% vs. 33%; p = 0.14), PPV (69.2% vs. 68.8%; p = 0.93) or AUC (0.606 vs. 0.583; p = 0.57). Around 73% (74% dense and 71% non-dense) and 77% (81% dense and 72% non-dense) of lesions assigned a RANZCR 3 by DBT and ultrasound, respectively, were benign. Conclusion: DBT has higher sensitivity, but lower specificity and PPV than ultrasound in women with dense breasts recalled for assessment. Most lesions rated RANZCR 3 on DBT and ultrasound are benign and may benefit from short interval follow-up rather than biopsy.
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Ukwuoma CC, Hossain MA, Jackson JK, Nneji GU, Monday HN, Qin Z. Multi-Classification of Breast Cancer Lesions in Histopathological Images Using DEEP_Pachi: Multiple Self-Attention Head. Diagnostics (Basel) 2022; 12:1152. [PMID: 35626307 PMCID: PMC9139754 DOI: 10.3390/diagnostics12051152] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/23/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION AND BACKGROUND Despite fast developments in the medical field, histological diagnosis is still regarded as the benchmark in cancer diagnosis. However, the input image feature extraction that is used to determine the severity of cancer at various magnifications is harrowing since manual procedures are biased, time consuming, labor intensive, and error-prone. Current state-of-the-art deep learning approaches for breast histopathology image classification take features from entire images (generic features). Thus, they are likely to overlook the essential image features for the unnecessary features, resulting in an incorrect diagnosis of breast histopathology imaging and leading to mortality. METHODS This discrepancy prompted us to develop DEEP_Pachi for classifying breast histopathology images at various magnifications. The suggested DEEP_Pachi collects global and regional features that are essential for effective breast histopathology image classification. The proposed model backbone is an ensemble of DenseNet201 and VGG16 architecture. The ensemble model extracts global features (generic image information), whereas DEEP_Pachi extracts spatial information (regions of interest). Statistically, the evaluation of the proposed model was performed on publicly available dataset: BreakHis and ICIAR 2018 Challenge datasets. RESULTS A detailed evaluation of the proposed model's accuracy, sensitivity, precision, specificity, and f1-score metrics revealed the usefulness of the backbone model and the DEEP_Pachi model for image classifying. The suggested technique outperformed state-of-the-art classifiers, achieving an accuracy of 1.0 for the benign class and 0.99 for the malignant class in all magnifications of BreakHis datasets and an accuracy of 1.0 on the ICIAR 2018 Challenge dataset. CONCLUSIONS The acquired findings were significantly resilient and proved helpful for the suggested system to assist experts at big medical institutions, resulting in early breast cancer diagnosis and a reduction in the death rate.
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Affiliation(s)
- Chiagoziem C. Ukwuoma
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China; (J.K.J.); (G.U.N.)
| | - Md Altab Hossain
- School of Management and Economics, University of Electronic Science and Technology of China, Chengdu 610054, China;
| | - Jehoiada K. Jackson
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China; (J.K.J.); (G.U.N.)
| | - Grace U. Nneji
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China; (J.K.J.); (G.U.N.)
| | - Happy N. Monday
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China;
| | - Zhiguang Qin
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China; (J.K.J.); (G.U.N.)
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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. Radiography (Lond) 2022; 28:848-856. [DOI: 10.1016/j.radi.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/07/2023]
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