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Hussein H, Abbas E, Keshavarzi S, Fazelzad R, Bukhanov K, Kulkarni S, Au F, Ghai S, Alabousi A, Freitas V. Supplemental Breast Cancer Screening in Women with Dense Breasts and Negative Mammography: A Systematic Review and Meta-Analysis. Radiology 2023; 306:e221785. [PMID: 36719288 DOI: 10.1148/radiol.221785] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background The best supplemental breast cancer screening modality in women at average risk or intermediate risk for breast cancer with dense breast and negative mammogram remains to be determined. Purpose To conduct systematic review and meta-analysis comparing clinical outcomes of the most common available supplemental screening modalities in women at average risk or intermediate risk for breast cancer in patients with dense breasts and mammography with negative findings. Materials and Methods A comprehensive search was conducted until March 12, 2020, in Medline, Epub Ahead of Print and In-Process and Other Non-Indexed Citations; Embase Classic and Embase; Cochrane Central Register of Controlled Trials; and Cochrane Database of Systematic Reviews, for Randomized Controlled Trials and Prospective Observational Studies. Incremental cancer detection rate (CDR); positive predictive value of recall (PPV1); positive predictive value of biopsies performed (PPV3); and interval CDRs of supplemental imaging modalities, digital breast tomosynthesis, handheld US, automated breast US, and MRI in non-high-risk patients with dense breasts and mammography negative for cancer were reviewed. Data metrics and risk of bias were assessed. Random-effects meta-analysis and two-sided metaregression analyses comparing each imaging modality metrics were performed (PROSPERO; CRD42018080402). Results Twenty-two studies reporting 261 233 screened patients were included. Of 132 166 screened patients with dense breast and mammography negative for cancer who met inclusion criteria, a total of 541 cancers missed at mammography were detected with these supplemental modalities. Metaregression models showed that MRI was superior to other supplemental modalities in CDR (incremental CDR, 1.52 per 1000 screenings; 95% CI: 0.74, 2.33; P < .001), including invasive CDR (invasive CDR, 1.31 per 1000 screenings; 95% CI: 0.57, 2.06; P < .001), and in situ disease (rate of ductal carcinoma in situ, 1.91 per 1000 screenings; 95% CI: 0.10, 3.72; P < .04). No differences in PPV1 and PPV3 were identified. The limited number of studies prevented assessment of interval cancer metrics. Excluding MRI, no statistically significant difference in any metrics were identified among the remaining imaging modalities. Conclusion The pooled data showed that MRI was the best supplemental imaging modality in women at average risk or intermediate risk for breast cancer with dense breasts and mammography negative for cancer. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Hooley and Butler in this issue.
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Affiliation(s)
- Heba Hussein
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Engy Abbas
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Sareh Keshavarzi
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Rouhi Fazelzad
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Karina Bukhanov
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Supriya Kulkarni
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Frederick Au
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Sandeep Ghai
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Abdullah Alabousi
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
| | - Vivianne Freitas
- From the Joint Department of Medical Imaging-Breast Division, University of Toronto, University Health Network, Sinai Health System, Women's College Hospital, 610 University Ave, Toronto, ON, Canada M5G 2M9 (H.H., E.A., K.B., S. Kulkarni, F.A., S.G., V.F.); Department of Radiology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom (H.H.); Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada (S. Keshavarzi); Department of Library and Information Services, University Health Network-Princess Margaret Cancer Centre, Toronto, Canada (R.F.); and Faculty of Health Sciences, Department of Radiology, McMaster University, St. Joseph's Healthcare, Hamilton, Canada (A.A.)
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Vairavan R, Abdullah O, Retnasamy PB, Sauli Z, Shahimin MM, Retnasamy V. A Brief Review on Breast Carcinoma and Deliberation on Current Non Invasive Imaging Techniques for Detection. Curr Med Imaging 2020; 15:85-121. [PMID: 31975658 DOI: 10.2174/1573405613666170912115617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/27/2017] [Accepted: 08/29/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Breast carcinoma is a life threatening disease that accounts for 25.1% of all carcinoma among women worldwide. Early detection of the disease enhances the chance for survival. DISCUSSION This paper presents comprehensive report on breast carcinoma disease and its modalities available for detection and diagnosis, as it delves into the screening and detection modalities with special focus placed on the non-invasive techniques and its recent advancement work done, as well as a proposal on a novel method for the application of early breast carcinoma detection. CONCLUSION This paper aims to serve as a foundation guidance for the reader to attain bird's eye understanding on breast carcinoma disease and its current non-invasive modalities.
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Affiliation(s)
- Rajendaran Vairavan
- School of Microelectronic Engineering, Universiti Malaysia Perlis, Pauh Putra Campus, 02600 Arau, Perlis, Malaysia
| | - Othman Abdullah
- Hospital Sultan Abdul Halim, 08000 Sg. Petani, Kedah, Malaysia
| | | | - Zaliman Sauli
- School of Microelectronic Engineering, Universiti Malaysia Perlis, Pauh Putra Campus, 02600 Arau, Perlis, Malaysia
| | - Mukhzeer Mohamad Shahimin
- Department of Electrical and Electronic Engineering, Faculty of Engineering, National Defence University of Malaysia (UPNM), Kem Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Vithyacharan Retnasamy
- School of Microelectronic Engineering, Universiti Malaysia Perlis, Pauh Putra Campus, 02600 Arau, Perlis, Malaysia
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Wengert GJ, Helbich TH, Leithner D, Morris EA, Baltzer PAT, Pinker K. Multimodality Imaging of Breast Parenchymal Density and Correlation with Risk Assessment. CURRENT BREAST CANCER REPORTS 2019; 11:23-33. [PMID: 35496471 PMCID: PMC9044508 DOI: 10.1007/s12609-019-0302-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Purpose of Review Breast density, or the amount of fibroglandular tissue in the breast, has become a recognized and independent marker for breast cancer risk. Public awareness of breast density as a possible risk factor for breast cancer has resulted in legislation for risk stratification purposes in many US states. This review will provide a comprehensive overview of the currently available imaging modalities for qualitative and quantitative breast density assessment and the current evidence on breast density and breast cancer risk assessment. Recent Findings To date, breast density assessment is mainly performed with mammography and to some extent with magnetic resonance imaging. Data indicate that computerized, quantitative techniques in comparison with subjective visual estimations are characterized by higher reproducibility and robustness. Summary Breast density reduces the sensitivity of mammography due to a masking effect and is also a recognized independent risk factor for breast cancer. Standardized breast density assessment using automated volumetric quantitative methods has the potential to be used for risk prediction and stratification and in determining the best screening plan for each woman.
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Abstract
Screening mammography saves lives. The mainstay of screening has been mammography. Multiple alternative options, however, for supplemental imaging are now available. Some are just improved anatomic delineation whereas others include physiology added to anatomy. A third group (molecular imaging) is purely physiologic. This article describes and compares the available options and for which patient populations they should be used.
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Affiliation(s)
- Lizza Lebron-Zapata
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| | - Maxine S Jochelson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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Wengert GJ, Helbich TH, Kapetas P, Baltzer PA, Pinker K. Density and tailored breast cancer screening: practice and prediction - an overview. Acta Radiol Open 2018; 7:2058460118791212. [PMID: 30245850 PMCID: PMC6144518 DOI: 10.1177/2058460118791212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 06/27/2018] [Indexed: 01/13/2023] Open
Abstract
Mammography, as the primary screening modality, has facilitated a substantial
decrease in breast cancer-related mortality in the general population. However,
the sensitivity of mammography for breast cancer detection is decreased in women
with higher breast densities, which is an independent risk factor for breast
cancer. With increasing public awareness of the implications of a high breast
density, there is an increasing demand for supplemental screening in these
patients. Yet, improvements in breast cancer detection with supplemental
screening methods come at the expense of increased false-positives, recall
rates, patient anxiety, and costs. Therefore, breast cancer screening practice
must change from a general one-size-fits-all approach to a more personalized,
risk-based one that is tailored to the individual woman’s risk, personal
beliefs, and preferences, while accounting for cost, potential harm, and
benefits. This overview will provide an overview of the available breast density assessment
modalities, the current breast density screening recommendations for women at
average risk of breast cancer, and supplemental methods for breast cancer
screening. In addition, we will provide a look at the possibilities for a
risk-adapted breast cancer screening.
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Affiliation(s)
- Georg J Wengert
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Thomas H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Panagiotis Kapetas
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Pascal At Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Katja Pinker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.,Department of Radiology, Breast Imaging Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Dong H, Huang Y, Song F, Dai H, Liu P, Zhu Y, Wang P, Han J, Hao X, Chen K. Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females. Clin Breast Cancer 2017; 18:e353-e361. [PMID: 28887010 DOI: 10.1016/j.clbc.2017.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/13/2017] [Accepted: 07/17/2017] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Until now, no studies have investigated whether women other than those with dense breasts are suitable for adjunctive ultrasonography after negative mammography, and investigated whether all women with negative mammography are suitable for adjunctive ultrasonography. METHODS Based on the Multi-modality Independent Screening Trial in China, a total of 31,918 women aged 45 to 65 years underwent both ultrasonography and mammography. Physicians performed ultrasonography and mammography separately and were blinded to each other's findings until their interpretations had been recorded. For both ultrasonography and mammography, suspicious results and those highly suggestive of a malignancy were confirmed by pathologic examination, whereas other results were confirmed by 1-year follow-up after initial screening. RESULTS Based on Breast Imaging Reporting and Data System (BIRADS) assessments, 84 (84.8%) of 99 cancers were identified on mammography (detection rate, 2.6/1000), and 61 (61.6%) of 99 cancers were identified on ultrasonography (detection rate, 1.9/1000). Integrated mammography with ultrasonography identified 94 (95.0%) of 99 cancers, with an increment of 11.9% in cancer detection rate (from 2.6/1000 to 2.9/1000) (P < .05). Moreover, among women with BIRADS 3, adjunctive ultrasonography detected no cancers. All 10 additional cancers detected by adjunctive ultrasonography were from women with BIRADS 0 to 2, at a cost of 207 women with false positives. Additionally, dense breasts and benign breast disease were significantly associated with positive ultrasonography after BIRADS 0 to 2 (all P values < .05). CONCLUSIONS After negative mammography, adjunctive ultrasonography should only be recommended for BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease.
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Affiliation(s)
- Henglei Dong
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yubei Huang
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Fengju Song
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hongji Dai
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Peifang Liu
- Department of Breast Imaging, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Ying Zhu
- Department of Breast Imaging, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Peishan Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jiali Han
- Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, IN
| | - Xishan Hao
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; Chinese Anti-Cancer Association, Tianjin, China.
| | - Kexin Chen
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
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Abstract
OBJECTIVE Current clinical guidelines are consistent in supporting annual mammography for women after treatment of primary breast cancer. Surveillance imaging beyond standard digital mammography, including digital breast tomosynthesis (DBT), breast ultrasound, and MRI, may improve outcomes. This article reviews the evidence on the performance and effectiveness of breast imaging modalities available for surveillance after treatment of sporadic unilateral primary breast cancer and identifies additional factors to be considered when selecting an imaging surveillance regimen. CONCLUSION Evidence review supports the use of mammography for surveillance after primary breast cancer treatment. Variability exists in guideline recommendations for surveillance initiation, interval, and cessation. DBT offers the most promise as a potential modality to replace standard digital mammography as a front-line surveillance test; a single published study to date has shown a significant decrease in recall rates compared with standard digital mammography alone. Most guidelines do not support the use of whole-breast ultrasound in breast cancer surveillance, and further studies are needed to define the characteristics of women who may benefit from MRI surveillance. The emerging evidence about surveillance imaging outcomes suggests that additional factors, including patient and imaging characteristics, tumor biology and gene expression profile, and choice of treatment, warrant consideration in selecting personalized posttreatment imaging surveillance regimens.
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Affiliation(s)
- Diana L Lam
- 1 Department of Radiology, University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave East, G2-600, Seattle, WA 98109-1023
| | - Nehmat Houssami
- 2 Screening and Test Evaluation Program, Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Janie M Lee
- 1 Department of Radiology, University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave East, G2-600, Seattle, WA 98109-1023
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Houssami N, Turner RM. Rapid review: Estimates of incremental breast cancer detection from tomosynthesis (3D-mammography) screening in women with dense breasts. Breast 2016; 30:141-145. [DOI: 10.1016/j.breast.2016.09.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/13/2016] [Indexed: 11/27/2022] Open
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Houssami N. Digital breast tomosynthesis (3D-mammography) for screening women with dense breasts. Expert Rev Med Devices 2016; 13:515-7. [DOI: 10.1080/17434440.2016.1184971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tagliafico AS, Calabrese M, Mariscotti G, Durando M, Tosto S, Monetti F, Airaldi S, Bignotti B, Nori J, Bagni A, Signori A, Sormani MP, Houssami N. Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts: Interim Report of a Prospective Comparative Trial. J Clin Oncol 2016; 34:1882-1888. [PMID: 26962097 DOI: 10.1200/jco.2015.63.4147] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Debate on adjunct screening in women with dense breasts has followed legislation requiring that women be informed about their mammographic density and related adjunct imaging. Ultrasound or tomosynthesis can detect breast cancer (BC) in mammography-negative dense breasts, but these modalities have not been directly compared in prospective trials. We conducted a trial of adjunct screening to compare, within the same participants, incremental BC detection by tomosynthesis and ultrasound in mammography-negative dense breasts. PATIENTS AND METHODS Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts is a prospective multicenter study recruiting asymptomatic women with mammography-negative screens and dense breasts. Eligible women had tomosynthesis and physician-performed ultrasound with independent interpretation of adjunct imaging. Outcome measures included cancer detection rate (CDR), number of false-positive (FP) recalls, and incremental CDR for each modality; these were compared using McNemar's test for paired binary data in a preplanned interim analysis. RESULTS Among 3,231 mammography-negative screening participants (median age, 51 years; interquartile range, 44 to 78 years) with dense breasts, 24 additional BCs were detected (23 invasive): 13 tomosynthesis-detected BCs (incremental CDR, 4.0 per 1,000 screens; 95% CI, 1.8 to 6.2) versus 23 ultrasound-detected BCs (incremental CDR, 7.1 per 1,000 screens; 95% CI, 4.2 to 10.0), P = .006. Incremental FP recall occurred in 107 participants (3.33%; 95% CI, 2.72% to 3.96%). FP recall (any testing) did not differ between tomosynthesis (FP = 53) and ultrasound (FP = 65), P = .26; FP recall (biopsy) also did not differ between tomosynthesis (FP = 22) and ultrasound (FP = 24), P = .86. CONCLUSION The Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts' interim analysis shows that ultrasound has better incremental BC detection than tomosynthesis in mammography-negative dense breasts at a similar FP-recall rate. However, future application of adjunct screening should consider that tomosynthesis detected more than 50% of the additional BCs in these women and could potentially be the primary screening modality.
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Affiliation(s)
- Alberto S Tagliafico
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Massimo Calabrese
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Giovanna Mariscotti
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Manuela Durando
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Simona Tosto
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Francesco Monetti
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Sonia Airaldi
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Bianca Bignotti
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Jacopo Nori
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Antonella Bagni
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Alessio Signori
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Maria Pia Sormani
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia
| | - Nehmat Houssami
- Alberto S. Tagliafico, Sonia Airaldi, Bianca Bignotti, Alessio Signori, and Maria Pia Sormani, University of Genoa; Massimo Calabrese, Simona Tosto, and Francesco Monetti, Istituto Di Ricovero e Cura a Carattere Scientifico AOU San Martino-IST, Genoa; Giovanna Mariscotti and Manuela Durando, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino; Jacopo Nori, Azienda Ospedaliero-Universitaria Carreggi, Firenze; Antonella Bagni, Ospedale Bufalini Viale Ghirotti, Cesena, Italy; and Nehmat Houssami, University of Sydney, Sydney, Australia.
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11
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Ohuchi N, Suzuki A, Sobue T, Kawai M, Yamamoto S, Zheng YF, Shiono YN, Saito H, Kuriyama S, Tohno E, Endo T, Fukao A, Tsuji I, Yamaguchi T, Ohashi Y, Fukuda M, Ishida T. Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomised controlled trial. Lancet 2016; 387:341-348. [PMID: 26547101 DOI: 10.1016/s0140-6736(15)00774-6] [Citation(s) in RCA: 318] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mammography is the only proven method for breast cancer screening that reduces mortality, although it is inaccurate in young women or women with dense breasts. We investigated the efficacy of adjunctive ultrasonography. METHODS Between July, 2007, and March, 2011, we enrolled asymptomatic women aged 40-49 years at 42 study sites in 23 prefectures into the Japan Strategic Anti-cancer Randomized Trial (J-START). Eligible women had no history of any cancer in the previous 5 years and were expected to live for more than 5 years. Randomisation was done centrally by the Japan Clinical Research Support Unit. Participants were randomly assigned in 1:1 ratio to undergo mammography and ultrasonography (intervention group) or mammography alone (control group) twice in 2 years. The primary outcome was sensitivity, specificity, cancer detection rate, and stage distribution at the first round of screening. Analysis was by intention to treat. This study is registered, number UMIN000000757. FINDINGS Of 72,998 women enrolled, 36,859 were assigned to the intervention group and 36,139 to the control group. Sensitivity was significantly higher in the intervention group than in the control group (91·1%, 95% CI 87·2-95·0 vs 77·0%, 70·3-83·7; p=0·0004), whereas specificity was significantly lower (87·7%, 87·3-88·0 vs 91·4%, 91·1-91·7; p<0·0001). More cancers were detected in the intervention group than in the control group (184 [0·50%] vs 117 [0·32%], p=0·0003) and were more frequently stage 0 and I (144 [71·3%] vs 79 [52·0%], p=0·0194). 18 (0·05%) interval cancers were detected in the intervention group compared with 35 (0·10%) in the control group (p=0·034). INTERPRETATION Adjunctive ultrasonography increases sensitivity and detection rate of early cancers. FUNDING Ministry of Health, Labour and Welfare of Japan.
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Affiliation(s)
- Noriaki Ohuchi
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
| | - Akihiko Suzuki
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomotaka Sobue
- Department of Environmental and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masaaki Kawai
- Department of Breast Surgery, Miyagi Cancer Centre Hospital, Miyagi, Japan
| | - Seiichiro Yamamoto
- Department of Screening Assessment and Management, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan
| | - Ying-Fang Zheng
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yoko Narikawa Shiono
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Hiroshi Saito
- Department of Screening Assessment and Management, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan
| | - Shinichi Kuriyama
- Department of Disaster-Related Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Eriko Tohno
- Department of Radiology, Tsukuba Health Evaluation Centre, Tsukuba, Japan
| | - Tokiko Endo
- Department of Radiology, Higashi Nagoya National Hospital, Nagoya, Japan
| | - Akira Fukao
- Department of Public Health, Yamagata University School of Medicine, Yamagata, Japan
| | - Ichiro Tsuji
- Department of Public Health, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Takuhiro Yamaguchi
- Department of Biostatistics, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - Mamoru Fukuda
- Department of Surgery, St Marianna University Breast and Imaging Centre, Kawasaki, Japan
| | - Takanori Ishida
- Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan
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12
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Ruile G, Djanatliev A, Kriza C, Meier F, Leb I, Kalender WA, Kolominsky-Rabas PL. Screening for breast cancer with Breast-CT in a ProHTA simulation. J Comp Eff Res 2015; 4:553-67. [DOI: 10.2217/cer.15.42] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aims: The potential of dedicated Breast-CT is evaluated by simulating its impact onto the performance of the German breast cancer screening program. Attendance rates, cancer detection and economic implications are quantified. Methods: Based on a prospective health technology assessment approach, we simulated screening in different scenarios. Results: In the simulation, attendance rates increase from 54 to up to 72% due to reduced pain. Breast cancers will be detected earlier while nodal positives and distant recurrences decrease. Assuming no additional cost, cost savings of up to €55 million in one screening period are computed. Conclusion: The simulation indicates that earlier cancer detection, fewer unnecessary biopsies and less pain are potential benefits of Breast-CT resulting in cost savings and higher attendance.
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Affiliation(s)
- Georg Ruile
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany
- National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’, Erlangen, Bavaria, Germany
| | - Anatoli Djanatliev
- Chair for Computer Networks & Communication Systems (Computer Science 7), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany
| | - Christine Kriza
- National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’, Erlangen, Bavaria, Germany
- Interdisciplinary Centre for Health Technology Assessment (HTA) & Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany
| | - Florian Meier
- Department of Health Management, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nürnberg, Bavaria, Germany
| | - Ines Leb
- Chair of Medical Informatics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany
| | - Willi A Kalender
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany
- National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’, Erlangen, Bavaria, Germany
| | - Peter L Kolominsky-Rabas
- National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’, Erlangen, Bavaria, Germany
- Interdisciplinary Centre for Health Technology Assessment (HTA) & Public Health (IZPH), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany
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13
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Lauby-Secretan B, Scoccianti C, Loomis D, Benbrahim-Tallaa L, Bouvard V, Bianchini F, Straif K. Breast-cancer screening--viewpoint of the IARC Working Group. N Engl J Med 2015; 372:2353-8. [PMID: 26039523 DOI: 10.1056/nejmsr1504363] [Citation(s) in RCA: 514] [Impact Index Per Article: 57.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Béatrice Lauby-Secretan
- From the International Agency for Research on Cancer, Lyon, France (B.L.-S., C.S., D.L., L.B.-T., V.B., K.S.); and the German Cancer Research Center, Heidelberg, Germany (F.B.)
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14
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Houssami N. Digital breast tomosynthesis (3D-mammography) screening: data and implications for population screening. Expert Rev Med Devices 2015; 12:377-9. [DOI: 10.1586/17434440.2015.1028362] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Araujo FI, Proença FPP, Ferreira CG, Ventilari SC, Rosado de Castro PH, Moreira RD, Fonseca LMB, Souza SAL, Gutfilen B. Use of (99m)Tc-doxorubicin scintigraphy in females with breast cancer: a pilot study. Br J Radiol 2015; 88:20150268. [PMID: 26111270 DOI: 10.1259/bjr.20150268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Doxorubicin (Eurofarma, São Paulo, Brazil) is an antitumour agent widely used in the treatment of breast cancer and can be used for tumour tracking when labelled with a radionuclide. Here, we present the results obtained with technetium-99m ((99m)Tc)-doxorubicin, using the direct method, to evaluate its uptake in breast cancer. METHODS Four females with confirmed breast carcinoma diagnosis and breast image reporting and data system Category 5 on mammography underwent whole-body and thorax single-photon emission CT/CT imaging 1 and 3 h after (99m)Tc-doxorubicin administration. RESULTS We observed increased uptake in breast carcinoma lesions and elimination via renal and hepatic pathways. CONCLUSION These preliminary results suggest that (99m)Tc-doxorubicin may be a promising radiopharmaceutical for the evaluation of patients with breast cancer. Further studies are ongoing. ADVANCES IN KNOWLEDGE To our knowledge, this is the first study to evaluate the use of a directly labelled doxorubicin tracer in humans. (99m)Tc-doxorubicin could provide information on the response of tumours to doxorubicin.
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Affiliation(s)
- F I Araujo
- 1 Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - F P P Proença
- 2 Nuclear Medicine Section, National Cancer Institute, Rio de Janeiro, Brazil
| | - C G Ferreira
- 3 Coordination of Clinical Research, National Cancer Institute, Rio de Janeiro, Brazil
| | - S C Ventilari
- 4 Division of Clinical Oncology, National Cancer Institute, Rio de Janeiro, Brazil
| | | | - R D Moreira
- 3 Coordination of Clinical Research, National Cancer Institute, Rio de Janeiro, Brazil
| | - L M B Fonseca
- 1 Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - S A L Souza
- 1 Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - B Gutfilen
- 1 Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
Routine screening mammography is recommended by most groups issuing breast cancer screening guidelines, especially for women 50 years of age and older. However, both the potential benefits and risks of screening should be discussed with individual patients to allow for shared decision making regarding their participation in screening, age of commencement and conclusion, and interval of mammography screening.
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Affiliation(s)
- Mackenzie S Fuller
- Department of Medicine, University of Washington, 325 Ninth Avenue, Mailbox 359780, Seattle, WA 98104, USA
| | - Christoph I Lee
- Department of Health Services, University of Washington School of Public Health, Box 357660, Seattle, WA 98195, USA; Department of Radiology, University of Washington, 825 Eastlake Avenue East, G3-200, Seattle, WA 98109, USA
| | - Joann G Elmore
- Department of Medicine, University of Washington, 325 Ninth Avenue, Mailbox 359780, Seattle, WA 98104, USA.
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17
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Scheel JR, Lee JM, Sprague BL, Lee CI, Lehman CD. Screening ultrasound as an adjunct to mammography in women with mammographically dense breasts. Am J Obstet Gynecol 2015; 212:9-17. [PMID: 24959654 DOI: 10.1016/j.ajog.2014.06.048] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/07/2014] [Accepted: 06/18/2014] [Indexed: 10/25/2022]
Abstract
There are potential benefits and harms of screening ultrasound (US) to supplement mammographic screening of women with dense breast tissue. We conducted a comprehensive literature review of studies assessing the efficacy of screening US to supplement mammography among women with dense breasts. From a total of 189 peer-reviewed publications on the performance of screening US, 12 studies were relevant to our analysis. The reporting of breast cancer risk factors varied across studies; however, the study populations tended to be at greater than average risk for developing breast cancer. Overall, US detected an additional 0.3-7.7 cancers per 1000 examinations (median, 4.2) and was associated with an additional 11.7-106.6 biopsies per 1000 examinations (median, 52.2). Significant improvements in cancer detection in dense breasts have been achieved with the transition from film to digital mammography. Thus adjunctive screening with ultrasound should be considered in the context of current screening mammography performance. Clinicians should discuss breast density as 1 of several important breast cancer risk factors, consider the potential harms of adjunctive screening, and arrive at a shared decision consistent with each woman's preferences and values.
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18
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Breast ultrasound in 22,131 asymptomatic women with negative mammography. Breast 2013; 22:806-9. [DOI: 10.1016/j.breast.2013.02.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Revised: 12/24/2012] [Accepted: 02/11/2013] [Indexed: 11/22/2022] Open
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Skaane P, Bandos AI, Gullien R, Eben EB, Ekseth U, Haakenaasen U, Izadi M, Jebsen IN, Jahr G, Krager M, Niklason LT, Hofvind S, Gur D. Comparison of Digital Mammography Alone and Digital Mammography Plus Tomosynthesis in a Population-based Screening Program. Radiology 2013; 267:47-56. [PMID: 23297332 DOI: 10.1148/radiol.12121373] [Citation(s) in RCA: 663] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Per Skaane
- Department of Radiology, Breast Imaging Center, Oslo University Hospital Ullevaal, University of Oslo, Kirkeveien 166, N-0407 Oslo, Norway.
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Multimodality GPU-based computer-assisted diagnosis of breast cancer using ultrasound and digital mammography images. Int J Comput Assist Radiol Surg 2013; 8:547-60. [DOI: 10.1007/s11548-013-0813-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 01/08/2013] [Indexed: 02/04/2023]
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21
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Urbanczyk H, McDonagh E, Marshall NW, Castellano I. Characterization of the effects of the FineView algorithm for full field digital mammography. Phys Med Biol 2012; 57:1987-2003. [DOI: 10.1088/0031-9155/57/7/1987] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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22
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Houssami N, Kerlikowske K. The Impact of Breast Density on Breast Cancer Risk and Breast Screening. CURRENT BREAST CANCER REPORTS 2012. [DOI: 10.1007/s12609-012-0070-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Miller AB. Breast cancer screening: commentary and conclusions. Prev Med 2011; 53:147-8. [PMID: 21911177 DOI: 10.1016/j.ypmed.2011.08.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 08/15/2011] [Accepted: 08/16/2011] [Indexed: 11/16/2022]
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