WorldWideScience

Sample records for repeat mammography screening

  1. Interventions to Promote Repeat Breast Cancer Screening With Mammography: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    McQueen, Amy; Tiro, Jasmin A.; del Junco, Deborah J.

    2010-01-01

    Background Various interventions to promote repeat use of mammography have been evaluated, but the efficacy of such interventions is not well understood. Methods We searched electronic databases through August 15, 2009, and extracted data to calculate unadjusted effect estimates (odds ratios [ORs] and 95% confidence intervals [CIs]). Eligible studies were those that reported estimates of repeat screening for intervention and control groups. We tested homogeneity and computed summary odds ratios. To explore possible causes of heterogeneity, we performed stratified analyses, examined meta-regression models for 15 a priori explanatory variables, and conducted influence analyses. We used funnel plots and asymmetry tests to assess publication bias. Statistical tests were two-sided. Results The 25 eligible studies (27 effect estimates) were statistically significantly heterogeneous (Q = 69.5, I  2 = 63%, P < .001). Although there were homogeneous subgroups in some categories of the 15 explanatory variables, heterogeneity persisted after stratification. For all but one explanatory variable, subgroup summary odds ratios were similar with overlapping confidence intervals. The summary odds ratio for the eight heterogeneous reminder-only studies was the largest observed (OR = 1.79, 95% CI = 1.41 to 2.29) and was statistically significantly greater than the summary odds ratio (Pdiff = .008) for the homogeneous group of 17 studies that used the more intensive strategies of education/motivation or counseling (OR = 1.27, 95% CI = 1.17 to 1.37). However, reminder-only studies remained statistically significantly heterogeneous, whereas the studies classified as education/motivation or counseling were homogeneous. Similarly, in meta-regression modeling, the only statistically significant predictor of the intervention effect size was intervention strategy (reminder-only vs the other two combined as the referent). Publication bias was not apparent. Conclusions The observed

  2. Barriers to screening mammography.

    Science.gov (United States)

    Sarma, Elizabeth A

    2015-01-01

    Breast cancer (BRCA) is the second most commonly diagnosed cancer among women in the USA, and mammography is an effective means for the early detection of BRCA. Identifying the barriers to screening mammography can inform research, policy and practice aiming to increase mammography adherence. A literature review was conducted to determine common barriers to screening mammography adherence. PsycINFO and PubMed databases were searched to identify studies published between 2000 and 2012 that examined barriers associated with reduced mammography adherence. Three thematic groups of barriers, based on social ecology, were identified from the literature: healthcare system-level, social and individual-level barriers. Researchers must consider screening behaviour in context and, therefore, should simultaneously consider each level of barriers when attempting to understand screening behaviour and create interventions to increase mammography adherence.

  3. Mammography screening in denmark

    DEFF Research Database (Denmark)

    Vejborg, Ilse Merete Munk; Mikkelsen, Ellen Margrethe; Garne, Jens Peter

    2011-01-01

    Mammography screening is offered healthy women, and a high standard on professional and organizational level is mandatory not only in the screening programme but even in the diagnostic work-up and treatment. The main goal is to achieve a substantial reduction in disease specific mortality...

  4. Mammography screening in Denmark

    DEFF Research Database (Denmark)

    Vejborg, Ilse; Mikkelsen, Ellen Margrethe; Garne, Jens Peter

    2011-01-01

    Mammography screening is offered healthy women, and a high standard on professional and organizational level is mandatory not only in the screening programme but even in the diagnostic work-up and treatment. The main goal is to achieve a substantial reduction in disease specific mortality...

  5. Abolishing mammography screening programs?

    OpenAIRE

    2015-01-01

    Biller-Andorno and Jüni (2014), in a widely debated commentary published in the May 22 issue of the New England Journal of Medicine, accept the concept that mammography every 2 years from age 50 can decrease breast cancer mortality by 20%, that is, from five to four deaths per 1000 women over a 10-year period. Both the absolute and the relative risk of breast cancer death may vary depending on the baseline mortality rates in various populations and on the impact of screening mammography in re...

  6. Mammography screening in Denmark

    DEFF Research Database (Denmark)

    Vejborg, Ilse; Mikkelsen, Ellen Margrethe; Garne, Jens Peter;

    2011-01-01

    Mammography screening is offered healthy women, and a high standard on professional and organizational level is mandatory not only in the screening programme but even in the diagnostic work-up and treatment. The main goal is to achieve a substantial reduction in disease specific mortality......, but it is not possible to evaluate the effect on mortality until several years later, and continuously monitoring of the quality of all aspects of a screening programme is necessary. Based on other European guidelines, 11 quality indicators have been defined, and guidelines concerning organizational requirements...

  7. Overdiagnosis in screening mammography in Denmark

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Olsen, Anne Helene; Blichert-Toft, Mogens

    2013-01-01

    To use data from two longstanding, population based screening programmes to study overdiagnosis in screening mammography.......To use data from two longstanding, population based screening programmes to study overdiagnosis in screening mammography....

  8. Barriers to Mammography among Inadequately Screened Women

    Science.gov (United States)

    Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

    2015-01-01

    Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

  9. Mammography and Other Screening Tests for Breast Problems

    Science.gov (United States)

    f AQ FREQUENTLY ASKED QUESTIONS FAQ178 GYNECOLOGIC PROBLEMS Mammography and Other Screening Tests for Breast Problems • What ... used to screen for breast problems? • What is mammography? • Why is mammography done? • When should I start ...

  10. Benefits and harms of mammography screening.

    Science.gov (United States)

    Løberg, Magnus; Lousdal, Mette Lise; Bretthauer, Michael; Kalager, Mette

    2015-05-01

    Mammography screening for breast cancer is widely available in many countries. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. This review discusses the benefits and harms of mammography screening in light of findings from randomized trials and from more recent observational studies performed in the era of modern diagnostics and treatment. The main benefit of mammography screening is reduction of breast-cancer related death. Relative reductions vary from about 15 to 25% in randomized trials to more recent estimates of 13 to 17% in meta-analyses of observational studies. Using UK population data of 2007, for 1,000 women invited to biennial mammography screening for 20 years from age 50, 2 to 3 women are prevented from dying of breast cancer. All-cause mortality is unchanged. Overdiagnosis of breast cancer is the main harm of mammography screening. Based on recent estimates from the United States, the relative amount of overdiagnosis (including ductal carcinoma in situ and invasive cancer) is 31%. This results in 15 women overdiagnosed for every 1,000 women invited to biennial mammography screening for 20 years from age 50. Women should be unpassionately informed about the benefits and harms of mammography screening using absolute effect sizes in a comprehensible fashion. In an era of limited health care resources, screening services need to be scrutinized and compared with each other with regard to effectiveness, cost-effectiveness and harms.

  11. Classification of findings in mammography screening

    DEFF Research Database (Denmark)

    Pamilo, M; Lönnqvist, J; Halttunen, A

    1991-01-01

    survey of mammography screening in Helsinki and surroundings in Finland. PATIENTS--21,417 women (aged 50-59 years) were invited to be screened, 18,012 (84.10%) participated. Of these 579 (3.21% of those screened) were recalled for further studies; 124 of these were referred for surgical biopsy and 82 had...

  12. Body weight and sensitivity of screening mammography

    DEFF Research Database (Denmark)

    Njor, Sisse H.; von Euler-Chelpin, My; Tjønneland, Anne

    2016-01-01

    Aim: Obese women tend to participate less in breast cancer screening than normal weight women. However, obese women have fattier breast than normal weight women, and screening mammography works better in fatty than in dense breasts. One might, therefore, hypothesise that obese women would actuall...

  13. Breast cancer screening: the underuse of mammography

    Energy Technology Data Exchange (ETDEWEB)

    Fox, S.; Baum, J.K.; Klos, D.S.; Tsou, C.V.

    1985-09-01

    The early detection of breast cancer is promoted by the American Cancer Society (ACS) and the American College of Radiology (ACR) by encouraging the regular use of three types of screening: breast self-examination (BSE), the clinical breast examination, and mammography. In August 1983, the ACS publicized seven recommendations pertaining to screening, including a revised statement about the routine use of mammography for women between the ages of 40 and 49 years. In response to the ACS statement, the present study assessed compliance with the updated recommendations for all three types of screening. The results show reasonable rates of compliance for the BSE (53%-69%) and clinical examination (70%-78%). In contrast, only 19% of the women between the ages of 35 and 49 and 25% of the women older than 50 reported complying with the recommendation to undergo one baseline screening mammogram. Some implications for health education by physicians and the professional education of physicians in the use of mammography are discussed.

  14. Digital mammography in breast cancer screening: Evaluation and innovation

    NARCIS (Netherlands)

    Bluekens, A.M.J.

    2015-01-01

    With all other imaging modalities in radiology being digitised and conventional mammography being ready to phase out the transition to digital mammography was inevitable. This thesis describes the performance of digital screening mammography and the consequences of implementation in a population-bas

  15. Time perspective and perceived risk as related to mammography screening.

    Science.gov (United States)

    Griva, Fay; Anagnostopoulos, Fotios; Potamianos, Gregory

    2013-01-01

    The present study explored the relation of time perspective to perceived risk for breast cancer and mammography screening. Women free from breast cancer (N = 194), eligible for mammography screening in terms of age, completed the Zimbardo Time Perspective Inventory (Zimbardo & Boyd, 1999) and measures of perceived risk, attitude toward performing mammography screening, intention to get a mammogram, and mammography screening behavior. Hierarchical multiple regression analysis revealed that perceived risk of breast cancer (β= .18, p < .01) and intention to be screened (β = .35, p < .01) were significantly associated with mammography screening, after controlling for the effects of sociodemographic (e.g., age, education, and economic level) and health-related variables (e.g., family history of breast cancer and previous benign breast disease). Path analyses including the main psychological variables indicated that perceived risk was indirectly related to intention via attitude (β = .17, p < .01), and to mammography screening through attitude and intention (β = .06, p < .01). Attitude was indirectly related to mammography screening via intention (β = .20, p < .01). Also, a significant indirect association was observed between future orientation and mammography screening, via perceived risk (β = .10, p < .01). Theoretical implications of study findings and suggestions for future research on use of mammography are presented.

  16. Danish Quality Database for Mammography Screening

    DEFF Research Database (Denmark)

    Mikkelsen, Ellen Margrethe; Njor, Sisse Helle; Vejborg, Ilse Merete Munk

    2016-01-01

    AIM: The Danish Quality Database for Mammography Screening (DKMS) was established in 2007, with the aim to monitor, sustain, and improve the quality of the Danish national breast cancer screening program. STUDY POPULATION: All Danish women aged 50-69 years who were invited every 2 years for breast...... required to determine the following eleven indicators: 1) radiation exposure, 2) participation among invited women and participation within the target population, 3) time between screening and result, 4) screening interval, 5) recall for further diagnostics, 6) interval cancers consisting of women...... working days, 2.7% of the screened women were recalled for further diagnostics, 82% of the women operated for invasive carcinomas were node negative, and 40% of the women had the tumor size of ≤10 mm. CONCLUSION: The DKMS has successfully evaluated the quality of the nationwide Danish breast cancer...

  17. Breast density and outcome of mammography screening: a cohort study

    DEFF Research Database (Denmark)

    Olsen, A H; Bihrmann, K; Jensen, M-B

    2009-01-01

    The purpose of this study was to investigate the effect of breast density on breast cancer (BC) mortality in a mammography screening programme. The cohort included 48 052 women participating in mammography screening in Copenhagen, Denmark, where biennial screening is offered to women aged 50-69 y...

  18. Patterns and determinants of mammography screening in Lebanese women

    Directory of Open Access Journals (Sweden)

    Nadia Elias

    2017-03-01

    Providing mammography free-of-charge may alleviate some obstacles among women with socio-economic disadvantage. Stressing that good results one year do not make the cancer less likely or repeating the test less important, as well as improving the comfort of mammography testing could ensure test repeating.

  19. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Nielsen, Margrethe

    2009-01-01

    BACKGROUND: A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary. OBJECTIVES: To assess the effect of screening for breast cancer with mammography on mortality and morbidity. SEARCH STRATEGY: We searched Pub...... excluded a biased trial and included 600,000 women in the analyses. Three trials with adequate randomisation did not show a significant reduction in breast cancer mortality at 13 years (relative risk (RR) 0.90, 95% confidence interval (CI) 0.79 to 1.02); four trials with suboptimal randomisation showed...... a significant reduction in breast cancer mortality with an RR of 0.75 (95% CI 0.67 to 0.83). The RR for all seven trials combined was 0.81 (95% CI 0.74 to 0.87). We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential...

  20. Screening Mammography Utilization in Tennessee Women: The Association with Residence

    Science.gov (United States)

    Brown, Kathleen C.; Fitzhugh, Eugene C.; Neutens, James J.; Klein, Diane A.

    2009-01-01

    Context: Approximately 70% of US women over age 40 report mammography screening within 2 years. However, rates are likely to vary by age, income, educational level, and residence. Purpose: To describe the prevalence of screening mammography and associated factors in women living in rural and urban areas of Tennessee. Methods: Using pooled data…

  1. Overdiagnosis in organised mammography screening in Denmark. A comparative study

    DEFF Research Database (Denmark)

    Jørgensen, Karsten J; Zahl, Per-Henrik; Gøtzsche, Peter C

    2009-01-01

    BACKGROUND: Overdiagnosis in cancer screening is the detection of cancer lesions that would otherwise not have been detected. It is arguably the most important harm. We quantified overdiagnosis in the Danish mammography screening programme, which is uniquely suited for this purpose, as only 20......% of the Danish population has been offered organised mammography screening over a long time-period. METHODS: We collected incidence rates of carcinoma in situ and invasive breast cancer in areas with and without screening over 13 years with screening (1991-2003), and 20 years before its introduction (1971...

  2. Statistical methods for determining the effect of mammography screening

    DEFF Research Database (Denmark)

    Lophaven, Søren

    2016-01-01

    In an overview of five randomised controlled trials from Sweden, a reduction of 29% was found in breast cancer mortality in women aged 50-69 at randomisation after a follow up of 5-13 years. Organised, population based, mammography service screening was introduced on the basis of these resultsin...... the municipality of Copenhagen in 1991, in the county of Fyn in 1993 and in the municipality of Frederiksberg in 1994, although reduced mortality in randomised controlled trials does not necessarily mean that screening also works in routine health care. In the rest of Denmark mammography screening was introdueed...... in 2007-2008. Women aged 50-69 were invited to screening every second year. Taking advantage of the registers of population and health, we present statistical methods for evaluating the effect of mammography screening on breast cancer mortality (Olsen et al. 2005, Njor et al. 2015 and Weedon-Fekjær etal...

  3. Statistical methods for determining the effect of mammography screening

    DEFF Research Database (Denmark)

    Lophaven, Søren

    2016-01-01

    In an overview of five randomised controlled trials from Sweden, a reduction of 29% was found in breast cancer mortality in women aged 50-69 at randomisation after a follow up of 5-13 years. Organised, population based, mammography service screening was introduced on the basis of these resultsin...... the municipality of Copenhagen in 1991, in the county of Fyn in 1993 and in the municipality of Frederiksberg in 1994, although reduced mortality in randomised controlled trials does not necessarily mean that screening also works in routine health care. In the rest of Denmark mammography screening was introdueed...... in 2007-2008. Women aged 50-69 were invited to screening every second year. Taking advantage of the registers of population and health, we present statistical methods for evaluating the effect of mammography screening on breast cancer mortality (Olsen et al. 2005, Njor et al. 2015 and Weedon-Fekjær etal...

  4. Influence of advertisement on women's attitudes toward mammography screening.

    Science.gov (United States)

    Collins, C; Davis, L S; Rentz, K; Vannoy, D

    1997-01-01

    This project represents an effort to incorporate a feminist perspective into research on mammography screening. The purpose of this study was to assess women's attitudes toward four advertisements designed to encourage mammography screening. The goal was to create awareness about women's attitudes toward mammography advertisements in order to encourage the development of more effective and responsive motivational materials. The results indicated that each ad communicated different messages about the seriousness of breast cancer and the efficacy of mammography in detecting early breast cancer. Each ad also affected women differently regarding their feelings of control over breast cancer, their perceived loss of sex appeal resulting from a breast cancer diagnosis, and their general fear of breast cancer.

  5. Impact of screening mammography on breast cancer mortality.

    Science.gov (United States)

    Bleyer, Archie; Baines, Cornelia; Miller, Anthony B

    2016-04-15

    The degree to which observed reductions in breast cancer mortality is attributable to screening mammography has become increasingly controversial. We examined this issue with three fundamentally different approaches: (i) Chronology--the temporal relationship of the onset of breast cancer mortality decline and the national implementation of screening mammography; (ii) Magnitude--the degree to which breast cancer mortality declined relative to the amount (penetration) of screening mammography; (iii) Analogy--the pattern of mortality rate reductions of other cancers for which population screening is not conducted. Chronology and magnitude were assessed with data from Europe and North America, with three methods applied to magnitude. A comparison of eight countries in Europe and North America does not demonstrate a correlation between the penetration of national screening and either the chronology or magnitude of national breast cancer mortality reduction. In the United States, the magnitude of the mortality decline is greater in the unscreened, younger women than in the screened population and regional variation in the rate of breast cancer mortality reduction is not correlated with screening penetrance, either as self-reported or by the magnitude of screening-induced increase in early-stage disease. Analogy analysis of United States data identifies 14 other cancers with a similar distinct onset of mortality reduction for which screening is not performed. These five lines of evidence from three different approaches and additional observations discussed do not support the hypothesis that mammography screening is a primary reason for the breast cancer mortality reduction in Europe and North America.

  6. Access to Mammography Facilities and Detection of Breast Cancer by Screening Mammography: A GIS Approach.

    Science.gov (United States)

    Rahman, Selina; Price, James H; Dignan, Mark; Rahman, Saleh; Lindquist, Peter S; Jordan, Timothy R

    2009-01-01

    OBJECTIVES: The objective of the study was to examine the association between access to mammography facilities and utilization of screening mammography in an urban population. METHODS: Data on female breast cancer cases were obtained from an extensive mammography surveillance project. Distance to mammography facilities was measured by using GIS, which was followed by measuring geographical access to mammography facilities using Floating Catchment Area (FCA) method (considering all available facilities within an arbitrary radius from the woman's residence by using Arc GIS 9.0 software). RESULTS: Of 2,024 women, 91.4% were Caucasian; age ranged from 25 to 98 years; most (95%) were non-Hispanic in origin. Logistic regression found age, family history, hormone replacement therapy, physician recommendation, and breast cancer stage at diagnosis to be significant predictors of having had a previous mammogram. Women having higher access to mammography facilities were less likely to have had a previous mammogram compared to women who had low access, considering all the facilities within 10 miles (OR=0.41, CI=0.22-0.76), 30 miles (OR=0.52, CI=0.29-0.91) and 40 miles (OR=0.51, CI=0.28-0.92) radiuses. CONCLUSIONS: Physical distance to mammography facilities does not necessarily predict utilization of mammogram and greater access does not assure greater utilizations, due to constraints imposed by socio economic and cultural barriers. Future studies should focus on measuring access to mammography facilities capturing a broader dimension of access considering qualitative aspect of facilities, as well as other travel impedances.

  7. 42 CFR 405.535 - Special rule for nonparticipating physicians and suppliers furnishing screening mammography...

    Science.gov (United States)

    2010-10-01

    ... suppliers furnishing screening mammography services before January 1, 2002. 405.535 Section 405.535 Public... Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002. The provisions in this section apply for screening mammography services...

  8. 42 CFR 405.534 - Limitation on payment for screening mammography services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitation on payment for screening mammography... for Determining Reasonable Charges § 405.534 Limitation on payment for screening mammography services... January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31,...

  9. Predicting the risk of a false-positive test for women following a mammography screening programme

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Olsen, Anne Helene; Schwartz, Walter

    2007-01-01

    OBJECTIVES: The objectives of this study was to provide a simple estimate of the cumulative risk of a false-positive test for women participating in mammography screening. To test the method, we used data from two well-established, organized mammography screening programmes offering biennial...... be calculated in a simple way relatively early after the start of a mammography screening programme....

  10. An equivalent relative utility metric for evaluating screening mammography.

    Science.gov (United States)

    Abbey, Craig K; Eckstein, Miguel P; Boone, John M

    2010-01-01

    Comparative studies of performance in screening mammography are often ambiguous. A new method will frequently show a higher sensitivity or detection rate than an existing standard with a concomitant increase in false positives or recalls. The authors propose an equivalent relative utility (ERU) metric based on signal detection theory to quantify screening performance in such comparisons. The metric is defined as the relative utility, as defined in classical signal detection theory, needed to make 2 systems equivalent. ERU avoids the problem of requiring a predefined putative relative utility, which has limited application of utility theory in receiver operating characteristic analysis. The metric can be readily estimated from recall and detection rates commonly reported in comparative clinical studies. An important practical advantage of ERU is that in prevalence matched populations, the measure can be estimated without an independent estimate of disease prevalence. Thus estimating ERU does not require a study with long-term follow-up to find cases of missed disease. The approach is applicable to any comparative screening study that reports results in terms of recall and detection rates, although the authors focus exclusively on screening mammography in this work. They derive the ERU from the definition of utility given in classical treatments of signal detection theory. They also investigate reasonable values of relative utility in screening mammography for use in interpreting ERU using data from a large clinical study. As examples of application of ERU, they reanalyze 2 recently published reports using recall and detection rates in screening mammography.

  11. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.

    2009-01-01

    -choice treatment. MATERIAL AND METHODS: 767 women had FNAC performed from a total of 783 lesions at the Mammography Clinic, University Hospital Odense. All FNACs were compared with the final histology diagnosis. Nine statistical parameters were calculated according to the European guidelines. RESULTS: A total...

  12. Variation in Screening Mammography Rates Among Medicare Advantage Plans.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Fleming, Margaret; Duszak, Richard

    2017-08-01

    Prior studies have shown higher screening mammography rates for beneficiaries in capitated managed care Medicare Advantage (MA) plans compared with traditional fee-for-service Medicare. The aim of this study was to explore variation in screening mammography rates at the level of MA managed care plans. Using the 2016 MA Healthcare Effectiveness Data and Information Set Public Use File, screening mammography rates were identified for all 385 reporting MA plans. Associations were explored with a range of plan characteristics from this file, as well as from the CMS Part C and Part D Medicare Star Ratings Data File, Medicare Advantage Plan Directory, and Medicare Monthly Enrollment by Plan File. Overall MA plan screening rates were high (mean, 72.6 ± 9.4%) but varied substantially among plans (range, 14.3%-91.8%). Screening rates were higher in nonprofit versus for-profit plans (77.3% versus 71.8%, P plans versus private fee-for-service or regional preferred provider organization plans (71.9%-73.2% versus 65.5%-66.8%, P = .001). Among parent organizations with five or more plans, screening rates were highest for Kaiser Foundation (median, 88.4%) and lowest for Molina Healthcare (median, 65.3%). Screening rates showed small but significant associations with plans' contract lengths, enrolled populations, and counties served. Screening rates showed strong associations (r = 0.796-0.798) with colorectal cancer screening and annual flu vaccine rates and showed moderate associations (r = 0.283-0.365) with ambulatory and preventive care visits, osteoporosis screenings, body mass index assessments, and nonrecommended prostate-specific antigen screenings after age 70. Screening mammography rates vary considerably among MA plans. With increased federal interest in promoting the MA program, enhanced transparency will be necessary to ensure appropriate Medicare beneficiary participation decision making. Copyright © 2017 American College of Radiology. Published by Elsevier Inc

  13. Two-view versus single-view mammography at subsequent screening in a region of the Dutch breast screening programme.

    NARCIS (Netherlands)

    Smallenburg, V.v.; Duijm, L.E.M.; Heeten, G.J. den; Groenewoud, J.H.; Jansen, F.H.M.; Fracheboud, J.; Plaisier, M.L.; Doorne-Nagtegaal, H.J. van; Broeders, M.J.M.

    2012-01-01

    We retrospectively determined the effect of analogue two-view mammography versus single-view mammography at subsequent screens on breast cancer detection and determined financial consequences for a current digital mammography setting. Two screening radiologists reviewed the mammograms of 536 screen

  14. Socio-demographic determinants of participation in mammography screening

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My; Olsen, Anne Helene; Njor, Sisse

    2008-01-01

    Our objective was to use individual data on socio-demographic characteristics to identify predictors of participation in mammography screening and control to what extent they can explain the regional difference. We used data from mammography screening programmes in Copenhagen, 1991-1999, and Funen......, 1993-2001, Denmark. Target groups were identified from the Population Register, screening data came from the health authority, and socio-demographic data from Statistics Denmark. Included were women eligible for at least 3 screens. The crude RR of never use versus always use was 3.21 (95%CI, 3...... women in Copenhagen, irrespective of their socio-demographic characteristics, had low participation. Screening programmes have to find ways to handle this urbanity factor....

  15. Barriers to Mammography Screening: How to Overcome Them

    Directory of Open Access Journals (Sweden)

    Yasmin Hassoun

    2015-10-01

    Full Text Available Background: Screening mammography is an established intervention that leads to early breast cancer detection and reduced mortality. The Lebanese Ministry of Health has initiated yearly awareness campaigns and provided free mammography in multiple centers around the country. Methods: The study took place in two major areas of Lebanon - Beirut and South Lebanon. This cross-sectional survey aimed to assess knowledge about breast cancer screening and screening behaviors in the Lebanese population. The primary outcome of the study was to assess the reasons that prevented women from performing screening mammography based on our categories of questions: lack of knowledge about breast cancer, lack of access to screening facilities, failure of primary care physician to encourage screening behavior, and other reasons. Results: The major barriers to seek screening that had statistically significant P-values, in order of prevalence, included: lack of knowledge about breast cancer, followed by social reasons and lack of access. Conclusion: Given the prevalence of breast cancer in our population, it is important to understand the pitfalls that we experience in promoting awareness. Our study is the first study to reach out to the community to assess perceived barriers against screening and provide solutions for such barriers.

  16. 42 CFR 413.123 - Payment for screening mammography performed by hospitals on an outpatient basis.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for screening mammography performed by... SKILLED NURSING FACILITIES Specific Categories of Costs § 413.123 Payment for screening mammography... mammographies performed by hospitals. (b) Payment to hospitals for outpatient services. Payment to hospitals...

  17. Psychosocial predictors of first attendance for organised mammography screening

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    1999-01-01

    of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. CONCLUSION: Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer......OBJECTIVE: To study psychosocial predictors of attendance at an organised breast cancer screening programme. SETTING: Finnish screening programme based on personal first round invitations in 1992-94, and with 90% attendance rate. METHODS: Attenders (n = 946) belonged to a 10% random sample (n...... Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance. RESULTS: Those most likely to attend were working, middle income, and averagely educated women, who had...

  18. Significance of screening mammography in the detection of breast diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ham, Soo Youn; Kim, Kyoung Ah; Oh, Yu Whan; Kim, Hong In; Chung, Kyoo Byung [College of Medicine Korea University, Seoul (Korea, Republic of)

    1995-02-15

    To evaluate the clinical significance of the screening mammography in the detection of the breast diseases, especially breast carcinoma. We analyzed 1,800 cases of mammography retrospectively. The mammography was done as a part of routine check in Health Counselling Center, Korea University Medical Center, during 9 months from November 1993 to July 1994. The age range was from 23 years to 76 years, mean 49.8 years, and the largest age group was 6th decade (31.4%). According to the mammographic findings, we divided the subjects into three groups; normal group, abnormal group in need of follow-up study, abnormal group requiring biopsy. On mammography, the normal group consisted of 1,534 cases (85%), and the abnormal group consisted of 266 cases (15%). The abnormal findings were benign-looking calcification (n = 140), fibroadeno ma (n = 29), fibrocystic changes (n = 27), cyst (n = 23), malignant lesion (n = 15) lipoma (n = 7), and others. In four of 15 cases, which were suspected to be malignant on mammograms, breast carcinoma was confirmed pathologically. In four cases of breast carcinoma, one was under 40 and the other 3 were over 50 years of age. All of the breast cancers were under 3 cm in size, and the mammographic findings of breast cancer included spiculated margin (n = 3), parenchymal distortion (n = 3), malignant calcification (n = 2) and enlarged axillary node (n = 1). Screening mammogram is helpful for early detection of non-palpable breast cancer, especially for women over 50 years of age.

  19. Comparison of digital screening mammography and screen-film mammography in the early detection of clinically relevant cancers: a multicenter study

    NARCIS (Netherlands)

    Bluekens, A.M.; Holland, R.; Karssemeijer, N.; Broeders, M.J.M.; Heeten, G.J. den

    2012-01-01

    Purpose: To compare screen-film mammography with digital mammography in a breast cancer screening program, with a focus on the clinical relevance of detected cancers. Materials and Methods: The study was approved by the regional medical ethics review board. Informed consent was not required. Before

  20. Overdiagnosis, sojourn time, and sensitivity in the Copenhagen mammography screening program

    DEFF Research Database (Denmark)

    Olsen, Anne Helene; Agbaje, Olorunsola F; Myles, Jonathan P

    2006-01-01

    The goal of this research was to estimate the overdiagnosis at the first and second screens of the mammography screening program in Copenhagen, Denmark. This study involves a mammography service screening program in Copenhagen, Denmark, with 35,123 women screened at least once. We fit multistate...

  1. Different BIRADS Categories in Screening and Diagnostic Mammography

    Directory of Open Access Journals (Sweden)

    A. R. Ehsanbakhsh

    2009-11-01

    Full Text Available Background/Objective: Breast cancer is the most common cancer among Iranian women. The mean age of these cancer patients is one decade younger than that of other developing countries. The aim of this study was frequency determination of Breast Imaging Reporting and Data System (BIRADS subcategories, especially, higher categories and analysis of its related factors in the patients referred to the radiology department of Valie-Asr Hospital, Birjand."n"nPatients and Methods: The study was performed on 437 female patients from June 2006 to May 2007. Patients were divided into two groups; namely, those who underwent screening mammography and those who underwent diagnostic mammography. An expert radiologist reported the mammograms according to BIRADS classification. SPSS ver 12 software and Chi-square test were used for statistical analysis and P-value was significant under 0.05. Results: The mean age was 43.8±9 years. Eighty-one percent of the mammograms were diagnostic and only 19% of them were screening mammographies. Unilateral breast pain was the most common symptom (29% of which 68% were premenopausal. Fify-five percent of them had a history of OCP consumption. The overall BIRADS classification frequencies were: category 0: 9 (3%, category 1: 85 (19%, category 2: 268 (61%, category 3: 37 (8%, category 4: 22 (5%, category 5: 16 (4%. A positive test result (BIRADS categories 4 and 5 in our study was 10.7% in the diagnostic group and 1.2% in the screening group (p=0.007. Five percent of all patients had a familial history of breast cancer. Conclusion: Screening mammography is recommended for early evaluation and early diagnosis of breast cancer.     

  2. Mammography screening. Benefits, harms, and informed choice

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl

    2013-01-01

    . A mortality reduction can never justify a medical intervention in its own right, but must be weighed against the harms. Overdiagnosis is the most important harm of breast screening, but has gained wider recognition only in recent years. Screening leads to the detection and treatment of breast cancers...... that would otherwise never have been detected because they grow very slowly or not at all and would not have been detected in the woman's lifetime in the absence of screening. Screening therefore turns women into cancer patients unnecessarily, with life-long physical and psychological harms. The debate about...

  3. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Jørgensen, Karsten Juhl

    2013-01-01

    A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary.......A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary....

  4. Discussing the benefits and harms of screening mammography.

    Science.gov (United States)

    Brennan, Meagan; Houssami, Nehmat

    2016-10-01

    Mammographic screening programs were established around the world following randomised clinical trials showing that women who were screened had a significant reduction in the risk of dying from breast cancer. Now, decades later, several harms of screening have become apparent and the degree of risk reduction is being debated. This article aims to provide clinicians with evidence-based information about the benefits and harms of screening mammography to enable them to confidently discuss the issues with their patients. The issues around screening for breast cancer in asymptomatic women at average risk are complex. Women need accurate, balanced information to make an informed decision about whether they wish to participate in screening. The decision will vary from one woman to another, depending on her level of anxiety about cancer and recall, her personal values and her philosophy about health care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Colorectal cancer screening participation: comparisons with mammography and prostate-specific antigen screening.

    Science.gov (United States)

    Lemon, S; Zapka, J; Puleo, E; Luckmann, R; Chasan-Taber, L

    2001-08-01

    The relation of personal characteristics, health and lifestyle behaviors, and cancer screening practices to current colorectal cancer (CRC) screening was assessed and compared with those factors' relation to current mammography screening in women and prostate-specific antigen (PSA) screening in men. A cross-sectional random-digit-dialed telephone survey of 954 Massachusetts residents aged 50 and older was conducted. The overall prevalence of current CRC screening was 55.3%. Logistic regression results indicated that family history of CRC (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.02, 3.86), receiving a regular medical checkup (OR = 3.07; 95% CI = 2.00, 4.71), current screening by mammography in women and PSA in men (OR = 4.40; 95% CI = 2.94, 6.58), and vitamin supplement use (OR = 1.87; 95% CI = 1.27, 2.77) were significant predictors of CRC screening. Health and lifestyle behaviors were related to increased current CRC, mammography, and PSA screening. Personal factors independently related to CRC screening were not consistent with those related to mammography and PSA screening. This lack of consistency may reflect different stages of adoption of each type of screening by clinicians and the public.

  6. Four Principles to Consider Before Advising Women on Screening Mammography.

    Science.gov (United States)

    Keen, John D; Jørgensen, Karsten J

    2015-11-01

    This article reviews four important screening principles applicable to screening mammography in order to facilitate informed choice. The first principle is that screening may help, hurt, or have no effect. In order to reduce mortality and mastectomy rates, screening must reduce the rate of advanced disease, which likely has not happened. Through overdiagnosis, screening produces substantial harm by increasing both lumpectomy and mastectomy rates, which offsets the often-promised benefit of less invasive therapy. Next, all-cause mortality is the most reliable way to measure the efficacy of a screening intervention. Disease-specific mortality is biased due to difficulties in attribution of cause of death and to increased mortality due to overdiagnosis and the resulting overtreatment with radiotherapy and chemotherapy. To enhance participation, the benefit from screening is often presented in relative instead of absolute terms. Third, some screening statistics must be interpreted with caution. Increased survival time and the percentage of early-stage tumors at detection sound plausible, but are affected by lead-time and length biases. In addition, analyses that only include women who attend screening cannot reliably correct for selection bias. The final principle is that accounting for tumor biology is important for accurate estimates of lead time, and the potential benefit from screening. Since "early detection" is actually late in a tumor's lifetime, the time window when screen detection might extend a woman's life is narrow, as many tumors that can form metastases will already have done so. Instead of encouraging screening mammography, physicians should help women make an informed decision as with any medical intervention.

  7. Is mammography screening history a predictor of future breast cancer risk?

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini

    2015-01-01

    Inspired by the model by Walter and Day for risk of cervical cancer following negative screens, one might hypothesize that women in a mammography screening programme with a certain number of negative screens had a lower remaining breast cancer risk than that of women in general. We studied whether...... number of negative screens was a predictor for a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Copenhagen and Funen. Data were collected from the mammography screening programmes in Stockholm, Sweden (1989-2012), Copenhagen, Denmark (1991...... was not a predictor of a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Sweden, Copenhagen and Funen, Denmark. The history of previous negative screens is therefore not suitable for personalisation of mammography screening....

  8. Socio-demographic determinants of participation in mammography screening.

    Science.gov (United States)

    von Euler-Chelpin, My; Olsen, Anne Helene; Njor, Sisse; Vejborg, Ilse; Schwartz, Walter; Lynge, Elsebeth

    2008-01-15

    Our objective was to use individual data on socio-demographic characteristics to identify predictors of participation in mammography screening and control to what extent they can explain the regional difference. We used data from mammography screening programmes in Copenhagen, 1991-1999, and Funen, 1993-2001, Denmark. Target groups were identified from the Population Register, screening data came from the health authority, and socio-demographic data from Statistics Denmark. Included were women eligible for at least 3 screens. The crude RR of never use versus always use was 3.21 (95%CI, 3.07-3.35) for Copenhagen versus Funen, and the adjusted RR was 2.55 (95%CI, 2.43-2.67). The adjusted RR for never use among women without contact to a primary care physician was 2.50 (95% CI, 2.31-2.71) and 2.89 (95% CI, 2.66-3.14), and for women without dental care 2.94 (95% CI, 2.77-3.12) and 2.88 (95% CI, 2.68-3.10) for Copenhagen and Funen, respectively. Other important predictive factors for nonparticipation were not being married and not being Danish. In conclusion, to enhance participation in mammography screening programmes special attention needs to be given to women not using other primary health care services. All women in Copenhagen, irrespective of their socio-demographic characteristics, had low participation. Screening programmes have to find ways to handle this urbanity factor. Copyright 2007 Wiley-Liss, Inc.

  9. Effect of adding screening ultrasonography to screening mammography on patient recall and cancer detection rates: A retrospective study in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Tohno, Eriko, E-mail: tohno@tmch.or.jp [Total Health Evaluation Center Tsukuba, 1-2, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Umemoto, Takeshi, E-mail: umemoto@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Sasaki, Kyoko, E-mail: kdon@za.cyberhome.ne.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Morishima, Isamu, E-mail: morishima@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Ueno, Ei, E-mail: e-ueno@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan)

    2013-08-15

    Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening.

  10. Performance of systematic and non-systematic ('opportunistic') screening mammography: a comparative study from Denmark

    DEFF Research Database (Denmark)

    Bihrmann, Kristine; Jensen, Allan; Olsen, Anne Helene;

    2008-01-01

    OBJECTIVES: Evaluation and comparison of the performance of organized and opportunistic screening mammography. METHODS: Women attending screening mammography in Denmark in 2000. The study included 37,072 women attending organized screening. Among these, 320 women were diagnosed with breast cancer...

  11. Breast cancer mortality in organised mammography screening in Denmark: comparative study

    DEFF Research Database (Denmark)

    Juhl Jørgensen, Karsten; Zahl, Per-Henrik; Gøtzsche, Peter C

    2010-01-01

    To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up.......To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up....

  12. Breast cancer mortality in organised mammography screening in Denmark: comparative study

    DEFF Research Database (Denmark)

    Juhl Jørgensen, Karsten; Zahl, Per-Henrik; Gøtzsche, Peter C

    2010-01-01

    To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up.......To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up....

  13. Effects of mammography screening under different screening schedules: Model estimates of potential benefits and harms

    NARCIS (Netherlands)

    J.S. Mandelblatt (Jeanne); K.A. Cronin (Kathleen); S. Bailey (Stephanie); D.A. Berry (Donald); H.J. de Koning (Harry); G. Draisma (Gerrit); H. Huang (Hailiang); S.J. Lee (Stephanie Joi); M.F. Munsell (Mark); S.K. Plevritis (Sylvia); P.M. Ravdin (P.); C.B. Schechter (Clyde); B. Sigal (Bronislava); M.A. Stoto (Michael); N.K. Stout (Natasha); N.T. van Ravesteyn (Nicolien); J. Venier (John); M. Zelen (Marvin); E. Feuer (Eric)

    2009-01-01

    textabstractBackground: Despite trials of mammography and widespread use, optimal screening policy is controversial. Objective: To evaluate U.S. breast cancer screening strategies. Design: 6 models using common data elements. Data Sources: National data on age-specific incidence, competing mortality

  14. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.

    2009-01-01

    INTRODUCTION: In the year 2000 a quality assurance programme for the preoperative breast diagnostics was introduced in Denmark. The programme was based on the "European guidelines for quality assurance in breast cancer screening and diagnosis" where - among other measures - five cytological...... diagnostic classes were introduced. The aim of this study was to evaluate the quality assurance programme in a screening population to determine whether fine needle aspiration cytology (FNAC) as first choice remains a useful tool in the preoperative diagnostics, or if needle core biopsy should be the first...... of 66% of the 783 FNACs had a malignant cytology diagnosis, which in 99% of the cases turned out to be the correct diagnosis. Four lesions were false positives all of which represented benign proliferative breast diseases. The surgical procedures in these cases were either excisional biopsy...

  15. ROC study of screen-film mammography and storage phosphor digital mammography: analysis of nonconcordant classifications and implications for the approval of digital mammography systems

    Science.gov (United States)

    Freedman, Matthew T.; Artz, Dorothy S.; Hogge, Jacquelyn; Zuurbier, Rebecca A.; Jafroudi, Hamid; Lo, Shih-Chung B.; Mun, Seong K.

    1997-04-01

    A recently completed ROC study of digital mammography using a 100 micron pixel storage phosphor receptor showed that digital mammography and conventional screen film mammography were essentially equivalent in areas under the ROC curve. In this study, there were 24 biopsy proven breast cancer cases, 25 benign biopsy cases and 48 clinically normal breast images each with matched screen film and storage phosphor images. Fifteen of the 24 cancer cases were 10 mm or less in size. Of these 10 presented with microcalcifications as the sign of disease. Six radiologists not involved with the research program and without prior experience with digital mammography and who met qualification criteria under the Mammography Quality Standards Act of 1992 served as readers. This poster looks at the cases in which there was variance between the radiologists ROC classification system for the digital and screen film system in order to analyze case specific discrepancies that may indicate benefits or deficits of the digital system. Aspects of the ROC ratings are also analyzed including an evaluation of the different thresholds used by radiologists on the digital and screen film systems, the distribution of ROC ratings in normal and abnormal cases, the effect of using different gold standards of proof on the results and the effect of substituting an ACR BIRADS category agreement study as proposed by the FDA compared to the ROC study outcome.

  16. Real-time reading in mammography breast screening.

    Science.gov (United States)

    Mariotto, R; Brancato, B; Bonetti, F; Manfrin, E; Strabbioli, M; Mercanti, A; Falsirollo, F; Bricolo, P; Pistolesi, G F

    2007-03-01

    This study was undertaken to assess the role of real-time reading in the mammography screening programme carried out at the Hospital of Marzana, Verona, Italy. During the 5-year period 1999-2004, 54,472 women attended the screening programme (32,291 first calls: unadjusted uptake 41.4%, adjusted uptake 50.3%; 21,551 2- year routine recalls: unadjusted uptake 86.4%, adjusted uptake 89.9%). Further diagnostic investigations [(FDI), imaging and cytohistological] were performed immediately after real-time reading of the screening mammograms (FDI rate among first calls 10.9%; FDI rate among 2-year recalls 5.4%). Overall, cytohistological FDI were requested in 27% of imaging FDI, with a clear prevalence of cytological [fine-needle aspiration cytology (FNAC) 87%] over histological procedures [core needle biopsy (CNB) 11%; vacuum aspiration biopsy (VAB) 2%]. Imaging FDI proved to be conclusive in 73%. Cytohistological FDI led to the use of surgical biopsy (SB) in 39.5% (ratio between benign and malignant SB: 0.19/first calls, 0.14/2-year recalls). There were a total of 427 screen-detected breast cancers (BC), with a very good breast cancer detection rate (BCDR/first calls 9.7 per thousand; BCDR/2-year recalls 5.1 per thousand). In the 427 screen-detected BC, the incidence of pTis, pT1a,b cancers was 59.6% (diagnostic anticipation); the incidence of pN0 cancers was 61.2%; the incidence of conservative surgical procedures was 78.6%. In interval cancers, the false negative rate was 8.3% only, whereas the proportional incidence was very low indeed (14% first year; 38% second year). The high sensitivity exhibited by the Marzana mammography screening programme suggests that the value of real-time reading should be validated by other programmes adopting a similar approach.

  17. Estimating the benefits of mammography screening: the impact of study design

    DEFF Research Database (Denmark)

    Olsen, Anne Helene; Njor, Sisse H; Lynge, Elsebeth

    2007-01-01

    BACKGROUND: Mammography screening is justifiable only if it leads to reduction in breast cancer mortality. However, evaluation of routine screening is not straightforward, as no unscreened control group is available. We report here on a cohort study of the effect of routine mammography on breast...... control group resulted in an estimated increase of 6% in breast cancer mortality. CONCLUSION: Estimated changes in breast cancer mortality following the introduction of routine mammography ranged from a 25% reduction (based on the best methodology) to a 6% increase with a less rigid study design....... The estimated effect of routine mammography on breast cancer mortality is thus highly dependent on study design....

  18. Spousal influence on mammography screening: a life course perspective.

    Science.gov (United States)

    Missinne, Sarah; Colman, Elien; Bracke, Piet

    2013-12-01

    Recently, researchers have challenged the basic tenet that marriage is universally protective for all individuals. We scrutinize socio-economic differences between married couples to shed light on the mechanisms underlying the effects of marriage. We introduce the life course perspective to investigate if differences in positive health behavior between couples are related to their early life conditions. Within the theoretical framework of cultural health capital, we hypothesize that the accumulation of cultural health capital proceeds at the marriage level when partners provide each other with health-related information and norms. For this purpose, we examine the influence of the childhood preventive health care behavior of both wives and husbands on the initiation of mammography screening for a sample of Belgian women (N = 734). Retrospective life histories of both partners are provided by the Survey of Health, Ageing and Retirement (SHARE) and are examined by means of event history analysis. The results show that a partner's cultural health capital affects the initiation of mammography screening by a woman in later life, even after her own cultural health capital and traditional measures of socio-economic status (SES) are taken into account. In line with cumulative advantage theory, it seems that inequalities in cultural health capital are accumulated at the marriage level. In order to shed further light on the spousal influence on health behavior, researchers should revert to early life in order to discern the attribution of premarital and marital conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Volumetric breast density affects performance of digital screening mammography.

    Science.gov (United States)

    Wanders, Johanna O P; Holland, Katharina; Veldhuis, Wouter B; Mann, Ritse M; Pijnappel, Ruud M; Peeters, Petra H M; van Gils, Carla H; Karssemeijer, Nico

    2017-02-01

    To determine to what extent automatically measured volumetric mammographic density influences screening performance when using digital mammography (DM). We collected a consecutive series of 111,898 DM examinations (2003-2011) from one screening unit of the Dutch biennial screening program (age 50-75 years). Volumetric mammographic density was automatically assessed using Volpara. We determined screening performance measures for four density categories comparable to the American College of Radiology (ACR) breast density categories. Of all the examinations, 21.6% were categorized as density category 1 ('almost entirely fatty') and 41.5, 28.9, and 8.0% as category 2-4 ('extremely dense'), respectively. We identified 667 screen-detected and 234 interval cancers. Interval cancer rates were 0.7, 1.9, 2.9, and 4.4‰ and false positive rates were 11.2, 15.1, 18.2, and 23.8‰ for categories 1-4, respectively (both p-trend density categories: 85.7, 77.6, 69.5, and 61.0% for categories 1-4, respectively (p-trend density, automatically measured on digital mammograms, impacts screening performance measures along the same patterns as established with ACR breast density categories. Since measuring breast density fully automatically has much higher reproducibility than visual assessment, this automatic method could help with implementing density-based supplemental screening.

  20. Statistical Methods for Estimating the Cumulative Risk of Screening Mammography Outcomes

    NARCIS (Netherlands)

    Hubbard, R.A.; Ripping, T.M.; Chubak, J.; Broeders, M.J.; Miglioretti, D.L.

    2016-01-01

    BACKGROUND: This study illustrates alternative statistical methods for estimating cumulative risk of screening mammography outcomes in longitudinal studies. METHODS: Data from the US Breast Cancer Surveillance Consortium (BCSC) and the Nijmegen Breast Cancer Screening Program in the Netherlands were

  1. Mammography and Other Screening Tests for Breast Problems

    Science.gov (United States)

    ... a clinical breast exam done? • What is breast self-awareness? • How is breast self-awareness different from the traditional breast self-exam? •Glossary ... problems includes mammography , clinical breast exams, and breast self-awareness. What is mammography? Mammography is an X-ray ...

  2. Teleradiology and mammography screening: evaluation of a network with dedicated workstations for reporting; Teleradiologie im Mammographie-Screening: Evaluation eines Testnetzes mit dedizierten Befundungsstationen

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, C.P.; Weigel, C.; Mohr, M.; Schimming, A.; Hosten, N. [Inst. fuer Diagnostische Radiologie und Neuroradiologie, Ernst-Moritz-Arndt-Univ., Greifswald (Germany); Bick, U. [Inst. fuer Radiologie, Charite Campus Mitte, Berlin (Germany)

    2007-02-15

    Purpose: Evaluation of a system that supports a workflow for breast cancer screening by mammography. The time of installation, system reliability and workstation operation were evaluated. Materials and Methods: The evaluated system (Image Diagnost, Munich, Germany) contains 2 diagnostic mammography workstations, a centralized server, and 2 Dicom shuttles for exchanging images via a physically existing network structure. Temporary archiving is possible. A mask designed for the needs of mammography screening facilitates assignment of BIRADS categories. The system automatically compares the categories assigned by a first and second reviewer and decides whether a consensus conference should be held. In the event that a conference is needed, the reviews are transmitted to the mammography expert responsible for the screening program and the consensus conference. Images are transferred via ISDN, Germany's National Research and Education Network (in the following DFN) and a central server between 2 sites which are approx. 100 km apart. We evaluated the duration of installation, the reliability of the system, and the usability of the workstation. Since we used curative mammography for evaluating the system, the patient age was noted for comparison. Results: the system was installed in five days. Once installed, the system functioned without any major breakdowns. Mammography units of 2 manufacturers were able to be connected to the system without difficulty. Mammographies of 151 patients were exchanged between the sites and evaluated by 2 radiologists. 57% of the patients were in the screening age (50-69 years). 9 exams were classified BIRADS 4a, 2 were 4b and 3 were BIRADS 5. The evaluations were technically perfect in 146/151 cases; hanging protocols had to be altered manually in 6 cases; the window/level had to be manually adjusted in 26/151 cases. Magnification was sufficient in all cases. The system exchanges examinations extremely quickly; up to 100 mammography

  3. Screening Mammography: A Pilot Study on Its Pertinence in Indian Population by Means of a Camp.

    Science.gov (United States)

    Kumar, Joish Upendra; Sreekanth, Vivek; Reddy, Harikiran R; Sridhar, Aishwarya B; Kodali, Niveditha; Prabhu, Anitha S

    2017-08-01

    Breast cancer incidence and related mortality is increasing in Indian women. Indian ladies hesitate to seek medical care for breast related issues. Screening mammography, proved to effectively reduce mortality, has been deemed not feasible in Indian context due to cost considerations. The suggested alternatives have not been proven to improve mortality rates. To find the relevance of screening mammography camp among Indian women. A week long screening mammography camp was organized in a tertiary care hospital. Clinical examination was done followed by bilateral mammography. Mammograms were reported as per American College of Radiology-Breast Imaging Reporting and Data Systems (ACR-BIRADS) 5(th) edition specifications. Lesions deemed BIRADS 4 and 5 were biopsied. BIRADS 3 category findings were suggested short interval follow up. A total of 118 women, ranging from 35 to 64 years of age with mean age of 49.6 years underwent mammography. Thirty ladies with dense breast compositions further underwent sono-mammography. Six (5.1%) new cases of breast carcinomas were detected during this study and 28 (23.7%) cases with probably benign findings were advised short interval follow up. Mammography, being a proven screening modality effective in reducing mortality, needs incorporation into the nationwide program for breast cancer detection, inspite of financial considerations. Organizing mammography camps will help create awareness and encourage public to utilize services.

  4. Digital mammography in a screening programme and its implications for pathology: a comparative study.

    LENUS (Irish Health Repository)

    Feeley, Linda

    2011-03-01

    Most studies comparing full-field digital mammography (FFDM) with conventional screen-film mammography (SFM) have been radiology-based. The pathological implications of FFDM have received little attention in the literature, especially in the context of screening programmes. The primary objective of this retrospective study is to compare FFDM with SFM in a population-based screening programme with regard to a number of pathological parameters.

  5. Comparison of mammography in combination with breast ultrasonography versus mammography alone for breast cancer screening in asymptomatic women.

    Science.gov (United States)

    Boonlikit, Sarawan

    2013-01-01

    To compare the agreement of screening breast mammography plus ultrasound and reviewed mammography alone in asymptomatic women. All breast imaging data were obtained for women who presented for routine medical checkup at National Cancer Institute (NCI), Thailand from January 2010 to June 2013. A radiologist performed masked interpretations of selected mammographic images retrieved from the computer imaging database. Previous mammography, ultrasound reports and clinical data were blinded before film re-interpretation. Kappa values were calculated to assess the agreement between BIRADS assessment category and BIRADS classification of density obtained from the mammography with ultrasound in imaging database and reviewed mammography alone. Regarding BIRADS assessment category, concordance between the two interpretations were good. Observed agreement was 96.1%. There was moderate agreement in which the Kappa value was 0.58% (95%CI; 0.45, 0.87). The agreement of BI-RADS classification of density was substantial, with a Kappa value of 0.60 (95%CI; 0.54, 0.66). Different results were obtained when a subgroup of patients aged ≥60 years were analyzed. In women in this group, observed agreement was 97.6%. There was also substantial agreement in which the Kappa value was 0.74% (95%CI; 0.49, 0.98). The present study revealed that concordance between mammography plus ultrasound and reviewed mammography alone in asymptomatic women is good. However, there is just moderate agreement which can be enhanced if age- targeted breast imaging is performed. Substantial agreement can be achieved in women aged ≥60. Adjunctive breast ultrasound is less important in women in this group.

  6. Comparison of cumulative false-positive risk of screening mammography in the United States and Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Katja Kemp

    2015-01-01

    INTRODUCTION: In the United States (US), about one-half of women screened with annual mammography have at least one false-positive test after ten screens. The estimate for European women screened ten times biennially is much lower. We evaluate to what extent screening interval, mammogram type......, and statistical methods, can explain the reported differences. METHODS: We included all screens from women first screened at age 50-69 years in the US Breast Cancer Surveillance Consortium (BCSC) (n=99,455) between 1996-2010, and from two population-based mammography screening programs in Denmark (n=230,452 and n...

  7. Determinants of mammography screening behavior in Iranian women: A population-based study

    Directory of Open Access Journals (Sweden)

    Mitra Moodi

    2012-01-01

    Full Text Available Background: Breast cancer remains a substantial health concern in Iran due to delay and late stage at diagnosis and treatment. Despite the potential benefits of mammography screening for early detection of breast cancer, the performance of this screening among Iranian women is low. For planning appropriate intervention, this study was carried out to identify mammography rates and explore determinants of mammography screening behavior in females of Isfahan, Iran. Materials and Methods: In this population-based study, 384 women of 40 years and older were interviewed by telephone. The Farsi version of Champion′s Health Belief Model scale (CHBMS was used to examine factors associated with mammography screening. The obtained data were analyzed by SPSS (version 16.0 using statistical Chi-square, Fisher Exact test, t-test and multiple logistic regression model to identify the importance rate of socio-demographic and Health Belief Model (HBM variables to predict mammography screening behavior. In all of tests, the level of significant was considered a = 0.05. Results: Mean age ΁ SD of women was 52.24 ΁ 8.2 years. Of the 384 participants, 44.3% reported at least one mammogram in their lifetime. Logistic regression analysis indicated that women were more likely to have mammography if they heard/read about breast cancer (OR = 4.17, 95% CI 2.09, 8.34, menopause in lower age (OR = 0.2, 95% CI 0.87, 0.99 and history of breast problem (OR = 0.9, 95% CI 0.12, 0.32. Also, women who perceived more benefits of mammography (OR = 1.84, 95% CI 1.63, 2.09, fewer barriers of mammography (OR = 0.91, 95% CI 0.86, 0.96 and had more motivation for health (OR = 0.94, 95% CI 0.89, 1 were more likely to have mammography. Conclusion: The findings indicated that the rate of mammography screening among women in Isfahan province is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the first

  8. Comparing sensitivity and specificity of screening mammography in the United States and Denmark

    DEFF Research Database (Denmark)

    Kemp Jacobsen, Katja; O'Meara, Ellen S; Key, Dustin

    2015-01-01

    Delivery of screening mammography differs substantially between the United States (US) and Denmark. We evaluated whether there are differences in screening sensitivity and specificity. We included screens from women screened at age 50-69 years during 1996-2008/2009 in the US Breast Cancer...... Surveillance Consortium (BCSC) (n = 2,872,791), and from two population-based mammography screening programs in Denmark (Copenhagen, n = 148,156 and Funen, n = 275,553). Women were followed-up for 1 year. For initial screens, recall rate was significantly higher in BCSC (17.6%) than in Copenhagen (4...

  9. Impact of Medicare Shared Savings Program Accountable Care Organizations at Screening Mammography: A Retrospective Cohort Study.

    Science.gov (United States)

    Narayan, Anand K; Harvey, Susan C; Durand, Daniel J

    2017-02-01

    Purpose To evaluate the impact of accountable care organizations (ACOs) on use of screening mammography in the Medicare Shared Savings Program (MSSP), the largest value-based reimbursement program in U.S.

  10. Type of hormone therapy and risk of misclassification at mammography screening

    DEFF Research Database (Denmark)

    Njor, Sisse H; Hallas, Jesper; Schwartz, Walter;

    2011-01-01

    Current users of hormone therapy (HT) are known to have a lower accuracy of mammography screening than do never users. We studied whether the risk of misclassification depends on type of hormone, administration, regimen, and dose of the therapy.......Current users of hormone therapy (HT) are known to have a lower accuracy of mammography screening than do never users. We studied whether the risk of misclassification depends on type of hormone, administration, regimen, and dose of the therapy....

  11. Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Lobbes, Marc B.I.; Wildberger, Joachim E. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Lalji, Ulrich; Houwers, Janneke; Nijssen, Estelle C. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); Nelemans, Patty J. [Maastricht University, Department of Epidemiology, Maastricht (Netherlands); Roozendaal, Lori van; Heuts, Esther [Maastricht University Medical Center, Department of Surgical Oncology, Maastricht (Netherlands); Smidt, Marjolein L. [Maastricht University Medical Center, Department of Surgical Oncology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2014-07-15

    Feasibility studies have shown that contrast-enhanced spectral mammography (CESM) increases diagnostic accuracy of mammography. We studied diagnostic accuracy of CESM in patients referred from the breast cancer screening programme, who have a lower disease prevalence than previously published papers on CESM. During 6 months, all women referred to our hospital were eligible for CESM. Two radiologists blinded to the final diagnosis provided BI-RADS classifications for conventional mammography and CESM. Statistical significance of differences between mammography and CESM was calculated using McNemar's test. Receiver operating characteristic (ROC) curves were constructed for both imaging modalities. Of the 116 eligible women, 113 underwent CESM. CESM increased sensitivity to 100.0 % (+3.1 %), specificity to 87.7 % (+45.7 %), PPV to 76.2 % (+36.5 %) and NPV to 100.0 % (+2.9 %) as compared to mammography. Differences between conventional mammography and CESM were statistically significant (p < 0.0001). A similar trend was observed in the ROC curve. For conventional mammography, AUC was 0.779. With CESM, AUC increased to 0.976 (p < 0.0001). In addition, good agreement between tumour diameters measured using CESM, breast MRI and histopathology was observed. CESM increases diagnostic performance of conventional mammography, even in lower prevalence patient populations such as referrals from breast cancer screening. (orig.)

  12. Predictive features of breast cancer on Mexican screening mammography patients

    Science.gov (United States)

    Rodriguez-Rojas, Juan; Garza-Montemayor, Margarita; Trevino-Alvarado, Victor; Tamez-Pena, José Gerardo

    2013-02-01

    Breast cancer is the most common type of cancer worldwide. In response, breast cancer screening programs are becoming common around the world and public programs now serve millions of women worldwide. These programs are expensive, requiring many specialized radiologists to examine all images. Nevertheless, there is a lack of trained radiologists in many countries as in Mexico, which is a barrier towards decreasing breast cancer mortality, pointing at the need of a triaging system that prioritizes high risk cases for prompt interpretation. Therefore we explored in an image database of Mexican patients whether high risk cases can be distinguished using image features. We collected a set of 200 digital screening mammography cases from a hospital in Mexico, and assigned low or high risk labels according to its BIRADS score. Breast tissue segmentation was performed using an automatic procedure. Image features were obtained considering only the segmented region on each view and comparing the bilateral di erences of the obtained features. Predictive combinations of features were chosen using a genetic algorithms based feature selection procedure. The best model found was able to classify low-risk and high-risk cases with an area under the ROC curve of 0.88 on a 150-fold cross-validation test. The features selected were associated to the differences of signal distribution and tissue shape on bilateral views. The model found can be used to automatically identify high risk cases and trigger the necessary measures to provide prompt treatment.

  13. Breast screening using 2D-mammography or integrating digital breast tomosynthesis (3D-mammography) for single-reading or double-reading--evidence to guide future screening strategies.

    Science.gov (United States)

    Houssami, Nehmat; Macaskill, Petra; Bernardi, Daniela; Caumo, Francesca; Pellegrini, Marco; Brunelli, Silvia; Tuttobene, Paola; Bricolo, Paola; Fantò, Carmine; Valentini, Marvi; Ciatto, Stefano

    2014-07-01

    We compared detection measures for breast screening strategies comprising single-reading or double-reading using standard 2D-mammography or 2D/3D-mammography, based on the 'screening with tomosynthesis or standard mammography' (STORM) trial. STORM prospectively examined screen-reading in two sequential phases, 2D-mammography alone and integrated 2D/3D-mammography, in asymptomatic women participating in Trento and Verona (Northern Italy) population-based screening services. Outcomes were ascertained from assessment and/or excision histology or follow-up. For each screen-reading strategy we calculated the number of detected and non-detected (including interval) cancers, cancer detection rates (CDRs), false positive recall (FPR) measures and incremental CDR relative to a comparator strategy. We estimated the false:true positive (FP:TP) ratio and sensitivity of each mammography screening strategy. Paired binary data were compared using McNemar's test. Amongst 7292 screening participants, there were 65 (including six interval) breast cancers; estimated first-year interval cancer rate was 0.82/1000 screens (95% confidence interval (CI): 0.30-1.79/1000). For single-reading, 35 cancers were detected at both 2D and 2D/3D-mammography, 20 cancers were detected only with 2D/3D-mammography compared with none at 2D-mammography alone (preading, 39 cancers were detected at 2D-mammography and 2D/3D-mammography, 20 were detected only with 2D/3D-mammography compared with none detected at 2D-mammography alone (preading. Incremental CDR attributable to double-reading (versus single-reading) of 0.55/1000 screens (95% CI: -0.02-1.4) was evident for 2D-mammography and for 2D/3D-mammography. Estimated FP:TP ratios showed that 2D/3D-mammography screening strategies had more favourable FP to TP trade-off and higher sensitivity, applying single-reading or double-reading, relative to 2D-mammography screening. The evidence we report warrants rethinking of breast screening strategies and should

  14. Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening.

    Science.gov (United States)

    Strech, Daniel

    2014-03-01

    Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates.

  15. Variation in detection of ductal carcinoma in situ during screening mammography

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Ponti, Antonio; James, Ted

    2014-01-01

    BACKGROUND: There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative ...

  16. Improving the Sensitivity of Screening Mammography in the South of the Netherlands

    NARCIS (Netherlands)

    V. van Breest Smallenburg (Vivian)

    2013-01-01

    textabstractIn this thesis I explore several factors that influence the sensitivity of screening mammography, with the aim to improve screening outcome in the southern breast cancer screening region of the Netherlands. This general introduction describes: - the background and implementation of mass

  17. Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts.

    Science.gov (United States)

    Lee, Christoph I; Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L; Tosteson, Anna N A; Miglioretti, Diana L; Kerlikowske, Karla; Stout, Natasha K; Jarvik, Jeffrey G; Ramsey, Scott D; Lehman, Constance D

    2015-03-01

    To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50-74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50-74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

  18. Mammography screening in Greece: An exploratory survey of women's views, experiences and behaviours

    Directory of Open Access Journals (Sweden)

    Athena Kalokerinou

    2012-01-01

    Full Text Available Background: Internationally, breast cancer comprises 29% of all cancer incidences. In Greece, 1,500-1,800women die annually from breast cancer out of the 4,000 who are affected. Only 5% are detected at an early diseasestage through mammography screening.Aim: This paper presents findings from a study exploring the factors that influence Greek women’smammography screening behaviour.Methodology: Data were collected in Athens-Greece, during the period March-July 2008, from individuals whowere members of six women’s associations. One hundred and eighty six questionnaires were completed and 33interviews were conducted from a sub-sample. This paper reports the findings from the questionnaire survey.Results: Participants had a variety of demographic characteristics with 85% of them having attendedmammography screening. Only 61% of them intended to continue in the future. Τhe majority of women agreedwith a number of factors which supported their decision to participate in regular mammography screening, such asdoctors’ encouragement and mammogram efficacy to detect breast cancer at an early stage, while anxiety wasidentified as a possible inhibitor to their participation.Conclusion: Women’s mammography screening behaviour and perceptions of mammography screening appearedto be positive in relation to their participation. However, the reasons as to why a large number of women indicatedthey were unlikely to go for mammography screening again is not known, and needs further investigation.

  19. Comparison of 2D versus 3D mammography with screening cases: an observer study

    Science.gov (United States)

    Fernandez, James Reza; Deshpande, Ruchi; Hovanessian-Larsen, Linda; Liu, Brent

    2012-02-01

    Breast cancer is the most common type of non-skin cancer in women. 2D mammography is a screening tool to aid in the early detection of breast cancer, but has diagnostic limitations of overlapping tissues, especially in dense breasts. 3D mammography has the potential to improve detection outcomes by increasing specificity, and a new 3D screening tool with a 3D display for mammography aims to improve performance and efficiency as compared to 2D mammography. An observer study using human studies collected from was performed to compare traditional 2D mammography with this new 3D mammography technique. A prior study using a mammography phantom revealed no difference in calcification detection, but improved mass detection in 2D as compared to 3D. There was a significant decrease in reading time for masses, calcifications, and normals in 3D compared to 2D, however, as well as more favorable confidence levels in reading normal cases. Data for this current study is currently being obtained, and a full report should be available in the next few weeks.

  20. Visualization of mocrocalcifications on mammographies obtained by digital fullfield mammography in comparison to conventional film-screen mammography; Visualisierung von Mikrokalzifikationen in digitaler Vollfeldmammographie im Vergleich zu konventioeller Film-Folien-Mammographie

    Energy Technology Data Exchange (ETDEWEB)

    Diekmann, S.; Heyden, H. von; Diekmann, F. [Humboldt-Universitaet, Berlin (Germany). Universitaetsklinikum Charite, Inst. fuer Radiologie; Bick, U. [Chicago Univ., IL (United States). Dept. of Radiology

    2003-06-01

    Purpose: To evaluate the visualization of microcalcifications on mammographies obtained by full-field digital mammography (FFDM) in comparison to conventional film-screen mammography (FSM). Material and Methods: Forty-seven digital and film-screen mammographies depicting histologically proven lesions (27 benign, 20 malignant) were assessed by 4 readers. The images obtained with the different systems were comparable in terms of positioning. Maximum time interval between film-screen mammography and digital mammography was three months. Using a questionnaire, the readers evaluated the number of microcalcifications and their subjective conspicuity for FFDM (Senographe 2000D, GE Medical Systems, Milwaukee, USA) and FSM. A 7-point scale based on the BIRADS classification was used to characterize the calcifications by means of ROC analysis. Results: No statistically significant differences were seen between the two types of mammography among the readers in assessing the number of microcalcifications. The subjective conspicuity of microcalcifications was found to be significantly better for digital mammographies. The diagnosis assigned by the readers did not show significant differences between the two systems. Conclusion: Although the subjective conspicuity of microcalcifications was found to be significantly better on digital mammography compared to film-screen mammography, there was no significant advantage of digital mammography resulting from the higher contrast resolution nor a disadvantage in terms of characterization of microcalcifications resulting from the lower spacial resolution. The advantages of digital mammography (e.g. CAD-systems, archiving, dose reduction) can be used without a loss of diagnostic quality. (orig.) [German] Zielsetzung: Mit der vorliegenden Studie soll die Erkennbarkeit von Mikroverkalkungen in der digitalen Vollfeldmammographie im Vergleich zur konventionellen Film-Folien-Mammographie evaluiert werden. Darueber hinaus soll die klinische

  1. Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network

    NARCIS (Netherlands)

    Lynge, E.; Ponti, A.; James, T.; Majek, O.; Euler-Chelpin, M. von; Anttila, A.; Fitzpatrick, P.; Frigerio, A.; Kawai, M.; Scharpantgen, A.; Broeders, M.J.; Hofvind, S.; Vidal, C.; Ederra, M.; Salas, D.; Bulliard, J.L.; Tomatis, M.; Kerlikowske, K.; Taplin, S.

    2014-01-01

    BACKGROUND: There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative ana

  2. Screening Mammography: Patient Perceptions and Preferences Regarding Communication of Estimated Breast Cancer Risk.

    Science.gov (United States)

    Amornsiripanitch, Nita; Mangano, Mark; Niell, Bethany L

    2017-05-01

    Many models exist to estimate a woman's risk of development of breast cancer. At screening mammography, many imaging centers collect data required for these models to identify women who may benefit from supplemental screening and referral for cancer risk assessment. The purpose of this study was to discern perceptions and preferences of screening mammography patients regarding communication of estimated breast cancer risk. An anonymous survey was distributed to screening and surveillance mammography patients between April and June 2015. Survey questions were designed to assess patient preferences regarding the receipt and complexity of risk estimate communication, including hypothetical scenarios with and without > 20% estimated risk of breast cancer. The McNemar test and the Wilcoxon signed rank test were used with p ≤ 0.05 considered statistically significant. The survey was distributed to 1061 screening and surveillance mammography patients, and 503 patients responded (response rate, 47%). Although 86% (431/503) of patients expressed interest in learning their estimated risk, only 8% (38/503) had undergone formal risk assessment. The preferred method (241 respondents [26%]) of communication of risk 20%, patients preferred oral communication and were 10-fold as likely to choose only oral communication (p 20%, patients preferred to learn their estimated risk in great detail (69% and 85%), although women were significantly more likely to choose greater detail for risk > 20% (p < 0.00001). Screening mammography patients expressed interest in learning their estimated risk of breast cancer regardless of their level of hypothetical risk.

  3. Breast cancer incidence after the introduction of mammography screening: what should be expected?

    DEFF Research Database (Denmark)

    Svendsen, Anne Louise; Olsen, Anne Helene; von Euler-Chelpin, My

    2006-01-01

    BACKGROUND: A prevalence peak is expected in breast cancer incidence when mammography screening begins, but afterward the incidence still may be elevated compared with prescreening levels. It is important to determine whether this is due to overdiagnosis (ie, the detection of asymptomatic disease...... that would otherwise not have arisen clinically). In the current study, the authors examined breast cancer incidence after the introduction of mammography screening in Denmark. METHODS: Denmark has 2 regional screening programs targeting women ages 50 years to 69 years. The programs were initiated in 1991...

  4. Mammography screening on healthy women - advantages and disadvantages. A critical discussion

    Energy Technology Data Exchange (ETDEWEB)

    Malterud, K.

    1986-06-01

    Studies from USA, the Netherlands and Sweden demonstrate that mamography screening reduces breast cancer mortality in women aged 50 to 74. Younger women do not profit. The results of mammography screening has never been compared with those of an organized health education programme for promoting self examination. The sensitivity, specificity, and predictive value of mammography for screening purpose must be scrutinized. The consequences of false positive tests are at best anxiety, at worst needless breast operations. An estimate of such consequences for the female population in Oslo is presented.

  5. A comparison of the performance of modern screen-film and digital mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Monnin, P [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Gutierrez, D [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Bulling, S [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Lepori, D [Department of Radiology, University Hospital Center (CHUV), CH-1011 Lausanne (Switzerland); Valley, J-F [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland); Verdun, F R [Institut Universitaire de Radiophysique Appliquee (IRA), CH-1007 Lausanne (Switzerland)

    2005-06-07

    This work compares the detector performance and image quality of the new Kodak Min-R EV mammography screen-film system with the Fuji CR Profect detector and with other current mammography screen-film systems from Agfa, Fuji and Kodak. Basic image quality parameters (MTF, NPS, NEQ and DQE) were evaluated for a 28 kV Mo/Mo (HVL = 0.646 mm Al) beam using different mAs exposure settings. Compared with other screen-film systems, the new Kodak Min-R EV detector has the highest contrast and a low intrinsic noise level, giving better NEQ and DQE results, especially at high optical density. Thus, the properties of the new mammography film approach those of a fine mammography detector, especially at low frequency range. Screen-film systems provide the best resolution. The presampling MTF of the digital detector has a value of 15% at the Nyquist frequency and, due to the spread size of the laser beam, the use of a smaller pixel size would not permit a significant improvement of the detector resolution. The dual collection reading technology increases significantly the low frequency DQE of the Fuji CR system that can at present compete with the most efficient mammography screen-film systems.

  6. First breast cancer mammography screening program in Mexico: initial results 2005-2006.

    Science.gov (United States)

    Rodríguez-Cuevas, Sergio; Guisa-Hohenstein, Fernando; Labastida-Almendaro, Sonia

    2009-01-01

    Breast cancer is the most frequent malignant neoplasia worldwide. In emergent countries as Mexico, an increase has been shown in frequency and mortality, unfortunately, most cases in advanced loco-regional stages developed in young women. The success of breast screening in mortality reduction has been observed since 1995 in Western Europe and the United States, where as many as 40% mortality reduction has been achieved. Most countries guidelines recommends an annual or biannual mammography for all women >40 years of age. In 2005, FUCAM, a nonlucrative civil foundation in Mexico join with Mexico City government, initiated the first voluntary mammography screening program for women >40 years of age residing in Mexico City's Federal District. Mammographies were carried out with analogical mammographs in specially designed mobile units and were performed in the area of women's domiciles. This report includes data from the first 96,828 mammographies performed between March 2005 and December 2006. There were 1% of mammographies in Breast Imaging Reporting and Data System 0, 4, or 5 and 208 out of 949 women with abnormal mammographies (27.7%) had breast cancer, a rate of 2.1 per thousand, most of them in situ or stage I (29.4%) or stage II (42.2%) nevertheless 21% of those women with abnormal mammography did not present for further clinical and radiologic evaluation despite being personally notified at their home addresses. The breast cancer rate of Mexican women submitted to screening mammography is lower than in European or North American women. Family history of breast cancer, nulliparity, absence of breast feeding, and increasing age are factors that increase the risk of breast cancer. Most cancers were diagnosed in women's age below 60 years (68.5%) with a mean age of 53.55 corroborating previous data published. It is mandatory to sensitize and educate our population with regard to accepting to visit the Specialized Breast Centers.

  7. Long-term psychosocial consequences of false-positive screening mammography

    DEFF Research Database (Denmark)

    Brodersen, John; Siersma, Volkert Dirk

    2013-01-01

    Cancer screening programs have the potential of intended beneficial effects, but they also inevitably have unintended harmful effects. In the case of screening mammography, the most frequent harm is a false-positive result. Prior efforts to measure their psychosocial consequences have been limited...

  8. Quality assurance for screening mammography data collection systems in 22 countries.

    NARCIS (Netherlands)

    Klabunde, C.N.; Sancho-Garnier, H.; Broeders, M.E.A.C.; Thoresen, S.; Rodrigues, V.J.; Ballard-Barbash, R.

    2001-01-01

    OBJECTIVES: To document the mammography data that are gathered by the organized screening programs participating in the International Breast Cancer Screening Network (IBSN), the nature of their procedures for data quality assurance, and the measures used to assess program performance and impact. MET

  9. Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.

    Science.gov (United States)

    Vyas, Ami; Madhavan, Suresh; Sambamoorthi, Usha

    2014-12-01

    Previous studies on the association between mammography screening and stage at breast cancer (BC) diagnosis have limitations because they did not analyze persistence with mammography screening and did not distinguish screening from diagnostic mammograms. The objective of this study is to determine the association between persistence with mammography screening and stage at BC diagnosis among elderly women. A retrospective observational study of 39,006 women age ≥70 diagnosed with incident BC from 2005 to 2009 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset was conducted. A validated algorithm with high sensitivity and specificity was used to distinguish between screening and diagnostic mammograms. Persistence with mammography screening was measured as having at least three screening mammograms in five years before BC diagnosis. Multinomial logistic regressions were performed to analyze the association between persistence with mammography screening and stage at diagnosis, in a multivariate framework. Overall, 46% of elderly women were persistent with mammography screening, 26% were not persistent, and 28% did not have any screening mammogram in five years before BC diagnosis. As compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC. The adjusted odds ratios were 3.28, 2.37, and 1.60 for in situ, local, and regional stages, respectively. A lower proportion of elderly women was persistent with mammography and it was highly associated with earlier stages of BC diagnosis. Interventions designed to promote persistent mammography screening among elderly women are warranted.

  10. Office systems for promoting screening mammography. A survey of primary care practices.

    Science.gov (United States)

    Melville, S K; Luckmann, R; Coghlin, J; Gann, P

    1993-12-01

    Office tracking, scheduling, and reminder systems have been shown to improve utilization of screening mammography, but little is known about the use of these systems by primary care physicians. We surveyed 132 primary care and obstetrics and gynecology practices affiliated with an independent practice association model health maintenance organization in central Massachusetts to determine their use of reminder, scheduling, and follow-up systems, and education and counseling services aimed at increasing screening mammography rates. The use of chart flags to remind physicians of a patient's need for mammography screening was reported by 30% of practices. Thirty-one percent reported the use of flow sheets, and 27% reported the use of mail or telephone patient reminders. At least one of these three systems was used by 57% of the practices, whereas 43% reported having none of these three systems. Variations in the use of these office systems were related to specialty type, physician number, and clinical staffing. The majority of practices (77%) reported using written educational materials, and 42% offered prevention counseling with nonphysician staff. Very few offices (8%) reported using mail or telephone reminders for previously scheduled appointments. Despite the proven effectiveness of reminder systems for screening mammography, many practices do not have a system in place. Promotion of reminder systems in primary care practices could have a substantial impact on mammography utilization.

  11. Socioeconomic status as determinant for participation in mammography screening: assessing the difference between using women's own versus their partner's

    DEFF Research Database (Denmark)

    Kjellén, Malin; von Euler-Chelpin, My

    2010-01-01

    Earlier research has shown that participation in mammography screening tends to vary across socioeconomic levels. We assessed the difference between using the woman's own socioeconomic status (SES) and using that of her household or partner as determinant of participation in mammography screening....

  12. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer.

    NARCIS (Netherlands)

    Kriege, M.; Brekelmans, C.T.; Obdeijn, I.M.; Boetes, C.; Zonderland, H.M.; Muller, S.H.; Kok, T.; Manoliu, R.A.; Besnard, A.P.; Tilanus-Linthorst, M.M.; Seynaeve, C.; Bartels, C.C.; Kaas, R.; Meijer, S.; Oosterwijk-Wakka, J.C.; Hoogerbrugge-van der Linden, N.; Tollenaar, R.A.E.M.; Rutgers, E.J.; Koning, H.J. de; Klijn, J.G.M.

    2006-01-01

    BACKGROUND: The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the specifici

  13. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer

    NARCIS (Netherlands)

    Kriege, Mieke; Brekelmans, Cecile T. M.; Obdeijn, Inge Marie; Boetes, Carla; Zonderland, Harmine M.; Muller, Sara H.; Kok, Theo; Manoliu, Radu A.; Besnard, A. Peter E.; Tilanus-Linthorst, Madeleine M. A.; Seynaeve, Caroline; Bartels, Carina C. M.; Kaas, Reini; Meijer, Siebren; Oosterwijk, Jan C.; Hoogerbrugge, Nicoline; Tollenaar, Rob A. E. M.; Rutgers, Emiel J. T.; de Koning, Harry J.; Klijn, Jan G. M.

    2006-01-01

    Background The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the specificit

  14. Impact of the Introduction of Digital Mammography in an Organized Screening Program on the Recall and Detection Rate.

    Science.gov (United States)

    Campari, Cinzia; Giorgi Rossi, Paolo; Mori, Carlo Alberto; Ravaioli, Sara; Nitrosi, Andrea; Vacondio, Rita; Mancuso, Pamela; Cattani, Antonella; Pattacini, Pierpaolo

    2016-04-01

    In 2012, the Reggio Emilia Breast Cancer Screening Program introduced digital mammography in all its facilities at the same time. The aim of this work is to analyze the impact of digital mammography introduction on the recall rate, detection rate, and positive predictive value. The program actively invites women aged 45-74 years. We included women screened in 2011, all of whom underwent film-screen mammography, and all women screened in 2012, all of whom underwent digital mammography. Double reading was used for all mammograms, with arbitration in the event of disagreement. A total of 42,240 women underwent screen-film mammography and 45,196 underwent digital mammography. The recall rate increased from 3.3 to 4.4% in the first year of digital mammography (relative recall adjusted by age and round 1.46, 95% CI = 1.37-1.56); the positivity rate for each individual reading, before arbitration, rose from 3 to 5.7%. The digital mammography recall rate decreased during 2012: after 12 months, it was similar to the recall rate with screen-film mammography. The detection rate was similar: 5.9/1000 and 5.2/1000 with screen-film and digital mammography, respectively (adjusted relative detection rate 0.95, 95% CI = 0.79-1.13). The relative detection rate for ductal carcinoma in situ remained the same. The introduction of digital mammography to our organized screening program had a negative impact on specificity, thereby increasing the recall rate. The effect was limited to the first 12 months after introduction and was attenuated by the double reading with arbitration. We did not observe any relevant effects on the detection rate.

  15. Performance of screening mammography: A report of the alliance for breast cancer screening in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Hye [Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kim, Keum Woo [Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of); Kim, Young Joong [Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of); and others

    2016-07-15

    To analyze the diagnostic accuracy and trend in screening mammography in Korea. We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI). We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR. The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations.

  16. Screen-film versus full-field digital mammography: Radiation dose and image quality in a large teaching hospital

    Directory of Open Access Journals (Sweden)

    Stantić Tomislav J.

    2013-01-01

    Full Text Available The objective of this paper is to measure the radiation dose and image quality in conventional screen-film mammography and full-field digital mammography in women referred to mammography examination. Participants underwent bilateral, two-view screen-film mammography or full-field digital mammography. The visibility of anatomical regions and overall clinical image quality was rated by experienced radiologists. Total of 387 women and 1548 mammograms were enrolled in the study. Image quality was assessed in terms of image quality score, whereas patient dose assessment was performed in terms of mean glandular dose. Average mean glandular dose for cranio-caudal projection was 1.5 mGy and 2.1 mGy in full-field digital mammography and screen-film mammography, respectively. For medio-lateral oblique projection, corresponding values were 2.3 and 2.1 mGy. Overall image quality criteria scoring was 0.82 and 0.99 for screen-film and digital systems, respectively. The scores were in the range from 0.11 to 1.0 for different anatomical structures. Overall, full-field digital mammography was superior both in terms of image quality and dose over the screen-film mammography. The results have indicated that phantom dose values can assist in setting the optimisation activities in mammography and for comparison between mammography units. To obtain accurate diagnostic information with an acceptable radiation dose to breast, it is necessary to periodically perform patient dose and image quality surveys in all mammography units.

  17. Screening mammography uptake within Australia and Scotland in rural and urban populations

    OpenAIRE

    Leung, J; MacLeod, C.; Mclaughlin, D.; Woods, LM; Henderson, R.; Watson, A.; Kyle, RG; Hubbard, G; Mullen, R.; Atherton, I

    2015-01-01

    Objective: To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Method: Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of th...

  18. The role of epidemiological quality parameters in a mammography screening programme; Die Rolle der epidemiologischen Qualitaetsparameter im Mammographie-Screeningprogramm

    Energy Technology Data Exchange (ETDEWEB)

    Becker, N. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Klinische Epidemiologie

    2006-11-15

    In the recently established mammography screening programme, for the first time in Germany an extensive data collection for prompt quantification of specified quality parameters will be intrinsic to an early detection programme. Epidemiological parameters taken from the European Guidelines are central. This article outlines how epidemiology is involved in quality assurance of cancer screening and why epidemiological quality indicators will be quantified. The reasons for focussing on those parameters, on which the European Guidelines and now the German programme are based, and their significance in the long-term effectiveness of this programme are explained. (orig.) [German] Bei dem gerade im Aufbau begriffenen Mammographie-Screeningprogramm wird erstmalig in Deutschland eine umfangreiche Datenerhebung zur zeitnahen Quantifizierung bestimmter Qualitaetsparameter zum integralen Bestandteil eines Frueherkennungsprogramms. Ein Herzstueck dieser in europaeischen Richtlinien festgelegten und in das deutsche Programm uebernommenen Parameter sind epidemiologische Groessen. In dem vorliegenden Beitrag wird dargestellt, weshalb im Kontext der Qualitaetssicherung von Krebsfrueherkennung die Epidemiologie eine Rolle spielt, und warum epidemiologische Qualitaetsparameter zu quantifizieren sind. Darauf aufbauend wird erlaeutert, aus welchen Gruenden man gerade diejenigen Groessen gewaehlt hat, die im Zentrum der europaeischen Richtlinien und nun auch der Qualitaetssicherung des deutschen Programms stehen, und was sie hinsichtlich der langfristigen Effektivitaet des Programms aussagen. (orig.)

  19. Sensitivity and Specificity of Screening Mammographies and Ultrasonographies Performed in Women at Seven Health Promotion Centers for One year

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Sung; Kang, Bong Joo; Yim, Hyeon Woo [Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2010-03-15

    We wanted to evaluate the sensitivity and specificity of screening mammography and ultrasonography for breast examinations and we assessed the clinical usefulness of breast ultrasound for cancer screening. Of all the women who visited the health promotion center of seven medical institutions from Mar 2004 to Feb 2005, we compared the sensitivity and specificity between a single use of mammography and mammography with ultrasonography for the patients who underwent both mammography and ultrasonography. Here, the reference criteria were the follow-up and the histopathology, which were performed after one year. A total of 1123 patients underwent both mammography and ultrasonography and they could be followed up for a year. For the 1123 patients who underwent both mammography and ultrasonography, the sensitivity and specificity of a single use of mammography were 14.3% and 86.9%, respectively. The sensitivity and specificity of mammography with ultrasonography were 85.7% and 85.9%, respectively. These results showed that the sensitivity was significantly increased when mammography was combined with ultrasonography (< 0.05). The sensitivity was improved for the cases that underwent both mammography and ultrasonography

  20. Improved Performance of Adjunctive Ultrasonography After Mammography Screening for Breast Cancer Among Chinese Females.

    Science.gov (United States)

    Dong, Henglei; Huang, Yubei; Song, Fengju; Dai, Hongji; Liu, Peifang; Zhu, Ying; Wang, Peishan; Han, Jiali; Hao, Xishan; Chen, Kexin

    2017-08-15

    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. 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. 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 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 BIRADS 0 to 2 but not BIRADS 3, especially for women with dense breasts or benign breast disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Design and methods for a randomized clinical trial comparing three outreach efforts to improve screening mammography adherence

    Directory of Open Access Journals (Sweden)

    Reed George

    2011-06-01

    Full Text Available Abstract Background Despite the demonstrated need to increase screening mammography utilization and strong evidence that mail and telephone outreach to women can increase screening, most managed care organizations have not adopted comprehensive outreach programs. The uncertainty about optimum strategies and cost effectiveness have retarded widespread acceptance. While 70% of women report getting a mammogram within the prior 2 years, repeat mammography rates are less than 50%. This 5-year study is conducted though a Central Massachusetts healthcare plan and affiliated clinic. All womenhave adequate health insurance to cover the test. Methods/Design This randomized study compares 3 arms: reminder letter alone; reminder letter plus reminder call; reminder letter plus a second reminder and booklet plus a counselor call. All calls provide women with the opportunity to schedule a mammogram in a reasonable time. The invention period will span 4 years and include repeat attempts. The counselor arm is designed to educate, motivate and counsel women in an effort to alleviate PCP burden. All women who have been in the healthcare plan for 24 months and who have a current primary care provider (PCP and who are aged 51-84 are randomized to 1 of 3 arms. Interventions are limited to women who become ≥18 months from a prior mammogram. Women and their physicians may opt out of the intervention study. Measurement of completed mammograms will use plan billing records and clinic electronic records. The primary outcome is the proportion of women continuously enrolled for ≥24 months who have had ≥1 mammogram in the last 24 months. Secondary outcomes include the number of women who need repeat interventions. The cost effectiveness analysis will measure all costs from the provider perspective. Discussion So far, 18,509 women aged 51-84 have been enrolled into our tracking database and were randomized into one of three arms. At baseline, 5,223 women were eligible

  2. Design and methods for a randomized clinical trial comparing three outreach efforts to improve screening mammography adherence.

    Science.gov (United States)

    Costanza, Mary E; Luckmann, Roger; White, Mary Jo; Rosal, Milagros C; Cranos, Caroline; Reed, George; Clark, Robin; Sama, Susan; Yood, Robert

    2011-06-03

    Despite the demonstrated need to increase screening mammography utilization and strong evidence that mail and telephone outreach to women can increase screening, most managed care organizations have not adopted comprehensive outreach programs. The uncertainty about optimum strategies and cost effectiveness have retarded widespread acceptance. While 70% of women report getting a mammogram within the prior 2 years, repeat mammography rates are less than 50%. This 5-year study is conducted though a Central Massachusetts healthcare plan and affiliated clinic. All women have adequate health insurance to cover the test. This randomized study compares 3 arms: reminder letter alone; reminder letter plus reminder call; reminder letter plus a second reminder and booklet plus a counselor call. All calls provide women with the opportunity to schedule a mammogram in a reasonable time. The invention period will span 4 years and include repeat attempts. The counselor arm is designed to educate, motivate and counsel women in an effort to alleviate PCP burden.All women who have been in the healthcare plan for 24 months and who have a current primary care provider (PCP) and who are aged 51-84 are randomized to 1 of 3 arms. Interventions are limited to women who become ≥ 18 months from a prior mammogram. Women and their physicians may opt out of the intervention study.Measurement of completed mammograms will use plan billing records and clinic electronic records. The primary outcome is the proportion of women continuously enrolled for ≥ 24 months who have had ≥ 1 mammogram in the last 24 months. Secondary outcomes include the number of women who need repeat interventions. The cost effectiveness analysis will measure all costs from the provider perspective. So far, 18,509 women aged 51-84 have been enrolled into our tracking database and were randomized into one of three arms. At baseline, 5,223 women were eligible for an intervention. We anticipate that the outcome will provide

  3. A randomised trial of screening with digital breast tomosynthesis plus conventional digital 2D mammography versus 2D mammography alone in younger higher risk women.

    Science.gov (United States)

    Maxwell, Anthony J; Michell, Michael; Lim, Yit Y; Astley, Susan M; Wilson, Mary; Hurley, Emma; Evans, D Gareth; Howell, Anthony; Iqbal, Asif; Kotre, John; Duffy, Stephen; Morris, Julie

    2017-06-30

    Digital breast tomosynthesis (DBT) has been shown to increase invasive cancer detection rates at screening compared to full field digital (2D) mammography alone, and some studies have reported a reduction in the screening recall rate. No prospective randomised studies of DBT have previously been published. This study compares recall rates with 2D mammography with and without concurrent DBT in women in their forties with a family history of breast cancer undergoing incident screening. Asymptomatic women aged 40-49 who had previously undergone mammography for an increased risk of breast cancer were recruited in two screening centres. Participants were randomised to screening with 2D mammography only at the first study screen followed a year later by screening with 2D plus DBT, or vice versa. Recall rates were compared using an intention to treat analysis. Reading performance was analysed for the larger centre. 1227 women were recruited. 1221 first screens (604 2D, 617 2D+DBT) and 1124second screens (558 2D+DBT, 566 2D) were analysed. Eleven women had screen-detected cancers: 5 after 2D, 6 after 2D+DBT. The false positive recall rates were 2.4% for 2D and 2.2% for 2D+DBT (p=0.89). There was a significantly greater reduction between rounds in the number of women with abnormal reads who were not recalled after consensus/arbitration with 2D+DBT than 2D (p=0.023). The addition of DBT to 2D mammography in incident screening did not lead to a significant reduction in recall rate. DBT may increase reader uncertainty until DBT screening experience is acquired. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Participation behaviour following a false positive test in the Copenhagen mammography screening programme

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Vejborg, Ilse; von Euler-Chelpin, My

    2008-01-01

    INTRODUCTION: There is an ongoing debate concerning possible disadvantages of mammography screening, one being the consequence of receiving a false positive test-result. It is argued that receiving a false positive answer may have short- and/or long-term adverse psychological effects on women, bu...

  5. Balancing sensitivity and specificity: sixteen year's of experience from the mammography screening programme in Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Utzon-Frank, Nicolai; Vejborg, Ilse; von Euler-Chelpin, My Catarina;

    2011-01-01

    To report on sensitivity and specificity from 7 invitation rounds of the organised, population-based mammography screening programme started in Copenhagen, Denmark, in 1991, and offered biennially to women aged 50-69. Changes over time were related to organisation and technology....

  6. American Indian Women and Screening Mammography: Findings from a Qualitative Study in Oklahoma

    Science.gov (United States)

    Tolma, Eleni; Batterton, Chasity; Hamm, Robert M.; Thompson, David; Engelman, Kimberly K.

    2012-01-01

    Background: Breast cancer is an important public health issue within the American Indian (AI) community in Oklahoma; however, there is limited information to explain the low screening mammography rates among AI women. Purpose: To identify the motivational factors affecting an AI woman's decision to obtain a mammogram. Methods: Through the use of…

  7. Rapid review: Estimates of incremental breast cancer detection from tomosynthesis (3D-mammography) screening in women with dense breasts.

    Science.gov (United States)

    Houssami, Nehmat; Turner, Robin M

    2016-12-01

    High breast tissue density increases breast cancer (BC) risk, and the risk of an interval BC in mammography screening. Density-tailored screening has mostly used adjunct imaging to screen women with dense breasts, however, the emergence of tomosynthesis (3D-mammography) provides an opportunity to steer density-tailored screening in new directions potentially obviating the need for adjunct imaging. A rapid review (a streamlined evidence synthesis) was performed to summarise data on tomosynthesis screening in women with heterogeneously dense or extremely dense breasts, with the aim of estimating incremental (additional) BC detection attributed to tomosynthesis in comparison with standard 2D-mammography. Meta-analysed data from prospective trials comparing these mammography modalities in the same women (N = 10,188) in predominantly biennial screening showed significant incremental BC detection of 3.9/1000 screens attributable to tomosynthesis (P mammography (N = 177,814) yielded a pooled difference in BC detection of 1.4/1000 screens representing significantly higher BC detection in tomosynthesis-screened women (P mammography. These estimates can inform planning of future trials of density-tailored screening and may guide discussion of screening women with dense breasts.

  8. Problems, solutions, and perspectives in the evaluation of interval cancers in Italian mammography screening programmes: a position paper from the Italian group for mammography screening (GISMa).

    Science.gov (United States)

    Bucchi, Lauro; Frigerio, Alfonso; Zorzi, Manuel; Fedato, Chiara; Angiolucci, Giovanni; Bernardi, Daniela; Campari, Cinzia; Crocetti, Emanuele; Ferretti, Stefano; Giorgi, Daniela; Marchisio, Francesca; Morrone, Doralba; Naldoni, Carlo; Petrella, Marco; Ponti, Antonio; Ravaioli, Alessandra; Saguatti, Gianni; Santini, Dolores; Sassoli de Bianchi, Priscilla; Serafini, Monica; Vergini, Viviana; Giordano, Livia

    2015-01-01

    In this position paper, a self-convened team of experts from the Italian Group for Mammography Screening (Gruppo italiano screening mammografico, GISMa) pointed out the problems that increasingly hamper the feasibility and validity of the estimate of the proportional incidence of interval breast cancer (IBC) in Italy, suggested potential solutions and an agenda for research, and proposed that the question of the sensitivity of mammography be viewed in a larger perspective, with a greater attention to radiological review activities and breast radiology quality assurance programmes. The main problems are as follows: the coverage of cancer registration is incomplete; the robustness of using the pre-screening incidence rates as underlying rates decreases with time since the start of screening; the intermediate mammograms performed for early detection purposes may cause an overrepresentation of IBCs; the classification of many borderline screening histories is prone to subjectivity; and, finally, the composition of cohorts of women with negative screening results is uncertain, because several mammography reports are neither clearly negative nor clearly positive, and because of the limitations and instability of the electronic mammography records. Several possibilities can be considered to cope with these issues: standard methods for using the hospital discharge records in the identification of IBCs should be established; for the calculation of regional estimates of the underlying incidence, a suitable mathematical model should be identified; the definition of IBC according to the 2008 GISMa guidelines needs to be updated, especially with respect to in situ cancers and to invasive cancers with borderline screening histories; a closer adherence to standard screening protocols, with a simplified patient management, would make it easier to objectively identify IBCs; alternative methods for estimating the sensitivity of mammography should be taken into consideration; and

  9. Contribution of the Unified Health Care System to mammography screening in Brazil, 2013*

    Science.gov (United States)

    Freitas-Junior, Ruffo; Rodrigues, Danielle Cristina Netto; Corrêa, Rosangela da Silveira; Peixoto, João Emílio; de Oliveira, Humberto Vinícius Carrijo Guimarães; Rahal, Rosemar Macedo Sousa

    2016-01-01

    Objective To estimate the coverage of opportunistic mammography screening performed via the Brazilian Sistema Único de Saúde (SUS, Unified Health Care System), at the state and regional level, in 2013. Materials and Methods This was an ecological study in which coverage was estimated by determining the ratio between the number of mammograms performed and the expected number of mammograms among the population of females between 50 and 69 years of age. The number of mammograms performed in the target population was obtained from the Outpatient Database of the Information Technology Department of the SUS. To calculate the expected number of mammograms, we considered 58.9% of the target population, the proportion that would be expected on the basis of the recommendations of the Brazilian National Cancer Institute. Results In 2013, the estimated national coverage of mammography screening via the SUS was 24.8%. The mammography rate ranged from 12.0% in the northern region to 31.3% in the southern region. When stratified by state, coverage was lowest in the state of Pará and highest in the state of Santa Catarina (7.5% and 35.7%, respectively). Conclusion The coverage of mammography screening performed via the SUS is low. There is a significant disparity among the Brazilian states (including the Federal District of Brasília) and among regions, being higher in the south/southeast and lower in the north/northeast. PMID:27818544

  10. Introduction of organised mammography screening in Tyrol: results following first year of complete rollout

    Directory of Open Access Journals (Sweden)

    Knapp Rudolf

    2011-08-01

    Full Text Available Abstract Background In Tyrol, Austria, the existing system of spontaneous mammography screening was switched in 2007 to an organised program by smoothly changing the established framework. This process followed most EU recommendations for organised mammography screening with the following exceptions: women aged 40-49 are part of the target population, screening is offered annually to the age group 40-59, breast ultrasound is available as an additional diagnostic tool, and double reading has not yet been implemented. After a pilot phase the program was rolled out to all of Tyrol in June 2008. The aim of this study was to analyse the performance of the organised screening system by comparing quality indices and recommended levels given in the well-established EU guidelines. Methods Working from the results of the pilot phase, we extended the organised mammography system to all counties in Tyrol. All women living in Tyrol and covered by compulsory social insurance were invited for a mammography, in the age group 40-59 annually and in the age group 60-69 biennially. Screening mammography was offered mainly by radiologists in private practice, with further assessment performed at hospitals. Using the screening database, all well-established performance indicators were analysed and compared with accepted/desired levels as per the EU guidelines. Results From June 2008 to May 2009, 120,440 women were invited. Per 1000 mammograms, 14 women were recalled for further assessment, nine underwent biopsy and four cancer cases were detected. Of invasive breast cancer cases, 32.3% and 68.4% were ≤ 10 mm and ≤ 15 mm in size, respectively, and 79.2% were node-negative. The positive predictive value for further assessment and for biopsy was 25.9% and 39.9%, respectively. Estimated two-year participation rate was 57.0%. In total, 14 interval cancer cases were detected during one year of follow-up; this is 18.4% of the background incidence rate. Conclusions In

  11. Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.

    Directory of Open Access Journals (Sweden)

    Jari Haukka

    Full Text Available BACKGROUND: Incidence-based mortality modelling comparing the risk of breast cancer death in screened and unscreened women in nine Swedish counties has suggested a 39% risk reduction in women 40 to 69 years old after introduction of mammography screening in the 1980s and 1990s. OBJECTIVE: We evaluated changes in breast cancer mortality in the same nine Swedish counties using a model approach based on official Swedish breast cancer mortality statistics, robust to effects of over-diagnosis and treatment changes. Using mortality data from the NordCan database from 1974 until 2003, we estimated the change in breast cancer mortality before and after introduction of mammography screening in at least the 13 years that followed screening start. RESULTS: Breast mortality decreased by 16% (95% CI: 9 to 22% in women 40 to 69, and by 11% (95% CI: 2 to 20% in women 40 to 79 years of age. DISCUSSION: Without individual data it is impossible to completely separate the effects of improved treatment and health service organisation from that of screening, which would bias our results in favour of screening. There will also be some contamination of post-screening mortality from breast cancer diagnosed prior to screening, beyond our attempts to adjust for delayed benefit. This would bias against screening. However, our estimates from publicly available data suggest considerably lower benefits than estimates based on comparison of screened versus non-screened women.

  12. Differences in radiological patterns, tumour characteristics and diagnostic precision between digital mammography and screen-film mammography in four breast cancer screening programmes in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Domingo, Laia; Sala, Maria [IMIM-Hospital del Mar, Department of Epidemiology and Evaluation, Barcelona (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona (Spain); Universitat Autonoma de Barcelona (UAB), EHEA Doctoral Program in Public Health. Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Barcelona (Spain); Romero, Anabel; Belvis, Francesc; Macia, Francesc; Castells, Xavier [IMIM-Hospital del Mar, Department of Epidemiology and Evaluation, Barcelona (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona (Spain); Sanchez, Mar [Government of Cantabria, General Directorate of Public Health, Department of Health, Santander (Spain); Ferrer, Joana [Radiology Unit. Hospital Santa Caterina, Girona (Spain); Salas, Dolores; Ibanez, Josefa [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Vega, Alfonso [Hospital Universitario Marques de Valdecilla, Radiology Unit, Santander (Spain); Ferrer, Francesc [Hospital del Mar, Radiology and Nuclear Medicine Service, Barcelona (Spain); Laso, M.S. [Breast Cancer Screening Unit Burjassot, Valencia (Spain)

    2011-09-15

    To compare tumour characteristics between cancers detected with screen-film mammography (SFM) and digital mammography (DM) and to evaluate changes in positive predictive values (PPVs) for further assessments, for invasive procedures and for distinct radiological patterns in recalled women. 242,838 screening mammograms (171,191 SFM and 71,647 DM) from 103,613 women aged 45-69 years, performed in four population-based breast cancer screening programmes in Spain, were included. The tumour characteristics and PPVs of each group were compared. Radiological patterns (masses, calcifications, distortions and asymmetries) among recalled women were described and PPVs were evaluated. The percentages of ductal carcinoma in situ (DCIS) were higher in DM than in SFM both in the first [18.5% vs. 15.8%(p = 0.580)] and in successive screenings [23.2% vs. 15.7%(p = 0.115)]. PPVs for masses, asymmetries and calcifications were higher in DM, being statistically significant in masses (5.3% vs. 3.9%; proportion ratio: 1.37 95%CI: 1.08-1.72). Among cancers detected by calcifications, the percentage of DCIS was higher in DM (60.3% vs. 46.4%, p = 0.060). PPVs were higher when DM was used, both for further assessments and for invasive procedures, with similar cancer detection rates and no statistically significant differences in tumour characteristics. The greatest improvements in PPVs were found for masses. (orig.)

  13. Breast cancer mortality in Norway after the introduction of mammography screening

    DEFF Research Database (Denmark)

    Olsen, Anne Helene; Lynge, Elsebeth; Njor, Sisse H;

    2013-01-01

    An organized mammography screening program was gradually implemented in Norway during the period 1996-2004. Norwegian authorities have initiated an evaluation of the program. Our study focused on breast cancer mortality. Using Poisson regression, we compared the change in breast cancer mortality...... from before to during screening in four counties starting the program early controlling for change in breast cancer mortality during the same time in counties starting the program late. A follow-up model included death in all breast cancers diagnosed during the follow-up period. An evaluation model...... to the program, the implementation of the organized mammography screening program was associated with a statistically nonsignificant decrease in breast cancer mortality of around 11%....

  14. Factors Influencing Breast Density in Japanese Women Aged 40-49 in Breast Cancer Screening Mammography

    Directory of Open Access Journals (Sweden)

    Hori,Keisuke

    2013-08-01

    Full Text Available A relatively large number of women in their 40s with high-density breasts, in which it can be difficult to detect lesions, are encountered in mammography cancer screenings in Japan. Here, we retrospectively investigated factors related to breast density. Two hundred women (40-49 years old were examined at the screening center in our hospital. Multivariate analysis showed that factors such as small abdominal circumference, high HDL cholesterol, and no history of childbirth were related to high breast density in women in their 40s undergoing mammography. Other non-mammographic screening methods should be considered in women with abdominal circumferences <76cm, HDL-C >53mg/dl, and no history of childbirth, as there is a strong possibility of these women having high-density breasts that can make lesion detection difficult.

  15. Comparative performance of modern digital mammography systems in a large breast screening program

    Energy Technology Data Exchange (ETDEWEB)

    Yaffe, Martin J., E-mail: martin.yaffe@sri.utoronto.ca; Bloomquist, Aili K.; Hunter, David M.; Mawdsley, Gordon E. [Physical Sciences Division, Sunnybrook Research Institute, Departments of Medical Biophysics and Medical Imaging, University of Toronto, Ontario M4N 3M5 (Canada); Chiarelli, Anna M. [Prevention and Cancer Control, Cancer Care Ontario, Dalla Lana School of Public Health, University of Toronto, Ontario M4N 3M5, Canada and Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Muradali, Derek [Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Mainprize, James G. [Physical Sciences Division, Sunnybrook Research Institute, Toronto, Ontario M4N 3M5 (Canada)

    2013-12-15

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography.

  16. The outcome of a quality-controlled mammography screening program: Experience from a population-based study in Taiwan

    Directory of Open Access Journals (Sweden)

    Huay-Ben Pan

    2014-10-01

    Conclusion: From the outcome review of this national mammography screening, there is still room to ameliorate our performance through comprehensive and continued education, to improve the competence of cancer detection and decrease false negative (FN cases.

  17. Value of Sonography in Screening Women with Dense Breasts in Mammography

    Directory of Open Access Journals (Sweden)

    Esmaeel Shokrollahi

    2010-05-01

    Full Text Available Breast cancer is one of the most common cancers in women and the main cause of death due to malignancy in women between 40-44 years of age.This cancer is responsible for 33% of all cancers in women and 20% of all deaths due to cancer in women."nMammography is the main modality for screening and diagnosis of breast lesions, but in dense breasts it has low sensitivity (about 48% with low possibility for visualization of mass lesions or calcifications, and this results in fading abnormal findings and increasing the risk of malignancy. This defect is compensated by ultrasonography."nSonography also elegantly shows hidden areas, which are covered by normal breast tissue in mammography, and also shows the pictures real time without overlap."nPresence of any palpable mass in clinical exam was an excluding criterion for patients from the study. Any lesion as a cystic or solid mass or echo change or calcification was recorded in the database. If a lesion had a malignant picture, FNA or core biopsy was done for it and the sample was sent for pathologic report."nThis study showed that correlation with sonography is mandatory in women who have dense breasts in mammography, even if it is a low-grade dense breast. If this correlation was not done, breast cancers present in 1.5% of the studied population would be missed."nSo due to the high false negativity of mammography in dense breasts, in the time being, sonography is considered as the second line screening method and complementary modality for mammography. It not only increases the diagnostic accuracy, but also as the only real time imaging modality, it can be used for localization and precise biopsy of breast lesions. Also, it can be used without any limitation as a cheap and harmless way for follow up imaging in short intervals for suspected patients.

  18. Self administered screening for hereditary cancers in conjunction with mammography and ultrasound.

    Science.gov (United States)

    McDonnell, Charles H; Seidenwurm, David J; McDonnell, Diana E; Bobolis, Kristie A

    2013-12-01

    We evaluated the feasibility of an automated tablet computer application providing a family and personal history based cancer risk assessment for hereditary breast, ovarian, endometrial and colorectal cancers. 1,002 women presenting for screening mammography and 1,000 presenting for ultrasound were offered screening. The application calculated the risk of BRCA mutations using BRCAPRO, Myriad and Tyrer-Cuzick risk assessment models. Lifetime risk of breast and ovarian cancer was assessed with the BRCAPRO, Claus and Tyrer-Cuzick models. Colorectal and endometrial cancer risk was calculated via the MMRpro model. Patients were identified as high-risk based on thresholds 10% or greater risk for carrying genetic mutations or 20% or greater lifetime risk of breast or ovarian cancer. The percent of women found to be high-risk by a single risk assessment tool ranged from 0.5 to 5.3%. Combining assessment tools found 9.3% of women to be high-risk. The risk assessments performed similarly for the mammography and ultrasound cohorts with yields (combining assessment tools) of 9.2 and 9.4% respectively. The average ages of all the high-risk women were 45.8 and 39.6 years for the mammography and ultrasound cohorts respectively. Difficulties encountered included a need for software upgrade, wireless network unreliability and hardware theft. Automated family history screening can identify women probably at high-risk for hereditary cancers efficiently. The number of women identified is increased by employing multiple risk assessment models simultaneously. Surveying women in conjunction with ultrasound identified women at increased risk as effectively and at a younger age than with screening mammography.

  19. Imaging performance of a low-dose screen-film mammography system

    Science.gov (United States)

    Jafroudi, Hamid; Jennings, Robert J.; Gagne, Robert M.; Artz, Dorothy S.; Vucich, James J.; Freedman, Matthew T.; Mun, Seong K.

    1997-05-01

    The purpose of this work is to evaluate the imaging and dose performance of an x-ray imaging system optimized for mammography. The x-ray system design was developed by the University of Southern California and the Center for Devices and Radiological Health using multiparameter optimization techniques. The prototype was built by Fischer Imaging and is now under evaluation at the National Institutes of Health. While previous reports have concentrated on demonstrating the does reduction potential of the system, for this study the x-ray spectrum was modified to maximize imaging performance. Measurements were made to assess the level of imaging performance achieved and to determine the increase in dose. Contrast-detail analysis along with qualitative evaluation of images of conventional mammography phantoms were used to assess imaging performance. Both imaging performance and the dose delivered by the system were compared to those of a conventional mammography system. Because of the current interest in digital mammography, the performance of the optimized system with a storage phosphor plate image receptor, sometimes referred to as computed radiography (CR), was also studied. The optimized system provided significantly better imaging performance than the conventional system with both film-screen and CR detectors. The dose was increased to a level comparable to the average value for conventional systems using grids.

  20. Existing data sources for clinical epidemiology: the Danish Quality Database of Mammography Screening

    Directory of Open Access Journals (Sweden)

    Langagergaard V

    2013-03-01

    Full Text Available Vivian Langagergaard,1 Jens P Garne,2 Ilse Vejborg,3 Walter Schwartz,4 Martin Bak,5 Anders Lernevall,1 Nikolaj B Mogensen,6 Heidi Larsson,7 Berit Andersen,1 Ellen M Mikkelsen7 1Department of Public Health Programs, Randers Hospital, Randers, Denmark; 2Department of Breast Surgery, Aalborg Hospital, Aalborg, Denmark; 3Diagnostic Imaging Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 4Center of Mammography, 5Department of Pathology, Odense University Hospital, Denmark; 6Department of Radiology, Ringsted Hospital, Ringsted, Denmark; 7Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Abstract: The Danish Quality Database of Mammography Screening (DKMS was established in 2007, when screening was implemented on a nationwide basis and offered biennially to all Danish women aged 50–69 years. The primary aims of the database are to monitor and evaluate the quality of the screening program and – after years of follow-up – to evaluate the effect of nationwide screening on breast cancer-specific mortality. Here, we describe the database and present results for quality assurance from the first round of national screening. The steering committee for the DKMS defined eleven organizational and clinical quality indicators and standards to monitor the Danish breast cancer screening program. We calculated the relevant proportions and ratios with 95% confidence intervals for each quality indicator. All indicators were assessed on a national and regional level. Of 670,039 women invited for mammography, 518,823 (77.4% participated. Seventy-one percent of the women received the result of their mammography examination within 10 days of screening, and 3% of the participants were recalled for further investigation. Among all detected cancers, 86% were invasive cancers, and the proportion of women with node negative cancer was 67%. There were 36% women with small cancers, and the ratio of surgery for

  1. Four Principles to Consider Before Advising Women on Screening Mammography

    DEFF Research Database (Denmark)

    Keen, John D; Juhl Jørgensen, Karsten

    2015-01-01

    of a screening intervention. Disease-specific mortality is biased due to difficulties in attribution of cause of death and to increased mortality due to overdiagnosis and the resulting overtreatment with radiotherapy and chemotherapy. To enhance participation, the benefit from screening is often presented...... in relative instead of absolute terms. Third, some screening statistics must be interpreted with caution. Increased survival time and the percentage of early-stage tumors at detection sound plausible, but are affected by lead-time and length biases. In addition, analyses that only include women who attend...... screening cannot reliably correct for selection bias. The final principle is that accounting for tumor biology is important for accurate estimates of lead time, and the potential benefit from screening. Since "early detection" is actually late in a tumor's lifetime, the time window when screen detection...

  2. Measurements and simulations of scatter imaging as a simultaneous adjunct for screening mammography

    Science.gov (United States)

    Kern, Katie; Hassan, Laila; Peerzada, Lubna; Ur-Rehman, Mahboob; MacDonald, C. A.

    2015-03-01

    X-ray coherent scatter is dependent upon the molecular structure of the scattering material and hence allows differentiation between tissue types with potentially much higher contrast than conventional absorption-based radiography. Coherent-scatter computed tomography has been used to produce images based on the x-ray scattering properties of the tissue. However, the geometry for CT imaging requires a thin fan beam and multiple projections and is incommensurate with screening mammography. In this work we demonstrate progress in a developing a system using a wide slot beam and simple anti-scatter grid which is adequate to differentiate between scatter peaks to remove the fat background from the coherent scatter image. Adequate intensity in the coherent scatter image can be achieved at the dose commonly used for screening mammography to detect carcinoma surrogates as small as 2 mm in diameter. This technique would provide an inexpensive, low dose, simultaneous adjunct to conventional screening mammography to provide a localized map of tissue type that could be overlaid on the conventional transmission mammogram. Comparisons between phantom measurements and Monte Carlo simulations show good agreement, which allowed for detailed examination of the visibility of carcinoma under realistic conditions.

  3. Underutilizers of mammography screening today: characteristics of women planning, undecided about, and not planning a mammogram.

    Science.gov (United States)

    Clemow, L; Costanza, M E; Haddad, W P; Luckmann, R; White, M J; Klaus, D; Stoddard, A M

    2000-01-01

    Using concepts from the Precaution Adoption Process Model, we identified behavioral factors, sociodemographic and psychosocial variables, and beliefs about breast cancer that discriminated among women at different stages with regard to their intention to obtain mammography screening. An independent survey company conducted telephone interviews with 2,507 women aged 50 to 80 who were identified as underutilizers of mammography screening. Each underutilizer was assigned to one of three stages with regard to intention to get a mammogram: (a) definitely planning, (b) thinking about, and (c) not planning. Estimated actual risk of breast cancer, perceived risk to breast cancer, worry about breast cancer, and fear of learning from a mammogram that one has breast cancer were variables found to be significantly associated with intention to obtain a mammogram for several subgroups of underutilizing women. There are significant behavioral and psychosocial variables, beliefs and feelings about breast cancer, and demographic characteristics that distinguish underutilizing women at various stages with regard to intention to obtain mammography screening. Our findings provide new information that could help the health care professional motivate women who are not planning to utilize this preventive health measure to become regular utilizers.

  4. Investigation of breast dose in five screening mammography centres in Greece

    Energy Technology Data Exchange (ETDEWEB)

    Tsapaki, V [Medical Physics Department, Konstantopoulio Hospital, Nea Ionia, 142 33, Athens (Greece); Tsalafoutas, I A [Medical Physics Department, Agios Savvas Hospital, 171 Alexandras Avenue, 115 22, Athens (Greece); Poga, V; Louizi, A; Kottou, S [Medical Physics Department, Medical School, Athens University, University of Athens, 75 Mikras Asias, 115 27, Athens (Greece); Koulentianos, E [Radiology Department, Konstantopoulio Hospital, Nea Ionia, 142 33, Athens (Greece)

    2008-09-01

    The objectives of this study were to investigate the techniques currently used for screening mammography in Greece, to estimate the mean glandular dose (MGD) for establishing a baseline radiation dose database, to analyse the effects of various factors on MGD, and to compare the results with others in the literature. Five mammographic facilities and 250 women having as a routine screening mammogram one craniocaudal (CC) and one mediolateral oblique (MLO) projection in each breast were included in the study. The parameters recorded were age, weight, compressed breast thickness (CBT), tube potential (kV), tube loading (mA s) and MLO projection angle. Large differences were observed among the different mammography facilities, mainly in terms of the tube potential setting and the MLO angle used. The average MGD per exposure was 1.4 {+-} 0.6 mGy while the respective averages separately for the CC and MLO projections were 1.2 {+-} 0.5 and 1.5 {+-} 0.7 mGy, respectively. The average MGD values recorded in this study were below the limit of 2 mGy established for the reference medium-sized breast of 4.5 cm CBT. However, the variety of techniques observed revealed the need for a nationwide survey concerning screening mammography in Greece.

  5. Evaluation of radiographers’ mammography screen-reading accuracy in Australia

    Energy Technology Data Exchange (ETDEWEB)

    Debono, Josephine C, E-mail: josephine.debono@bci.org.au [Westmead Breast Cancer Institute, Westmead, New South Wales (Australia); Poulos, Ann E [Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales (Australia); Houssami, Nehmat [Screening and Test Evaluation Program, School of Public Health (A27), Sydney Medical School, University of Sydney, Sydney, New South Wales (Australia); Turner, Robin M [School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales (Australia); Boyages, John [Macquarie University Cancer Institute, Macquarie University Hospital, Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Westmead, New South Wales (Australia)

    2015-03-15

    This study aimed to evaluate the accuracy of radiographers’ screen-reading mammograms. Currently, radiologist workforce shortages may be compromising the BreastScreen Australia screening program goal to detect early breast cancer. The solution to a similar problem in the United Kingdom has successfully encouraged radiographers to take on the role as one of two screen-readers. Prior to consideration of this strategy in Australia, educational and experiential differences between radiographers in the United Kingdom and Australia emphasise the need for an investigation of Australian radiographers’ screen-reading accuracy. Ten radiographers employed by the Westmead Breast Cancer Institute with a range of radiographic (median = 28 years), mammographic (median = 13 years) and BreastScreen (median = 8 years) experience were recruited to blindly and independently screen-read an image test set of 500 mammograms, without formal training. The radiographers indicated the presence of an abnormality using BI-RADS®. Accuracy was determined by comparison with the gold standard of known outcomes of pathology results, interval matching and client 6-year follow-up. Individual sensitivity and specificity levels ranged between 76.0% and 92.0%, and 74.8% and 96.2% respectively. Pooled screen-reader accuracy across the radiographers estimated sensitivity as 82.2% and specificity as 89.5%. Areas under the reading operating characteristic curve ranged between 0.842 and 0.923. This sample of radiographers in an Australian setting have adequate accuracy levels when screen-reading mammograms. It is expected that with formal screen-reading training, accuracy levels will improve, and with support, radiographers have the potential to be one of the two screen-readers in the BreastScreen Australia program, contributing to timeliness and improved program outcomes.

  6. Performance indicators for participation in organized mammography screening

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My Catarina; Jacobsen, Katja Kemp

    2012-01-01

    A population's acceptance of a screening programme is reflected by its participation. Participation can be measured by cross-section, in an individual screening round, or by cumulative examination rate, which covers participation in numerous rounds at a pre-specified frequency. To establish an in...

  7. Do Social Network Characteristics Predict Mammography Screening Practices?

    Science.gov (United States)

    Allen, Jennifer D.; Stoddard, Anne M.; Sorensen, Glorian

    2008-01-01

    Background: Many breast cancer outreach programs assume that dissemination of information through social networks and provision of social support will promote screening. The authors prospectively examined the relationship between social network characteristics and adherence to screening guidelines. Method: Employed women age 40 years and older…

  8. Do Social Network Characteristics Predict Mammography Screening Practices?

    Science.gov (United States)

    Allen, Jennifer D.; Stoddard, Anne M.; Sorensen, Glorian

    2008-01-01

    Background: Many breast cancer outreach programs assume that dissemination of information through social networks and provision of social support will promote screening. The authors prospectively examined the relationship between social network characteristics and adherence to screening guidelines. Method: Employed women age 40 years and older…

  9. Statistical analyses in Swedish randomised trials on mammography screening and in other randomised trials on cancer screening: a systematic review

    Science.gov (United States)

    Boniol, Mathieu; Smans, Michel; Sullivan, Richard; Boyle, Peter

    2015-01-01

    Objectives We compared calculations of relative risks of cancer death in Swedish mammography trials and in other cancer screening trials. Participants Men and women from 30 to 74 years of age. Setting Randomised trials on cancer screening. Design For each trial, we identified the intervention period, when screening was offered to screening groups and not to control groups, and the post-intervention period, when screening (or absence of screening) was the same in screening and control groups. We then examined which cancer deaths had been used for the computation of relative risk of cancer death. Main outcome measures Relative risk of cancer death. Results In 17 non-breast screening trials, deaths due to cancers diagnosed during the intervention and post-intervention periods were used for relative risk calculations. In the five Swedish trials, relative risk calculations used deaths due to breast cancers found during intervention periods, but deaths due to breast cancer found at first screening of control groups were added to these groups. After reallocation of the added breast cancer deaths to post-intervention periods of control groups, relative risks of 0.86 (0.76; 0.97) were obtained for cancers found during intervention periods and 0.83 (0.71; 0.97) for cancers found during post-intervention periods, indicating constant reduction in the risk of breast cancer death during follow-up, irrespective of screening. Conclusions The use of unconventional statistical methods in Swedish trials has led to overestimation of risk reduction in breast cancer death attributable to mammography screening. The constant risk reduction observed in screening groups was probably due to the trial design that optimised awareness and medical management of women allocated to screening groups. PMID:26152677

  10. Breast cancers detected in only one of two arms of a tomosynthesis (3D-mammography) population screening trial (STORM-2).

    Science.gov (United States)

    Bernardi, Daniela; Houssami, Nehmat

    2017-04-01

    The prospective 'screening with tomosynthesis or standard mammography-2 (STORM-2)' trial compared mammography screen-reading strategies and showed that each of integrated 2D/3D-mammography or 2Dsynthetic/3D-mammography detected significantly more breast cancers than 2D-mammography alone. This short report describes 13 (from 90) cancers detected in only one of two parallel double-reading arms implemented in STORM-2. Amongst this subset of cases, the majority was invasive cancer ≤16 mm, mostly depicted as irregular masses or distortions. Furthermore, most were detected at 3D-mammography only and predominantly by one reader from double-reading pairs, highlighting that 3D-mammography may enable detection of cancers that are challenging to perceive at routine screening.

  11. [Validation of a questionnaire to assess consumer satisfaction with mammography screening, Rome (Italy)].

    Science.gov (United States)

    Semyonov, Leda; Boggi, Roberto; Napoli, Massimo; Ravelli, Giuliana; Fulgenzi, Roberta; Landi, Adelaide; La Torre, Giuseppe

    2015-01-01

    Only 40% of women in the territory of the Local Health Unit RMA (Rome, Italy) adhere to the local breast cancer screening programme. A questionnaire was administered to participating women, to assess their level of satisfaction with the programme. A descriptive analysis, logistic regression and reliability analysis using the Cronbach's alpha as a measure of internal consistency, were performed. Most women who adhere to mammography screening are employers, retired, and with a low education. Factors that affect adherence include receiving a letter of invitation, intent to participate, age, and low education. The questionnaire is reliable for evaluating reasons affecting participation.

  12. Nationwide survey of glandular tissue dose for establishment of breast cancer screening using mammography

    Energy Technology Data Exchange (ETDEWEB)

    Katoh, Tsuguhisa; Matsumoto, Mitsuomi [Tokyo Metropolitan Univ. of Health Sciences (Japan); Higashida, Yoshiharu [and others

    1999-06-01

    A nationwide survey was performed in an attempt to investigate the distribution of average glandular doses caused by mammography for breast cancer mass screening, and to utilize the data to determine the national guidance level for mammography. A phantom equivalent to a breast with a compressed thickness of 42 mm, and glass radio-photo luminescence dosimeters were sent to 104 institutions and facilities. The dosimeters were exposed using a method based on the protocols described in the Mammography Quality Control Manual. The returned dosimeters were then analyzed, and the beam qualities and the entrance surface exposure were determined. Using these values, the average glandular doses were estimated with an accuracy of {+-}8%. The doses ranged from 0.5 to 3.7 mGy. The mean dose and the standard deviation were 1.48 mGy and 0.52 mGy, respectively. In 91 facilities, the doses were less than 2 mGy. Regarding the technical factors for facilities which presented doses of 2 mGy or over, it seemed that the doses could be easily reduced to less than 2 mGy if the settings of the auto exposure controller (AEC), anti-scatter grid and/or the film-screen system were optimized. (author)

  13. [Quality assurance of fine-needle aspiration cytology of the organized mammography screening].

    Science.gov (United States)

    Bak, Mihály; Konyár, Eva; Schneider, Ferenc; Bidlek, Mária; Szabó, Eva; Nyári, Tibor; Godény, Mária; Kásler, Miklós

    2010-08-08

    The National Public Health Program has established the organized mammography screening in Hungary. The aim of our study was to determine the quality assurance of breast aspiration cytology. Cytology results were rated to 5 categories (C1, C2, C3, C4 and C5). All cytology reports were compared with the final histology diagnosis. 1361 women had aspiration cytology diagnosis performed from a total of 47718 mammography non-negative lesions. There were 805 (59.1%) benign and 187 (13.7%) malignant alterations. Sensitivity was 91%, specificity 88%, positive predictive value 96.6% and negative predictive value turned to be 71% (pauditing values of fine needle aspiration cytology in our laboratory meet, or in certain aspects exceed the proposed minimum threshold values.

  14. Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age : individual patient data meta-analysis

    NARCIS (Netherlands)

    Phi, Xuan-Anh; Saadatmand, Sepideh; Bock, de Geertruida H; Warner, Ellen; Sardanelli, Francesco; Leach, Martin O; Riedl, Christopher C; Trop, Isabelle; Hooning, Maartje J; Mandel, Rodica; Santoro, Filippo; Kwan-Lim, Gek; Helbich, Thomas H; Tilanus-Linthorst, Madeleine Ma; van den Heuvel, Edwin R.; Houssami, Nehmat

    2016-01-01

    BACKGROUND: We investigated the additional contribution of mammography to screening accuracy in BRCA1/2 mutation carriers screened with MRI at different ages using individual patient data from six high-risk screening trials. METHODS: Sensitivity and specificity of MRI, mammography and the combinatio

  15. Pap, Mammography, and Clinical Breast Examination Screening Among Women with Disabilities: A Systematic Review

    Science.gov (United States)

    Andresen, Elena M.; Peterson-Besse, Jana J.; Krahn, Gloria L.; Walsh, Emily S.; Horner-Johnson, Willi; Iezzoni, Lisa I.

    2015-01-01

    Background Research has found some disparities between U.S. women with and without disabilities in receiving clinical preventive services. Substantial differences may also exist within the population of women with disabilities. The current study examined published research on Pap smears, mammography, and clinical breast examinations across disability severity levels among women with disabilities. Methods: Informed by an expert panel, we followed guidelines for systematic literature reviews and searched MEDLINE, PsycINFO, and Cinahl databases. We also reviewed in-depth four disability- or preventive service-relevant journals. Two reviewers independently extracted data from all selected articles. Findings Five of 74 reviewed publications of met all our inclusion criteria and all five reported data on Pap smears, mammography, and clinical breast examination. Articles classified disability severity groups by functional and/or activity levels. Associations between disability severity and Pap smear use were inconsistent across the publications. Mammography screening fell as disability level increased according to three of the five studies. Results demonstrated modestly lower screening, but also were inconsistent for clinical breast examinations across studies. Conclusion Evidence is inconsistent concerning disparities in these important cancer screening services with increasing disability levels. Published studies used differing methods and definitions, adding to concerns about the evidence for screening disparities rising along with increasing disability. More focused research is required to determine whether significant disparities exist in cancer screening among women with differing disability levels. This information is essential for national and local public health and health care organizations to target interventions to improve care for women with disabilities. PMID:23816150

  16. Minimizing misclassification of hormone users at mammography screening

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Pedersen, Anette Tønnes; Schwartz, Walter

    2009-01-01

    ; at subsequent screens, one projection for fatty and two projections for mixed/dense breasts. Until June 3, 2002, 2-year-old mammograms were used for comparison, and later 4-year-old mammograms. Prescription drug data were used to identify hormone, hormone therapy (HT), use. False positive risk and interval...

  17. Validation of a susceptibility, benefits, and barrier scale for mammography screening among Peruvian women: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Huaman Moises A

    2011-12-01

    Full Text Available Abstract Background Perceived beliefs about breast cancer and breast cancer screening are important predictors for mammography utilization. This study adapted and validated the Champion's scale in Peru. This scale measures perceived susceptibility for breast cancer and perceived benefits and barriers for mammography. Methods A cross-sectional study was conducted among women ages 40 to 65 attending outpatient gynecology services in a public hospital in Peru. A group of experts developed and pre-tested a Spanish version of the Champion's scale to assess its comprehensibility (N = 20. Factor analysis, internal consistency, and test-retest reliability analyses were performed (N = 285. Concurrent validity compared scores from participants who had a mammogram and those who did not have it in the previous 15 months. T-test and multiple regression analysis adjusting for socio-demographic factors, mammography knowledge and other preventive behaviors were performed. Results The construct validity and reliability were optimal. Cronbach-Alpha coefficients were 0.75 (susceptibility, 0.72 (benefits and 0.86 (barriers. Concurrent validity analysis showed an association between barriers and mammography screening use in bivariate (22.3 ± 6.7 vs. 30.2 ± 7.6; p Conclusion Concurrent validity analysis showed that the Champion's scale has important limitations for assessing perceived susceptibility for breast cancer and perceived benefits for mammography among Peruvian women. There is still a need for developing valid and reliable instruments for measuring perceived beliefs about breast cancer and mammography screening among Peruvian women.

  18. Influences of Radiology Trainees on Screening Mammography Interpretation.

    Science.gov (United States)

    Hawley, Jeffrey R; Taylor, Clayton R; Cubbison, Alyssa M; Erdal, B Selnur; Yildiz, Vedat O; Carkaci, Selin

    2016-05-01

    Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes. Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded. A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Digital mammography screening: sensitivity of the programme dependent on breast density.

    Science.gov (United States)

    Weigel, Stefanie; Heindel, W; Heidrich, J; Hense, H-W; Heidinger, O

    2017-07-01

    To analyse the impact of breast density on the sensitivity of a population-based digital mammography screening programme (SP) as key evaluation parameter. 25,576 examinations were prospectively stratified from ACR category 1 to 4 for increments of 25 % density during independent double reading. SP was calculated as number of screen-detected cancers divided by the sum of screen-detected plus interval cancers (24-months period) per ACR category, related to the first reading (a), second reading (b) and highest stratification if discrepant (c). Chi-square tests were used for comparison. Overall sensitivity of the programme was 79.9 %. SP in ACR 4 (a: 50 %, b: 50 %, c: 50 %) was significantly lower than in ACR 3 (a: 72.9 %, b: 79.4 %, c: 80.7 %, p density classified as ACR 4 SP is significantly reduced compared to all other ACR categories. • Overall sensitivity of a population-based digital mammography screening programme (SP) was 79.9 %. • In women with ACR 1, 2, or 3, SP ranged between 72.9 %-100 %. • ACR 4 was rare in participants (<7 %) and SP was only 50 %. • SP in ACR 4 differed significantly from ACR 3 (p < 0.001).

  20. Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA

    Directory of Open Access Journals (Sweden)

    Maria E. Fernandez

    Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomes<=$15,000. All women were Spanish speakers and had low acculturation levels. Ninety six percent had reported having a Pap smear, but 24% were not in compliance with recommended screening (Pap test within the last 3 years. Among women 40 and older, 62% had received a mammogram, but only 33% were compliant with age appropriate recommended mammography screening guidelines. Women in this study had more misconceptions about cancer than Hispanics in other studies. Multivariate logistic models for correlates of Pap test and mammography screening behavior indicate that factors such as fear of the screening test, embarrassment, and lack of knowledge influenced screening behavior. In conclusion, women in this study had lower rates of mammography screening than non-Hispanic women and lower rates of compliance with recommended Mammography and Pap test screening guidelines.

  1. Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA

    Directory of Open Access Journals (Sweden)

    Fernandez Maria E.

    1998-01-01

    Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomes<=$15,000. All women were Spanish speakers and had low acculturation levels. Ninety six percent had reported having a Pap smear, but 24% were not in compliance with recommended screening (Pap test within the last 3 years. Among women 40 and older, 62% had received a mammogram, but only 33% were compliant with age appropriate recommended mammography screening guidelines. Women in this study had more misconceptions about cancer than Hispanics in other studies. Multivariate logistic models for correlates of Pap test and mammography screening behavior indicate that factors such as fear of the screening test, embarrassment, and lack of knowledge influenced screening behavior. In conclusion, women in this study had lower rates of mammography screening than non-Hispanic women and lower rates of compliance with recommended Mammography and Pap test screening guidelines.

  2. Computer-aided diagnostics of screening mammography using content-based image retrieval

    Science.gov (United States)

    Deserno, Thomas M.; Soiron, Michael; de Oliveira, Júlia E. E.; de A. Araújo, Arnaldo

    2012-03-01

    Breast cancer is one of the main causes of death among women in occidental countries. In the last years, screening mammography has been established worldwide for early detection of breast cancer, and computer-aided diagnostics (CAD) is being developed to assist physicians reading mammograms. A promising method for CAD is content-based image retrieval (CBIR). Recently, we have developed a classification scheme of suspicious tissue pattern based on the support vector machine (SVM). In this paper, we continue moving towards automatic CAD of screening mammography. The experiments are based on in total 10,509 radiographs that have been collected from different sources. From this, 3,375 images are provided with one and 430 radiographs with more than one chain code annotation of cancerous regions. In different experiments, this data is divided into 12 and 20 classes, distinguishing between four categories of tissue density, three categories of pathology and in the 20 class problem two categories of different types of lesions. Balancing the number of images in each class yields 233 and 45 images remaining in each of the 12 and 20 classes, respectively. Using a two-dimensional principal component analysis, features are extracted from small patches of 128 x 128 pixels and classified by means of a SVM. Overall, the accuracy of the raw classification was 61.6 % and 52.1 % for the 12 and the 20 class problem, respectively. The confusion matrices are assessed for detailed analysis. Furthermore, an implementation of a SVM-based CBIR system for CADx in screening mammography is presented. In conclusion, with a smarter patch extraction, the CBIR approach might reach precision rates that are helpful for the physicians. This, however, needs more comprehensive evaluation on clinical data.

  3. The effects of music on pain and anxiety during screening mammography.

    Science.gov (United States)

    Zavotsky, Kathleen Evanovich; Banavage, Adrienne; James, Patricia; Easter, Kathy; Pontieri-Lewis, Vicky; Lutwin, Lynn

    2014-06-01

    One in four women who are diagnosed with breast cancer die annually, and the single most important way to prevent this is early detection; therefore, women older than 40 years should have an annual screening mammography. Many barriers have been reported that prevent compliance with this recommendation, including lack of insurance, fear, anxiety, pain, worry, and mistrust of the medical community. Nurses are in a position to use creative interventions, such as music therapy, to help minimize barriers. Although this study did not show that music therapy during screening mammograms decreased the amount of pain that the participants experienced, it did suggest that music therapy has the potential to decrease the amount of anxiety. Assisting patients in decreasing anxiety reduces barriers for screening mammography. The literature does suggest that music is a distraction for many populations of patients; however, when patients are faced with the possible diagnosis of breast cancer, it may be difficult to find an intervention to distract a woman's mind, which was supported by the findings of this study.

  4. A randomized trial of telephone counseling to promote screening mammography in two HMOs.

    Science.gov (United States)

    Luckmann, Roger; Savageau, Judith A; Clemow, Lynn; Stoddard, Anne M; Costanza, Mary E

    2003-01-01

    Tailored telephone counseling (TTC) is effective in increasing utilization of screening mammography, but has received limited testing on a large scale in a contemporary HMO setting in which most eligible women get regular screening. We conducted a randomized controlled trial comparing TTC to an active control (mailed reminders) among women aged 50-80 enrolled in two HMOs in New England (n=12,905). Over a 1-year period counselors attempted to contact women in the intervention arm who had not had a mammogram within the last 15 months. The absolute increase in mammography use due to the intervention was 4.9% (OR 1.3, 95% CI 1.0-1.6) in one HMO and 3.1% (OR 1.2, 95% CI 1.0-1.3) in the other. We estimated that one additional woman was screened for each 10.9 women eligible for counseling. An intervention process analysis documented a high level of acceptance of TTC and identified subgroups that could be targeted for counseling to improve the efficiency of TTC.

  5. [Chlamydia: from population screening to individual repeated screening].

    Science.gov (United States)

    Bally, F; Quach, A

    2014-10-08

    Chlamydia trachomatis is a frequent sexually transmitted infection especially in young adults and adolescents. Its complications can impair a woman's reproductive potential. chlamydia control has several challenges. These include asymptomatic infections; a long duration of untreated infections; re-infections and partner treatments. Any person with infection is at high risk of re-infection. Repeated screening would decrease, at an individual level, the risk of complications. General practitioners, gynaecologists and centres for sexual health could participate in Chlamydia screening for asymptomatic infections, in Switzerland, the cost of the laboratory test is fixed by national tariff regulations. The cost is high and prohibitive for many, especially adolescents and young adults and needs to be lowered.

  6. Shapelet analysis of pupil dilation for modeling visuo-cognitive behavior in screening mammography

    Science.gov (United States)

    Alamudun, Folami; Yoon, Hong-Jun; Hammond, Tracy; Hudson, Kathy; Morin-Ducote, Garnetta; Tourassi, Georgia

    2016-03-01

    Our objective is to improve understanding of visuo-cognitive behavior in screening mammography under clinically equivalent experimental conditions. To this end, we examined pupillometric data, acquired using a head-mounted eye-tracking device, from 10 image readers (three breast-imaging radiologists and seven Radiology residents), and their corresponding diagnostic decisions for 100 screening mammograms. The corpus of mammograms comprised cases of varied pathology and breast parenchymal density. We investigated the relationship between pupillometric fluctuations, experienced by an image reader during mammographic screening, indicative of changes in mental workload, the pathological characteristics of a mammographic case, and the image readers' diagnostic decision and overall task performance. To answer these questions, we extract features from pupillometric data, and additionally applied time series shapelet analysis to extract discriminative patterns in changes in pupil dilation. Our results show that pupillometric measures are adequate predictors of mammographic case pathology, and image readers' diagnostic decision and performance with an average accuracy of 80%.

  7. Fractal Analysis of Radiologists Visual Scanning Pattern in Screening Mammography

    Energy Technology Data Exchange (ETDEWEB)

    Alamudun, Folami T [ORNL; Yoon, Hong-Jun [ORNL; Hudson, Kathy [University of Tennessee, Knoxville (UTK); Morin-Ducote, Garnetta [University of Tennessee, Knoxville (UTK); Tourassi, Georgia [ORNL

    2015-01-01

    Several investigators have investigated radiologists visual scanning patterns with respect to features such as total time examining a case, time to initially hit true lesions, number of hits, etc. The purpose of this study was to examine the complexity of the radiologists visual scanning pattern when viewing 4-view mammographic cases, as they typically do in clinical practice. Gaze data were collected from 10 readers (3 breast imaging experts and 7 radiology residents) while reviewing 100 screening mammograms (24 normal, 26 benign, 50 malignant). The radiologists scanpaths across the 4 mammographic views were mapped to a single 2-D image plane. Then, fractal analysis was applied on the derived scanpaths using the box counting method. For each case, the complexity of each radiologist s scanpath was estimated using fractal dimension. The association between gaze complexity, case pathology, case density, and radiologist experience was evaluated using 3 factor fixed effects ANOVA. ANOVA showed that case pathology, breast density, and experience level are all independent predictors of the visual scanning pattern complexity. Visual scanning patterns are significantly different for benign and malignant cases than for normal cases as well as when breast parenchyma density changes.

  8. Screening mammography beliefs and recommendations: a web-based survey of primary care physicians

    Directory of Open Access Journals (Sweden)

    Yasmeen Shagufta

    2012-02-01

    Full Text Available Abstract Background The appropriateness and cost-effectiveness of screening mammography (SM for women younger than 50 and older than 74 years is debated in the clinical research community, among health care providers, and by the American public. This study explored primary care physicians' (PCPs perceptions of the influence of clinical practice guidelines for SM; the recommendations for SM in response to hypothetical case scenarios; and the factors associated with perceived SM effectiveness and recommendations in the US from June to December 2009 before the United States Preventive Services Task Force (USPSTF recently revised guidelines. Methods A nationally representative sample of 11,922 PCPs was surveyed using a web-based questionnaire. The response rate was 5.7% (684; (41% 271 family physicians (FP, (36% 232 general internal medicine physicians (IM, (23% 150 obstetrician-gynaecologists (OBG, and (0.2% 31 others. Cross-sectional analysis examined PCPs perceived effectiveness of SM, and recommendation for SM in response to hypothetical case scenarios. PCPs responses were measured using 4-5 point adjectival scales. Differences in perceived effectiveness and recommendations for SM were examined after adjusting for PCPs specialty, race/ethnicity, and the US region. Results Compared to IM and FP, OBG considered SM more effective in reducing breast cancer mortality among women aged 40-49 years (p = 0.003. Physicians consistently recommended mammography to women aged 50-69 years with no differences by specialty (p = 0.11. However, 94% of OBG "always recommended" SM to younger and 86% of older women compared to 81% and 67% for IM and 84% and 59% for FP respectively (p = p = Conclusions A majority of physicians, especially OBG, favour aggressive breast cancer screening for women from 40 through 79 years of age, including women with short life expectancy. Policy interventions should focus on educating providers to provide tailored recommendations for

  9. Breast cancer screening: Evidence of the effect of adjunct ultrasound screening in women with unilateral mammography-negative dense breasts

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2015-01-01

    Full Text Available Background: Patients with the previous history of breast cancer are in risk of contralateral breast cancer. On the other hand, increased breast density is a risk factor for breast cancer and the sensitivity of detecting nonpalpable cancers in screening mammography in radiographically dense breasts is low. The use of ultrasonography in dense breast remains a controversial topic. The purpose of this study was to assess the usefulness of routine ultrasonography in follow-up of women with the previous history of breast cancer and negative mammography but dense breasts. Materials and Methods: In a cross-sectional study, a total of 267 individuals with unilateral postmastectomy mammogram screened and 153 subjects assigned to study. There were 28 subjects with American College of Radiology (ACR breast density 2 and 125 with ACR breast density 3-4, which there was no new finding in their mammogram in comparison to previous studies. We assumed subjects with ACR breast density 3-4 as mammographic Breast Imaging Reporting and Data System (BI-RADS category 0 for malignancy. Standard two-view mammogram was performed for all participants, and breast ultrasound (US examinations were performed by an expert radiologist in radial and anti-radial planes. The data were analyzed using SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA. Results: The results showed that in subjects with ACR breast density 3-4, when there was no new density in two consecutive mammograms in comparison to previous studies, US also showed no possibility for malignancy (BI-RADS 1-2. And also in subjects with ACR breast density 2, when the mammographic results were BI-RADS 1-2, the US results was the same. Conclusion: Our data indicate that for the detection of breast cancer, sensitivity of US was not greater than mammography in patients with postmastectomy unilateral dense breast if there is not any new density.

  10. Rational choice(s)? Rethinking decision-making on breast cancer risk and screening mammography.

    Science.gov (United States)

    Vahabi, Mandana; Gastaldo, Denise

    2003-12-01

    Women who refrain from undergoing breast cancer screening are believed to be uninformed about risks and usually labeled as irrational. Our purpose in writing this paper is to challenge the traditional notion of rational behaviour, illustrating with qualitative data that people's rationality is influenced by their socio-cultural and political identities. We explore three major themes: (1) cultural explanations regarding intention to use screening mammography (2) (dis)trust in science and expert opinion, and (3) self-responsibility and self-surveillance in caring for one's body. Understanding that women rely on different risk discourses to make decisions about their health should aide researchers, health professionals, and the community in better understanding alternative ways of conceptualizing people's health-related behaviours when they do not coincide with health authorities recommendations.

  11. Experience with the European quality assurance guidelines for digital mammography systems in a national screening programme.

    Science.gov (United States)

    McCullagh, J; Keavey, E; Egan, G; Phelan, N

    2013-02-01

    The transition to a fully digital breast screening programme, utilising three different full-field digital mammography (FFDM) systems has presented many challenges to the implementation of the European guidelines for physico-technical quality assurance (QA) testing. An analysis of the QA results collected from the FFDM systems in the screening programme over a 2-y period indicates that the three different systems have similar QA performances. Generally, the same tests were failed by all systems and failure rates were low. The findings provide some assurance that the QA guidelines are being correctly implemented. They also suggest that there is more scope for the development of the relevance of the guidelines with respect to modern FFDM systems. This study has also shown that a summary review of the QA data can be achieved by simple organisation of the QA data storage and by automation of data query and retrieval using commonly available software.

  12. Direct Interactive Public Education by Breast Radiologists About Screening Mammography: Impact on Anxiety and Empowerment.

    Science.gov (United States)

    Lee, Jiyon; Hardesty, Lara A; Kunzler, Nathan M; Rosenkrantz, Andrew B

    2016-01-01

    Anxiety has been called a "harm" of screening mammography. The authors provided direct, interactive education to lay audiences and measured these sessions' impact on anxiety and any increased understanding of breast cancer screening. Academic breast radiologist provided seven 1-hour sessions of structured lectures and question-and-answer periods. Lay language and radiologic images were used to discuss disease background, screening guidelines, and areas of debate. One hundred seventeen participants (mean age, 45 ± 15 years) completed voluntary, anonymous, institutional review board-approved pre and postsession questionnaires relaying their attitudes regarding screening and the impact of the sessions. Results are summarized descriptively. Mean reported anxiety regarding screening (on a scale ranging from 1-5; 1 = no anxiety) was 2.5 ± 1.3. Anxiety was attributed to unknown results (56.4%), anticipation of pain (21.8%), known risk factors (14.5%), general uncertainty (12.7%), waiting for results (9.1%), possibility of more procedures (3.6%), and personal breast cancer history (3.6%). Ninety-seven percent reported that immediate results would lower anxiety (78% of those women indicated a 75%-100% decrease in anxiety); 93% reported that radiologist consultation with images would lower anxiety (75.6% indicated a 75%-100% decrease in anxiety). After the lecture, women reported (on a scale ranging from 1-5) increased understanding of the topic (4.7 ± 0.6), encouragement to screen (4.6 ± 0.7), and reduced anxiety (4.0 ± 1.1). Ninety-seven percent to 100% provided correct responses to these questions: rationale for screening in the absence of family history, recall does not equate to cancer diagnosis, benefit of prior films, and continued importance of physical examination. Attendees of radiologist-provided direct public lectures reported decreased anxiety and improved knowledge regarding screening mammography. The resultant reduced anxiety ("harm") and educational

  13. Screening Mammography

    OpenAIRE

    1988-01-01

    Breast cancer is the most commonly occurring cancer in women and, until recently surpassed by lung cancer, was the leading cause of cancer-related death in women. It is the leading cause of death in women aged 39 to 44 years. The American Cancer Society has estimated that there will be 135,000 new cases of breast cancer and 42,300 breast cancer-related deaths in 1988. It is now predicted that breast cancer will develop in one out of every ten women in the United States. Given the clinical and...

  14. Development and validation of the PCQ: a questionnaire to measure the psychological consequences of screening mammography.

    Science.gov (United States)

    Cockburn, J; De Luise, T; Hurley, S; Clover, K

    1992-05-01

    We have developed a reliable and valid questionnaire to measure the psychological consequences of screening mammography. The questionnaire measures the effect of screening on an individual's functioning on emotional, social, and physical life domains. Content validity was ensured by extensive review of the relevant literature, discussion with professionals and interviews with attenders at a pilot Breast X-ray Screening Program in Melbourne, Australia. Discriminant validity was assessed by having expert judges sort items into dimensions which they appeared to be measuring. Acceptable levels of concordance (above 80%) with a priori classifications were found. Concurrent validity was demonstrated by comparison of subscale scores of 53 attenders at the Breast X-ray Program with an independent interview assessment of dysfunction on each of the emotional, social and physical dimensions. There was over 79% agreement between interview scores and questionnaire scores for each dimension. Construct validity was confirmed by showing that subscale scores varied in predicted ways. For women who were recalled for further investigation, scores on each subscale measuring negative consequences, were higher at the recall clinic than at screening clinic (emotional: t = -7.28; df = 70; P less than 0.001; physical: t = -2.53; df = 70; P = 0.014; social: t = -2.49; df = 70; P = 0.015). The internal consistency of all subscales was found to be acceptable. This questionnaire is potentially useful for assessing the psychological consequences of the screening process and should have wide application.

  15. The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme--a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone.

    Science.gov (United States)

    Gilbert, Fiona J; Tucker, Lorraine; Gillan, Maureen Gc; Willsher, Paula; Cooke, Julie; Duncan, Karen A; Michell, Michael J; Dobson, Hilary M; Lim, Yit Yoong; Purushothaman, Hema; Strudley, Celia; Astley, Susan M; Morrish, Oliver; Young, Kenneth C; Duffy, Stephen W

    2015-01-01

    Digital breast tomosynthesis (DBT) is a three-dimensional mammography technique with the potential to improve accuracy by improving differentiation between malignant and non-malignant lesions. The objectives of the study were to compare the diagnostic accuracy of DBT in conjunction with two-dimensional (2D) mammography or synthetic 2D mammography, against standard 2D mammography and to determine if DBT improves the accuracy of detection of different types of lesions. Women (aged 47-73 years) recalled for further assessment after routine breast screening and women (aged 40-49 years) with moderate/high of risk of developing breast cancer attending annual mammography screening were recruited after giving written informed consent. All participants underwent a two-view 2D mammography of both breasts and two-view DBT imaging. Image-processing software generated a synthetic 2D mammogram from the DBT data sets. In an independent blinded retrospective study, readers reviewed (1) 2D or (2) 2D + DBT or (3) synthetic 2D + DBT images for each case without access to original screening mammograms or prior examinations. Sensitivities and specificities were calculated for each reading arm and by subgroup analyses. Data were available for 7060 subjects comprising 6020 (1158 cancers) assessment cases and 1040 (two cancers) family history screening cases. Overall sensitivity was 87% [95% confidence interval (CI) 85% to 89%] for 2D only, 89% (95% CI 87% to 91%) for 2D + DBT and 88% (95% CI 86% to 90%) for synthetic 2D + DBT. The difference in sensitivity between 2D and 2D + DBT was of borderline significance (p = 0.07) and for synthetic 2D + DBT there was no significant difference (p = 0.6). Specificity was 58% (95% CI 56% to 60%) for 2D, 69% (95% CI 67% to 71%) for 2D + DBT and 71% (95% CI 69% to 73%) for synthetic 2D + DBT. Specificity was significantly higher in both DBT reading arms for all subgroups of age, density and dominant radiological

  16. A comparison of fixed and variable kVp technique protocols for film-screen mammography.

    Science.gov (United States)

    McParland, B J; Boyd, M M

    2000-06-01

    Mammographic image quality, contrast and dose for a variable tube potential (kVp) technique protocol for film-screen mammography have been investigated. In this protocol, the tube potential is increased for larger breast thicknesses. Comparisons were made with fixed kVp protocols, in which the tube potential is kept constant and the breast thickness compensated for by prolonging the exposure ("fixed kVp" protocol). All measurements were performed on a mammography unit with a molybdenum target and filter. Image quality was quantified by image contrast, image detail detection and the minimum detectable dimension of low contrast objects. It was demonstrated that for a compressed breast thickness of less than about 40 mm, varying the tube potential had a negligible effect upon dose but a significant effect upon image quality. For a compressed breast thickness greater than about 60 mm, the effect of the tube potential upon image quality was much reduced; however, the effect upon dose was significantly greater. The variable kVp protocol takes advantage of this feature to yield a significantly lower dose for thicker breasts with a small reduction in image quality, often only within experimental uncertainty. For an exposure under automatic exposure control, increasing the tube potential from 26 kVp to 30 kVp for a breast of a reference tissue composition (50% adipose and 50% glandular) with a compressed thickness of 60 mm reduced the mean glandular dose from 6 mGy to 3.9 mGy (-35%), but increased the minimum detectable dimension of a low contrast mass from 0.8 (+/- 0.1) mm to 1.1 (+/- 0.1) mm. Adopting a variable kVp protocol led to a median patient mean glandular dose per film of 2.7 mGy, nearly independent of compressed breast thickness. In our survey, the mean age of women presenting for mammography is younger and the mean compressed breast thickness is less than reported from screening centres. This suggests that there will be a higher proportion of denser, glandular

  17. Teaching syllabus for radiological aspects of breast cancer screening with digital mammography.

    Science.gov (United States)

    Van Ongeval, Chantal; Van Steen, André; Bosmans, Hilde

    2008-01-01

    The purpose of this study is to discuss the content of our new accreditation programme for radiologists' reading digital mammograms in a screening setting and to report our first experience with the new course. The course consisted of a theoretical part, given by the medical physicist, and a practical part given by the radiologist. The practical session is closely linked with the theoretical part and a reading session. The material is fully digital and can be presented on different platforms. In practice, the need for parallel soft-copy reading sessions on high-end workstations limits the number of participants. A high level of interactivity was noted between teacher and participant, with a thorough discussion of different digital mammography systems during a single teaching course. The main challenge for the teacher turned out to be the collection of representative material and the continuous updating of the material: new systems, processing techniques and artefacts need to be included regularly.

  18. Breast cancer incidence and mortality in the Nordic capitals, 1970-1998. Trends related to mammography screening programmes

    DEFF Research Database (Denmark)

    Törnberg, Sven; Kemetli, Levent; Lynge, Elsebeth

    2006-01-01

    The aim of the present study was to relate the time trends in breast cancer incidence and mortality to the introduction of mammography screening in the Nordic capitals. Helsinki offered screening to women aged 50-59 starting in 1986. The other three capitals offered screening to women aged 50......-69 starting in 1989 in Stockholm, 1991 in Copenhagen, and 1996 in Oslo. Prevalence peaks in breast cancer incidence depended on the age groups covered by the screening, the length of the implementation of screening, and the extent of background opportunistic screening. No mortality reduction following...... the introduction of screening was visible after seven to 12 years of screening in any of the three capitals where significant effects of the screening on the breast cancer mortality had already been demonstrated by using other analytical methods for the evaluation. No visible effect on mortality reduction...

  19. Relation between breast cancer mortality and screening effectiveness: systematic review of the mammography trials

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C

    2011-01-01

    as in the control group) predicted a significant 16% reduction in breast cancer mortality after 13 years (95% confidence interval, 9% to 23% reduction). This can only occur if there is bias. Further analyses uncovered bias in both assessment of the cause of death and of the number of cancers in advanced stages...... an advanced stage. I performed a systematic review of the mammography screening trials using metaregression. Finding many cancers was not related to the size of the reduction in breast cancer mortality (p = 0.19 after seven and p = 0.73 after 13 years of follow-up). In contrast, finding few cancers in stage...... II and above predicted a larger reduction in breast cancer mortality (p = 0.04 and p = 0.006). This expected association was also found for node-positive cancers (p = 0.008 and p = 0.04). However, a screening effectiveness of zero (same proportion of node-positive cancers in the screened group...

  20. A multiparametric automatic method to monitor long-term reproducibility in digital mammography: results from a regional screening programme.

    Science.gov (United States)

    Gennaro, G; Ballaminut, A; Contento, G

    2017-09-01

    This study aims to illustrate a multiparametric automatic method for monitoring long-term reproducibility of digital mammography systems, and its application on a large scale. Twenty-five digital mammography systems employed within a regional screening programme were controlled weekly using the same type of phantom, whose images were analysed by an automatic software tool. To assess system reproducibility levels, 15 image quality indices (IQIs) were extracted and compared with the corresponding indices previously determined by a baseline procedure. The coefficients of variation (COVs) of the IQIs were used to assess the overall variability. A total of 2553 phantom images were collected from the 25 digital mammography systems from March 2013 to December 2014. Most of the systems showed excellent image quality reproducibility over the surveillance interval, with mean variability below 5%. Variability of each IQI was 5%, with the exception of one index associated with the smallest phantom objects (0.25 mm), which was below 10%. The method applied for reproducibility tests-multi-detail phantoms, cloud automatic software tool to measure multiple image quality indices and statistical process control-was proven to be effective and applicable on a large scale and to any type of digital mammography system. • Reproducibility of mammography image quality should be monitored by appropriate quality controls. • Use of automatic software tools allows image quality evaluation by multiple indices. • System reproducibility can be assessed comparing current index value with baseline data. • Overall system reproducibility of modern digital mammography systems is excellent. • The method proposed and applied is cost-effective and easily scalable.

  1. Trends in compressed breast thickness and radiation dose in breast screening mammography.

    Science.gov (United States)

    Robinson, M; Kotre, C J

    2008-03-01

    An analysis was performed of the compressed breast thickness recorded in 146 mammographic patient dose surveys each consisting of 50 or more women carried out between 1993 and 2004. The results show a steady and statistically significant increase in compressed breast thickness with time, which is also present when individual independent screening centres and equipment manufacturers are compared. This increase seems most likely to be associated with an increase in the proportion of women in the breast screening age range classified as overweight and obese, which has occurred over the same time period. The associated trends in mean glandular dose per image were calculated for the mammography units used at the time of the surveys, using the most recently published conversion factors. The increase in average radiation dose that might have been expected as a result of the increase in average compressed breast thickness was not actually found in practice, possibly because of advances in equipment design and dose optimization strategies made during the 11-year period. Other implications of an increasing average compressed breast thickness are discussed.

  2. Dose to patients in mammography. Retrospective study during more than 10 years of mammography screening program; Dosis a pacientes en mamografia. Estudio retrospectivo de mas de 10 anos de programa de cribado mamografico

    Energy Technology Data Exchange (ETDEWEB)

    Ramirez Munoz, A.; Chapel Gomez, M. L.

    2010-07-01

    Breast screening programs include large number of women, most of them asymptomatic, receiving a significant absorbed dose. Under these circumstances, estimation of breast dose arises as a valuable tool to evaluate carcinogenic risk to the patient. Dose estimation can also become a tool for comparison of imaging systems, beam qualities and techniques for mammography. Mammographic systems have undergone many changes since its origins: new beam qualities have been introduced and digital mammography has replaced conventional systems. Data obtained from 2266 mammographic studies, during more than ten years of experience on the Canary Islands Breast Cancer Screening Program, have been analysed. Semi-automatic exposure control, completely automatic exposure control, screen-film and full field digital systems have been considered, Average glandular dose (the carcinogenic risk indicator) received by patients has been compared. A reduction in average glandular dose of full field digital mammography has been found. The optimisation of exposition parameters appears as critical factor on dose reduction. (Author) 26 refs.

  3. Comparative effectiveness of breast MRI and mammography in screening young women with elevated risk of developing breast cancer: a retrospective cohort study.

    Science.gov (United States)

    Narayan, Anand K; Visvanathan, Kala; Harvey, Susan C

    2016-08-01

    Screening guidelines recommend that women with 20 % or greater lifetime risk of breast cancer undergo annual breast MRI screening to supplement mammography, irrespective of age. In patients less than 40 years, mammography is often avoided due to concerns about radiation and decreased performance. However, prior studies have been limited by large percentages of women above 40 with decreased breast density. Our purpose was to test whether adding mammography to breast MRI screening compared to breast MRI screening alone in women below 40 increases cancer detection rates. After obtaining IRB approval, chart review identified patients aged 25-40 years undergoing breast MR screening (2005-2014). Demographics, risk factors, BI-RADS assessments, background parenchymal enhancement, and mammographic breast tissue density were recorded. Cancer detection rates, short-term follow-up (BIRADS 3), image-guided biopsy (BIRADS 4,5), and PPV1-3 were calculated. 342 breast MRI exams were identified (average age was 33, 37 % were nulliparous, and 64 % had prior benign biopsy), 226 (66 %) of which underwent concurrent mammography. Risk factors included 64 % with breast cancer in first-degree relative(s), 90 % had heterogeneous or extremely dense breast tissue on mammography, and 16 % were BRCA carriers. Four invasive cancers were detected by MRI (11.7 cancers/1000 examinations, 95 % CI 8.3, 15.1). None of these was detected by mammography, and no cancers were independently identified by mammography. Breast MRI screening in high-risk women under 40 yielded elevated cancer detection rates (11.7/1000). The cancer detection rate for mammography was 0 %, suggesting that MRI alone may be useful in screening high-risk women under 40.

  4. Informed Choice in the German Mammography Screening Program by Education and Migrant Status: Survey among First-Time Invitees.

    Directory of Open Access Journals (Sweden)

    Eva-Maria Berens

    Full Text Available Breast cancer is the most prevalent cancer among women and mammography screening programs are seen as a key strategy to reduce breast cancer mortality. In Germany, women are invited to the population-based mammography screening program between ages 50 to 69. It is still discussed whether the benefits of mammography screening outweigh its harms. Therefore, the concept of informed choice comprising knowledge, attitude and intention has gained importance. The objective of this observational study was to assess the proportion of informed choices among women invited to the German mammography screening program for the first time. A representative sample of 17,349 women aged 50 years from a sub-region of North Rhine Westphalia was invited to participate in a postal survey. Turkish immigrant women were oversampled. The effects of education level and migration status on informed choice and its components were assessed. 5,847 (33.7% women responded to the postal questionnaire of which 4,113 were used for analyses. 31.5% of the women had sufficient knowledge. The proportion of sufficient knowledge was lower among immigrants and among women with low education levels. The proportion of women making informed choices was low (27.1%, with similar associations with education level and migration status. Women of low (OR 2.75; 95% CI 2.18-3.46 and medium education level (OR 1.49; 95% CI 1.27-1.75 were more likely to make an uninformed choice than women of high education level. Turkish immigrant women had the greatest odds for making an uninformed choice (OR 5.30, 95% CI 1.92-14.66 compared to non-immigrant women. Other immigrant women only had slightly greater odds for making an uninformed choice than non-immigrant women. As immigrant populations and women with low education level have been shown to have poor knowledge, they need special attention in measures to increase knowledge and thus informed choices.

  5. Where's Maria? A video to increase awareness about breast cancer and mammography screening among low-literacy Latinas.

    Science.gov (United States)

    Borrayo, Evelinn A

    2004-07-01

    The need exists to educate and motivate medically disadvantaged Latinas to engage in regular mammography screening to reduce their high breast cancer (BC) mortality risk due to the illness' late detection. Qualitative research methods [e.g., focus groups, key informants] were primarily used during the basic and formative research phases in preproducing and producing a breast cancer educational video for low-literacy Latinas. An 8-min video was created in an Entertainment-Education soap opera format. The purpose of the video is to create awareness about breast cancer and to motivate low-literacy Latinas who are at the precontemplation stage of behavior change to consider engaging in mammography screening. Thus, the video presents a compelling story of a Latina with whom the target audience can identify and become involved with the unfolding events of her story as she realizes her risk for breast cancer and struggles with the decision to engage in mammography. The content and format of the video include culturally relevant clues and modeling to influence Latinas' cognitive and subjective processes involved in making the decision to change. Complex attitudinal and behavioral issues can be effectively targeted to decrease the influence that psychological barriers exert in Latinas low breast cancer screening rates. Copyright 2004 The Institute for Cancer Prevention and Elsevier Inc.

  6. Peer reviewing of screening mammography in Taiwan: its reliability and the improvement

    Institute of Scientific and Technical Information of China (English)

    PAN Huay-ben; HSU Giu-cheng; YANG Tsung-lung; HUANG Jer-shyung; CHOU Chen-pin; LIANG Huei-lung; LEE San-kan

    2013-01-01

    Background Early detection with screening mammography can potentially reduce breast cancer mortality rates.To achieve an efficient screening,a peer review system provides a compensatory double-check reviewing,will hopefully to prevent the omission of detectable lesions and reduce unnecessary recall.Methods In 2009,4643 initial mammographic screenings reported by 74 screening radiologists had negative results with a recall rate of less than 5%.In the same year,2538 initial positives screened by 18 screening radiologists had a recall rate higher than 15%.Those 7181 randomized screenings were evenly distributed for reassessment by 39 reviewing radiologists.The disagreement of assessments between the reviewers and screening radiologists was recorded.The differential rate was defined as the number of the disagreements divided by the number of audited films reviewed by a screening radiologist.The equality of the differential rates for each screening radiologists with negative and positive assessments was compared by a Chi-square test.The performance of the 39 auditors was measured by the Kendall's tau statistic.P values less than 0.05 were considered statistically significant.Results The mean differential rate for screening radiologists of negative assessments was 6.7% (P=-0.588),while 35.0% for positive assessments were significant (P <0.001).The result indicated that most of the initial negative assessments reported by the screening radiologists were generally accepted by the reviewers but not the positive assessments.With respect to the 39 reviewers,there was no significant evidence for the association of the difference rates between negative and positive assessments.Nine reviewers were found to have their differential rate for negative and positive assessments larger than the average of the population.Eleven reviewers were found to have their differential rates smaller than the average for both.Thirteen reviewers had their differential rates smaller than

  7. Changing behavior and accuracy with time on task in mammography screening

    Science.gov (United States)

    Taylor-Phillips, Sian; Jenkinson, David; Stinton, Chris; Wallis, Matthew G.; Clarke, Aileen

    2017-03-01

    Background: The vigilance decrement and prevalence effect both describe changes to speed and accuracy with time on task. Whilst there is much laboratory based research on these effects, little is known about whether they occur in real world mammography practice. Methods: The Changing Case Order to Optimise Patterns of Performance in Screening (CO-OPS) trial randomised 37,724 batches containing 1.2 million women attending breast screening to intervention or control (222,208 from the Midlands of England). In the control arm the batch was examined in the same order by both readers, in the intervention arm it was examined in a different order by both readers. Time taken, recall decision by both readers, and cancers detected were recorded for each case, and used to examine patterns of performance with time on task. Results: 49,575 women were recalled and 10,484 had cancer detected. Median time taken to examine each case was 35 seconds (out of cases where time taken was 10 minutes or less). The intervention did not affect overall cancer detection rates or recall rates. A more detailed analysis of the Midlands data indicates cancer detection rate did not change when reading up to 60 cases in a batch, but recall rate reduced. Time taken per case reduced with time on task, from a median 41 seconds when examining the second case in the batch to 28.5 seconds examining the 60th case. Conclusion: Reader behavior and performance systematically changes with time on task in breast screening.

  8. Exploring the potential of context-sensitive CADe in screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Tourassi, Georgia D.; Mazurowski, Maciej A.; Harrawood, Brian P.; Krupinski, Elizabeth A. [Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, University of Arizona, Tucson, Arizona 85724 (United States)

    2010-11-15

    Purpose: Conventional computer-assisted detection (CADe) systems in screening mammography provide the same decision support to all users. The aim of this study was to investigate the potential of a context-sensitive CADe system which provides decision support guided by each user's focus of attention during visual search and reporting patterns for a specific case. Methods: An observer study for the detection of malignant masses in screening mammograms was conducted in which six radiologists evaluated 20 mammograms while wearing an eye-tracking device. Eye-position data and diagnostic decisions were collected for each radiologist and case they reviewed. These cases were subsequently analyzed with an in-house knowledge-based CADe system using two different modes: Conventional mode with a globally fixed decision threshold and context-sensitive mode with a location-variable decision threshold based on the radiologists' eye dwelling data and reporting information. Results: The CADe system operating in conventional mode had 85.7% per-image malignant mass sensitivity at 3.15 false positives per image (FPsI). The same system operating in context-sensitive mode provided personalized decision support at 85.7%-100% sensitivity and 0.35-0.40 FPsI to all six radiologists. Furthermore, context-sensitive CADe system could improve the radiologists' sensitivity and reduce their performance gap more effectively than conventional CADe. Conclusions: Context-sensitive CADe support shows promise in delineating and reducing the radiologists' perceptual and cognitive errors in the diagnostic interpretation of screening mammograms more effectively than conventional CADe.

  9. Parameter optimization of parenchymal texture analysis for prediction of false-positive recalls from screening mammography

    Science.gov (United States)

    Ray, Shonket; Keller, Brad M.; Chen, Jinbo; Conant, Emily F.; Kontos, Despina

    2016-03-01

    This work details a methodology to obtain optimal parameter values for a locally-adaptive texture analysis algorithm that extracts mammographic texture features representative of breast parenchymal complexity for predicting falsepositive (FP) recalls from breast cancer screening with digital mammography. The algorithm has two components: (1) adaptive selection of localized regions of interest (ROIs) and (2) Haralick texture feature extraction via Gray- Level Co-Occurrence Matrices (GLCM). The following parameters were systematically varied: mammographic views used, upper limit of the ROI window size used for adaptive ROI selection, GLCM distance offsets, and gray levels (binning) used for feature extraction. Each iteration per parameter set had logistic regression with stepwise feature selection performed on a clinical screening cohort of 474 non-recalled women and 68 FP recalled women; FP recall prediction was evaluated using area under the curve (AUC) of the receiver operating characteristic (ROC) and associations between the extracted features and FP recall were assessed via odds ratios (OR). A default instance of mediolateral (MLO) view, upper ROI size limit of 143.36 mm (2048 pixels2), GLCM distance offset combination range of 0.07 to 0.84 mm (1 to 12 pixels) and 16 GLCM gray levels was set. The highest ROC performance value of AUC=0.77 [95% confidence intervals: 0.71-0.83] was obtained at three specific instances: the default instance, upper ROI window equal to 17.92 mm (256 pixels2), and gray levels set to 128. The texture feature of sum average was chosen as a statistically significant (p<0.05) predictor and associated with higher odds of FP recall for 12 out of 14 total instances.

  10. Single-screen single-emulsion versus dual-screen dual-emulsion system in mammography; Comparison of imaging properties and detection of microcalcifications

    Energy Technology Data Exchange (ETDEWEB)

    Katsuda, Noboru; Hiai, Yasuhiro (Kumamoto Univ. (Japan). Hospital); Higashida, Yoshiharu (and others)

    1993-05-01

    A dual-screen/dual-emulsion film combination (Kodak MinR Fast screen/TMG film) that allows for a decrease in patient exposure was evaluated with widely used single-screen/single-emulsion systems (Kodak MinR/OM, Kodak MinR/MinR, and Toshiba MM6/MINC film) in contrast to mammography. Clustered microcalcifications randomly superimposed on a breast specimen were detected, and the locations were determined by eight observers. The dual screen-film system provided about a 64% reduction in patient exposure compared with the single-screen/single-emulsion system (MM6/MINC), but it failed to equal the single-system in detection of simulated microcalcifications. Our results suggested that the conventional single-screen/single-emulsion systems showed better detectability of microcalcifications than the dual-screen/dual-emulsion film combinations. (author).

  11. Clarifying the debate on population-based screening for breast cancer with mammography

    Science.gov (United States)

    Chen, Tony Hsiu-Hsi; Yen, Amy Ming-Fang; Fann, Jean Ching-Yuan; Gordon, Paula; Chen, Sam Li-Sheng; Chiu, Sherry Yueh-Hsia; Hsu, Chen-Yang; Chang, King-Jen; Lee, Won-Chul; Yeoh, Khay Guan; Saito, Hiroshi; Promthet, Supannee; Hamashima, Chisato; Maidin, Alimin; Robinson, Fredie; Zhao, Li-Zhong

    2017-01-01

    Abstract Background: The recent controversy about using mammography to screen for breast cancer based on randomized controlled trials over 3 decades in Western countries has not only eclipsed the paradigm of evidence-based medicine, but also puts health decision-makers in countries where breast cancer screening is still being considered in a dilemma to adopt or abandon such a well-established screening modality. Methods: We reanalyzed the empirical data from the Health Insurance Plan trial in 1963 to the UK age trial in 1991 and their follow-up data published until 2015. We first performed Bayesian conjugated meta-analyses on the heterogeneity of attendance rate, sensitivity, and over-detection and their impacts on advanced stage breast cancer and death from breast cancer across trials using Bayesian Poisson fixed- and random-effect regression model. Bayesian meta-analysis of causal model was then developed to assess a cascade of causal relationships regarding the impact of both attendance and sensitivity on 2 main outcomes. Results: The causes of heterogeneity responsible for the disparities across the trials were clearly manifested in 3 components. The attendance rate ranged from 61.3% to 90.4%. The sensitivity estimates show substantial variation from 57.26% to 87.97% but improved with time from 64% in 1963 to 82% in 1980 when Bayesian conjugated meta-analysis was conducted in chronological order. The percentage of over-detection shows a wide range from 0% to 28%, adjusting for long lead-time. The impacts of the attendance rate and sensitivity on the 2 main outcomes were statistically significant. Causal inference made by linking these causal relationships with emphasis on the heterogeneity of the attendance rate and sensitivity accounted for the variation in the reduction of advanced breast cancer (none-30%) and of mortality (none-31%). We estimated a 33% (95% CI: 24–42%) and 13% (95% CI: 6–20%) breast cancer mortality reduction for the best scenario (90

  12. Repeated depression screening during the first postpartum year.

    Science.gov (United States)

    Yawn, Barbara P; Bertram, Susan; Kurland, Marge; Wollan, Peter C

    2015-01-01

    Postpartum depression (PPD) screening at 4 to 12 weeks' postpartum can improve outcomes for women when linked to in-practice management programs. The benefit of repeated PPD screening during the first year postpartum remains unclear. We report a substudy of a large pragmatic trial of early PPD screening and practice management, the Translating Research into Practice for Postpartum Depression (TRIPPD) study. Outcome analyses were based on demographic information and Patient Health Questionnaire (PHQ-9) screening scores from questionnaires mailed to all enrolled women at baseline (4 to 12 weeks' postpartum) and again at 6 and at 12 months' postpartum. The main outcomes of this substudy were the 6- and 12-month rates of PHQ-9 scores that were 10 or greater for women whose baseline PHQ-9 scores were less than 10. Women whose scores were 10 or greater would be considered at high risk of PPD and appropriate for further evaluation. At 6 months, 134 (10.9%) of the 1,235 women who did not have PHQ-9 scores greater than 10 at baseline had elevated scores appropriate for further evaluation. At 12 months, 59 (6.1%) of the 969 women who did not have PHQ-9 scores greater than 10 at baseline or at 6 months had elevated scores. Together the 6- and 12-month repeated screenings identified 193 women at high risk of depression. This finding represents 13.5% of the 1,432 women whose screening results were negative for PPD at baseline. Repeated PPD screening at 6 and 12 months' postpartum increases the percentage of women identified as being at high risk of PPD. Further work will be required to understand the impact of this repeated screening on patient outcomes. © 2015 Annals of Family Medicine, Inc.

  13. The interplay of attention economics and computer-aided detection marks in screening mammography

    Science.gov (United States)

    Schwartz, Tayler M.; Sridharan, Radhika; Wei, Wei; Lukyanchenko, Olga; Geiser, William; Whitman, Gary J.; Haygood, Tamara Miner

    2016-03-01

    Introduction: According to attention economists, overabundant information leads to decreased attention for individual pieces of information. Computer-aided detection (CAD) alerts radiologists to findings potentially associated with breast cancer but is notorious for creating an abundance of false-positive marks. We suspected that increased CAD marks do not lengthen mammogram interpretation time, as radiologists will selectively disregard these marks when present in larger numbers. We explore the relevance of attention economics in mammography by examining how the number of CAD marks affects interpretation time. Methods: We performed a retrospective review of bilateral digital screening mammograms obtained between January 1, 2011 and February 28, 2014, using only weekend interpretations to decrease distractions and the likelihood of trainee participation. We stratified data according to reader and used ANOVA to assess the relationship between number of CAD marks and interpretation time. Results: Ten radiologists, with median experience after residency of 12.5 years (range 6 to 24,) interpreted 1849 mammograms. When accounting for number of images, Breast Imaging Reporting and Data System category, and breast density, increasing numbers of CAD marks was correlated with longer interpretation time only for the three radiologists with the fewest years of experience (median 7 years.) Conclusion: For the 7 most experienced readers, increasing CAD marks did not lengthen interpretation time. We surmise that as CAD marks increase, the attention given to individual marks decreases. Experienced radiologists may rapidly dismiss larger numbers of CAD marks as false-positive, having learned that devoting extra attention to such marks does not improve clinical detection.

  14. Breast cancer incidence and mortality in the Nordic capitals, 1970-1998. Trends related to mammography screening programmes

    Energy Technology Data Exchange (ETDEWEB)

    Toernberg, Sven; Kemetli, Levent [Karolinska Univ. Hospital, Stockholm (Sweden). Cancer Screening Unit, Oncologic Centre; Lynge, Elsebeth; Olsen, Anne Helene [Univ. of Copenhagen, (Denmark). Inst. of Public Health; Hofvind, Solveig; Wang, Hege [The Cancer Registry of Norway, Oslo (Norway); Anttila, Ahti [Finnish Cancer Registry, Helsinki (Finland); Hakama, Matti [Univ. of Tampere (Finland). School of Public Health; Nystroem, Lennarth [Umeaa Univ. (Sweden). Dept. of Public Health and Clinical Medicine

    2006-07-15

    The aim of the present study was to relate the time trends in breast cancer incidence and mortality to the introduction of mammography screening in the Nordic capitals. Helsinki offered screening to women aged 50-59 starting in 1986. The other three capitals offered screening to women aged 50-69 starting in 1989 in Stockholm, 1991 in Copenhagen, and 1996 in Oslo. Prevalence peaks in breast cancer incidence depended on the age groups covered by the screening, the length of the implementation of screening, and the extent of background opportunistic screening. No mortality reduction following the introduction of screening was visible after seven to 12 years of screening in any of the three capitals where significant effects of the screening on the breast cancer mortality had already been demonstrated by using other analytical methods for the evaluation. No visible effect on mortality reduction was expected in Oslo due to too short an observation period. The study showed that the population-based breast cancer mortality trend is too crude a measure to detect the effect of screening on breast cancer mortality during the first years after the start of a programme.

  15. News media coverage of a women's health contraversy: how newspapers and TV outlets covered a recent debate over screening mammography.

    Science.gov (United States)

    Steele, Whitney Randolph; Mebane, Felicia; Viswanath, K; Solomon, Janice

    2005-01-01

    Over the past decade, there have been several highly visible debates about mammography that have captured professional, public and media attention. This paper looks at newspaper and television news coverage of a controversial research letter in The Lancet by Gøtzsche and Olsen (2001) that concluded that screening mammography did not prevent deaths from breast cancer. The news pieces examined for this project were published between October 2001 and March 2002 in one of eight U.S. newspapers or aired on one of six national or cable news networks. The six-month period was divided into one-week segments; the numbers of articles published or stories aired in each week were graphed to examine patterns. Each newspaper article and television transcript was then reviewed to identify its main content area and the amount of coverage for each major event was quantified. The highest number of newspaper articles appeared to result from several events during the end of January through the beginning of February. These events included the publication of another meta-analysis of mammography that disputed the original letter's conclusion and a full-page New York Times advertisement paid for by major medical organizations stating their continued support for mammography. The greatest amount of television news coverage was devoted to the announcement of the official federal guidelines by the Secretary of Health and Human Services in late February. We conclude by discussing how the flow of news coverage of medical controversies can potentially impact the actions and reactions of the public, the medical community and health policy makers.

  16. Survey of mammography practices

    Energy Technology Data Exchange (ETDEWEB)

    Bassett, L.W.; Diamond, J.J.; Gold, R.H.; McLelland, R.

    1987-12-01

    Of the 319 radiologists who responded to a survey concerning mammography practices, 50% were employed in a private hospital and 26% in a private office. Film-screen mammography was used most often (54%) followed by xeromammography (30%) and a combination of film-screen and xeromammography (16%). Of the respondents, 62% had changed their method of performing mammography in the last 10 years. Of these, 50% had switched from xeromammography to film-screen, 23% from direct film to film-screen, 15% from direct film to xeromammography, and 6% from film-screen to xeromammography. Mammographic equipment had been purchased by 71% of respondents after 1983. Most respondents (71%) monitored mammography equipment doses, usually at 6- to 12-month intervals. Manual breast examinations were done at the time of mammography at 42% of the facilities, and breast self-examination was taught at 32%. For screening, 87.4% used a two-view examination, 92% required the name of a referring physician to whom the report could be sent, 28% accepted self-referred patients, and only 12% charged a reduced fee for screening. Breast sonography was performed by 53% (93% hand-held vs 7% automated), but none used sonography for screening. Only one respondent reported using thermography; three used light scanning. A need for postgraduate mammography courses for radiologists was indicated by 81%, while 69% recommended technologist courses and 64% recommended 1-week fellowships for radiologists.

  17. First epidemiological analysis of breast cancer incidence and tumor characteristics after implementation of population-based digital mammography screening

    Energy Technology Data Exchange (ETDEWEB)

    Weigel, Stefanie; Heindel, Walter [Inst. fuer Klinische Radiologie und Referenzzentrum Mammographie Muenster, Universitaetsklinikum Muenster (Germany); Batzler, W.U. [Epidemiologisches Krebsregister, NRW (Germany); Decker, T. [Gerhard-Domagk-Inst. fuer Pathologie und Brust-Screening-Referenzpathologie, Universitaetsklinikum Muenster (Germany); Hense, H.W. [Inst. fuer Epidemiologie und Sozialmedizin, Univ. Muenster (Germany)

    2009-12-15

    Purpose: to epidemiologically evaluate the impact of digital mammography screening on incidence rates and tumor characteristics for breast cancer. Materials and methods: the first German digital screening units in the clinical routine were evaluated during the implementation period by using data from the cancer registry to compare the incidence rate of breast cancers and prognostic characteristics. 74% of women aged 50-69 within the region of Muenster/Coesfeld/Warendorf were invited between 10/2005 and 12/2007 for initial screening; 55% participated (n = 35961). Results: in 2002-2004 the average breast cancer incidence rate (per 100000) was 297.9. During the implementation of screening, the rate rose to 532.9 in 2007. Of the 349 cancers detected with screening, 76% (265/349) were invasive compared to 90% (546/608) of cases not detected with screening during the same period. 37% (97/265) of cancers detected in the screening program had a diameter of {<=} 10 mm and 75% (198/265) were node-negative compared to 15% (79/546) and 64% (322/503), respectively, in cancers detected outside the screening program. The distribution of invasive tumor size (pT categories) and the nodal status differed with statistical significance between cancers detected in and outside the program (p = 0.005 and p = 0.004, respectively). (orig.)

  18. Mammography Screening Among African-American Women With a Family History of Breast Cancer

    Science.gov (United States)

    1999-02-01

    gestalt that emerged was that women’s evaluations of mammography increased, and these results were not due to any differential component of the...transtheoretical approach: Crossing traditional boundaries of therapy . Chicago: Dow Jones/Irwin. 17. Prochaska, J.O., & DiClemente, C.C. (1983). Stages

  19. Mammography Screening in a Large Health System Following the U.S. Preventive Services Task Force Recommendations and the Affordable Care Act.

    Science.gov (United States)

    Nelson, Heidi D; Weerasinghe, Roshanthi; Wang, Lian; Grunkemeier, Gary

    2015-01-01

    Practice recommendations for mammography screening were issued by the U.S. Preventive Services Task Force in 2009 and expansion of insurance coverage was provided under the Patient Protection and Affordable Care Act soon thereafter, yet the influence of these changes on screening practices in the United States is not known. To determine changes in mammography screening and their associations with new practice recommendations and the Affordable Care Act, we examined patient-level data from 249,803 screening mammograms from January 1, 2008 through December 31, 2012 in a large community-based health system in the northwestern United States. Associations were determined by an intervention analysis of time-series data method. Among women screened, 64% were age 50-74 years; 84% self-identified as white race; 62% had commercial insurance; and 70% were seen in facilities located in metropolitan areas. Practice recommendations were associated with decreased screening volumes among women age Act was associated with increased screening among women age 50-74 (+184.3 mammograms/month; +7.2% change; P=0.001), but not women Act was associated with increased screening for women with Medicare, Medicaid, or other noncommercial sources of payment. Mammography screening volumes in a large community health system decreased among women age Act were associated with increased screening volumes among women age 50-74.

  20. Breast density as indicator for the use of mammography or MRI to screen women with familial risk for breast cancer (FaMRIsc: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Saadatmand Sepideh

    2012-10-01

    Full Text Available Abstract Background To reduce mortality, women with a family history of breast cancer often start mammography screening at a younger age than the general population. Breast density is high in over 50% of women younger than 50 years. With high breast density, breast cancer incidence increases, but sensitivity of mammography decreases. Therefore, mammography might not be the optimal method for breast cancer screening in young women. Adding MRI increases sensitivity, but also the risk of false-positive results. The limitation of all previous MRI screening studies is that they do not contain a comparison group; all participants received both MRI and mammography. Therefore, we cannot empirically assess in which stage tumours would have been detected by either test. The aim of the Familial MRI Screening Study (FaMRIsc is to compare the efficacy of MRI screening to mammography for women with a familial risk. Furthermore, we will assess the influence of breast density. Methods/Design This Dutch multicentre, randomized controlled trial, with balanced randomisation (1:1 has a parallel grouped design. Women with a cumulative lifetime risk for breast cancer due to their family history of ≥20%, aged 30–55 years are eligible. Identified BRCA1/2 mutation carriers or women with 50% risk of carrying a mutation are excluded. Group 1 receives yearly mammography and clinical breast examination (n = 1000, and group 2 yearly MRI and clinical breast examination, and mammography biennially (n = 1000. Primary endpoints are the number and stage of the detected breast cancers in each arm. Secondary endpoints are the number of false-positive results in both screening arms. Furthermore, sensitivity and positive predictive value of both screening strategies will be assessed. Cost-effectiveness of both strategies will be assessed. Analyses will also be performed with mammographic density as stratification factor. Discussion Personalized breast cancer screening

  1. Direct Interactive Public Education by Breast Radiologists About Screening Mammography: Impact on Anxiety and Empowerment.

    Science.gov (United States)

    Lee, Jiyon; Hardesty, Lara A; Kunzler, Nathan M; Rosenkrantz, Andrew B

    2016-11-01

    Anxiety has been called a "harm" of screening mammography. The authors provided direct, interactive education to lay audiences and measured these sessions' impact on anxiety and any increased understanding of breast cancer screening. Academic breast radiologist provided seven 1-hour sessions of structured lectures and question-and-answer periods. Lay language and radiologic images were used to discuss disease background, screening guidelines, and areas of debate. One hundred seventeen participants (mean age, 45 ± 15 years) completed voluntary, anonymous, institutional review board-approved pre and postsession questionnaires relaying their attitudes regarding screening and the impact of the sessions. Results are summarized descriptively. Mean reported anxiety regarding screening (on a scale ranging from 1-5; 1 = no anxiety) was 2.5 ± 1.3. Anxiety was attributed to unknown results (56.4%), anticipation of pain (21.8%), known risk factors (14.5%), general uncertainty (12.7%), waiting for results (9.1%), possibility of more procedures (3.6%), and personal breast cancer history (3.6%). Ninety-seven percent reported that immediate results would lower anxiety (78% of those women indicated a 75%-100% decrease in anxiety); 93% reported that radiologist consultation with images would lower anxiety (75.6% indicated a 75%-100% decrease in anxiety). After the lecture, women reported (on a scale ranging from 1-5) increased understanding of the topic (4.7 ± 0.6), encouragement to screen (4.6 ± 0.7), and reduced anxiety (4.0 ± 1.1). Ninety-seven percent to 100% provided correct responses to these questions: rationale for screening in the absence of family history, recall does not equate to cancer diagnosis, benefit of prior films, and continued importance of physical examination. Attendees of radiologist-provided direct public lectures reported decreased anxiety and improved knowledge regarding screening mammography. The resultant reduced anxiety ("harm") and educational

  2. Retrospective analysis on malignant calcification previously misdiagnosed as benign on screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Su Min [Dept. of Radiology, Research Institute of Radiology, Chung Ang University Hospital, Seoul(Korea, Republic of); Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young; Choi, Woo Jung [Dept. of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    The purpose of our study was to investigate the morphology and distribution of calcifications initially interpreted as benign or probably benign, but proven to be malignant by subsequent stereotactic biopsy, and to identify the reason for misinterpretation or underestimation at the initial diagnosis. Out of 567 women who underwent stereotactic biopsy for calcifications at our hospital between January 2012 and December 2014, 167 women were diagnosed with malignancy. Forty-six of these 167 women had previous mammography assessed as benign or probably benign which was changed to suspicious malignancy on follow-up mammography. Of these 46 women, three women with biopsy-proven benign calcifications at the site of subsequent cancer were excluded, and 43 patients were finally included. The calcifications (morphology, distribution, extent, associated findings) in the previous and follow-up mammography examinations were analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and assessment category. We classified the patients into two groups: 1) group A patients who were still retrospectively re-categorized as less than or equal to BI-RADS 3 and 2) group B patients who were re-categorized as equal to or higher than BI-RADS 4a and whose results should have prompted previous diagnostic assessment. In the follow-up mammography examinations, change in calcification morphology (n = 27, 63%) was the most frequent cause of assessment change. The most frequent previous mammographic findings of malignant calcification were amorphous morphology (n = 26, 60%) and grouped distribution (n = 36, 84%). The most frequent calcification findings at reassessment were amorphous morphology (n = 4, 9%), fine pleomorphic calcification (n = 30, 70%), grouped distribution (n = 23, 53%), and segmental calcification (n = 12, 28%). There were 33 (77%) patients in group A, and 10 patients (23%) in group B. Amorphous morphology and grouped distribution were the most frequent

  3. Breast density as indicator for the use of mammography or MRI to screen women with familial risk for breast cancer (FaMRIsc) : a multicentre randomized controlled trial

    NARCIS (Netherlands)

    Saadatmand, Sepideh; Rutgers, Emiel J. T.; Tollenaar, Rob A. E. M.; Zonderland, Hermien M.; Ausems, Margreet G. E. M.; Keymeulen, Kristien B. M. I.; Schlooz-Vries, Margreet S.; Koppert, Linetta B.; Heijnsdijk, Eveline A. M.; Seynaeve, Caroline; Verhoef, Cees; Oosterwijk, Jan C.; Obdeijn, Inge-Marie; de Koning, Harry J.; Tilanus-Linthorst, Madeleine M. A.

    2012-01-01

    Background: To reduce mortality, women with a family history of breast cancer often start mammography screening at a younger age than the general population. Breast density is high in over 50% of women younger than 50 years. With high breast density, breast cancer incidence increases, but sensitivit

  4. Why did the breast cancer lymph node status distribution improve in Denmark in the pre-mammography screening period of 1978-1994?

    DEFF Research Database (Denmark)

    Rostgaard, K.; Vaeth, M.; Rootzen, Helle;

    2010-01-01

    Background. Danish breast cancer patients diagnosed in 1978-1994 experienced a trend over time towards a more favourable distribution of lymph node status at time of diagnosis, which was not due to mammography screening. We investigated how this trend could be explained by patient characteristics...

  5. Design of linear anti-scatter grid geometry with optimum performance for screen-film and digital mammography systems.

    Science.gov (United States)

    Khodajou-Chokami, H; Sohrabpour, M

    2015-08-01

    A detailed 3D Monte Carlo simulation of the grid geometrical parameters in screen-film mammography (SFM) and digital mammography (DM) systems has been performed. A combination of IEC 60627:2013 international standard conditions and other more clinically relevant parameters were used for this simulation. Accuracy of our results has been benchmarked with previously published data and good agreement has been obtained. Calculations in a wide range of linear anti-scatter grid geometries have been carried out. The evaluated parameters for the SFM system were the Bucky factor (BF) and contrast improvement factor (CIF) and for the DM system it was signal difference-to-noise ratio improvement factor (SIF). The CIF parameter was chosen to be nearly the same as the commercial grade, the BF and SIF were significantly improved compared to commercial grids in use today. Our optimized grid parameters for the SFM system were lead strip thickness d = 12 µm, grid ratio r = 5 and strip density N = 65 lines/cm. And for the DM system these parameters were d = 5 µm, r = 3 and N = 100 lines/cm. Both optimized grid sets have thinner d and higher N compared to the commercial grids.

  6. Differences in Patient Screening Mammography Rates Associated With Internist Gender and Level of Training and Change Following the 2009 U.S. Preventive Services Task Force Guidelines.

    Science.gov (United States)

    Brooks, Dawn J

    2016-06-01

    Significant discordance arose between screening mammography clinical practice guidelines published by different national health care organizations following the release of the U.S. Preventive Services Task Force (USPSTF) guidelines in 2009. This allowed for greater interprovider variation in clinical practice while remaining within standard of care. The objective of this study was to determine how differences in patient screening mammography rates between internal medicine physician subgroups defined by gender and level of training changed, if at all, following the release of the new guidelines. The study was an observational study including all internists and internal medicine residents at a single academic medical center, Dartmouth-Hitchcock Medical Center. Screening mammography rates were determined for patients of subgroups of internists defined by gender and level of training (attending vs resident physician) for the 2 years before and after the release of the updated screening guidelines. Patients having female attending internists as their primary care provider were more likely to undergo screening mammography than those having male attending or resident internists of either gender both before and after the release of the new guidelines, with the difference in patient screening mammography rates between physician subgroups increasing following their release (rates before and after, respectively, by subgroup: female attending = 67%, 64%; male attending = 56%, 50%; female resident = 58%, 41%; male resident = 55%, 41%; PInternist gender and level of training are associated with differences in patient screening mammography rates at one academic medical center, with these differences increasing following the 2009 USPSTF guidelines. These findings suggest that the correlation between provider gender/level of training and a woman's likelihood of undergoing a screening mammogram strengthened as discordance arose between clinical guidelines published by different

  7. A novel case-control design to estimate the extent of over-diagnosis of breast cancer due to organised population-based mammography screening.

    Science.gov (United States)

    Beckmann, Kerri R; Lynch, John W; Hiller, Janet E; Farshid, Gelareh; Houssami, Nehmat; Duffy, Stephen W; Roder, David M

    2015-03-15

    Debate about the extent of breast cancer over-diagnosis due to mammography screening has continued for over a decade, without consensus. Estimates range from 0 to 54%, but many studies have been criticized for having flawed methodology. In this study we used a novel study design to estimate over-diagnosis due to organised mammography screening in South Australia (SA). To estimate breast cancer incidence at and following screening we used a population-based, age-matched case-control design involving 4,931 breast cancer cases and 22,914 controls to obtain OR for yearly time intervals since women's last screening mammogram. The level of over-diagnosis was estimated by comparing the cumulative breast cancer incidence with and without screening. The former was derived by applying ORs for each time window to incidence rates in the absence of screening, and the latter, by projecting pre-screening incidence rates. Sensitivity analyses were undertaken to assess potential biases. Over-diagnosis was estimated to be 8% (95%CI 2-14%) and 14% (95%CI 8-19%) among SA women aged 45 to 85 years from 2006-2010, for invasive breast cancer and all breast cancer respectively. These estimates were robust when applying various sensitivity analyses, except for adjustment for potential confounding assuming higher risk among screened than non-screened women, which reduced levels of over-diagnosis to 1% (95%CI 5-7%) and 8% (95%CI 2-14%) respectively when incidence rates for screening participants were adjusted by 10%. Our results indicate that the level of over-diagnosis due to mammography screening is modest and considerably lower than many previous estimates, including others for Australia.

  8. Impact of the digitalisation of mammography on performance parameters and breast dose in the Flemish Breast Cancer Screening Programme

    Energy Technology Data Exchange (ETDEWEB)

    Timmermans, Lore; Hauwere, An de; Bacher, Klaus; Thierens, Hubert [Ghent University, Department of Basic Medical Sciences, QCC-Gent, Ghent (Belgium); Bosmans, Hilde; Lemmens, Kim; Steen, Andre van [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Bleyen, Luc; Mortier, Griet; Herck, Koen van [Ghent University, Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Ghent (Belgium); Limbergen, Erik van [Leuvens Universitair Centrum voor Kankerpreventie, Leuven (Belgium); Martens, Patrick [Vroegtijdige Opsporing van Borstklierkanker vzw, Bruges (Belgium)

    2014-08-15

    To investigate the impact of digitalisation on performance parameters and breast dose of the Flemish Breast Cancer Screening Programme. Both computed (CR) and direct radiography (DR) are compared with screen-film mammography (SFM). Data from 975,673 mammographic examinations were collected from units which underwent digitalisation from SFM to CR (41 units) or DR (72 units) in the period 2005-2011. Performance indicators were obtained by consulting the Screening Programme database. Phantom and patient dosimetry data were acquired from the physical technical quality assurance of the programme. Digitalisation induced no significant change in cancer detection rate (CDR), percentage of ductal carcinomas in situ and percentage of breast cancers smaller than 1 cm. A decrease in false-positive results and third readings was observed, which was a time-related observation. After digitalisation, positive predictive value (PPV) increased and recall rates decreased. Compared with SFM, an increase of 30 % in mean glandular dose (MGD) was found for CR, while a similar change in the opposite direction was found for DR. No major differences in performance parameters after digitalisation were found. Transition of SFM to CR resulted in a higher MGD and associated lower detection-over-induction ratio (DIR), while the change to DR induced an improvement of DIR. (orig.)

  9. Interobserver agreement and performance score comparison in quality control using a breast phantom: screen-film mammography vs computed radiography.

    Science.gov (United States)

    Shimamoto, Kazuhiro; Ikeda, Mitsuru; Satake, Hiroko; Ishigaki, Satoko; Sawaki, Akiko; Ishigaki, Takeo

    2002-09-01

    Our objective was to evaluate interobserver agreement and to compare the performance score in quality control of screen-film mammography and computed radiography (CR) using a breast phantom. Eleven radiologists interpreted a breast phantom image (CIRS model X) by four viewing methods: (a) original screen-film; (b) soft-copy reading of the digitized film image; (c) hard-copy reading of CR using an imaging plate; and (d) soft-copy reading of CR. For the soft-copy reading, a 17-in. CRT monitor (1024x1536x8 bits) was used. The phantom image was evaluated using a scoring system outlined in the instruction manual, and observers judged each object using a three-point rating scale: (a) clearly seen; (b) barely seen; and (c) not seen. For statistical analysis, the kappa statistic was employed. For "mass" depiction, interobserver agreement using CR was significantly lower than when using screen-film ( pscore of "microcalcification" on CR hard-copy was significantly lower than on the other three viewing methods ( pfilm or CR, soft-copy or hard-copy) could affect how the phantom image is judged. Paying special attention to viewing conditions is recommended for quality control of CR mammograms.

  10. Application of computer-extracted breast tissue texture features in predicting false-positive recalls from screening mammography

    Science.gov (United States)

    Ray, Shonket; Choi, Jae Y.; Keller, Brad M.; Chen, Jinbo; Conant, Emily F.; Kontos, Despina

    2014-03-01

    Mammographic texture features have been shown to have value in breast cancer risk assessment. Previous models have also been developed that use computer-extracted mammographic features of breast tissue complexity to predict the risk of false-positive (FP) recall from breast cancer screening with digital mammography. This work details a novel locallyadaptive parenchymal texture analysis algorithm that identifies and extracts mammographic features of local parenchymal tissue complexity potentially relevant for false-positive biopsy prediction. This algorithm has two important aspects: (1) the adaptive nature of automatically determining an optimal number of region-of-interests (ROIs) in the image and each ROI's corresponding size based on the parenchymal tissue distribution over the whole breast region and (2) characterizing both the local and global mammographic appearances of the parenchymal tissue that could provide more discriminative information for FP biopsy risk prediction. Preliminary results show that this locallyadaptive texture analysis algorithm, in conjunction with logistic regression, can predict the likelihood of false-positive biopsy with an ROC performance value of AUC=0.92 (pclinical implications of using prediction models incorporating these texture features may include the future development of better tools and guidelines regarding personalized breast cancer screening recommendations. Further studies are warranted to prospectively validate our findings in larger screening populations and evaluate their clinical utility.

  11. Screening mammography: update and review of publications since our report in the New England Journal of Medicine on the magnitude of the problem in the United States.

    Science.gov (United States)

    Bleyer, Archie

    2015-08-01

    After a half century of clinical trials, expansive observations, vigorous advocacy and debate, screening mammography could not be in a more controversial condition, especially the potential harm of overdiagnosis. Despite a simple rationale (catch the cancer early and either prevent death or at least decrease the amount of therapy needed for cure), the estimates to date of overdiagnosis rates are conflicting and the interpretations complex. Since the author's 2012 publication in the New England Journal of Medicine (NEJM), the peer-reviewed publications on overdiagnosis caused by screening mammography are reviewed and the NEJM analyses updated with three additional calendar years of results. The recent peer-reviewed medical literature on screening mammography induced overdiagnosis of breast cancer has increased exponentially, nearly 10-fold in 10 years. The average estimate of overdiagnosis is about 30%, but the range extends from 0% to 70+%. An update of the NEJM report estimates that in the US, 78,000 women and 30%-31% of those diagnosed with breast cancer at the age of 40 years or older during 2011 were overdiagnosed. Until we have better screening procedures that identify who really has cancer and needs to be treated, the risk of overdiagnosis relative to the benefit of screening merits more effective public and professional education. Radiologists, pathologists, and other professionals involved with screening mammography should recognize that the potential harm of overdiagnosis is downplayed or not discussed with the patient and family, despite agreement that the objective is informed choice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  12. Improved set of short-tandem-repeat polymorphisms for screening the human genome

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Bo; Vaske, D.; Weber, J.L. [Marshfield Medical Research Foundation, WI (United States)] [and others

    1997-02-01

    Short-tandem-repeat (microsatellite) DNA polymorphisms are widely used for screening the human and other genomes in initial linkage mapping. Since the average spacing between polymorphisms in genome screens is usually {ge}10 cM and since many thousands of human short-tandem-repeat polymorphisms (STRPs) are now available, optimal subsets of STRPs must be selected for screening. Two screening sets of STRPs for humans have been described in the literature, both of which are based primarily on dinucleotide-repeat polymorphisms. Here we describe our eighth and most recent human screening set, which is based almost entirely on trinucleotide-and tetranucleotide-repeat polymorphisms. 7 refs., 1 tab.

  13. Natural history of breast cancers detected in the Swedish mammography screening programme: a cohort study

    DEFF Research Database (Denmark)

    Zahl, Per-Henrik; Gøtzsche, Peter C; Mæhlen, Jan

    2011-01-01

    The natural history of screen-detected breast cancers is not well understood. A previous analysis of the incidence change during the introduction of the Norwegian screening programme in the late 1990s suggested that the natural history of many screen-detected invasive breast cancers is to regress...

  14. Risk of breast cancer after false-positive test results in screening mammography

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My Catarina; Risør, Louise Madeleine; Thorsted, Brian Larsen

    2012-01-01

    Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests is un...

  15. In situ and invasive carcinoma identified through an opportunistic screening mammography in asymptomatic women of Mexico City.

    Directory of Open Access Journals (Sweden)

    Nancy Reynoso-Noverón

    2013-09-01

    Full Text Available Objective. To describe the mammographic findings and carcinoma detection rate in asymptomatic women of Mexico City, that participated in an opportunistic screening program. Materials and methods. 39 491 participants were included, with mammograms performed and interpreted in the National Cancer Institute, from 2008 to 2011. The mammographic findings, type of lesion and true positives (TP, are described by age groups. We calculated the crude effect of age on the classification BIRADS (Breast Imaging Reporting and Data System 0 and the type of lesion. Results. The median age was 50 (45-57 years. 80.5% were classified as BIRADS 2, 11.4%(0, 4.1%(1, 3.5%(3, 0.5%(4 y 0.1%(5. Malignant lesions were detected in 1.3 and 3.3 per 1000 and the proportion of true positives (TP was 8.2% and 20.6%, in women of 41-50 and 51-70 years, respectively. Conclusions. Although some cases are detected in women 40 to 50 years, in women over 50 years the screening by mammography is more efficient, with a higher proportion of cases detected and fewer false positives.

  16. Is computer aided detection (CAD) cost effective in screening mammography? A model based on the CADET II study

    Science.gov (United States)

    2011-01-01

    Background Single reading with computer aided detection (CAD) is an alternative to double reading for detecting cancer in screening mammograms. The aim of this study is to investigate whether the use of a single reader with CAD is more cost-effective than double reading. Methods Based on data from the CADET II study, the cost-effectiveness of single reading with CAD versus double reading was measured in terms of cost per cancer detected. Cost (Pound (£), year 2007/08) of single reading with CAD versus double reading was estimated assuming a health and social service perspective and a 7 year time horizon. As the equipment cost varies according to the unit size a separate analysis was conducted for high, average and low volume screening units. One-way sensitivity analyses were performed by varying the reading time, equipment and assessment cost, recall rate and reader qualification. Results CAD is cost increasing for all sizes of screening unit. The introduction of CAD is cost-increasing compared to double reading because the cost of CAD equipment, staff training and the higher assessment cost associated with CAD are greater than the saving in reading costs. The introduction of single reading with CAD, in place of double reading, would produce an additional cost of £227 and £253 per 1,000 women screened in high and average volume units respectively. In low volume screening units, the high cost of purchasing the equipment will results in an additional cost of £590 per 1,000 women screened. One-way sensitivity analysis showed that the factors having the greatest effect on the cost-effectiveness of CAD with single reading compared with double reading were the reading time and the reader's professional qualification (radiologist versus advanced practitioner). Conclusions Without improvements in CAD effectiveness (e.g. a decrease in the recall rate) CAD is unlikely to be a cost effective alternative to double reading for mammography screening in UK. This study

  17. Is computer aided detection (CAD cost effective in screening mammography? A model based on the CADET II study

    Directory of Open Access Journals (Sweden)

    Wallis Matthew G

    2011-01-01

    Full Text Available Abstract Background Single reading with computer aided detection (CAD is an alternative to double reading for detecting cancer in screening mammograms. The aim of this study is to investigate whether the use of a single reader with CAD is more cost-effective than double reading. Methods Based on data from the CADET II study, the cost-effectiveness of single reading with CAD versus double reading was measured in terms of cost per cancer detected. Cost (Pound (£, year 2007/08 of single reading with CAD versus double reading was estimated assuming a health and social service perspective and a 7 year time horizon. As the equipment cost varies according to the unit size a separate analysis was conducted for high, average and low volume screening units. One-way sensitivity analyses were performed by varying the reading time, equipment and assessment cost, recall rate and reader qualification. Results CAD is cost increasing for all sizes of screening unit. The introduction of CAD is cost-increasing compared to double reading because the cost of CAD equipment, staff training and the higher assessment cost associated with CAD are greater than the saving in reading costs. The introduction of single reading with CAD, in place of double reading, would produce an additional cost of £227 and £253 per 1,000 women screened in high and average volume units respectively. In low volume screening units, the high cost of purchasing the equipment will results in an additional cost of £590 per 1,000 women screened. One-way sensitivity analysis showed that the factors having the greatest effect on the cost-effectiveness of CAD with single reading compared with double reading were the reading time and the reader's professional qualification (radiologist versus advanced practitioner. Conclusions Without improvements in CAD effectiveness (e.g. a decrease in the recall rate CAD is unlikely to be a cost effective alternative to double reading for mammography screening

  18. Pain and discomfort during mammography

    DEFF Research Database (Denmark)

    Aro, A R; Absetz-Ylöstalo, P; Eerola, T

    1996-01-01

    The aim of this prospective study was to investigate associations of mammography pain and discomfort with sociodemographics, personal history and psychological and situational factors. Subjects were women with a negative screening finding (n = 883) from a random sample of 50-year-old Finnish women...... was the most powerful factor explaining pain and discomfort among women with earlier mammography. However, it had no effect among women without earlier mammography, for whom screening-related nervousness and perceptions of staff were crucial. Suggested interventions include better information before screening...

  19. An observer study for a computer-aided reading protocol (CARP) in the screening environment for digital mammography.

    Science.gov (United States)

    Moin, Paymann; Deshpande, Ruchi; Sayre, Jim; Messer, Ellen; Gupte, Sangeeta; Romsdahl, Harlan; Hasegawa, Akira; Liu, Brent J

    2011-11-01

    The aims of this study were to investigate improving work flow efficiency by shortening the reading time of digital mammograms using a computer-aided reading protocol (CARP) in the screening environment and to increase detection sensitivity using CARP, compared to the current protocol, commonly referred to as the quadrant view (QV). A total of 200 cases were selected for a receiver-operating characteristic (ROC) study to evaluate two image display work flows, CARP and QV, in the screening environment. A Web-based tool was developed for scoring, reporting, and statistical analysis. Cases were scored for and stratified by difficulty. A total of six radiologists of differing levels of training ranging from dedicated mammographers to senior radiology residents participated. Each was timed while interpreting the 200 cases in groups of 50, first using QV and then, after a washout period, using CARP. The data were analyzed using ROC and κ analysis. Interpretation times were also assessed. Using QV, readers' average area under the ROC curve was 0.68 (range, 0.54-0.73). Using CARP, readers' average area under the ROC curve was 0.71 (range, 0.66-0.75). There was no statistically significant difference in reader performance using either work flow. However, there was a statistically significant reduction in the average interpretation time of negative cases from 64.7 seconds using QV to 58.8 seconds using CARP. CARP determines the display order of regions of interest depending on computer-aided detection findings. This is a variation of traditional computer-aided detection for digital mammography that has the potential to reduce interpretation times of studies with negative findings without significantly affecting sensitivity, thus allowing improved work flow efficiency in the screening environment, in which, in most settings, the majority of cases are negative. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

  20. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands.

    NARCIS (Netherlands)

    Fracheboud, J.; Otto, S.J.; Dijck, J.A.A.M. van; Broeders, M.J.M.; Verbeek, A.L.M.; Koning, H.J. de

    2004-01-01

    The effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Netherlands Can

  1. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

    NARCIS (Netherlands)

    J. Fracheboud (Jacques); S.J. Otto (Suzie); J.A.A.M. van Dijck; M.J.M. Broeders (Mireille); A.L.M. Verbeek (Andre); H.J. de Koning (Harry)

    2004-01-01

    textabstractThe effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Net

  2. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

    NARCIS (Netherlands)

    J. Fracheboud (Jacques); S.J. Otto (Suzie); J.A.A.M. van Dijck; M.J.M. Broeders (Mireille); A.L.M. Verbeek (Andre); H.J. de Koning (Harry)

    2004-01-01

    textabstractThe effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The

  3. Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: a prospected population based study in the south of The Netherlands

    NARCIS (Netherlands)

    Klompenhouwer, E.G.; Voogd, A.C.; Heeten, GJ. den; Strobbe, L.J.A.; Haan, A.F.J. de; Wauters, C.A.; Broeders, M.J.; Duijm, L.E.M.

    2015-01-01

    PURPOSE: To prospectively determine the screening mammography outcome at blinded and non-blinded double reading in a biennial population based screening programme in the south of the Netherlands. METHODS: We included a consecutive series of 87,487 digital screening mammograms, obtained between July

  4. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  5. Does the Neighborhood Area of Residence Influence Non-Attendance in an Urban Mammography Screening Program? A Multilevel Study in a Swedish City

    Science.gov (United States)

    Lagerlund, Magdalena; Merlo, Juan; Vicente, Raquel Pérez; Zackrisson, Sophia

    2015-01-01

    Background and aim The public health impact of population-based mammography screening programs depends on high participation rates. Thus, monitoring participation rates, as well as understanding and considering the factors influencing attendance, is important. With the goal to acquire information on the appropriate level of intervention for increasing screening participation our study aimed to (1) examine whether, over and above individual factors, the neighborhood of residence influences a woman’s mammography non-attendance, and (2) evaluate, whether knowing a woman’s neighborhood of residence would be sufficient to predict non-attendance. Methods We analyze all women invited to mammography screening in 2005–09, residing in the city of Malmö, Sweden. Information regarding mammography screening attendance was linked to data on area of residence, demographic and socioeconomic characteristics available from Statistics Sweden. The influence of individual and neighborhood factors was assessed by multilevel logistic regression analysis with 29,901 women nested within 212 neighborhoods. Results The prevalence of non-attendance among women was 18.3%. After adjusting for individual characteristics, the prevalence in the 212 neighborhoods was 3.6%. Neighborhood of residence had little influence on non-attendance. The multilevel analysis indicates that 8.4% of the total individual differences in the propensity of non-attendance were at the neighborhood level. However, when adjusting for specific individual characteristics this general contextual effect decreased to 1.8%. This minor effect was explained by the sociodemographic characteristic of the neighborhoods. The discriminatory accuracy of classifying women according to their non-attendance was 0.747 when considering only individual level variables, and 0.760 after including neighborhood level as a random effect. Conclusion Our results suggest that neighborhoods of residence in Malmö, Sweden (as defined by small

  6. Level and distribution of the radiation dose to the population from a mammography screening programme in New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Bulling, S.M.; Nicoll, J.J. [Otago Univ., Dunedin (New Zealand). Dept. of Physics

    1995-12-31

    The Otago Southland Breast Screening Programme offers biennial mammography to 19,000 eligible women on the South Island of New Zealand. A Quality Assurance programme ensures that international performance standards are met, in particular the radiation dose for a mammogram of 5 cm CIRS-X phantom is 1.7 mGy and careful retake analysis undertaken. This however does not reveal the absorbed dose received by individuals, nor how this varies between individuals. Machine parameters and compressed breast thickness for each film were recorded for 310 women who attended one centre during the three months ending February 1993 and absorbed doses calculated using Monte Carlo data. The mean compressed breast thickness for the 310 women was 4.9 cm, doses received for individual films ranged from 0.7 to 8.5 mGy while patient total doses were in the range 4 to 29 mGy with 75% of women receiving a dose of 7.1 mGy or less. (Author).

  7. A cross sectional study on the motivators for Asian women to attend opportunistic mammography screening in a private hospital in Malaysia: the MyMammo study.

    Science.gov (United States)

    Hassan, Norhashimah; Ho, Weang Kee; Mariapun, Shivaani; Teo, Soo Hwang

    2015-06-12

    To date, because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening. However, there have been few studies which have assessed the motivators for women attending such programmes and the appropriateness of the programmes in terms of targeting women at risk. We conducted a prospective cross-sectional study of 1,619 women aged 40 to 74 years attending a subsidized opportunistic screening mammogram from October 2011 to October 2013 at a private hospital in Malaysia. Breast cancer risk was estimated using the Gail Model and two-step cluster analysis was used to examine the motivators of attending screening. Although Malaysia comprises 54.5% Malay, 24.5% Chinese and 7.3% Indian, the majority of women in the MyMammo Study were Chinese (70.1%) and 99.2% had a educated women, cited doctors, family and friends as their main motivators. Of those with only secondary school education, their main motivators were doctors. Taken together, our results suggest the women attending opportunistic mammography screening in Asia are at low risk of breast cancer and this poses challenges to cost-effective and equitable strategies for cancer control. We propose that to improve uptake of screening mammography, awareness programmes should target both doctors and members of the public.

  8. Applying the Fuzzy Delphi Method for determining socio-ecological factors that influence adherence to mammography screening in rural areas of Mexico.

    Science.gov (United States)

    Sánchez-Lezama, Ana Paola; Cavazos-Arroyo, Judith; Albavera-Hernández, Cidronio

    2014-02-01

    In Mexico, regular participation in mammography screening is low, despite higher survival rates. The objective of our research is to highlight healthcare procedures to be optimized and target areas to encourage investment and to raise awareness about the benefits of early diagnosis. Those socio-ecological factors (community, interpersonal and individual) were collected through a review of literature and based on the spatial interaction model of mammography use developed by Mobley et al. The opinion of diverse groups of experts on the importance of those factors was collected by survey. The Fuzzy Delphi Method helped to solve the inherent uncertainty of the survey process. Our findings suggest that population health behaviors, proximity-density to facilities/ physicians and predisposing factors are needed to increase the screening rate. Variations in expert group size could affect the accuracy of the conclusions. However, the application of the enhanced aggregation method provided a group consensus that is less susceptible to misinterpretation and that weighs the opinion of each expert according to their clinical experience in mammography research.

  9. Gold silver alloy nanoparticles (GSAN): an imaging probe for breast cancer screening with dual-energy mammography or computed tomography

    Science.gov (United States)

    Naha, Pratap C.; Lau, Kristen C.; Hsu, Jessica C.; Hajfathalian, Maryam; Mian, Shaameen; Chhour, Peter; Uppuluri, Lahari; McDonald, Elizabeth S.; Maidment, Andrew D. A.; Cormode, David P.

    2016-07-01

    Earlier detection of breast cancer reduces mortality from this disease. As a result, the development of better screening techniques is a topic of intense interest. Contrast-enhanced dual-energy mammography (DEM) is a novel technique that has improved sensitivity for cancer detection. However, the development of contrast agents for this technique is in its infancy. We herein report gold-silver alloy nanoparticles (GSAN) that have potent DEM contrast properties and improved biocompatibility. GSAN formulations containing a range of gold : silver ratios and capped with m-PEG were synthesized and characterized using various analytical methods. DEM and computed tomography (CT) phantom imaging showed that GSAN produced robust contrast that was comparable to silver alone. Cell viability, reactive oxygen species generation and DNA damage results revealed that the formulations with 30% or higher gold content are cytocompatible to Hep G2 and J774A.1 cells. In vivo imaging was performed in mice with and without breast tumors. The results showed that GSAN produce strong DEM and CT contrast and accumulated in tumors. Furthermore, both in vivo imaging and ex vivo analysis indicated the excretion of GSAN via both urine and feces. In summary, GSAN produce strong DEM and CT contrast, and has potential for both blood pool imaging and for breast cancer screening.Earlier detection of breast cancer reduces mortality from this disease. As a result, the development of better screening techniques is a topic of intense interest. Contrast-enhanced dual-energy mammography (DEM) is a novel technique that has improved sensitivity for cancer detection. However, the development of contrast agents for this technique is in its infancy. We herein report gold-silver alloy nanoparticles (GSAN) that have potent DEM contrast properties and improved biocompatibility. GSAN formulations containing a range of gold : silver ratios and capped with m-PEG were synthesized and characterized using various

  10. Comparison of standard reading and computer aided detection (CAD) on a national proficiency test of screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Ciatto, Stefano E-mail: s.ciatto@cspo.it; Del Turco, Marco Rosselli; Risso, Gabriella; Catarzi, Sandra; Bonardi, Rita; Viterbo, Valeria; Gnutti, Pierangela; Guglielmoni, Barbara; Pinelli, Lelio; Pandiscia, Anna; Navarra, Francesco; Lauria, Adele; Palmiero, Rosa; Indovina, Pietro Luigi

    2003-02-01

    Objective: To evaluate the role of computer aided detection (CAD) in improving the interpretation of screening mammograms Material and methods: Ten radiologists underwent a proficiency test of screening mammography first by conventional reading and then with the help of CAD. Radiologists were blinded to test results for the whole study duration. Results of conventional and CAD reading were compared in terms of sensitivity and recall rate. Double reading was simulated combining conventional readings of four expert radiologists and compared with CAD reading. Results: Considering all ten readings, cancer was identified in 146 or 153 of 170 cases (85.8 vs. 90.0%; {chi}{sup 2}=0.99, df=1, P=0.31) and recalls were 106 or 152 of 1330 cases (7.9 vs. 11.4%; {chi}{sup 2}=8.69, df=1, P=0.003) at conventional or CAD reading, respectively. CAD reading was essentially the same (sensitivity 97.0 vs. 96.0%; {chi}{sup 2}=7.1, df=1, P=0.93; recall rate 10.7 vs. 10.6%; {chi}{sup 2}=1.5, df=1, P=0.96) as compared with simulated conventional double reading. Conclusion: CAD reading seems to improve the sensitivity of conventional reading while reducing specificity, both effects being of limited size. CAD reading had almost the same performance of simulated conventional double reading, suggesting a possible use of CAD which needs to be confirmed by further studies inclusive of cost-effective analysis.

  11. Cancer screening with digital mammography for women at average risk for breast cancer, magnetic resonance imaging (MRI) for women at high risk: an evidence-based analysis.

    Science.gov (United States)

    2010-01-01

    The purpose of this review is to determine the effectiveness of 2 separate modalities, digital mammography (DM) and magnetic resonance imaging (MRI), relative to film mammography (FM), in the screening of women asymptomatic for breast cancer. A third analysis assesses the effectiveness and safety of the combination of MRI plus mammography (MRI plus FM) in screening of women at high risk. An economic analysis was also conducted. How does the sensitivity and specificity of DM compare to FM?How does the sensitivity and specificity of MRI compare to FM?How do the recall rates compare among these screening modalities, and what effect might this have on radiation exposure? What are the risks associated with radiation exposure?How does the sensitivity and specificity of the combination of MRI plus FM compare to either MRI or FM alone?What are the economic considerations? The effectiveness of FM with respect to breast cancer mortality in the screening of asymptomatic average- risk women over the age of 50 has been established. However, based on a Medical Advisory Secretariat review completed in March 2006, screening is not recommended for women between the ages of 40 and 49 years. Guidelines published by the Canadian Task Force on Preventive Care recommend mammography screening every 1 to 2 years for women aged 50 years and over, hence, the inclusion of such women in organized breast cancer screening programs. In addition to the uncertainty of the effectiveness of mammography screening from the age of 40 years, there is concern over the risks associated with mammographic screening for the 10 years between the ages of 40 and 49 years. The lack of effectiveness of mammography screening starting at the age of 40 years (with respect to breast cancer mortality) is based on the assumption that the ability to detect cancer decreases with increased breast tissue density. As breast density is highest in the premenopausal years (approximately 23% of postmenopausal and 53% of

  12. BMI and breast cancer prognosis benefit: mammography screening reveals differences between normal weight and overweight women.

    Science.gov (United States)

    Crispo, Anna; Grimaldi, Maria; D'Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Amore, Alfonso; D'Aiuto, Giuseppe; Giudice, Aldo; Ciliberto, Gennaro; Montella, Maurizio

    2015-02-01

    Few studies are available on the potential impact of body weight on breast cancer prognosis in screen-detected patients. Moreover, it is not known whether body mass index (BMI) could have a different prognostic impact in screen-detected versus symptomatic breast cancer patients. To investigate these unsolved issues, we carried out a retrospective study evaluating the effect of BMI on breast cancer prognosis in screen-detected vs symptomatic breast cancer patients. We conducted a follow-up study on 448 women diagnosed with incident, histologically-confirmed breast cancer. Patients were categorized according to their BMI as normal weight, overweight and obese. Disease free survival (DFS), overall survival (OS), and BMI curves were compared according to mode of cancer detection. Among screen-detected patients, higher BMI was associated with a significant lower DFS, whereas no significant difference was observed among symptomatic patients. OS showed similar results. In the multivariate analysis adjusting for age, education, tumor size, nodal status, estrogen receptor (ER), progesterone receptor (PR) and menopausal status, the risk for high level of BMI among screen-detected patients did not reach the statistical significance for either recurrence or survival. Our study highlights the potential impact of high bodyweight in breast cancer prognosis, the findings confirm that obesity plays a role in women breast cancer prognosis independently from diagnosis mode. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Prospective trial comparing full-field digital mammography (FFDM) versus combined FFDM and tomosynthesis in a population-based screening programme using independent double reading with arbitration.

    Science.gov (United States)

    Skaane, Per; Bandos, Andriy I; Gullien, Randi; Eben, Ellen B; Ekseth, Ulrika; Haakenaasen, Unni; Izadi, Mina; Jebsen, Ingvild N; Jahr, Gunnar; Krager, Mona; Hofvind, Solveig

    2013-08-01

    To compare double readings when interpreting full field digital mammography (2D) and tomosynthesis (3D) during mammographic screening. A prospective, Ethical Committee approved screening study is underway. During the first year 12,621 consenting women underwent both 2D and 3D imaging. Each examination was independently interpreted by four radiologists under four reading modes: Arm A-2D; Arm B-2D + CAD; Arm C-2D + 3D; Arm D-synthesised 2D + 3D. Examinations with a positive score by at least one reader were discussed at an arbitration meeting before a final management decision. Paired double reading of 2D (Arm A + B) and 2D + 3D (Arm C + D) were analysed. Performance measures were compared using generalised linear mixed models, accounting for inter-reader performance heterogeneity (P reading radiologists detected 27 additional invasive cancers (P reading of 2D + 3D significantly improves the cancer detection rate in mammography screening. • Tomosynthesis-based screening was successfully implemented in a large prospective screening trial. • Double reading of tomosynthesis-based examinations significantly reduced false-positive interpretations. • Double reading of tomosynthesis significantly increased the detection of invasive cancers.

  14. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Visser, Roelant; Schuur, Klaas H. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Veldkamp, Wouter J.H.; Bun, Petra A.M. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Centre/Mid-West, Utrecht (Netherlands); Imhof-Tas, Mechli W.; Snoeren, Miranda M.; Karssemeijer, Nico [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Heeten, Gerard J. den [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Academical Medical Center Amsterdam, Department of Radiology, Amsterdam (Netherlands); Broeders, Mireille J.M. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Epidemiology, Biostatistics and HTA, Nijmegen (Netherlands)

    2012-04-15

    To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was available twice, once processed with a tissue equalisation (TE) algorithm and once with local contrast optimisation (PV). All cases had digitised previous mammograms. For both algorithms, the probability of malignancy of each finding was scored independently by six screening radiologists. Perceived case suspiciousness was defined as the highest probability of malignancy of all findings of a radiologist within a case. Differences in diagnostic accuracy of the processing algorithms were analysed by comparing the areas under the receiver operating characteristic curves (A{sub z}). Differences in perceived case suspiciousness were analysed using sign tests. There was no significant difference in A{sub z} (TE: 0.909, PV 0.917, P = 0.46). For all radiologists, perceived case suspiciousness using PV was higher than using TE more often than vice versa (ratio: 1.14-2.12). This was significant (P <0.0083) for four radiologists. Optimisation of local contrast by image processing may increase perceived case suspiciousness, while diagnostic accuracy may remain similar. (orig.)

  15. Automatically assessed volumetric breast density and breast cancer risk : The era of digital screening mammography

    NARCIS (Netherlands)

    Wanders, J.O.P .

    2017-01-01

    Breast cancer is the most frequently diagnosed cancer among females worldwide. As the burden of breast cancer is high, many countries have introduced a breast cancer screening program with the aim to find and treat breast cancers in an early stage. In the Netherlands, women between the ages of 50

  16. Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl; Gøtzsche, Peter C

    2009-01-01

    . DATA SOURCES: PubMed (April 2007), reference lists, and authors. Review methods One author extracted data on incidence of breast cancer (including carcinoma in situ), population size, screening uptake, time periods, and age groups, which were checked independently by the other author. Linear regression...

  17. Patient doses and radiation risks in film-screen mammography in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Servomaa, A.; Parviainen, T.; Komppa, T. [Finnish Centre for Radiation and Nuclear Safety (STUK), Helsinki (Finland)

    1995-12-31

    Screen-film mamography is the most sensitive method for the early detection of breast cancer. Breast doses in mamography should be measured for several reasons, especially for the evaluation of patient risk in a screening programme, but also for the assessment and comparison of imaging techniques and equipment performance. In this study, the factors affecting patient doses were assessed by making performance and patient dose measurements; about 50 mammographic units used for screening were included in the study. The lifetime risk as a function of age at exposure was calculated using the average glandular dose, the relative risk model shown in the BEIR V report, and the breast cancer mortality in Finland. The mean surface dose of a 4.5 cm thick phantom was 6.3 mGy, and the mean glandular dose 1.0 mGy. Analysis of the surface dose with respect to film optical density, relative speed of film processing, sensitivity of image receptors, and antiscatter grid showed that the mean surface dose could be decreased by more than 50%. For the screened age group of 50 to 59 years, the risk of exposure-induced death (REID) of breast cancer is about 1.4 x 10{sup -6} mSv{sup -1}, and the average loss of life expectancy due to the radiation-induced breast cancer deaths (LLE/REID) is about 9.5 years. (Author).

  18. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography.

    NARCIS (Netherlands)

    Saslow, D.; Boetes, C.; Burke, W.; Harms, S.; Leach, M.O.; Lehman, C.D.; Morris, E.; Pisano, E.; Schnall, M.; Sener, S.; Smith, R.A.; Warner, E.; Yaffe, M.; Andrews, K.S.; Russell, C.A.

    2007-01-01

    New evidence on breast Magnetic Resonance Imaging (MRI) screening has become available since the American Cancer Society (ACS) last issued guidelines for the early detection of breast cancer in 2003. A guideline panel has reviewed this evidence and developed new recommendations for women at differen

  19. Why mammography screening has not lived up to expectations from the randomised trials

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Jørgensen, Karsten Juhl; Zahl, Per-Henrik

    2012-01-01

    We analysed the relation between tumour sizes and stages and the reported effects on breast cancer mortality with and without screening in trials and observational studies. The average tumour sizes in all the trials suggest only a 12% reduction in breast cancer mortality, which agrees with the 10...

  20. Analysis of participant factors that affect the diagnostic performance of screening mammography: A report of the alliance for breast cancer screening in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Joong [Dept. of Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of); Lee, Eu Hye [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); and others

    2017-08-01

    To analyze participant factors that affect the diagnostic performance of screening mammography. We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables. Increasing age improved recall rates (27.4% in 40's, 17.5% in 50's, 11.1% in 60's, and 8.6% in 70's), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001). Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance.

  1. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer.

    Science.gov (United States)

    Lee, Carol H; Dershaw, D David; Kopans, Daniel; Evans, Phil; Monsees, Barbara; Monticciolo, Debra; Brenner, R James; Bassett, Lawrence; Berg, Wendie; Feig, Stephen; Hendrick, Edward; Mendelson, Ellen; D'Orsi, Carl; Sickles, Edward; Burhenne, Linda Warren

    2010-01-01

    Screening for breast cancer with mammography has been shown to decrease mortality from breast cancer, and mammography is the mainstay of screening for clinically occult disease. Mammography, however, has well-recognized limitations, and recently, other imaging including ultrasound and magnetic resonance imaging have been used as adjunctive screening tools, mainly for women who may be at increased risk for the development of breast cancer. The Society of Breast Imaging and the Breast Imaging Commission of the ACR are issuing these recommendations to provide guidance to patients and clinicians on the use of imaging to screen for breast cancer. Wherever possible, the recommendations are based on available evidence. Where evidence is lacking, the recommendations are based on consensus opinions of the fellows and executive committee of the Society of Breast Imaging and the members of the Breast Imaging Commission of the ACR.

  2. Two distinct groups of non-attenders in an organized mammography screening program

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    2001-01-01

    on personal first round invitations, with 89% attendance rate. PARTICIPANTS: Four hundred thirty six women with both pre-screening response to socioeconomic and psychosocial measures, and post-screening response reporting reasons of non-attendance. MAIN RESULTS: Most common single reason for non......, more socially isolated, depressed and anxious than ELSE. Level of depression among REAL was clearly higher (10.80) than the mean value (7.91, SD = 7.28) of the age group, and was also slightly above the cut-off score of 10 indicating mild or moderate depression. Trait anxiety was also markedly higher...... (40.18) than that of the same age group (37.76, SD = 8.95). CONCLUSIONS: Further research should clarify determinants and consequences of depression and anxiety among real non-attenders. Knowledge gaps and attitudinal barriers among non-attenders require more targeted campaigns....

  3. Adesão ao rastreamento mamográfico oportunístico em serviços de saúde públicos e privados Adherence to the opportunistic mammography screening in public and private health systems

    Directory of Open Access Journals (Sweden)

    Ailton Augustinho Marchi

    2010-04-01

    mammographic screening. The association of the outcomes with the independent variables was studied by obtaining the risk rates (RR and the respective 95% confidence intervals (95%CI. The adjusted prevalence rates were calculated by the COX regression model. RESULTS: although more than 90% of the studied women repeated the mammography at least once, the rate of correct compliance with the recommendations of mammographic screening, with repetition of the procedure every 24 months, was low (about 30% of the study sample. The preditive factors associated with compliance with mammographic screening were related to the unequal access to public or private healthcare services (RR=1.77; 95%CI=1.26-2.48 and to previous screening (RR=3.07; 95%CI=1.86-5.08. CONCLUSION: we concluded that compliance with the recommendations of opportunistic mammographic screening for breast cancer was low in both studied population segments.

  4. Consequences of a false-positive mammography result: drug consumption before and after screening.

    Science.gov (United States)

    von Euler-Chelpin, My; Bæksted, Christina; Vejborg, Ilse; Lynge, Elsebeth

    2016-05-01

    Background Previous research showed women experiencing false-positive mammograms to have greater anxiety about breast cancer than women with normal mammograms. To elucidate psychological effects of false-positive mammograms, we studied impact on drug intake. Methods We calculated the ratio of drug use for women with false-positive versus women with normal mammograms, before and after the event, using population-based registers, 1997-2006. The ratio of the ratios (RRR) assessed the impact. Results Before the test, 40.3% of women from the false-positive group versus 36.2% from the normal group used anxiolytic and antidepressant drugs. There was no difference in use of beta blockers. Hormone therapy was used more frequently by the false-positive, 36.6% versus 28.7%. The proportion of women using anxiolytic and antidepressant drugs increased with 19% from the before to the after period in the false-positive group, and with 16% in the normal group, resulting in an RRR of 1.02 (95% CI 0.92-1.14). RRR was 1.03 for beta blockers, 0.97 for hormone therapy. Conclusion(s) Drugs used to mitigate mood disorders were used more frequently by women with false-positive than by women with normal mammograms already before the screening event, while the changes from before to after screening were similar for both groups. The results point to the importance of control for potential selection in studies of screening effects.

  5. Women's interest in a personal breast cancer risk assessment and lifestyle advice at NHS mammography screening

    Science.gov (United States)

    Wilkinson, L.; Valencia, A.

    2017-01-01

    Abstract Background Although mortality from breast cancer is declining, incidence continues to increase and is often detected at routine NHS screening. Most middle aged and older women in England attend for screening every 3 years. Assessing their personal breast cancer risk and providing preventative lifestyle advice could help to further reduce breast cancer incidence. Methods A cross-sectional, self-complete postal survey measured attendees' interest in having a personal risk assessment, expected impact on screening attendance, knowledge of associations between lifestyle and breast cancer and preferred ways of accessing preventative lifestyle advice. Results A total of 1803/4948 (36.4%) completed questionnaires were returned. Most participants (93.7%) expressed interest in a personal risk assessment and 95% (1713/1803) believed it would make no difference or encourage re-attendance. Two-thirds (1208/1803) associated lifestyle with breast cancer, but many were unaware of specific risks such as weight gain, obesity, alcohol consumption and physical inactivity. NHS sourced advice was expected to be more credible than other sources, and booklets, brief counselling or an interactive website were most preferred for accessing this. Conclusions Attendees appear to welcome an intervention that would facilitate more proactive clinical and lifestyle prevention and address critical research gaps in breast cancer prevention and early detection. PMID:26834190

  6. Mammography - misunderstood and underutilized

    Energy Technology Data Exchange (ETDEWEB)

    Broadbent, R.V.; Reid, M.H.

    1981-12-01

    A mammography screening program for breast cancer carried out in Sacramento by the University of California Davis School of Medicine, Davis, was canceled because of negative public reaction to sensationalized reports in the lay press on the potential carcinogenic risks of the radiation exposure, along with passivity on the part of the medical community in defending the procedure and the program. Disappointment in this occurrence spurred us to explore physician's knowledge of and attitudes toward breast cancer and mammography. The results confirmed our suspicions that a significant number of physicians lack accurate knowledge of breast cancer and of the extremely high benefit-to-risk ratio of mammography as a means of early detection.

  7. Mortality from breast carcinoma among US women: the role and implications of socio-economics, heterogeneous insurance, screening mammography, and geography.

    Science.gov (United States)

    Okunade, Albert A; Karakus, Mustafa C

    2003-11-01

    Despite rapid advances in medicine and beneficial lifestyle changes, the incidence and mortality rate of gynecologic carcinoma remains high worldwide. This paper presents the econometric model findings of the major drivers of breast cancer mortality among US women. The results have implications for public health policy formulation on disease incidence and the drivers of mortality risks. The research methodology is a fixed-effects GLS regression model of breast cancer mortality in US females age 25 and above, using 1990-1997 time-series data pooled across 50 US states and DC. The covariates are age, years schooled, family income, 'screening' mammography, insurance coverage types, race, and US census region. The regressions have strong explanatory powers. Finding education and income to be significantly and positively correlated with mortality supports the 'life in the fast lanes' hypothesis of Phelps. The policy of raising a woman's education at a given income appears more beneficial than raising her income at a given education level. The relatively higher mortality rate for Blacks suggests implementing culturally appropriate set of disease prevention and health promotion programs and policies. Mortality differs across insurance types with Medicaid the worst suggesting need for program reform. Mortality is greater for women ages 25-44 years, females 40-49 years who have had screening mammography, smokers, and residents of some US states. These findings suggest imposing more effective tobacco use control policies (e.g., imposing a special tobacco tax on adult smokers), creating a more tractable screening mammography surveillance system, and designing region-specific programs to cut breast cancer mortality risks.

  8. Screening of breast lesions: a comparative study between mammography, B-mode ultrasonography, sonoelastography and histological results

    Directory of Open Access Journals (Sweden)

    Raquel Constantino Pardal

    2013-07-01

    Full Text Available Objective To compare the capacity of mammography, sonoelastography, B-mode ultrasonography and histological analysis to differentiate benign from malignant breast lesions. Materials and Methods A total of 12 histopathologically confirmed breast lesions were documented. The lesions were assessed by means of mammography, B-mode ultrasonography and sonoelastography, and histopathological analysis was utilized as a gold standard. Sensitivity and specificity were calculated. A receiver operating characteristic (ROC curve was constructed to evaluate the diagnostic performance of the mentioned techniques. Results Sensitivity and specificity in the differentiation between benign and malignant lesions were respectively 100% and 50% for mammography, 100% and 71% for B-mode ultrasonography, and 67% and 83% for sonoelastography. The area under the ROC curve was calculated for the three imaging modalities and corresponded to 0.792 for mammography, 0.847 for B-mode ultrasonography, and 0.806 for sonoelastography. Conclusion Sonoelastography demonstrated higher specificity and lower sensitivity as compared with mammography and B-mode ultrasonography. On the other hand, B-mode ultrasonography had the largest area under the ROC curve. Sonoelastography has demonstrated to be a promising technique to detect and evaluate breast lesions, and could potentially reduce the number of unnecessary biopsies.

  9. Retrospective observation on contribution and limitations of screening for breast cancer with mammography in Korea: detection rate of breast cancer and incidence rate of interval cancer of the breast

    OpenAIRE

    2016-01-01

    Background The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography. Methods Descriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rat...

  10. Measuring breast cancer and mammography screening beliefs among Chinese American immigrants.

    Science.gov (United States)

    Lee-Lin, Frances; Menon, Usha; Pett, Marjorie; Nail, Lillian; Lee, Sharon; Mooney, Kathi

    2008-11-01

    Disparities in breast cancer outcomes persist among Asian American women. Breast cancer is the most commonly diagnosed cancer among Chinese American women. This article describes the psychometric evaluation of an instrument measuring knowledge and beliefs related to breast cancer and screening among Chinese American women aged 40 or older. A sample of 100 foreign-born Chinese American women were recruited from an Asian community. Guided by the health belief model, a questionnaire was adapted from three existing questionnaires. Principal axis factoring analyses yielded a three-factor solution that accounted for 53% of the variance in the breast cancer items and a four-factor solution that accounted for 69% of the variance in the cultural items (Cronbach's alphas = .71-.89). Whereas these findings contribute to the understanding of the psychometric properties of an instrument targeted for Chinese American women, additional research is needed to evaluate its utility and efficacy for other Asian Americans.

  11. Inequity of healthcare utilization on mammography examination and Pap smear screening in Thailand: Analysis of a population-based household survey

    Science.gov (United States)

    2017-01-01

    Healthcare in Thailand is not equally distributed, and not all people can equally access healthcare resources even if they are covered by health insurance. To examine factors associated with the utilization of mammography examination for breast cancer and Pap smear screening for cervical cancer, data from the national reproductive health survey conducted by the National Statistical Office of Thailand in 2009 was examined. The survey was carried out on 15,074,126 women aged 30–59 years. The results showed that the wealthier respondents had more mammograms than did the lower-income groups. The concentration index was 0.144. The data on Pap smears for cervical cancer also showed that the wealthier respondents were more likely to have had a Pap smear than their lower-income counterparts. The concentration index was 0.054. Determinants of mammography examination were education, followed by health welfare and wealth index, whereas the determinants of Pap smear screening were wealth index, followed by health welfare and education. The government should support greater education for women because education was associated with socioeconomic status and wealth. There should be an increase in the number of screening campaigns, mobile clinics, and low-cost mammograms and continued support for accessibility to mammograms, especially in rural areas and low-income communities. PMID:28282430

  12. Association of adipokines and adhesion molecules with indicators of obesity in women undergoing mammography screening

    Directory of Open Access Journals (Sweden)

    Isoppo de Souza Caroline

    2012-10-01

    Full Text Available Abstract Background The soluble cell adhesion molecules and adipokines are elevated in patients with obesity, hypertension, type 2 diabetes mellitus, breast cancer and atherosclerosis. Objective To investigate the relationship between anthropometric profile, dietary intake, lipid profile and fasting glycemia with serum levels of adipokines (adiponectin and PAI-1 and adhesion molecules (ICAM-1 and VCAM-1 in women without breast cancer undergoing routine mammographic screening. Design Transversal study. Subjects One hundred and forty-five women over 40-years old participated in this study. Results In 39.3% of cases the BMI was above 30 kg/m2; 46.9% had hypertension, 14.5% had type 2 Diabetes Mellitus, 31.7% had dyslipidemia and 88.3% presented a waist-to-hip ratio ≥ 0.8. A linear correlation was found between serum levels of PAI-1 and triglycerides, between serum levels of PAI-1 and WHR and between serum levels of VCAM-1 and BMI. Conclusion We found a high prevalence of obesity and metabolic syndrome. PAI-1 and VCAM-1 levels were correlated with clinical indicators of obesity and overweight.

  13. Update on new technologies in digital mammography

    Directory of Open Access Journals (Sweden)

    Patterson SK

    2014-08-01

    Full Text Available Stephanie K Patterson, Marilyn A Roubidoux Division of Breast Imaging, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA Abstract: Despite controversy regarding mammography's efficacy, it continues to be the most commonly used breast cancer-screening modality. With the development of digital mammography, some improved benefit has been shown in women with dense breast tissue. However, the density of breast tissue continues to limit the sensitivity of conventional mammography. We discuss the development of some derivative digital technologies, primarily digital breast tomosynthesis, and their strengths, weaknesses, and potential patient impact. Keywords: screening mammography, breast cancer, contrast media, digital breast tomosynthesis

  14. Mammography Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Mammography Facility Database is updated periodically based on information received from the four FDA-approved accreditation bodies: the American College of...

  15. High-grade histologic features of DCIS are associated with R5 rather than R3 calcifications in breast screening mammography.

    LENUS (Irish Health Repository)

    Hayes, Brian D

    2013-01-01

    Mammographic calcification is an important radiologic feature of early breast carcinoma whose index of suspicion for malignancy may be reported by a five-tier R-category system. This study aims to describe the histologic diagnoses underlying screen-detected mammographic calcifications using both digital and screen-film mammography, and to correlate these findings with radiologic R-categories. Patients attending the Merrion Breast Screening Unit in Dublin between 2000 and 2011 were identified, who underwent needle-core biopsy for assessment of mammographic calcifications without associated mass or architectural distortion. Radiologic R-category was correlated with biopsy and excision histology reports. A total of 776 cases of calcification were identified, involving 769 individual patients. The radiologic R-categories were as follows: R3 513 (66.1%), R4 192 (24.7%), R5 71 (9.1%). The positive predictive values for malignancy were R3 32.6%, R4 69.8%, R5 95.8%. Several histologic features of DCIS were associated with R5 rather than R3 radiology: high nuclear grade, solid or cribriform architecture, necrosis, periductal inflammation or fibrosis, and associated microinvasive or invasive carcinoma. Mammographic lesions and histologic whole and invasive tumors increased in size from R3 to R5. Radiologic size of calcifications correlated with whole (but not invasive) tumor size, although it tended to underestimate it by several millimeters. Digital-detected calcifications were more likely than screen-film detected to be categorized as R3 and less likely R4 or R5, and there was no significant difference in positive predictive value between the two imaging techniques in any R-category. In conclusion, histologic features of DCIS, in particular those associated with high grade, are associated with R5 radiology. There is no significant difference in positive predictive value for malignancy in any R-category between digital and screen-film mammography.

  16. CADx Mammography

    Science.gov (United States)

    Costaridou, Lena

    Although a wide variety of Computer-Aided Diagnosis (CADx) schemes have been proposed across breast imaging modalities, and especially in mammography, research is still ongoing to meet the high performance CADx requirements. In this chapter, methodological contributions to CADx in mammography and adjunct breast imaging modalities are reviewed, as they play a major role in early detection, diagnosis and clinical management of breast cancer. At first, basic terms and definitions are provided. Then, emphasis is given to lesion content derivation, both anatomical and functional, considering only quantitative image features of micro-calcification clusters and masses across modalities. Additionally, two CADx application examples are provided. The first example investigates the effect of segmentation accuracy on micro-calcification cluster morphology derivation in X-ray mammography. The second one demonstrates the efficiency of texture analysis in quantification of enhancement kinetics, related to vascular heterogeneity, for mass classification in dynamic contrast-enhanced magnetic resonance imaging.

  17. Minimal invasive biopsy results of 'uncertain malignant potential' in digital mammography screening. High prevalence but also high predictive value for malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Weigel, S.; Heindel, W. [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie; Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammographie; Decker, T. [Dietrich Bonhoeffer Klinikum, Neubrandenburg (Germany). Inst. fuer Pathologie; Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammographie; Korsching, E. [Universitaetsklinikum Muenster (Germany). Inst. fuer Bioinformatik; Biesheuvel, C.; Woestmann, A.; Boecker, W. [Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammographie; Hungermann, D. [Universitaetsklinikum Muenster (Germany). Gerhard-Domagk-Inst. fuer Pathologie; Roterberg, K.; Tio, J. [Universitaetsklinikum Muenster (Germany). Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe, Bereich Senologie

    2011-08-15

    Purpose: To evaluate the rate, the histological spectrum and the positive predictive value (PPV) for malignancy of minimally invasive biopsies with 'uncertain malignant potential (B3)' in digital mammography screening. Methods and Materials: Consecutive data of 37 178 participants of one digital unit of the German screening program were included. Results: The B 3 rate was 15.1 % (148/979). The frequencies of lesion subtypes were as follows: atypical epithelial proliferation of ductal type (AEPDT) 35.1 % (52/148), radial scar (RS) 28.4 % (42/148), papillary lesions (PAP) 20.3 % (30/148), lobular carcinoma in situ 8.8 % (13/148), flat epithelial atypia 5.4 % (8/148), and mucocele-like lesions 2.0 % (3/148). The PPV for malignancy in surgical excisions was overall 0.28 (25/91); in detail 0.40 (19/47) for AEPDT, 0.20 (5/25) for RS, 0.08 (1/12) for PAP. Conclusion: Despite a higher B 3 rate of minimally invasive biopsies with 'uncertain malignant potential' in digital screening, the benign surgical biopsy rate is not disproportionally increased compared with analog screening programs. Together with defined management protocols, this results in an increased cancer detection rate per screening participant with surgical excision. (orig.)

  18. Prospective trial comparing full-field digital mammography (FFDM) versus combined FFDM and tomosynthesis in a population-based screening programme using independent double reading with arbitration

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, Per [Oslo University Hospital, University of Oslo, Department of Radiology, Oslo (Norway); Oslo University Hospital Ullevaal, Department of Radiology, Breast Imaging Center, Oslo (Norway); Bandos, Andriy I. [University of Pittsburgh, Department of Biostatistics, Pittsburgh (United States); Gullien, Randi; Eben, Ellen B.; Haakenaasen, Unni; Izadi, Mina; Jebsen, Ingvild N.; Jahr, Gunnar; Krager, Mona [Department of Radiology, Oslo University Hospital, Oslo (Norway); Ekseth, Ulrika [Curato Roentgen Institute, Oslo (Norway); Hofvind, Solveig [The Cancer Registry, Institute of Population-based Cancer Research, Oslo (Norway)

    2013-08-15

    To compare double readings when interpreting full field digital mammography (2D) and tomosynthesis (3D) during mammographic screening. A prospective, Ethical Committee approved screening study is underway. During the first year 12,621 consenting women underwent both 2D and 3D imaging. Each examination was independently interpreted by four radiologists under four reading modes: Arm A - 2D; Arm B - 2D + CAD; Arm C - 2D + 3D; Arm D - synthesised 2D + 3D. Examinations with a positive score by at least one reader were discussed at an arbitration meeting before a final management decision. Paired double reading of 2D (Arm A + B) and 2D + 3D (Arm C + D) were analysed. Performance measures were compared using generalised linear mixed models, accounting for inter-reader performance heterogeneity (P < 0.05). Pre-arbitration false-positive scores were 10.3 % (1,286/12,501) and 8.5 % (1,057/12,501) for 2D and 2D + 3D, respectively (P < 0.001). Recall rates were 2.9 % (365/12,621) and 3.7 % (463/12,621), respectively (P = 0.005). Cancer detection was 7.1 (90/12,621) and 9.4 (119/12,621) per 1,000 examinations, respectively (30 % increase, P < 0.001); positive predictive values (detected cancer patients per 100 recalls) were 24.7 % and 25.5 %, respectively (P = 0.97). Using 2D + 3D, double-reading radiologists detected 27 additional invasive cancers (P < 0.001). Double reading of 2D + 3D significantly improves the cancer detection rate in mammography screening. (orig.)

  19. Mammography accreditation program

    Energy Technology Data Exchange (ETDEWEB)

    Wilcox, P.

    1993-12-31

    In the mid-1980`s, the movement toward the use of dedicated mammography equipment provided significant improvement in breast cancer detection. However, several studies demonstrated that this change was not sufficient to ensure optimal image quality at a low radiation dose. In particular, the 1985 Nationwide Evaluation of X-ray Trends identified the wide variations in image quality and radiation dose, even from dedicated units. During this time period, the American Cancer Society (ACS) launched its Breast Cancer Awareness Screening Campaign. However, there were concerns about the ability of radiology to respond to the increased demand for optimal screening examinations that would result from the ACS program. To respond to these concerns, the ACS and the American College of Radiology (ACR) established a joint committee on mammography screening in 1986. After much discussion, it was decided to use the ACR Diagnostic Practice Accreditation Program as a model for the development of a mammography accreditation program. However, some constraints were required in order to make the program meet the needs of the ACS. This voluntary, peer review program had to be timely and cost effective. It was determined that the best way to address these needs would be to conduct the program by mail. Finally, by placing emphasis on the educational nature of the program, it would provide an even greater opportunity for improving mammographic quality. The result of this effort was that, almost six years ago, in May 1987, the pilot study for the ACR Mammography Accreditation Program (MAP) began, and in August of that year, the first applications were received. In November 1987, the first 3-year accreditation certificates were awarded.

  20. Assertiveness with physicians: does it predict mammography use?.

    Science.gov (United States)

    Andersen, M Robyn; Guthrie, Katherine A

    2004-01-01

    In a prior study we found that women's self-reported assertiveness with their healthcare providers was associated with their use of mammography in a population-based cross-sectional sample of women. Women who reported being more assertive, by repeating information if they felt their doctor didn't hear them, asking their doctor to explain information they didn't understand, or reminding their doctor about screening tests, were more likely to have received a mammogram recently than those who reported being less assertive. Here we examined how women's self-reports of assertiveness predicted their use of mammography three years later. We examined this using a population-based sample of 781 women living in rural Washington State who were participating in a trial of mammography promotion. We found that assertive women were younger on average than less assertive women, but that even after controlling for age, education, income, and marital status, women who reported being assertive with their doctor in 1994 were more likely to receive regular mammograms in the next three years than those who did not (OR 2.1; CI 1.5, 2.9). If future studies also suggest that assertiveness predicts use of mammography or other preventive healthcare services, it would be valuable to examine the promotion of assertiveness as a means of improving public health.

  1. The evolution of mammography.

    Science.gov (United States)

    Gold, R H

    1992-01-01

    The history of mammography can be arbitrarily subdivided into three periods: The Age of Pioneers highlights the work of Salomon, Kleinschmidt, Warren, Vogel, Seabold, Gershon-Cohen, Leborgne, Egan, Gallager, Martin, Dodd, Strax and their colleagues; The Age of Technical Progress adds the names of Gould, Wolfe, and Gros and their co-workers; The Modern Era reflects the contributions of Price, Butler, Ostrum, Becker, Isard, Moskowitz, Sickles, Kopans, Homer, Tabár, and their associates. The ultimate success of mammography, the preeminent method of breast cancer screening, could not have been achieved without the intense vision, idealism, and scientific skill of its creators and nurturers. These investigators deserve a debt of gratitude that society can never adequately repay.

  2. 彩超联合钼靶x线在乳腺普查中的应用价值%The value of color Dopplor ultrasound and mammography combined for the diognsis of breast cancer in the breast image screening projects

    Institute of Scientific and Technical Information of China (English)

    王秀荣; 朱长征

    2013-01-01

    Objective:To evaluate the value of color Dopplor ultrasound and mammography combined for the diagnosis of breast cancer in the breast image screening project.Methods:7084 persons had undergone mammography and color Dopplor ultrasound and the suiting rate of diagnosis with pathology were statistical y analysed.Results:Suilting rate of diagnosis by mammography was 86.8%;suit ing rate by color Dopplor ultrasound was 88.7%,there isn’t statistical y difference between them (p>0.05),the suiting rate of diagnosis of color Dopplor ultrasound combined mammography was 96.2%,which had marked significant compared with mammography and color Dopplor ultrasound alone (p<0.05).Conclusion:Physical examination with color Dopplor ultrasound and mammography is the best method for breast cancer screening.%目的:探讨彩超与钼靶x线联合应用在乳腺筛查中的应用价值。方法:对7084人进行乳腺钼靶及彩超检查,并与病理诊断结果对照进行统计学分析。结果:彩超与病理诊断总符合率88.7%,钼靶与病理诊断总符合率86.8%,两者差异无显著性(p>0.05),彩超联合钼靶的符合率为96.2%,与单钼靶及单独彩超相比均有显著性差异(p<0.05)。结论:临床触诊+钼靶+彩超的模式是目前进行乳腺普查的最佳模式。

  3. Applying the European protocol for the quality control of the physical and technical aspects of mammography screening threshold contrast visibility assessment to digital systems

    Science.gov (United States)

    Van Metter, Richard; Heath, Michael; Fletcher-Heath, Lynn

    2006-03-01

    The need to assure the image quality of digital systems for mammography screening applications is now widely recognized. One approach is embodied in Part B of the European Protocol for the Quality Control of the Physical and Technical Aspects of Mammography Screening (EPQCM), which prescribes criteria for several interconnected image quality metrics. The focus of this study is on the "threshold contrast visibility" (TCV) protocol (section 2.4.1 of the EPQCM), in which human observers score images of a CDMAM or similar 4-AFC phantom. This section of the EPQCM currently omits many critical experimental details, which must be gleaned from ancillary documents. Given these, the purpose of this study is to quantify the effects of several remaining experimental variables, including phantom design, and the methods used for scoring and analysis, on the measured results. Preliminary studies of two CDMAM version 3.4 (CDMAM 3.4) phantoms have revealed a 17% difference in TCV when averaged over all target diameters from 0.1 to 2.0 mm. This indicates phantom variability may affect results at some sites. More importantly, we have shown that the current CDMAM phantom design, methods for scoring, and analysis, substantially limit the ability to measure system performance accurately and precisely. An improved phantom design has been shown to avoid these limitations. Viewing environment and presentation context affect the performance and efficiency of visual scoring of phantom images. An automated display tool has been developed that isolates individual 4-AFC targets of CDMAM phantom images, automatically optimizes window/level, and automatically records observers' scores. While not substantially changing TCV, the tool has increased scoring efficiency while mitigating several of the limitations associated with unassisted visual scoring. For example, learning bias and navigational issues are completely avoided. Ultimately, software-based ideal observer scoring will likely prove to be

  4. Mammography activity in Norway 1983 to 2008

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Braaten, Tonje; Njor, Sisse H

    2011-01-01

    In Norway, an organized screening mammography program, the Norwegian Breast Cancer Screening Program (NBCSP) started in four counties in 1996 and became nationwide in 2004. We collected data on pre-program screening activity, and in view of this activity we evaluated the potential impact of the p......In Norway, an organized screening mammography program, the Norwegian Breast Cancer Screening Program (NBCSP) started in four counties in 1996 and became nationwide in 2004. We collected data on pre-program screening activity, and in view of this activity we evaluated the potential impact...... of the program on breast cancer mortality in Norway....

  5. Mammography; Mamma

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Baum, F. [Diagnostisches Brustzentrum, Goettingen (Germany)

    2007-07-01

    The book covers the stat-of-the art of mammographic diagnostics. The first chapter on the diagnostic methods, i.e. sonography and mammography, includes a short definition of the specific methods, technical device descriptions, information on radiation exposure and radiation protection, quality criteria and data analysis methods. The other chapters contain a variety of demonstrating images on the respective topics: definitions and indications, benign changes, evaluation criteria and borderline findings, mammal carcinomas, other malignomas, post-traumatic lesions, and prosthetics.

  6. Dual-Energy Contrast-Enhanced Spectral Mammography: Enhancement Analysis on BI-RADS 4 Non-Mass Microcalcifications in Screened Women

    Science.gov (United States)

    Cheung, Yun-Chung; Juan, Yu-Hsiang; Lin, Yu-Ching; Lo, Yung-Feng; Tsai, Hsiu-Pei; Ueng, Shir-Hwa; Chen, Shin-Cheh

    2016-01-01

    Background Mammography screening is a cost-efficient modality with high sensitivity for detecting impalpable cancer with microcalcifications, and results in reduced mortality rates. However, the probability of finding microcalcifications without associated cancerous masses varies. We retrospectively evaluated the diagnosis and cancer probability of the non-mass screened microcalcifications by dual-energy contrast-enhanced spectral mammography (DE-CESM). Patients and Methods With ethical approval from our hospital, we enrolled the cases of DE-CESM for analysis under the following inclusion criteria: (1) referrals due to screened BI-RADS 4 microcalcifications; (2) having DE-CESM prior to stereotactic biopsy; (3) no associated mass found by sonography and physical examination; and (4) pathology-based diagnosis using stereotactic vacuum-assisted breast biopsy. We analyzed the added value of post-contrast enhancement on DE-CESM. Results A total of 94 biopsed lesions were available for analysis in our 87 women, yielding 27 cancers [19 ductal carcinoma in situ (DCIS), and 8 invasive ductal carcinoma (IDC)], 32 pre-malignant and 35 benign lesions. Of these 94 lesions, 33 showed associated enhancement in DE-CESM while the other 61 did not. All 8 IDC (100%) and 16 of 19 DCIS (84.21%) showed enhancement, but the other 3 DCIS (15.79%) did not. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 88.89%, 86.56%, 72.72%, 95.08% and 87.24%, respectively. The performances of DE-CESM on both amorphous and pleomorphic microcalcifications were satisfactory (AUC 0.8 and 0.92, respectively). The pleomorphous microcalcifications with enhancement showed higher positive predictive value (90.00% vs 46.15%, p = 0.013) and higher cancer probability than the amorphous microcalcifications (46.3% VS 15.1%). The Odds Ratio was 4.85 (95% CI: 1.84–12.82). Conclusion DE-CESM might provide added value in assessing the non-mass screened breast

  7. Cross-trimester repeated measures testing for Down's syndrome screening: an assessment.

    LENUS (Irish Health Repository)

    Wright, D

    2010-07-01

    To provide estimates and confidence intervals for the performance (detection and false-positive rates) of screening for Down\\'s syndrome using repeated measures of biochemical markers from first and second trimester maternal serum samples taken from the same woman.

  8. Advanced Breast Cancer as Indicator of Quality Mammography

    Science.gov (United States)

    Gaona, Enrique

    2003-09-01

    Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is the more important screening tool for detecting early breast cancer. Screening mammography involves taking x-rays from two views from each breast, typically from above (cranial-caudal view, CC) and from an oblique or angled view (mediolateral-oblique, MLO). The purpose of this study was to carry out an exploratory survey of the issue of patients with advanced breast cancer who have had a screening mammography. A general result of the survey is that 22.5% of all patients (102) with advanced breast cancer that participated in the study had previous screening mammography. But we should consider that 10% of breast cancers are not detected by mammography. Only 70% of the family doctors prescribed a diagnostic mammography when the first symptoms were diagnosed.

  9. Preimplantation Genetic Screening: An Effective Testing for Infertile and Repeated Miscarriage Patients?

    Directory of Open Access Journals (Sweden)

    Ning Wang

    2010-01-01

    Full Text Available Aneuploidy in pregnancy is known to increase with advanced maternal age (AMA and associate with repeated implantation failure (RIF, and repeated miscarriage (RM. Preimplantation genetic screening (PGS has been introduced into clinical practice, screening, and eliminating aneuploidy embryos, which can improve the chance of conceptions for infertility cases with poor prognosis. These patients are a good target group to assess the possible benefit of aneuploidy screening. Although practiced widely throughout the world, there still exist some doubts about the efficacy of this technique. Recent randomized trials were not as desirable as we expected, suggesting that PGS needs to be reconsidered. The aim of this review is to discuss the efficacy of PGS.

  10. Breast Density Awareness and Knowledge, and Intentions for Breast Cancer Screening in a Diverse Sample of Women Age Eligible for Mammography.

    Science.gov (United States)

    Santiago-Rivas, Marimer; Benjamin, Shayna; Andrews, Janna Z; Jandorf, Lina

    2017-08-14

    The objectives of this study were to assess breast density knowledge and breast density awareness, and to identify information associated with intention to complete routine and supplemental screening for breast cancer in a diverse sample of women age eligible for mammography. We quantitatively (self-report) assessed breast density awareness and knowledge (N = 264) in black (47.7%), Latina (35.2%), and white (17%) women recruited online and in the community. Most participants reported having heard about breast density (69.2%); less than one third knew their own breast density status (30.4%). Knowing their own breast density, believing that women should be notified of their breast density in their mammogram report, and feeling informed if being provided this information are associated with likelihood of completing mammogram. Intending mammogram completion and knowledge regarding the impact of breast density on mammogram accuracy are associated with likelihood of completing supplemental ultrasound tests of the breast. These findings help inform practitioners and policy makers about information and communication factors that influence breast cancer screening concerns and decisions. Knowing this information should prepare practitioners to better identify women who may have not been exposed to breast density messages.

  11. Transition from film to digital mammography: Impact for breast cancer screening through the national breast and cervical cancer early detection program

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien); L. Van Lier (Lisanne); C.B. Schechter (Clyde); D.U. Ekwueme (Donatus U.); J. Royalty (Janet); J.W. Miller (Jacqueline W.); A.M. Near (Aimee); K.A. Cronin (Kathleen); E.A.M. Heijnsdijk (Eveline); J.S. Mandelblatt (Jeanne); H.J. de Koning (Harry)

    2015-01-01

    textabstractIntroduction The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides mammograms and diagnostic services for low-income, uninsured women aged 40-64 years. Mammography facilities within the NBCCEDP gradually shifted from plain-film to digital mammography. The pur

  12. Mammographic density and structural features can individually and jointly contribute to breast cancer risk assessment in mammography screening

    DEFF Research Database (Denmark)

    Winkel, Rikke Rass; von Euler-Chelpin, My; Nielsen, Mads;

    2016-01-01

    BACKGROUND: Mammographic density is a well-established risk factor for breast cancer. We investigated the association between three different methods of measuring density or parenchymal pattern/texture on digitized film-based mammograms, and examined to what extent textural features independently......-RADS alone). CONCLUSION: Our findings suggest that the (relative) amount of fibroglandular tissue (density) and mammographic structural features (texture/parenchymal pattern) jointly can improve risk segregation of screening women, using information already available from normal screening routine, in respect...... to future personalized screening strategies....

  13. Establishing daily quality control (QC) in screen-film mammography using leeds tor (max) phantom at the breast imaging unit of USTH-Benavides Cancer Institute

    Science.gov (United States)

    Acaba, K. J. C.; Cinco, L. D.; Melchor, J. N.

    2016-03-01

    Daily QC tests performed on screen film mammography (SFM) equipment are essential to ensure that both SFM unit and film processor are working in a consistent manner. The Breast Imaging Unit of USTH-Benavides Cancer Institute has been conducting QC following the test protocols in the IAEA Human Health Series No.2 manual. However, the availability of Leeds breast phantom (CRP E13039) in the facility made the task easier. Instead of carrying out separate tests on AEC constancy and light sensitometry, only one exposure of the phantom is done to accomplish the two tests. It was observed that measurements made on mAs output and optical densities (ODs) using the Leeds TOR (MAX) phantom are comparable with that obtained from the usual conduct of tests, taking into account the attenuation characteristic of the phantom. Image quality parameters such as low contrast and high contrast details were also evaluated from the phantom image. The authors recognize the usefulness of the phantom in determining technical factors that will help improve detection of smallest pathological details on breast images. The phantom is also convenient for daily QC monitoring and economical since less number of films is expended.

  14. SweDCIS: Radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomised trial in a population offered mammography screening

    Energy Technology Data Exchange (ETDEWEB)

    Emdin, Stefan O.; Granstrand, Bengt [Umeaa Univ. Hospital (Sweden). Dept. of Surgery; Ringberg, Anita [Malmoe Univ. Hospital (Sweden). Dept. of Plastic and Reconstructive Surgery; Sandelin, Kerstin [Karolinska Univ. Hospital, Stockholm (Sweden); Arnesson, Lars-Gunnar [Linkoeping Univ. Hospital (Sweden). Dept. of Surgery; Nordgren, Hans [Uppsala Univ. Hospital (Sweden). CLM; Anderson, Harald [Univ. Hospital, Lund (Sweden). Dept. of Cancer Epidemiology; Garmo, Hans; Holmberg, Lars [Uppsala Univ. (Sweden). Regional Oncologic Centre; Wallgren, Arne [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

    2006-07-15

    We studied the effect of postoperative radiotherapy (RT) after breast sector resection for ductal carcinoma in situ (DCIS). The study protocol stipulated radical surgery but microscopically clear margins were not mandatory. We randomised 1,046 operated women to postoperative RT or control between 1987 and 1999. The primary endpoint was ipsilateral local recurrence. Secondary endpoints were contralateral breast cancer, distant metastasis and death. After a median follow-up of 5.2 years (range 0.1-13.8) there were 44 recurrences in the RT group corresponding to a cumulative incidence of 0.07 (95% confidence interval (CI) 0.05-0.10). In the control group there were 117 recurrences giving a cumulative incidence of 0.22 (95% CI 0.18-0.26) giving an overall hazard ratio of 0.33 (95% CI 0.24-0.47, p<0.0001). Twenty two percent of the patients had microscopically unknown or involved margins. We found no evidence for different effects of RT on the relative risk of invasive or in situ recurrence. Secondary endpoints did not differ. Women undergoing sector resection for DCIS under conditions of population based screening mammography benefit from postoperative RT to the breast. Seven patients needed RT-treatment to prevent one recurrence.

  15. Implementation of population screening for colorectal cancer by repeated Fecal Immunochemical Test (FIT: third round

    Directory of Open Access Journals (Sweden)

    Stegeman Inge

    2012-06-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the most common cancer in Europe with a mortality rate of almost 50%. The prognosis of patients is largely determined by the clinical and pathological stage at the time of diagnosis. Population screening has been shown to reduce CRC-related mortality rate. Most screening programs worldwide rely on fecal immunochemical testing (FIT. The effectiveness of a FIT screening program is not only influenced by initial participation rate, but also by program adherence during consecutive screening rounds. We aim to evaluate the participation rate in and yield of a third CRC screening round using FIT. Methods and design Four years after the first screening round and two years after the second round, a total number of approximately 11,000 average risk individuals (50 to 75 years of age will be invited to participate in a third round of FIT-based CRC screening. We will select individuals in the same target area as in the previous screening rounds, using the electronic database of the regional municipal administration registrations. We will invite all FIT-negatives and all non-participants in previous screening rounds, as well as eligible first time invitees who have moved into the area or have become 50 years of age. FITs will be analyzed in the special technique laboratory of the Academic Medical Center of the University of Amsterdam. All FIT-positives will be invited for a consultation at the outpatient clinic. In the absence of contra-indications, a colonoscopy will follow at the Academic Medical Center or at the Flevohospital. The primary outcome measures are the participation rate, defined as the proportion of invitees that return a FIT in this third round of FIT-screening, and the diagnostic yield of the program. Implications This study will provide precise data on the participation in later FIT screening rounds. This enables to estimate the effectiveness of CRC screening programs that rely on repeated

  16. False-positive findings in mammography screening induces short-term distress - breast cancer-specific concern prevails longer

    DEFF Research Database (Denmark)

    Aro, A R; Pilvikki Absetz, S; van Elderen, T M

    2000-01-01

    -ups at 2 and 12 months postscreening. At 2 months, there was a moderate multivariate effect of group on distress; and intrusive thinking and worry about breast cancer, in particular, were most frequent amongst the false positives. Intrusive thinking still prevailed at 12 months, in addition to a higher...... perceived breast cancer risk and susceptibility. Distress related to screening and false-positive findings seems to be moderate, but prevailing cancer-specific concerns call for improvements in screening programmes....... findings (n=1407), false-positive findings (n=492) and referents from outside the screening programme (n=1718, age 48-49 years). Distress was measured as illness worry, anxiety, depression, cancer beliefs and early detection behaviour. Measurements were one month before screening invitation with follow...

  17. Imaging evaluation of digital mammography X line camera operation in breast cancer screening%数字钼靶X线摄像术在乳腺癌筛查中的影像学评价

    Institute of Scientific and Technical Information of China (English)

    夏秀梅

    2015-01-01

    目的:探讨数字化钼靶X线在乳腺癌筛查中的作用。方法:收治乳腺癌患者84例,对其数字X线钼靶摄片资料作回顾性分析。结果:X线征象与病理诊断结果基本相似。结论:乳腺钼靶X线摄影在女性乳腺癌的筛查中发挥重要的作用,准确率较高。%Objective:To investigate the effect of digital mammography in breast cancer screening.Methods:84 patients with breast cancer were selected,then we analyzed the digital mammography data retrospectively.Results:The X-ray findings and pathological diagnosis results were basically similar.Conclusion:Mammography plays an important role in the screening of breast cancer in women,and it also has high accuracy.

  18. 2D vs. 3D mammography observer study

    Science.gov (United States)

    Fernandez, James Reza F.; Hovanessian-Larsen, Linda; Liu, Brent

    2011-03-01

    Breast cancer is the most common type of non-skin cancer in women. 2D mammography is a screening tool to aid in the early detection of breast cancer, but has diagnostic limitations of overlapping tissues, especially in dense breasts. 3D mammography has the potential to improve detection outcomes by increasing specificity, and a new 3D screening tool with a 3D display for mammography aims to improve performance and efficiency as compared to 2D mammography. An observer study using a mammography phantom was performed to compare traditional 2D mammography with this ne 3D mammography technique. In comparing 3D and 2D mammography there was no difference in calcification detection, and mass detection was better in 2D as compared to 3D. There was a significant decrease in reading time for masses, calcifications, and normals in 3D compared to 2D, however, as well as more favorable confidence levels in reading normal cases. Given the limitations of the mammography phantom used, however, a clearer picture in comparing 3D and 2D mammography may be better acquired with the incorporation of human studies in the future.

  19. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    Energy Technology Data Exchange (ETDEWEB)

    Ascunce, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Instituto de Salud Publica, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Ederra, Maria; Delfrade, Josu; Erdozain, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Baroja, Araceli [Fundacion Rioja Salud, Logrono (Spain); Zubizarreta, Raquel [Public Health and Planning Directorate, Health Office, Galician Breast Cancer Screening Programme, Galicia (Spain); Salas, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Castells, Xavier [Mar Teaching Hospital, CIBERESP, Department of Clinical Epidemiology, Barcelona (Spain)

    2012-02-15

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  20. FDA Certified Mammography Facilities

    Science.gov (United States)

    ... Products Radiation-Emitting Products Home Radiation-Emitting Products Mammography Quality Standards Act and Program Consumer Information (MQSA) ... it Email Print This list of FDA Certified Mammography Facilities is updated weekly. If you click on ...

  1. A prospective assessment of racial/ethnic differences in future mammography behavior among women who had early mammography

    Science.gov (United States)

    Kapp, Julie M.; Walker, Rod; Haneuse, Sebastien; Yankaskas, Bonnie C.

    2011-01-01

    BACKGROUND 29% of women aged 30-39 report having had a mammogram though sensitivity and specificity are low. We investigate racial/ethnic differences in future mammography behavior among women who had a baseline screening mammogram prior to age 40. METHODS Using 1994-2008 data from the Breast Cancer Surveillance Consortium (BCSC), we identified 29,390 women ages 35-39 with a baseline screening mammogram. We followed this cohort for two outcomes: (1) future BCSC mammography between ages 40-45; and (2) among those, delay in screening mammography until ages 43-45 compared to 40-42. Using adjusted log-linear models, we estimated the relative risk (RR) of these outcomes by race/ethnicity, while also considering the impact of false positive/true negative (FP/TN) baseline mammography results on these outcomes. RESULTS Relative to non-Hispanic white women, Hispanic women had an increased risk of no future BCSC mammography (RR: 1.21, 95% confidence interval (CI): 1.13-1.30); Asian women had a decreased risk (RR: 0.67, 95% CI: 0.61-0.74). Women with a FP, compared to TN, had a decreased risk of no future BCSC mammography (RR: 0.89, 95% CI: 0.85-0.95). Among those with future BCSC screening mammography, African American women were more likely to delay the timing (RR: 1.26, 95% CI: 1.09-1.45). The interaction between race/ethnicity and FP/TN baseline results was not significant. CONCLUSIONS Race/ethnicity is differentially associated with future BCSC mammography and the timing of screening mammography after age 40. IMPACT These findings introduce the need for research that examines disparities in lifetime mammography use patterns from the initiation of mammography screening. PMID:21242330

  2. 中国妇女乳腺X线钼靶摄影普查成本效益分析%Cost-effectiveness analysis of mammography screening for Chinese women

    Institute of Scientific and Technical Information of China (English)

    张峰; 罗立民; 鲍旭东; 陈北京

    2012-01-01

    Objective: To analyze the cost-effectiveness of mammography screening for Chinese women. Methods: A model of Markov process adapted with clinical data about breast cancer and population of Chinese women was developed to simulate the progression of breast cancer. The model was running over ten cycles (each cycle represents one year) and then to estimate the total cost/effectiveness of mammography screening by summing across those cycles. Results: For women groups aged between 35-59 years and 35-69 years, ICER (incremental cost-effectiveness ratio) of mammography screening group will be 216656.00 yuan/QALY (quality adjusted life year) and 248 727.50 yuan/QALY respectively compared with non-screening group, and mammography screening can reduce the mortality of breast cancer by 14.66% and 14.79%, respectively. The ICER is closely correlated with the incidence of breast cancer, sensitivity and specificity of mammography screening and the costs for screening. Conclusion: The result of this analysis indicates that mammography screening in Chinese women can reduce the breast cancer mortality about 1 5%. According to the incidence rate, mean screening performance (including sensitivity and specificity) and screening costs of breast cancer in Chinese women, the mammography screening is not of cost-effectiveness at present. However, the cost-effectiveness of mammography screening is closely correlated with the incidence rate of breast cancer, screening performance and screening costs, the screening for breast cancer in Chinese women will be of or even good cost-effectiveness with the increased incidence of breast cancer, the decreased costs of screening and the improved performance of screening.%目的:分析中国妇女乳腺X线钼靶摄影普查的成本效益.方法:结合中国妇女的人群年龄结构以及乳腺癌相关数据,利用Markov模型模拟乳腺癌发展过程,结合每一种状态的成本消耗和健康收益,通过10个周期(每个周期为1年)的

  3. CONTRAST ENHANCED SPECTRAL MAMMOGRAPHY (CESM (REVIEW

    Directory of Open Access Journals (Sweden)

    N. I. Rozhkova

    2015-01-01

    Full Text Available The problem of early diagnosis of a breast cancer is extremely actual. Growth of incidence at women from 19 to 39 years increased for 34% over the last 10 years. It defines need of acceleration of development and deployment of the latest technologies of identification of the earliest symptoms of diseases. The x-ray mammography is the conducting method among of all radiological methods of diagnostics. Nevertheless a number of restrictions of method reduces its efficiency. The technologies increasing informational content of x-ray mammography – the leading method of screening – due to use of artificial contrasting and advantages of digital technologies are constantly developed. In this review it is described works, in which the authors having clinical experience of application of CESM – contrastenhanced spectral mammography on representative group of women. Positive sides and restrictions of new technology in comparison with mammography, ultrasonography and MRT are shown in this article.

  4. The Assessment of the Likelihood of Mammography Usage with Relevant Factors among Women with Disabilities

    Science.gov (United States)

    Kung, Pei-Tseng; Tsai, Wen-Chen; Chiou, Shang-Jyh

    2012-01-01

    Research that identifies the determinants of low mammography use among disabled people is scant. This study examines the determining factors related to the low usage of mammography among women with disabilities. To identify the barriers that prevent women with disabilities from participating in mammography screening can help authorities conceive…

  5. The Design of a Multi-component Intervention to Promote Screening Mammography in an American Indian Community: The Native Women’s Health Project

    Directory of Open Access Journals (Sweden)

    Eleni L. Tolma

    2016-11-01

    Full Text Available Background: Breast cancer is an important public health issue among American Indian/Alaska Native (AI/AN women in the US. This article describes the design and implementation of a culturally sensitive intervention to promote breast health among AI/AN women through a hybrid model that incorporates clinical and community-based approaches. This is one of the first studies using this model addressing breast cancer disparities among AI/AN populations in the US. Methods: The Theory of Planned Behavior was used as the guiding framework of the intervention and Community Based Participatory Research was the primary vehicle for the intervention planning and implementation. Three preliminary studies took place that aimed to identify qualitatively and quantitatively what deterred or encouraged AI women to get past or future mammograms. The research results were shared with community members who, through a prioritization process, identified the theoretical focus of the intervention and its corresponding activities. The priority population consisted of AI women ages 40–74, with no recent mammogram, and no breast cancer history. Results: The intervention centered on the promotion of social modeling and physician recommendation. The main corresponding activities included enhancing patient-physician communication about screening mammography through a structured dialogue, receipt of a breast cancer brochure, participation in an inter-generational discussion group, and a congratulatory bracelet upon receipt of a mammogram. Environmental and policy related changes also were developed. Conclusion: Creating a theory-based, culturally-sensitive intervention through tribal participatory research is a challenging approach towards eliminating breast cancer disparities among hard-to-reach populations.

  6. Impact on the recall rate of digital breast tomosynthesis as an adjunct to digital mammography in the screening setting. A double reading experience and review of the literature.

    Science.gov (United States)

    Carbonaro, Luca A; Di Leo, Giovanni; Clauser, Paola; Trimboli, Rubina M; Verardi, Nicola; Fedeli, Maria P; Girometti, Rossano; Tafà, Alfredo; Bruscoli, Paola; Saguatti, Gianni; Bazzocchi, Massimo; Sardanelli, Francesco

    2016-04-01

    To estimate the impact on recall rate (RR) of digital breast tomosynthesis (DBT) associated with digital mammography (DM+DBT), compared to DM alone, evaluate the impact of double reading (DR) and review the literature. Ethics committees approved this multicenter study. Patients gave informed consent. Women recalled from population-based screening reading were included. Reference standard was histology and/or ≥ 1 year follow up. Negative multiple assessment was considered for patients lost at follow up. Two blinded readers (R1, R2) evaluated first DM and subsequently DM+DBT. RR, sensitivity, specificity, accuracy, positive and negative predictive values (PPV, NPV), were calculated for R1, R2, and DR. Cohen κ and χ(2) were used for R1-R2 agreement and RR related to breast density. We included 280 cases (41 malignancies, 66 benign lesions, and 173 negative examinations). The RR reduction was 43% (R1), 58% (R2), 43% (DR). Sensitivity, specificity, accuracy, PPV and NPV were: 93%, 67%, 71%, 33%, 98% for R1; 88%, 73%, 75%, 36%, 97% for R2; 98%, 55%, 61%, 27%, 99% for DR. The agreement was higher for DM+DBT (κ=0.459 versus κ=0.234). Reduction in RR was independent from breast density (p=0.992). DBT was confirmed to reduce RR, as shown by 13 of 15 previous studies (reported reduction 6-82%, median 31%). This reduction is confirmed when using DR. DBT allows an increased inter-reader agreement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Influence of the radiographer on the pain felt during mammography

    Energy Technology Data Exchange (ETDEWEB)

    Goethem, M. van; Verslegers, I.; Biltjes, I.; De Schepper, A. [Department of Radiology, University of Antwerp (UZA), Wilrijkstraat 10, 2650 Edegem (Belgium); Mortelmans, D.; Bruyninckx, E.; Hove, E. Van [Department of Political and Social Sciences, Department PSW, University of Antwerp (UIA), Universiteitsplein 1, 2610 Wilrijk (Belgium)

    2003-10-01

    Mammography is the only useful examination in screening for breast cancer. Mortality from breast cancer can be reduced if women go regularly for a screening mammography. Moreover, it is still the key examination in diagnosis of breast diseases and in the follow-up of patients treated for breast cancer. Pain with mammography can deter women from going for regular screening or follow-up; therefore, it is important to reduce pain experience or discomfort from mammography. In this study we evaluate the impact of the ''radiographer'' on the pain risk during mammography by analysing questionnaires filled in by women and radiographers. Study results reveal that the opinion of the radiographer, the information and communication during the examination and the number of years of experience are important factors in pain and discomfort experience. The attitude of the radiographer plays an important role in the pain experience. (orig.)

  8. Influence of the radiographer on the pain felt during mammography.

    Science.gov (United States)

    Van Goethem, M; Mortelmans, D; Bruyninckx, E; Verslegers, I; Biltjes, I; Van Hove, E; De Schepper, A

    2003-10-01

    Mammography is the only useful examination in screening for breast cancer. Mortality from breast cancer can be reduced if women go regularly for a screening mammography. Moreover, it is still the key examination in diagnosis of breast diseases and in the follow-up of patients treated for breast cancer. Pain with mammography can deter women from going for regular screening or follow-up; therefore, it is important to reduce pain experience or discomfort from mammography. In this study we evaluate the impact of the "radiographer" on the pain risk during mammography by analysing questionnaires filled in by women and radiographers. Study results reveal that the opinion of the radiographer, the information and communication during the examination and the number of years of experience are important factors in pain and discomfort experience. The attitude of the radiographer plays an important role in the pain experience.

  9. Screening mammography interpretation test: more frequent mistakes; Laboratorio di radiologia-Modulo di senologia: errori piu' frequenti

    Energy Technology Data Exchange (ETDEWEB)

    Gozzi, Gino; Ganzetti, Alessandra [U.O. Radiologia P.O. Sant' Anna, Como (Italy); Martinoli, Carlo; Bacigalupo, Lorenzo [Genova Univ., Genova (Italy). U.O. Radiologia Clinica; Conti, Giovanni Maria [Istituto di Radiologia Ospedali Riuniti, Parma (Italy); Bodini, Maria; Fiorentino, Carla; Marini, Ugo Paolo [P.O. Cremonese Azienda Istituti Ospedalieri, Cremona (Italy). Servizio di Radiologia; Santini, Dolores [Azienda USL Modena Poliambulatori Distretto 3, Modena (Italy). Screening Mammografico

    2005-03-01

    Purpose: To present the mammographic cases most commonly misinterpreted by the participants in the mammography self-test proposed by the Italian Society of Medical Radiology (SIRM) National Congress in Rimini, Italy, 2002, by analysing the findings responsible for errors, suggesting reasons for the errors, and assessing possible inadequacies in the format of the test. Materials and methods: The self-test was performed on the mammograms of 160 cases (32 positive and 128 negative for cancer as confirmed by histology). The mammograms had been taken in the four standard projections and placed on four multi-panel diaphanoscopes, each displaying a set of 40 cases comprising benign and malignant cases in equal proportions. The participants were given pre-printed forms on which to note down their diagnostic judgement. We evaluated a total of 134 fully-completed forms. Among these, we identified the 23 cases most frequently misread by over 15 participants in percentages varying between 40-90%. Of these cases, 10 were malignancies and 13 were negative mammograms. On review, we also assessed the diagnostic contribution of complementary investigations (not available the participants). The 134 fully-completed forms (all of the 40 cases) yielded a total of 5360 responses, 1180 of which (22.01%) were incorrect. Of these 823 out of the 4288 cases expected to be negative (19.2%) were false positive, and 357 out of the 1072 cases expected to be positive (33.3%) were false negative. As regards the 23 most frequently misread cases, these were 10/32 (31.25%) mammograms positive for malignancy and 13/128 (10.15%) negative mammograms or mammograms showing benign disease. The 10 malignancies included 7 infiltrating ductal carcinomas, 1 infiltrating cribriform carcinoma, 1 infiltrating tubular carcinoma, and 1 carcinoma in situ. The 13 cases of benign disease - as established by histology or long-term follow-up - mistaken for malignancies by the test participants were fibrocystic breast

  10. BIRADS classification in mammography.

    Science.gov (United States)

    Balleyguier, Corinne; Ayadi, Salma; Van Nguyen, Kim; Vanel, Daniel; Dromain, Clarisse; Sigal, Robert

    2007-02-01

    The Breast Imaging Report and Data System (BIRADS) of the American College of Radiology (ACR) is today largely used in most of the countries where breast cancer screening is implemented. It is a tool defined to reduce variability between radiologists when creating the reports in mammography, ultrasonography or MRI. Some changes in the last version of the BIRADStrade mark have been included to reduce the inaccuracy of some categories, especially for category 4. The BIRADStrade mark includes a lexicon and descriptive diagrams of the anomalies, recommendations for the mammographic report as well as councils and examples of mammographic cases. This review describes the mammographic items of the BIRADS classification with its more recent developments, while detailing the advantages and limits of this classification.

  11. Mammography and breast sonography in transsexual women

    Energy Technology Data Exchange (ETDEWEB)

    Weyers, S., E-mail: steven.weyers@ugent.b [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Villeirs, G.; Vanherreweghe, E. [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Verstraelen, H. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Monstrey, S. [Department of Plastic Surgery, Ghent University Hospital, Ghent (Belgium); Van den Broecke, R.; Gerris, J. [Department of Gynecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)

    2010-06-15

    Data on the necessity of performing screening mammographies in transsexual women are lacking. The main objective of this study was to assess the possibility to perform mammography and breast sonography in transsexual women. Fifty Dutch-speaking transsexual women were interviewed about the following: attitude towards mammography and breast sonography, importance attributed to and satisfaction with breast appearance, opinion about the necessity of breast check-up, expectations regarding discomfort during the exams and knowledge about the breast surgery. A fasting blood sample, clinical breast exam, mammography and breast sonography were performed. At mammography the following parameters were noted: density, technical quality, location of the prostheses, presence of any abnormalities and painfulness. At sonography the following parameters were recorded: density, presence of cysts, visualisation of retro-areolar ducts or any abnormalities. Twenty-three percent of patients are not aware of the type of breast implants and 79% do not know their position to the pectoral muscles. Patient satisfaction with the appearance of their breasts was rather high (7.94 on a scale of 0-10). Mean expected and experienced pain from mammography was low (4.37 and 2.00 respectively). There was no statistically significant difference in expected pain between those who already had mammography and those who did not. There was a significant positive correlation between the expected and the experienced pain. Mammography and breast sonography were technically feasible and no gross anomalies were detected. Since both exams were judged as nearly painless, 98% of transsexual women intended to come back if they would be invited. Since breast cancer risk in transsexual women is largely unknown and breast exams are very well accepted, breast screening habits in this population should not differ from those of biological women.

  12. Audit of mammography requests in Abakaliki, South-East Nigeria.

    Science.gov (United States)

    Eni, U E; Ekwedigwe, K C; Sunday-Adeoye, I; Daniyan, Abc; Isikhuemen, M E

    2017-03-07

    Breast cancer is the leading cancer in women in both developed and developing countries. Screening mammography detects breast cancer even before a lump can be palpated, with better prognosis. The introduction of mammographic technique for screening breast cancer, despite its importance, has been slow to adopt and virtually non-existent in many parts of Sub-Saharan Africa including Nigeria. For this reason, the indications of mammography have not been well defined in our setting. The aim of this study was to audit our mammography requests, with a view to improving its application in our setting. This is a descriptive study carried out on 69 female patients who had mammography at the National Obstetric Fistula Centre, Abakaliki, from January 2014 to December 2015. Findings on clinical examination were entered in a proforma. Mammography was performed in craniocaudal and mediolateral views using the Lorad M-IV (film-screen) mammography machine. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 21. All 69 patients were females. Their mean age was 42.1 ± 11 years. Majority of the patients (69.6%) were between 30 and 49 years. The commonest indication for mammography was breast lump which was found in 46 patients (66.7%). Breast pain was present in 36 (52.2%) of patients. The different Breast Imaging Reporting and Data System (BIRADS) categories were BIRADS 0: 20 (28.99%), BIRADS 1: 8 (11.59%), BIRADS 2: 9 (13.04%), BIRADS 3: 4 (5.8%), BIRADS 4: 19 (27.54%) and BIRADS 5: 9 (13.04%). Diagnostic mammography remains the commonest indication for mammography in our setting. Public awareness, poverty reduction and ready availability of mammography facilities are required to improve screening mammography in our setting.

  13. Mammography - recent technical developments and their clinical potential

    Energy Technology Data Exchange (ETDEWEB)

    Hemdal, Bengt; Mattsson, Soeren [Malmoe Univ. Hospital (Sweden). Dept. of Radiation Physics; Andersson, Ingvar [Malmoe Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Thilander Klang, Anne [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Medical Physics and Biomedical Engineering; Bengtsson, Gert; Jarlman, O. [Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology; Leitz, Wolfram [Swedish Radiation Protection Authority, Stockholm (Sweden); Bjurstam, Nils [Univ. of North Norway, Troms (Norway). Dept. of Radiology

    2002-05-01

    The recent technical developments in digital as well as screen-film X-ray mammography have been reviewed in order to evaluate their clinical potential and to analyse possible lines for future development. Material and methods: The scientific literature has been reviewed, conferences covered and contacts with colleagues developed. Companies in the field have been inquired and invited for presentations. Own experience has been gathered from different screen-film and digital mammography systems. Results and conclusions: Although there are important complementary techniques such as ultrasound and magnetic resonance imaging (MRI), X-ray mammography is still the golden standard for breast imaging. It is relatively simple and cost-effective, and it is presently the only realistic technique for screening in a large scale. It is still largely the only technique that can detect breast cancer in a pre invasive stage. Equipment for digital mammography is commercially available both with small area and full field technique (FFDM). The development of FFDM systems is now intense, as well as the development of dedicated workstations and computer-aided detection (CAD). In spite of this, the introduction of digital mammography has been very slow compared to most other X-ray examinations due to high costs and technical challenges to meet the high demands on image quality and dose in mammography as well as the demands on specialised workflow support for screening mammography and suitable display techniques. Film reading of digital mammograms has been the most common display mode so far, but to take full advantage of the digital concept, diagnostic as well as logistic, monitor reading must be applied. There is a potential of FFDM systems for significantly higher image quality or significantly lower dose than screen-film mammography (SFM), or both. Further research is necessary to fully use this potential. The investment costs are much higher for digital than screen-film mammography

  14. Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk.

    Science.gov (United States)

    Morman, Nichole A; Byrne, Lindsey; Collins, Christy; Reynolds, Kelly; Bell, Jeffrey G

    2017-08-01

    The purpose of this study was to evaluate the utility of a breast cancer risk assessment (BCRA) at the time of screening mammogram. Women whose BCRA indicated a high risk for cancer received a letter with instructions for breast health care and genetic counseling if appropriate. After 6 months this group received surveys to evaluate their risk perception and their recall of, and compliance with, recommendations. We also explored the impact of other variables such as a recommendation for genetic counseling and physician communication with the women. After the BCRA, the majority of high risk women reported no change in their perceived risk of cancer. A woman's perceived risk of cancer after a BCRA was significantly associated with her recall of recommendations for breast health care, but not with compliance. A recommendation for genetic counseling was not significantly related to women's perceived risk of cancer after the BCRA. Ten percent of women who should have obtained genetic counseling actually completed an appointment. Women who discussed their BCRA results with their physicians were more compliant with a six month breast exam with a doctor (53% vs 17%, p = 0.018). Overall, women felt that the BCRA was helpful and did not cause undue stress or anxiety. Although the cohort's compliance with recommendations was suboptimal, physicians' interactions with their patients may have a positive influence on their compliance.

  15. Dual-energy in mammography: feasibility study

    Science.gov (United States)

    Jafroudi, Hamid; Lo, Shih-Chung B.; Li, Huai; Steller Artz, Dorothy E.; Freedman, Matthew T.; Mun, Seong K.

    1996-04-01

    The purpose of this work is to examine the feasibility of dual-energy techniques to enhance the detection of microcalcifications in digital mammography. The digital mammography system used in this study consists of two different mammography systems; one is the conventional mammography system with molybdenum target and Mo filtration and the other is the clinical version of a low dose x-ray system with tungsten target and aluminum filtration. The low dose system is optimized for screen-film mammography with a highly efficient scatter rejection device built by Fischer Imaging Systems for evaluation at NIH. The system was designed by the University of Southern California based on multiparameter optimization techniques. Prototypes of this system have been constructed and evaluated at the Center for Devices and Radiological Health. The digital radiography system is based on the Fuji 9000 computed radiography (CR) system which uses a storage phosphor imaging plate as the receptor. High resolution plates (HR-V) are used in this study. Dual-energy is one technique to reduce the structured noise associated with the complexity of the background of normal anatomy surrounding a lesion. This can be done by taking the advantage of the x-ray attenuation characteristics of two different structures such as soft tissue and bone in chest radiography. We have applied this technique to the detection of microcalcifications in mammography. The overall system performance based on this technique is evaluated. Results presented are based on the evaluation of phantom images.

  16. Mammography use and mode of detection among breast cancer patients in Estonia.

    Science.gov (United States)

    Innos, Kaire; Valvere, Vahur; Padrik, Peeter; Eelma, Evelyn; Kütner, Riina; Lehtsaar, Jaak; Tekkel, Mare

    2016-01-01

    The aim of this study was to examine past mammography use and mode of detection among breast cancer (BC) patients in Estonia, a country that has low screening coverage and high BC mortality. Women newly diagnosed with primary BC in Estonia in 2008-2010 were interviewed. Determinants of past mammography use and the detection of BC by mammography were studied using multivariate logistic regression. Among 977 participants, almost half reported no mammograms prior to the detection of BC. Overall, 22% of the cases were detected by mammography (16% by screening mammography). Detection by mammography was strongly related to age, past mammography use, and obesity. Among cases detected by mammography, 10% were stage III/IV at diagnosis (32% among cases detected by other modes). This study showed low mammography utilization and high rate of self-detection of BC in Estonia. Increased detection by mammography would help diagnose the disease at an earlier stage and consequently avoid premature BC deaths. Efforts should be undertaken to increase participation in screening and improve the availability of mammography among older and high-risk women. The results are likely to be relevant for other countries and population groups with low screening coverage.

  17. Toxicological assessment of heavy straight run naphtha in a repeated dose/reproductive toxicity screening test.

    Science.gov (United States)

    McKee, Richard H; Steup, David; Schreiner, Ceinwen; Podhasky, Paula; Malley, Linda A; Roberts, Linda

    2014-01-01

    Gasoline blending stocks (naphthas) are comprised of normal, iso- and cycloparaffins and aromatic hydrocarbons with carbon numbers ranging from C4 to C12. Heavy straight run naphtha (HSRN, CAS number 64741-41-9) was selected for toxicity screening because substances of this type contain relatively high levels (28%) of cycloparaffins by comparison to other naphtha streams and the data complement toxicity information on other gasoline blending streams. Rats were exposed by inhalation to wholly vaporized material at levels of approximately 100, 500, or 3000 parts per million (ppm) daily to screen the potential for systemic toxicity, neurotoxicity, reproductive toxicity, and developmental effects to postnatal day 4. All animals survived the treatment period. Principal effects of repeated exposure included increased liver weights in males and females, increased kidney weights in males, and histological changes in the thyroid, secondary to liver enzyme induction. These changes were not considered to be toxicologically meaningful and are not relevant to humans. There were no treatment-related effects in functional observation tests or motor activity; no significant reductions in fertility or changes in other reproductive parameters; and no evidence of developmental toxicity in offspring. The overall no observed adverse effect concentration was 3000 ppm (approximately 13, 600 mg/m(3)). In conclusion the HSRN effects on liver and kidney are consistent with the results of other studies of volatile fractions or other naphthas or formulated gasoline, and there were no HSRN effects on neurological developmental or reproductive parameters.

  18. A simplified method for screening siblings for HLA identity using short tandem repeat (STR) polymorphisms.

    Science.gov (United States)

    Schiller, Jennifer J; Hopp, Kathleen A; Pietz, Bradley C; Bick, David P; Lau, Eduardo C; Ellis, Thomas M

    2013-05-01

    Identifying an HLA-matched sibling donor for hematopoietic stem cell transplantation (HSCT) is time-consuming and expensive, and often limited by reimbursement caps imposed by insurance providers. To improve the effectiveness and efficiency of screening for HLA-matched siblings, we developed an assay for determining HLA identity using a panel of nine informative short tandem repeat (STR) loci located throughout the HLA complex. The STR panel was assessed for accuracy in identifying HLA-matched siblings in 88 family workups comprising a total of 132 related donor and recipient typing comparisons. All sibling pairs with identical STR alleles were also HLA identical. Of the 48 pairs mismatched at one or more STR alleles, all were genotypically HLA non-identical at one or more loci. The sensitivity and specificity of STR analysis for identifying HLA-matched siblings were 91% and 100%, respectively. Three false negatives occurred due to an STR mutation or possible HLA-DPB1/DQB1 recombination. Additionally, STR genotyping provided additional information allowing determination of the extent of HLA identity in families where HLA haplotype inheritance was ambiguous, due to extensive homozygosity or shared parental haplotypes. The HLA STR assay is a reliable and rapid test that can be used to inexpensively screen potential sibling donors for HLA identity.

  19. Perspectives of the digital mammography platform; Perspektiven der digitalen Mammographieplattform

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, R.; Riedl, C.C.; Reisegger, M.; Pinker, K.; Sturm, E.; Semturs, F.; Helbich, T.H. [Medizinische Universitaet Wien, Abteilung fuer Allgemeine Radiologie und Kinderradiologie, Division fuer Molekulare und Gender-Bildgebung, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2010-11-15

    In Europe one out of every nine women suffers from breast cancer during her lifetime. Since the introduction of mammography screening programs more breast cancers are being diagnosed when they are still small and early stage cancers with a favourable prognosis. The introduction of digital mammography systems has led to a continuous reduction of breast cancer mortality especially in specific patient subgroups. Furthermore, the digital mammography platform enables the development of new, innovative breast imaging methods to increase sensitivity and decrease breast cancer mortality. This digital mammography platform includes digital breast tomosynthesis, digital contrast medium mammography and digital contrast medium breast tomosynthesis as well as fused data sets from digital mammography with ultrasound or MRI. The following article summarizes these new applications, describes the strengths of the digital platform and illustrates the potential advantages of an improved breast cancer diagnosis by digital mammography. (orig.) [German] Etwa jede neunte Frau in Europa erkrankt im Laufe ihres Lebens an Brustkrebs. Durch die Einfuehrung von Mammographiescreeningprogrammen werden immer mehr kleine Brustkarzinome in einem fruehen Stadium entdeckt. Die Einfuehrung der digitalen Mammographie erzielt insbesondere bei bestimmten Patientinnengruppen eine weitere kontinuierliche Senkung der Brustkrebsmortalitaet. Zusaetzlich ermoeglicht die digitale Mammographie die Entwicklung neuer und Fusion bereits existierender bildgebender Methoden. Zu dieser ''digitalen Mammographieplattform'' gehoeren die digitale Brusttomosynthese, die digitale Kontrastmittelmammographie und die digitale Kontrastmittel-Brusttomosynthese sowie fusionierte Datensaetze der digitalen Mammographie mit dem Ultraschall oder der MRT. Diese innovativen Techniken bieten die Moeglichkeit, die Sensitivitaet der Mammographie zu steigern und die Brustkrebsmortalitaet weiter zu senken. Der folgende

  20. Beyond the mammography debate: a moderate perspective.

    Science.gov (United States)

    Kaniklidis, C

    2015-06-01

    After some decades of contention, one can almost despair and conclude that (paraphrasing) "the mammography debate you will have with you always." Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete. To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis-also known as three-dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patient-accessible levels to facilitate informed decisions.

  1. Clinical Analysis of Color Doppler Ultrasound and X-ray Mammography in Screening Female Breast Cancer%彩超与X线钼靶筛查妇女乳腺癌临床分析

    Institute of Scientific and Technical Information of China (English)

    冯庆菁; 骆有寿; 徐惊; 黄晓芸; 朱超群; 周广慧

    2016-01-01

    Objective To discuss the effect of color Doppler ultrasound and x-ray mammography in screening female breast cancer. Methods 118 cases of patients with breast cancer diagnosed in our hospital from October 2012 to October 2015 were selected and screened and diagnosed with color Doppler ultrasound and X-ray mammography, and the diagnostic re-sults of them were compared. Results The coincident rate and detection rate of blood flow signal of color ultrasonic diagno-sis were obviously higher than those of x-ray mammography diagnosis, and the differences were obvious(P<0.05), the calci-fication detection rate of x-ray mammography was higher than that of the color Doppler ultrasound, and the difference was obvious(P<0.01), the coincident rate of pathological report and color ultrasonic diagnosis was 93.22%(110/118), the coinci-dent rate of X-ray mammography diagnosis was 79.66%(94/118), and the sensitivity, specificity, missed detection rate and misdiagnosis rate were respectively 93.55%, 97.70%, 6.45% and 2.30%. Conclusion Both color Doppler ultrasound and x-ray mammography in diagnosis of breast cancer are effective diagnostic methods, and each has its advantages and disadvan-tages, which can be selected according to the specific conditions of patients.%目的:探究彩超与X线钼靶对妇女乳腺癌的筛查效果。方法整群选择该院2012年10月—2015年10月确诊的118例乳腺癌患者,对其采用彩超和X线钼靶进行筛查诊断,对比两者诊断结果。结果彩超诊断符合率、血流信号检出率显著高于X线钼靶诊断,差异有统计学意义(P<0.05);X线钼靶的钙化检出率高于彩超,差异有统计学意义(P<0.01)。彩超诊断病理报告符合率为93.22%(110/118),X线钼靶诊断符合率为79.66%(94/118),彩超检查的灵敏度为93.55%,特异度为97.70%,漏检率为6.45%,误诊率为2.30%。结论彩超与X线钼靶诊断乳腺癌均为有效诊断方式,且各有利弊,可根据患者具体情况选择。

  2. Yes to early detection of cancer - no to routine mammography examinations. Parting from wishful thinking, turning to new strategies

    CERN Document Server

    Dersee, T; Koehnlein, W; Kuni, H; Lengfelder, E; Pflugbeil, S; Schmitz-Feuerhake, I

    2002-01-01

    Many experts find it difficult to accept what experience has shown, namely that routine mammography examinations have lowered neither the breast cancer fatality rate nor the crude death rate. One aspect that has been neglected in propagating screenings is the high radiation sensitivity of genetically predisposed females (0.5% - 1.0%). These females should not be exposed to repeated X-rays for screening purposes. True preventive measures, which promise significant effects, include the avoidance of radiation exposure, especially during the early stages of life, and a restrictive use of oestrogen substitution therapies.

  3. Prospective study on determinants of repeat attendance and attendance patterns in breast cancer screening using the Theory of Planned Behaviour.

    NARCIS (Netherlands)

    Drossaert, Constance H.C.; Boer, Hendrik; Seydel, E.R.

    2003-01-01

    This prospective study, using the Theory of Planned Behaviour (TPB) as a theoretical framework, was carried out to identify the determinants of repeat attendance and attendance patterns in organised breast screening. A group of 2657 women filled out a baseline questionnaire, approximately 8 weeks

  4. A transcription blocker isolated from a designed repeat protein combinatorial library by in vivo functional screen.

    Science.gov (United States)

    Tikhonova, Elena B; Ethayathulla, Abdul S; Su, Yue; Hariharan, Parameswaran; Xie, Shicong; Guan, Lan

    2015-01-28

    A highly diverse DNA library coding for ankyrin seven-repeat proteins (ANK-N5C) was designed and constructed by a PCR-based combinatorial assembly strategy. A bacterial melibiose fermentation assay was adapted for in vivo functional screen. We isolated a transcription blocker that completely inhibits the melibiose-dependent expression of α-galactosidase (MelA) and melibiose permease (MelB) of Escherichia coli by specifically preventing activation of the melAB operon. High-resolution crystal structural determination reveals that the designed ANK-N5C protein has a typical ankyrin fold, and the specific transcription blocker, ANK-N5C-281, forms a domain-swapped dimer. Functional tests suggest that the activity of MelR, a DNA-binding transcription activator and a member of AraC family of transcription factors, is inhibited by ANK-N5C-281 protein. All ANK-N5C proteins are expected to have a concave binding area with negative surface potential, suggesting that the designed ANK-N5C library proteins may facilitate the discovery of binders recognizing structural motifs with positive surface potential, like in DNA-binding proteins. Overall, our results show that the established library is a useful tool for the discovery of novel bioactive reagents.

  5. Genetic screening in infertile Mexican men: chromosomal abnormalities, Y chromosome deletions, and androgen receptor CAG repeat length.

    Science.gov (United States)

    Martínez-Garza, Sandra Guadalupe; Gallegos-Rivas, Mayra Celina; Vargas-Maciel, Marcos; Rubio-Rubio, Juan Manuel; de Los Monteros-Rodríguez, Mario Espinosa; González-Ortega, Claudia; Cancino-Villarreal, Patricia; de Lara, Luis G Vazquez; Gutiérrez-Gutiérrez, Antonio Martín

    2008-01-01

    In our study, we analyzed chromosomal abnormalities, Y chromosome deletions, androgen receptor CAG repeat length and their association with defective spermatogenesis in infertile Mexican men. Eighty-two infertile patients and 40 controls were screened for karyotypic abnormalities, Y chromosome microdeletions, and CAG repeats. Nine infertile males (11%) carried chromosomal abnormalities and 10 (12.2%) presented Y chromosome microdeletions. The mean CAG repeat length was 21.6 and 20.88 base pairs in idiopathic infertile males and controls, respectively. Our results suggest that chromosomal aberrations and Y-chromosomal microdeletions are related to male infertility in Mexican men. In addition, expansion of the CAG repeat segments of the androgen receptor is not correlated with male idiopathic infertility.

  6. Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: a prospected population based study in the south of The Netherlands.

    Science.gov (United States)

    Klompenhouwer, Elisabeth G; Voogd, Adri C; den Heeten, Gerard J; Strobbe, Luc J A; de Haan, Anton F J; Wauters, Carla A; Broeders, Mireille J M; Duijm, Lucien E M

    2015-02-01

    To prospectively determine the screening mammography outcome at blinded and non-blinded double reading in a biennial population based screening programme in the south of the Netherlands. We included a consecutive series of 87,487 digital screening mammograms, obtained between July 2009 and July 2011. Screening mammograms were double read in either a blinded (2nd reader was not informed about the 1st reader's decision) or non-blinded fashion (2nd reader was informed about the 1st reader's decision). This reading strategy was alternated on a monthly basis. Women with discrepant readings between the two radiologists were always referred for further analysis. During 2 years follow-up, we collected the radiology reports, surgical correspondence and pathology reports of all referred women and interval breast cancers. Respectively 44,491 and 42,996 screens had been read either in a blinded or non-blinded fashion. Referral rate (3.3% versus 2.8%, preading whereas the cancer detection rate per 1000 screens (7.4 versus 6.5, p=0.14) and positive predictive value of referral (22% versus 23%, p=0.51) were comparable. Blinded double reading resulted in a significantly higher programme sensitivity (83% versus 76%, p=0.01). Per 1000 screened women, blinded double reading would yield 0.9 more screen detected cancers and 0.6 less interval cancers than non-blinded double reading, at the expense of 4.4 more recalls. We advocate the use of blinded double reading in order to achieve a better programme sensitivity, at the expense of an increased referral rate and false positive referral rate. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. 社区女性钼靶筛查行为现状及影响因素研究%Status and influencing factors of mammography screening behaviors of women in community

    Institute of Scientific and Technical Information of China (English)

    陈乐英; 吴怡颖; 郁骐襄; 沈坤炜; 方琼

    2016-01-01

    Objective To investigate the status of mammography screening behaviors of women in community, and analyze the influencing factors. Methods The questionnaire about early screening of breast cancer was used to investigate 1 502 women from 16 communities in Shanghai. Results Among the women older than 40 years,544(49. 5% )never underwent mammography examination;Only 284 women(25. 8% )underwent annual mammography examination. The influecing factors included personal breast disease history, the accessibility of breast examination,the level of konwledge of breast self-examination methods,and professional medical staff and equipment in the hospital. Conclusion The status of mammography screening behaviors of women in community is not optimistic. Healthcare workers should explore the ways how to improve early breast cancer screening behaviors.%目的:调查社区女性实施乳腺钼靶筛查行为的现状,并分析其影响因素。方法采用陈瑜等编制的乳腺癌早期筛查行为问卷,于2012年对上海16个社区共1502名女性进行问卷调查。内容包括基本情况、乳腺钼靶筛查的可及性及早期筛查行为3个部分,共18项选择题。结果调查显示,≥40岁的女性中,有544名(占49.5%)从未做过乳腺钼靶检查,仅有284名(占25.8%)每年参与乳腺钼靶检查,乳腺疾病史、是否有机会参加乳腺健康检查、是否知道乳腺自我检查方法、医院是否有专业检查人员及设备是重要影响因素(F =34.427,P <0.001,R2=0.468)。结论目前社区女性参与乳腺钼靶筛查行为处于较低水平,医护人员需从其影响因素着手,探索并研究如何提高女性乳腺保健意识,促进乳腺癌早期筛查的普遍开展。

  8. Frequently Asked Questions about Digital Mammography

    Science.gov (United States)

    ... Consumer Information (MQSA) Frequently Asked Questions About Digital Mammography Share Tweet Linkedin Pin it More sharing options ... mammography exams, such as DBT? What is digital mammography? Full field digital mammography (FFDM, also known simply ...

  9. Breast cancer detection using single-reading of breast tomosynthesis (3D-mammography) compared to double-reading of 2D-mammography: Evidence from a population-based trial.

    Science.gov (United States)

    Houssami, Nehmat; Bernardi, Daniela; Pellegrini, Marco; Valentini, Marvi; Fantò, Carmine; Ostillio, Livio; Tuttobene, Paolina; Luparia, Andrea; Macaskill, Petra

    2017-04-01

    Most population breast cancer (BC) screening programs use double-reading of 2D-mammography. We recently reported the screening with tomosynthesis or standard mammography-2 (STORM-2) trial, showing that double-read tomosynthesis (pseudo-3D-mammography) detected more BC than double-read 2D-mammography. In this study, we compare screen-detection measures for single-reading of 3D-mammography with those for double-reading of 2D-mammography, to inform screening practice. This is a secondary analysis based on STORM-2 which prospectively compared 3D-mammography and 2D-mammography in sequential screen-readings. Asymptomatic women ≥49 years who attended population-based screening (Trento, 2013-2015) were recruited. Participants recalled at any screen-read from parallel double-reading arms underwent further testing and/or biopsy. Single-reading of 3D-mammography, integrated with acquired or synthetized 2D-mammograms, was compared to double-reading of 2D-mammograhy alone for screen-detection measures: number of detected BCs, cancer detection rate (CDR), number and percentage of false-positive recall (FPR). Paired binary data were compared using McNemar's test. Screening detected 90, including 74 invasive, BCs in 85 of 9672 participants. CDRs for single-reading using integrated 2D/3D-mammography (8.2 per 1000 screens; 95% CI 6.5-10.2) or 2D synthetic/3D-mammography (8.4 per 1000 screens; 95% CI: 6.7-10.4) were significantly higher than CDR for double-reading of 2D-mammography (6.3 per 1000 screens; 95% CI: 4.8-8.1), Pread 2D/3D-mammography (2.60%; 95% CI: 2.29-2.94), or single-read 2D synthetic/3D-mammography (2.76%; 95% CI: 2.45-3.11), were significantly lower than FPR% for double-read 2D-mammography (3.42%; 95% CI: 3.07-3.80), Preading of 3D-mammography (integrated 2D/3D or 2Dsynthetic/3D) detected more BC, and had lower FPR, compared to current practice of double-reading 2D-mammography alone - these findings have implications for population BC screening programs. Copyright

  10. Digital mammography and their developments; Digitale Mammografie und ihre Weiterentwicklung

    Energy Technology Data Exchange (ETDEWEB)

    Wienbeck, Susanne [Universitaetsmedizin Goettingen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Fischer, Uwe [Diagnostisches Brustzentrum Goettingen (Germany)

    2015-09-15

    At the present time digital mammography is a satisfactory breast diagnostic imaging in clinical as well as screening mammography in defined age groups. Nevertheless it shows beside the application of ionizing radiation in women with dense breasts limitations in the detection of non calcification breast cancers. Tomosynthesis, digital contrast-enhanced mammography and breast-CT with or without contrast media lead to better results. Especially the application of contrast media for the visualisation of the tumor angiogenesis is invariably superior to all other non-contrast imaging modalities. However, the excellent results of breast MRI will be probably accessible with none of the new procedures.

  11. Improvement of detectability of microcalcifications by magnification digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Higashida, Yoshiharu [Kumamoto Univ. (Japan). College of Medical Science; Hatemura, Masahiro; Yoshida, Akira; Takada, Takao; Takahashi, Mutsumasa

    1998-08-01

    Our aim in this study was to evaluate the potential utility of magnification mammography with a CR system by investigating the basic imaging parameters and detectability of microcalcifications in comparison with those of conventional screen-film systems. The basic imaging parameters were evaluated by measuring scatter fraction, modulation transfer function (MTF), Wiener spectrum, and incident dose for the various magnification factors. The detection of simulated microcalcifications in radiographs of a mammographic phantom and breast specimens were evaluated subjectively and quantitatively for screen-film and CR techniques with various magnification factors. The scatter fraction of digital magnification mammography decreased with increasing magnification factor. MTF of magnification digital mammography improved with increasing magnification factor. The detectability of microcalcifications with the CR system was significantly improved by magnification technique. From the above results, it is expected that the use of magnification mammography with a CR system will improve the detectability of microcalcification. (author)

  12. Apresentação de resultados de um serviço de rastreamento mamográfico com ênfase na auditoria epidemiológica Outcome of a screening mammography practice with regard to epidemiological audit

    Directory of Open Access Journals (Sweden)

    Hélio Sebastião Amâncio de Camargo Júnior

    2009-10-01

    Full Text Available OBJETIVO: apurar os dados epidemiológicos de uma clínica de diagnóstico mamário. MÉTODOS: foram estudadas as mamografias de 35.041 pacientes, em um período de 2 anos e 7 meses, entre 2004 e 2006, sendo 32.049 (91,5% de rastreamento e 2.992 (8,5% de pacientes sintomáticas. Foram calculados: taxa de detecção das pacientes de rastreamento; porcentagem de câncer nas pacientes sintomáticas; taxa de indicação de biópsias; porcentagem de carcinomas mínimos, in situ e nos estádios 0 e I; taxa de reconvocação; e valor preditivo positivo das mamografias lidas como anormais e das indicações de biópsias nas pacientes de rastreamento. RESULTADOS: houve 228 diagnósticos de câncer de mama, 111 em pacientes de rastreamento (taxa de detecção 0,34% e 117 em pacientes sintomáticas (3,91% do total. Foram feitas 544 recomendações de biópsias nas pacientes de rastreamento (1,7% das pacientes rastreadas. Nas pacientes de rastreamento, houve 28% de carcinomas mínimos, 10% de carcinomas in situ e 93% de carcinomas nos estádios 0 e I. A taxa de reconvocação foi de 19%. A taxa de positividade das mamografias lidas como anormais (VPP1 foi de 1,65%. A taxa de positividade das biópsias (VPP2 foi 21,9%. CONCLUSÕES: esse estudo traz dados epidemiológicos de importância para a auditoria do rastreamento mamográfico, os quais são raros em nosso meio. Os dados foram analisados em comparação com o que é recomendado pela literatura, sendo encontradas taxa de detecção e porcentagem de carcinomas mínimos e in situ comparáveis aos valores preconizados, mas com valores de VPP abaixo do ideal.PURPOSE: to check epidemiological data from a breast diagnostic clinic. METHODS: mammographies from 35,041 patients were studied, within a period of 2 years and 7 months, from 2004 to 2006, 32,049 (91.5% of them from screening, and 2,992 from symptomatic patients (8.5%. The calculated parameters were: detection rate of the screening patients, percentage

  13. FDA Certified Mammography Facilities

    Science.gov (United States)

    ... Program Consumer Information (MQSA) Search for a Certified Facility Share Tweet Linkedin Pin it More sharing options ... Email Print This list of FDA Certified Mammography Facilities is updated weekly. If you click on Search ...

  14. Screening for C9orf72 repeat expansions in Chinese amyotrophic lateral sclerosis patients.

    Science.gov (United States)

    Zou, Zhang-Yu; Li, Xiao-Guang; Liu, Ming-Sheng; Cui, Li-Ying

    2013-06-01

    An intronic GGGGCC hexanucleotide repeat expansion in the C9orf72 gene was recently identified as a major cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia in white populations. To determine if the C9orf72 repeat expansion was present in ALS patients in Chinese populations, we studied the size of the hexanucleotide repeat expansion in a cohort of familial and sporadic ALS patients of Chinese origin. No expanded hexanucleotide repeats were identified. This indicates that C9orf72 mutations are not a common cause of familial or sporadic ALS in Chinese mainland.

  15. Mammography results analysis of breast diseases screening in 100 000 healthy women%10万例妇女乳腺筛查影像结果分析

    Institute of Scientific and Technical Information of China (English)

    巴蕾; 管延升; 朱玲英; 蔡玲红; 应灵鹏

    2013-01-01

    %(455/619) respectively in benign diseases. Conclusion Digital mammography is useful for breast diseases screening, and it is helpful for preventing the rmsdiagnosis of breast cancer for the follow up patients with Bl-RADS 3 after the breast screening.%目的 分析浙江温岭市10万例40岁以上健康妇女数字乳腺钼靶X线筛查结果,探讨数字乳腺X线摄影检出乳腺良恶性病变的意义,提高对早期乳腺癌的诊断水平.方法 回顾性分析10万份数字乳腺X线筛查片,征象分析参照美国放射学会推荐的乳腺影像报告和数据系统(breast imaging reporting and data system,BIRADS)分类;并对病理干预的病例进行影像分析;0、4和5均召回经B超进一步检查,其中3级半年后召回进行随访.结果 (1)10万例乳腺X线筛查妇女中,农村和城市妇女所占的百分比分别为62.6%和37.4%;共791例受检妇女的乳腺病变最终经病理学证实,其中恶性172例,良性619例.(2)在10万例乳腺X线受检者中,BIRADS分类为0、1、2、3、4和5的百分比分别为1.0%、70.9%、22.0%、5.7%、0.3%和0.1%,阳性发现率(BIRADS分类为4及其以上者)为0.4%;对照病理结果,恶性病变多发生在BIRADS 分类为4及其以上者,且二者有统计学意义(P<0.05).(3) 172例筛查癌中,52.9% (91/172)为早期乳腺癌(导管原位癌47例,I期浸润性乳腺癌44例),47.1%(81/172)为Ⅱ期癌.在X线上,69.2%(63/91)的早期乳腺癌患者主要表现为钙化;65.4%(53/81)的Ⅱ期癌患者则以高密度肿块为主要表现.(4) 本组筛查BIRADS 3级者共5 676人次,半年后随访3级回叫率为73.9%(4 200人次),其中病理干预的共91例中共检出7例恶性病变.(5)在791例病理证实的乳腺病变中,B超及X 线检出恶性病变的准确度分别为67.4%(116/172)和97.7%(168/172),检出良性病变的准确度分别为94.0% (582/619) 和73.5%(455/619).结论数字化乳腺X线摄影适合进行乳腺癌筛查,在乳腺筛查后对3级进行短期随访可有效避免乳腺癌的漏诊.

  16. MR Mammography (MRM). MR-Mammographie (MRM)

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, W.A. (Radiologische Universitaetsklinik Bonn (Germany))

    1991-01-01

    MR mammography is carried out using a special breast coil. Gd-DTPA is injected as a contrast medium. Gradient-echo sequences are superior to the formerly used spin-echo sequences in that they show a greater sensitivity to contrast media. After the advent of gradient-echo sequences, the 0.2 mmol/kg dose that used to be injected in connection with spin-echo sequences was regarded as being too high. The best results were then achieved with 0.1 mmol/kg injections amounting to no more than 50% of the former dose. Provided that magnetic resonance imaging of the breast is carried out using the spexial examination technique discussed here, it may justly be described as magnetic resonance mammography (MRM). MR criteria are defined for such conditions as carcinoma, fibroadenoma, scars, mastopathy and cysts. (GDG).

  17. Screening for ovarian cancer in women with varying levels of risk, using annual tests, results in high recall for repeat screening tests

    Directory of Open Access Journals (Sweden)

    Nobbenhuis Marielle AE

    2011-11-01

    Full Text Available Abstract Background We assessed ovarian cancer screening outcomes in women with a positive family history of ovarian cancer divided into a low-, moderate- or high-risk group for development of ovarian cancer. Methods 545 women with a positive family history of ovarian cancer referred to the Ovarian Screening Service at the Royal Marsden Hospital, London from January 2000- December 2008 were included. They were stratified into three risk-groups according to family history (high-, moderate- and low-risk of developing ovarian cancer and offered annual serum CA 125 and transvaginal ultrasound screening. The high-risk group was offered genetic testing. Results The median age at entry was 44 years. The number of women in the high, moderate and low-risk groups was 397, 112, and 36, respectively. During 2266 women years of follow-up two ovarian cancer cases were found: one advanced stage at her fourth annual screening, and one early stage at prophylactic bilateral salpingo-oophorectomy (BSO. Prophylactic BSO was performed in 138 women (25.3%. Forty-three women had an abnormal CA125, resulting in 59 repeat tests. The re-call rate in the high, moderate and low-risk group was 14%, 3% and 6%. Equivocal transvaginal ultrasound results required 108 recalls in 71 women. The re-call rate in the high, moderate, and low-risk group was 25%, 6% and 17%. Conclusion No early stage ovarian cancer was picked up at annual screening and a significant number of re-calls for repeat screening tests was identified.

  18. Healthcare Factors for Obtaining a Mammogram in Latinas With a Variable Mammography History

    Science.gov (United States)

    Scheel, John R.; Molina, Yamile; Coronado, Gloria D.; Bishop, Sonia; Doty, Sarah; Jimenez, Ricardo; Thompson, Beti; Lehman, Constance D.; Beresford, Shirley A.A.

    2017-01-01

    Purpose/Objectives To understand the relationship between mammography history and current thoughts about obtaining a mammogram among Latinas and examine the mediation effects of several healthcare factors. Design Cross-sectional survey. Setting Federally qualified health centers (Sea Mar Community Health Centers) in western Washington. Sample 641 Latinas nonadherent and adherent with screening mammography. Methods Baseline survey data from Latinas with a mammography history of never, not recent (more than two years), or recent (less than two years) were analyzed. Preacher and Hayes methods were used to estimate the mediation effect of healthcare factors. Main Research Variables The survey assessed mammography history, sociodemographic and healthcare factors, and current thoughts about obtaining a mammogram. Findings Latinas’ thoughts about obtaining a mammogram were associated with mammography history. Having had a clinical breast examination mediated 70% of differences between Latinas with a never and recent mammography history. Receipt of a provider recommendation mediated 54% of differences between Latinas with and without a recent mammography history. Conclusions These findings emphasize the importance of the patient–provider relationship during a clinic visit and help inform how nurses may be incorporated into subsequent screening mammography interventions tailored to Latinas. Implications for Nursing As providers, health educators, and researchers, nurses have critical roles in encouraging adherence to screening mammography guidelines among Latinas. PMID:27991613

  19. An assessment of American Indian women's mammography experiences

    Directory of Open Access Journals (Sweden)

    Faseru Babalola

    2010-12-01

    Full Text Available Abstract Background Mortality from breast cancer has increased among American Indian/Alaskan Native (AI/AN women. Despite this alarming reality, AI/AN women have some of the lowest breast cancer screening rates. Only 37% of eligible AI/AN women report a mammogram within the last year and 52% report a mammogram within the last two years compared to 57% and 72% for White women. The experiences and satisfaction surrounding mammography for AI/AN women likely are different from that of women of other racial/ethnic groups, due to cultural differences and limited access to Indian Health Service sponsored mammography units. The overall goals of this study are to identify and understand the mammography experiences and experiential elements that relate to satisfaction or dissatisfaction with mammography services in an AI/AN population and to develop a culturally-tailored AI/AN mammography satisfaction survey. Methods and Design The three project aims that will be used to guide this work are: 1 To compare the mammography experiences and satisfaction with mammography services of Native American/Alaska Native women with that of Non-Hispanic White, Hispanic, and Black women, 2 To develop and validate the psychometric properties of an American Indian Mammography Survey, and 3 To assess variation among AI/AN women's assessments of their mammography experiences and mammography service satisfaction. Evaluations of racial/ethnic differences in mammography patient satisfaction have received little study, particularly among AI/AN women. As such, qualitative study is uniquely suited for an initial examination of their experiences because it will allow for a rich and in-depth identification and exploration of satisfaction elements. Discussion This formative research is an essential step in the development of a validated and culturally tailored AI/AN mammography satisfaction assessment. Results from this project will provide a springboard from which a maximally

  20. Practical digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Beverly E. [Washington Univ., Seattle, WA (United States)]|[Virginia Mason Medical Center, VA (United States)

    2008-07-01

    This book is meant for the radiologist who is facing the challenge of organizing a digital mammographic imaging center. This text is meant to be a practical book that provides information about digital mammographic physics and equipment which will allow one to intelligently compare technologies and systems. Some of the major challenges include: large expense; rapidly changing technology, and inconsistent connectivity; and finally, need for strong information technology support. The initial conversion cost to digital mammographic imaging is relatively expensive due to the cost of digital mammography hardware, software, and storage. Virtually all other imaging modalities are being converted to purely digital storage and transfer, and the digital trend in mammography is inevitable. Technical advantages of digital mammography are described. However, the improved flexibility in image display and transfer are some of its strongest features. In conclusion, although there are increasing imaging modalities that may be used to evaluate breast disease, mammography will continue to play a key role in detecting breast cancer. To be an effective imager, the radiologist should become familiar with digital mammography and understand its role within the increasing complex structure of breast imaging techniques.

  1. Introduction of the Mammography unit; SEPIO series

    Energy Technology Data Exchange (ETDEWEB)

    Nanbu, Yukiko; Sasaki, Osamu; Tsuji, Hisao [Shimadzu Corp., Medical Systems Division, Kyoto (Japan)

    2003-06-01

    Mammography unit SEPIO series are designed for the both screening and diagnosis of the breast cancer. SEPIO series have the following features; iso-centric C-arm rotation leads to high throughput, two phase compression method called Twincomp minimizes the blind are near chest wall and the bi-angular X-ray tube contributes to better image quality. Furthermore optional MaxVision system which has a function to pull the breast toward the film is introduced to SEPIO series. (author)

  2. Image quality in mammography

    Energy Technology Data Exchange (ETDEWEB)

    Haus, A.G.; Doi, K.; Metz, C.E. Bernstein, J.

    1976-01-01

    In mammography, image quality is a function of the shape, size, and x-ray absorption properties of the anatomic part to be radiographed and of the lesion to be detected; it also depends on geometric unsharpness, and the resolution, characteristic curve and noise properties of the recording system. X-ray energy spectra, modulation transfer functions, Wiener spectra, characteristic and gradient curves, and radiographs of a breast phantom and of a resected breast specimen containing microcalcifications are used in a review of some current considerations of the factors, and the complex relationship among factors, that affect image quality in mammography. Image quality and patient radiation exposure in mammography are interrelated. An approach to the problem of evaluating the trade-off between diagnostic certainty and the cost or risk of performing a breast imaging procedure is discussed.

  3. Sixty women a day examined with world-unique mammography system from Sectra. Breast disease centre in Sweden offers lowest radiation dose in the world

    CERN Multimedia

    2003-01-01

    "Sectra's digital mammography system, Sectra MicroDose Mammography(TM), has been used to examine more than 1,500 women in the Helsingborg Hospital mammography screening program. This was accomplished in the record time of two months in clinical operation. The system is now being used to examine more than sixty women every day" (1 page).

  4. CT screening for lung cancer: Frequency of enlarged adrenal glands identified in baseline and annual repeat rounds

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Minxia [Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY (United States); Capital Medical University, Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Beijing (China); Yip, Rowena; Yankelevitz, David Y.; Henschke, Claudia I. [Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY (United States)

    2016-12-15

    To determine the frequency of adrenal enlargement of participants in a CT-screening program for lung cancer and demonstrate the progression during follow-up, separately for baseline and annual repeat rounds. HIPAA-compliant informed consent was obtained in 4,776 participants. The adrenal gland was defined as enlarged if it measured ≥6 mm at its largest diameter. Logistic regression analyses were performed. At baseline, 202 (4 %) of 4,776 participants had adrenal enlargement. Significant factors were age (OR = 1.4, 95 % CI: 1.2-1.7) and current smoker (OR = 1.8, 95 % CI: 1.3-2.4). Follow-up 7-18 months after baseline for 133 cases with adrenal enlargement <40 mm showed it decreased or was stable in 85 (64 %), and increased by <10 mm in 48 (36 %). Five (0.04 %) cases of adrenal enlargement were newly identified, none increased beyond 40 mm on follow-up. Adrenal enlargement was a significant predictor of a subsequent diagnosis of lung cancer (OR = 2.0, 95 % CI: 1.2-3.4). Participants with adrenal enlargement <40 mm identified at baseline and on repeat screening could be reasonably assessed on subsequent annual screening. Adrenal enlargement increased with increasing pack-years of smoking. Adrenal enlargement was an independent predictor of a subsequent diagnosis of lung cancer. (orig.)

  5. Cultural Views, Language Ability, and Mammography Use in Chinese American Women

    Science.gov (United States)

    Liang, Wenchi; Wang, Judy; Chen, Mei-Yuh; Feng, Shibao; Yi, Bin; Mandelblatt, Jeanne S.

    2009-01-01

    Mammography screening rates among Chinese American women have been reported to be low. This study examines whether and how culture views and language ability influence mammography adherence in this mostly immigrant population. Asymptomatic Chinese American women (n = 466) aged 50 and older, recruited from the Washington, D.C. area, completed a…

  6. BIRADS mammography: exercises.

    Science.gov (United States)

    Balleyguier, Corinne; Bidault, François; Mathieu, Marie Christine; Ayadi, Salma; Couanet, Dominique; Sigal, Robert

    2007-02-01

    Some radiological cases are presented in this article to train the reader to the BIRADS classification in mammography. Each case is described according to the fourth American version of the BIRADS lexicon. Some classifications difficulties will also be presented, in order to show the complexity and the observer variability, commonly encountered in BIRADS 3 and 4 categories.

  7. Performance Study of Screen-Printed Textile Antennas after Repeated Washing

    Directory of Open Access Journals (Sweden)

    Kazani I.

    2014-06-01

    Full Text Available The stability of wearable textile antennas after 20 reference washing cycles was evaluated by measuring the reflection coefficient of different antenna prototypes. The prototypes’ conductive parts were screen-printed on several textile substrates using two different silver-based conductive inks. The necessity of coating the antennas with a thermoplastic polyurethane (TPU coating was investigated by comparing coated with uncoated antennas. It is shown that covering the antennas with the TPU layer not only protects the screen-printed conductive area but also prevents delamination of the multilayered textile fabric substrates, making the antennas washable for up to 20 cycles. Furthermore, it is proven that coating is not necessary for maintaining antenna operation and this up to 20 washing cycles. However, connector detachment caused by friction during the washing process was the main problem of antenna performance degradation. Hence, other flexible, durable methods should be developed for establishing a stable electrical connection.

  8. Effect of Mammography-Positive Criteria on the Cost-Effectiveness of Breast Cancer Screening%不同钼靶X线阳性标准对乳腺癌筛查成本效果的影响

    Institute of Scientific and Technical Information of China (English)

    杨振华; 戴宏季; 闫烨; 汪培山; 陈可欣

    2012-01-01

    Objective: The current work aims to investigate the effect of mammography-positive criteria on the cost-effectiveness of a breast cancer screening program, and provide a reference for the development of breast cancer screening programs in China. Methods:From July 2008 to September 2009, a cross-sectional breast cancer screening research project was developed in four cities: (a) Shenyang, located in northeast China; (b) Tianjin, situated in the coastal area of northern China; (c) Feicheng, an inland city in Shandong;and (d) Nanchang, located in southern China. A total of 21,986 asymptomatic women, aged 45 to 69 years, volunteered to undergo breast mammography examination after signing an informed consent form. After a one-year follow-up, 65 new cases with breast cancer were diagnosed. The sensitivity and specificity of mammography were calculated on the basis of different criteria of positivity. A Markov model was used to simulate the entire screening process and calculate the cost-effectiveness ratios. The sensitivity analysis was performed using Tree Age pro 2011. The cost-effectiveness analysis was measured by the cost per life year saved ( Lys ), and the discounted rate was 3 %. Results: When the defined BIRADS 0 scale ( used for further imaging scan or for comparison with the previous image data to draw conclusions ) was classified as negative. A total of 55 new cases with breast cancer were detected. The sensitivity was 84.6 %, the specificity was 98.6 %, and the cost-effectiveness ratio was 45 632 ¥ / Lys. Moreover, when the defined BIRADS 0was classified as positive, 56 new cases with breast cancer were identified, with a sensitivity of 86.2 %, a specificity of 93.9 %, and a cost-effectiveness ratio of 52 392 ¥ / Lys. Conclusion: This study suggests that different mammography-positive criteria have minimal effect on sensitivity, but a considerable effect on specificity and cost-effectiveness.%目的:根据乳腺癌筛查数据,比较不同钼靶X线阳

  9. Diagnostic Invasiveness and Psychosocial Consequences of False-Positive Mammography

    DEFF Research Database (Denmark)

    Heleno, Bruno M.; Siersma, Volkert Dirk; Brodersen, John

    2015-01-01

    of a cohort study of 454 womenwith abnormal screening mammography and 908 matched control women withnormal results. Using a condition-specific questionnaire (Consequences of Screening in Breast Cancer), we assessed 12 psychosocial consequences at 5 time points (0, 1, 6, 18, and 36 months after final diagnosis......) and compared the 2 groups of women with false-positives (invasive and noninvasive management groups). RESULTS: Among the 252 women with false-positive mammography eligible forthis study, psychosocial consequences were similar for those managed invasivelyand those managed noninvasively during the 36 months...... between those of women withnormal mammography and those of women determined to have breast cancer. CONCLUSIONS: We found no evidence that use of more invasive diagnosticswas associated with worse psychosocial consequences. It is therefore reasonableto pool subgroups of women with false...

  10. Impact of the Addition of Digital Breast Tomosynthesis (DBT) to Standard 2D Digital Screening Mammography on the Rates of Patient Recall, Cancer Detection, and Recommendations for Short-term Follow-up.

    Science.gov (United States)

    Powell, Jaclynn L; Hawley, Jeffrey R; Lipari, Adele M; Yildiz, Vedat O; Erdal, B Selnur; Carkaci, Selin

    2017-03-01

    The addition of digital breast tomosynthesis (DBT) to digital screening mammography (DM) has been shown to decrease recall rates and improve cancer detection rates, but there is a lack of data regarding the impact of DBT on rates of short-term follow-up. We assessed possible changes in performance measures with the introduction of DBT at our facility. In our observational study, databases were used to compare rates of recall, short-term follow-up, biopsy, and cancer detection between women undergoing DM without (n = 10,477) and women undergoing DM with (n = 2304) the addition of DBT. Regression analysis was performed to determine associations with patient age, breast density, and availability of comparison examinations. The addition of DBT resulted in significantly lower recall rates (16%-14%, P = .017), higher rates of biopsy (12.7%-19.1%, P < .01), and increased detection of ductal carcinoma in situ, with a difference of 2.3 cases per 1000 screens (P = .044). A 33% increase in cancer detection rates was observed with DBT, which did not reach statistical significance. Short-term follow-up of probably benign findings was 80% higher in the DBT group (odds ratio = 1.80, 95% confidence interval = 1.38-2.36, P < .001). To our knowledge, we are the first to study the impact of DBT on rates of short-term follow-up, and observed an 80% increase over the DM group. Further research is needed to determine the malignancy rate of Breast Imaging Reporting and Data System 3 lesions detected with DBT, and establish appropriate follow-up to maximize cancer detection while minimizing expense and patient anxiety. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  11. Mammographic density is the main correlate of tumors detected on ultrasound but not on mammography.

    Science.gov (United States)

    Häberle, Lothar; Fasching, Peter A; Brehm, Barbara; Heusinger, Katharina; Jud, Sebastian M; Loehberg, Christian R; Hack, Carolin C; Preuss, Caroline; Lux, Michael P; Hartmann, Arndt; Vachon, Celine M; Meier-Meitinger, Martina; Uder, Michael; Beckmann, Matthias W; Schulz-Wendtland, Rüdiger

    2016-11-01

    Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography.

  12. Breast Cancer Screening: An Evidence-Based Update

    Science.gov (United States)

    Fuller, Mackenzie S.; Lee, Christoph I.; Elmore, Joann G.

    2015-01-01

    Synopsis Routine screening mammography is recommended by most groups issuing breast cancer screening guidelines, especially for women ≥ 50 years of age. 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. PMID:25841594

  13. Positron emission mammography imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moses, William W.

    2003-10-02

    This paper examines current trends in Positron Emission Mammography (PEM) instrumentation and the performance tradeoffs inherent in them. The most common geometry is a pair of parallel planes of detector modules. They subtend a larger solid angle around the breast than conventional PET cameras, and so have both higher efficiency and lower cost. Extensions to this geometry include encircling the breast, measuring the depth of interaction (DOI), and dual-modality imaging (PEM and x-ray mammography, as well as PEM and x-ray guided biopsy). The ultimate utility of PEM may not be decided by instrument performance, but by biological and medical factors, such as the patient to patient variation in radiotracer uptake or the as yet undetermined role of PEM in breast cancer diagnosis and treatment.

  14. Positron Emission Mammography imaging

    Science.gov (United States)

    Moses, William W.

    2004-06-01

    This paper examines current trends in Positron Emission Mammography (PEM) instrumentation and the performance tradeoffs inherent in them. The most common geometry is a pair of parallel planes of detector modules. They subtend a larger solid angle around the breast than conventional PET cameras, and so have both higher efficiency and lower cost. Extensions to this geometry include encircling the breast, measuring the depth of interaction (DOI), and dual-modality imaging (PEM and X-ray mammography, as well as PEM and X-ray guided biopsy). The ultimate utility of PEM may not be decided by instrument performance, but by biological and medical factors, such as the patient to patient variation in radiotracer uptake or the as yet undetermined role of PEM in breast cancer diagnosis and treatment.

  15. Nationwide survey of glandular tissue doses for the establishment of a breast cancer screening system using mammography. Analysis of technical parameters affecting the glandular tissue dose

    Energy Technology Data Exchange (ETDEWEB)

    Higashida, Yoshiharu [Kyushu Univ., Fukuoka (Japan). School of Health Sciences; Hagiwara, Akira; Asahara, Masaki [and others

    2000-09-01

    The effects of technical parameters, such as screen-film combinations, antiscatter grids, processing conditions and X-ray beam qualities, on the average glandular tissue dose of radiation were analyzed under two exposure conditions: The standard radiographic condition for an RMI 156 phantom at each facility (Standard Radiographic Condition). The radiographic condition needed to obtain a radiographic density of 1.20 to 1.40 with an RMI 156 phantom (Canonical Radiographic Condition). The analysis included 208 dose measurements at 104 facilities. The results showed that the average glandular tissue dose depends strongly on the grid types and screen-film combinations used. There were also significant differences in radiographic density between the Standard Radiographic Condition and the Canonical Radiographic Condition. This analysis of the technical parameters affecting the glandular tissue dose will be useful in establishing a standardized mammographic breast cancer screening system. (author)

  16. Cost and clinical utility of repeated syphilis screening in the third trimester in a high-risk population.

    Science.gov (United States)

    Shiber, Linda; Todia, William J

    2014-03-01

    We sought to determine the clinical utility and cost of repeating syphilis testing in the third trimester of pregnancy in a high-risk urban population. A retrospective cohort analysis was performed for patients delivering from January 1993 through December 2009 with at least 1 venereal disease research laboratory (VDRL) test sent during pregnancy. Chart review was performed for patients with confirmed syphilis to determine the temporal relationship of syphilis diagnosis to the pregnancy. For patients who seroconverted during pregnancy (no antecedent history or treatment for syphilis), newborn charts were reviewed. The costs of treating seropositive neonates and the costs of implementing additional third-trimester syphilis screening were then compared. In the 17-year cohort, 58,569 deliveries were available for analysis. In all, 113 new cases of syphilis occurred (192.9/100,000 deliveries). There were 17 detected seroconversions; 10 were not rescreened in the third trimester and tested positive at delivery. These 10 patients may have benefitted from implementing uniform VDRL testing at 28-32 weeks' gestation. All newborns were asymptomatic with a negative workup and received empiric penicillin therapy. Based on 2011 hospital charges, the cost of evaluating and treating a neonate for syphilis is $11,079. Implementing an additional VDRL screen at 28-32 weeks' gestation for each pregnant patient during the 17 years studied would cost $1,991,346. An 18-fold increase in syphilis prevalence (3500/100,000 [3.5%] deliveries) would be required for the cost of implementation of universal early third-trimester screening to be equal to the potential health care charges saved by detecting maternal seroconversion and obviating the need for neonatal therapy. In this high-risk population, additional syphilis screening in the third trimester is costly and is not clinically helpful in detecting maternal seroconversion. Copyright © 2014 Mosby, Inc. All rights reserved.

  17. Digital breast tomosynthesis versus digital mammography: a clinical performance study

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Baldan, Enrica; Bezzon, Elisabetta; Polico, Ilaria; Proietti, Alessandro; Toffoli, Aida [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Toledano, Alicia [Statistics Collaborative Inc., Washington, DC (United States); Di Maggio, Cosimo [Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); La Grassa, Manuela [Aviano Oncological Reference Center (CRO), IRCCS, Department of Radiology, Aviano (Pordenone) (Italy); Pescarini, Luigi [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); Muzzio, Pier Carlo [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Medical Diagnostic Sciences, Padua (Italy)

    2010-07-15

    To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population. The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores. Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%. Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views. (orig.)

  18. Study on knowledge, experiences and barriers to mammography among working women from Delhi

    OpenAIRE

    Khokhar, A.

    2015-01-01

    INTRODUCTION: Mammography is not a popular screening tool for deducting breast cancer in India although regular screening is associated with reduced mortality from breast cancer. OBJECTIVE: The objective of this study is to find out knowledge, experiences and barriers to mammography among working women of Delhi. MATERIALS AND METHODS: Cross-sectional descriptive study was conducted from October 2012 to March 2013 among working women from Delhi, India. The study was conducted as a part of ongo...

  19. Mediating factors in the relationship between income and mammography use in low-income insured women.

    Science.gov (United States)

    Park, Alice N; Buist, Diana S M; Tiro, Jasmin A; Taplin, Stephen H

    2008-10-01

    We used secondary data from a prospective randomized mammography recruitment trial to examine whether attitudinal and facilitating characteristics mediate the observed relationship between annual household income and mammogram receipt among women in an integrated health plan. We compared 1419 women due for a screening mammogram based on the 1995 annual household income poverty definition for a family of four ($15,000). A telephone survey was used to collect information on household income, demographics, health behavior, attitudinal and facilitating variables. Administrative databases were used to document mammography receipt. We used Cox proportional hazards models to estimate the hazards ratio (HR) and 95% confidence interval (CI) of subsequent mammography use separately for women with and without a prior mammogram. Several variables, including employment, living alone, believing that mammograms are unnecessary, having friends supportive of mammography, and ease of arranging transportation, completely mediated the effect of income on mammography use. In multivariable models, the direct predictive effect of income on mammography was reduced to nonsignificance (HR 1.13, 95% CI 0.82-1.54 in women with previous mammogram and HR 0.91, 95% CI 0.41-2.00 in women without previous mammogram). Providing insurance does not ensure low-income populations will seek screening mammography. Efficacious interventions that address attitudes and facilitating conditions may motivate mammography use among low-income women with insurance.

  20. Latinas' Mammography Intention Following a Home-Based Promotores-Led Intervention.

    Science.gov (United States)

    Scheel, John R; Molina, Yamile; Briant, Katherine J; Ibarra, Genoveva; Lehman, Constance D; Thompson, Beti

    2015-12-01

    Despite increases in mammography rates among Latinas, screening rates remain lower than in non-Latina Whites and Latinas typically present with breast cancer at a later stage. Trained lay community workers (promotores) have been successfully used to increase screening mammography intention in Latinas. Little is known, however, about the potential mechanisms of these interventions, such as increased breast cancer knowledge (knowledge) and social interactions concerning mammography practices (social engagement). This prospective pre-post study examined this gap in the literature by (1) documenting changes in knowledge and social engagement after receipt of a promotores-based intervention; and (2) establishing if post-intervention knowledge and social engagement predicted mammography intention, after adjusting for socio-demographic and lifetime mammography history. There were significant increases in knowledge and social engagement about mammography. Finally, post-intervention social engagement was a significant predictor of mammography intention. Future promotores-based interventions should focus on enhancing social engagement to improve mammography intention and use.

  1. Authenticity and integrity of digital mammography images.

    Science.gov (United States)

    Zhou, X Q; Huang, H K; Lou, S L

    2001-08-01

    Data security becomes more and more important in telemammography which uses a public high-speed wide area network connecting the examination site with the mammography expert center. Generally, security is characterized in terms of privacy, authenticity and integrity of digital data. Privacy is a network access issue and is not considered in this paper. We present a method, authenticity and integrity of digital mammography, here which can meet the requirements of authenticity and integrity for mammography image (IM) transmission. The authenticity and integrity for mammography (AIDM) consists of the following four modules. 1) Image preprocessing: To segment breast pixels from background and extract patient information from digital imaging and communication in medicine (DICOM) image header. 2) Image hashing: To compute an image hash value of the mammogram using the MD5 hash algorithm. 3) Data encryption: To produce a digital envelope containing the encrypted image hash value (digital signature) and corresponding patient information. 4) Data embedding: To embed the digital envelope into the image. This is done by replacing the least significant bit of a random pixel of the mammogram by one bit of the digital envelope bit stream and repeating for all bits in the bit stream. Experiments with digital IMs demonstrate the following. 1) In the expert center, only the user who knows the private key can open the digital envelope and read the patient information data and the digital signature of the mammogram transmitted from the examination site. 2) Data integrity can be verified by matching the image hash value decrypted from the digital signature with that computed from the transmitted image. 3) No visual quality degradation is detected in the embedded image compared with the original. Our preliminary results demonstrate that AIDM is an effective method for image authenticity and integrity in telemammography application.

  2. Collaborative modeling of the benefits and harms associated with different U.S. Breast cancer screening strategies

    NARCIS (Netherlands)

    J.S. Mandelblatt (Jeanne); N.K. Stout (Natasha); C.B. Schechter (Clyde); J.J. Van Den Broek (Jeroen J.); D.L. Miglioretti (Diana); M. Krapcho (Martin); A. Trentham-Dietz (Amy); D. Munoz (Diego); S.J. Lee (Sandra J.); D.A. Berry (Donald); N.T. van Ravesteyn (Nicolien); O. Alagoz (Oguzhan); K. Kerlikowske (Karla); A.N.A. Tosteson (Anna N.A.); A.M. Near (Aimee); A. Hoeffken (Amanda); Y. Chang (Yaojen); E.A.M. Heijnsdijk (Eveline); G. Chisholm (Gary); X. Huang (Xuelin); H. Huang (Hailiang); M.A. Ergun (Mehmet Ali); R. Gangnon (Ronald); B.L. Sprague (Brian L.); S. Plevritis (Sylvia); E. Feuer (Eric); H.J. de Koning (Harry); K.A. Cronin (Kathleen)

    2016-01-01

    textabstractBackground: Controversy persists about optimal mammography screening strategies. Objective: To evaluate screening outcomes, taking into account advances in mammography and treatment of breast cancer. Design: Collaboration of 6 simulation models using national data on incidence, digital

  3. Unbiased identification of signal-activated transcription factors by barcoded synthetic tandem repeat promoter screening (BC-STAR-PROM).

    Science.gov (United States)

    Gosselin, Pauline; Rando, Gianpaolo; Fleury-Olela, Fabienne; Schibler, Ueli

    2016-08-15

    The discovery of transcription factors (TFs) controlling pathways in health and disease is of paramount interest. We designed a widely applicable method, dubbed barcorded synthetic tandem repeat promoter screening (BC-STAR-PROM), to identify signal-activated TFs without any a priori knowledge about their properties. The BC-STAR-PROM library consists of ∼3000 luciferase expression vectors, each harboring a promoter (composed of six tandem repeats of synthetic random DNA) and an associated barcode of 20 base pairs (bp) within the 3' untranslated mRNA region. Together, the promoter sequences encompass >400,000 bp of random DNA, a sequence complexity sufficient to capture most TFs. Cells transfected with the library are exposed to a signal, and the mRNAs that it encodes are counted by next-generation sequencing of the barcodes. This allows the simultaneous activity tracking of each of the ∼3000 synthetic promoters in a single experiment. Here we establish proof of concept for BC-STAR-PROM by applying it to the identification of TFs induced by drugs affecting actin and tubulin cytoskeleton dynamics. BC-STAR-PROM revealed that serum response factor (SRF) is the only immediate early TF induced by both actin polymerization and microtubule depolymerization. Such changes in cytoskeleton dynamics are known to occur during the cell division cycle, and real-time bioluminescence microscopy indeed revealed cell-autonomous SRF-myocardin-related TF (MRTF) activity bouts in proliferating cells.

  4. Breast cancer detection: radiologists' performance using mammography with and without automated whole-breast ultrasound.

    Science.gov (United States)

    Kelly, Kevin M; Dean, Judy; Lee, Sung-Jae; Comulada, W Scott

    2010-11-01

    Radiologist reader performance for breast cancer detection using mammography plus automated whole-breast ultrasound (AWBU) was compared with mammography alone. Screenings for non-palpable breast malignancies in women with radiographically dense breasts with contemporaneous mammograms and AWBU were reviewed by 12 radiologists blinded to the diagnoses; half the studies were abnormal. Readers first reviewed the 102 mammograms. The American College of Radiology (ACR) Breast Imaging Reporting and Data System (BIRADS) and Digital Mammographic Imaging Screening Trial (DMIST) likelihood ratings were recorded with location information for identified abnormalities. Readers then reviewed the mammograms and AWBU with knowledge of previous mammogram-only evaluation. We compared reader performance across screening techniques using absolute callback, areas under the curve (AUC), and figure of merit (FOM). True positivity of cancer detection increased 63%, with only a 4% decrease in true negativity. Reader-averaged AUC was higher for mammography plus AWBU compared with mammography alone by BIRADS (0.808 versus 0.701) and likelihood scores (0.810 versus 0.703). Similarly, FOM was higher for mammography plus AWBU compared with mammography alone by BIRADS (0.786 versus 0.613) and likelihood scores (0.791 versus 0.614). Adding AWBU to mammography improved callback rates, accuracy of breast cancer detection, and confidence in callbacks for dense-breasted women.

  5. Staging mammography nonadherent women: a qualitative study.

    Science.gov (United States)

    LaPelle, Nancy; Costanza, Mary E; Luckmann, Roger; Rosal, Milagros C; White, Mary Jo; Stark, Jennifer Rider

    2008-01-01

    Few studies have related stages of mammography screening nonadherence with the rationale used by overdue women. We used a grounded theory approach to obtain and analyze data from focus groups, telephone interviews, and surveys. Emergent specific themes were compared with emerging decision levels of nonadherence. Each decision level was then compared with the Precaution Adoption Process Model and the Transtheoretical Model. A total of 6 key themes influencing mammogram nonadherence emerged as did 6 decision levels. Variability within themes was associated with specific decision levels. The decision levels were not adequately classified by either stage model. Stage-based educational strategies may benefit by tailoring interventions to these 6 decision levels.

  6. 乳腺高频钼靶X线联合乳管镜筛查乳腺癌%Ductoscopy combined X-ray mammography for breast cancer screening

    Institute of Scientific and Technical Information of China (English)

    冯立文; 黄茂伦; 廖女珠; 李誉

    2013-01-01

    Objective Understand shunde Uistrict Foshan City,Guangdong Province in the incidence of breast cancer in women.Methods The joint selectivity ductoscopy examination of the clinical breast examination screening,breast X-ray radiography examination from March 2011 to January 2013,Shunde District,FoShan City,Guangdong Provice,3 600 bladder than 40 years old woman with breast cancer screening.Results Three thousand six hundred women were found in 10 cases of breast cancer,the detection rate of 278/100 000 (10/3 600).Breast clinical examination found 1 313 cases of breast abnormalities,142 cases of breast lumps,nipple discharge line fiberoptic ductoscopy to cheek the 100 cases,X-ray radiography examination of four and more than 72 cases,accounted for a total of 45.19% of the screening population (1 627/3 600).Conclusions Joint ductoscopy X-ray radiography examination of breast cancer screening in the normal population can help to detect early breast cancer,and to provide the basis for early clinical treatment.%目的 了解广东省佛山市顺德区城市妇女乳腺高频钼靶X线联合乳管镜筛查乳腺癌的情况.方法 2011年3月-2013年1月采用临床乳腺检查初筛,以及乳腺高频钼靶X线检查联合选择性乳管镜检查,对广东省佛山市顺德区3 600例40岁以上妇女进行了乳腺癌筛查.结果 3 600例妇女共检出乳腺癌10例,检出率为278/10万(10/3600).乳腺临床检查中发现乳腺异常1 313例、乳腺肿块142例、乳头溢液行乳管镜检查100例;乳腺高频钼靶X线检查4级及以上者72例,总共占筛查人群的45.19%(1 627/3 600).结论 通过乳管镜联合乳腺高频钼靶X线片在正常人群中进行乳腺癌筛查,有助于发现早期乳腺癌,为临床早期治疗提供依据.

  7. Cultural views, language ability, and mammography use in Chinese American women.

    Science.gov (United States)

    Liang, Wenchi; Wang, Judy; Chen, Mei-Yuh; Feng, Shibao; Yi, Bin; Mandelblatt, Jeanne S

    2009-12-01

    Mammography screening rates among Chinese American women have been reported to be low. This study examines whether and how culture views and language ability influence mammography adherence in this mostly immigrant population. Asymptomatic Chinese American women (n = 466) aged 50 and older, recruited from the Washington, D.C. area, completed a telephone interview. Regular mammography was defined as having two mammograms at age-appropriate recommended intervals. Cultural views were assessed by 30 items, and language ability measured women's ability in reading, writing, speaking, and listening to English. After controlling for risk perception, worry, physician recommendation, family encouragement, and access barriers, women holding a more Chinese/Eastern cultural view were significantly less likely to have had regular mammograms than those having a Western cultural view. English ability was positively associated with mammography adherence. The authors' results imply that culturally sensitive and language-appropriate educational interventions are likely to improve mammography adherence in this population.

  8. Determination of mass attenuation coefficients for threshold contrast evaluation in digital mammography

    Science.gov (United States)

    Hummel, Johann; Semturs, Friedrich; Menhart, Susanne; Figl, Michael

    2010-04-01

    According to the 'European protocol for the quality control of the physical and technical aspects of mammography screening' (EPQC) image quality digital mammography units has to be evaluated at different breast thicknesses. At the standard thickness of 50 mm polymethyl methacrylate (PMMA) image quality is determined by the analysis of CDMAM contrast detail phantom images where threshold contrasts are calculated for different gold disc diameters. To extend these results to other breast thicknesses contrast-to-noise ratios (CNR) and threshold contrast (TC) visibilities have to be calculated for all required thicknesses. To calculate the latter the mass attenuation coefficient (MAC) of gold has to be known for all possible beam qualities in the tube voltage range between 26 and 32 kV. In this paper we first determined the threshold contrast visibility using the CDMAM phantom with the same beam quality at different current-time products (mAs). We can derive from Rose theory that CNR • CT • α = const, where α is the diameter of the gold cylinder. From this the corresponding attenuation coefficients can be calculated. This procedure was repeated for four different beam qualities (Mo/Mo 27kV, Rh/Rh 29kV, Rh/Rh 31 kV, and W/Rh 29 kV)). Next, we measured the aluminium half value layer (HVL) of all x-ray spectra relevant for mammography. Using a first order Taylor expansion of MAC as a function of HVL, all other desired MAC can be calculated. The MAC as a function of the HVL was derived to MAChvl = -286.97 * hvl+186.03 with R2 = 0.997, where MAChvl indicates the MAC for all specific x-ray spectrum defined by its aluminium half value layer. Based on this function all necessary MACs needed for quality assurance (QA) were calculated. The results were in good agreement with the data found in the protocol.

  9. MR mammography (MRM)

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, W.A.

    1993-01-01

    The book deals with MRI for the diagnostic evaluation of malignant breast lesions. A survey of methods available for breast examination, magnetic resonance mammography (MRM) is briefly explained in terms of development and technical problems encountered in the various examinations. The clinical aspects from a central part of the book, giving information relating to the various neoplasms and a comprehensive review of cases. The book concludes with a chapter discussing the interpretation of data and images, presenting examples of normal findings and of manifestations of carcinoma, fibroadenoma, cysts, mastopathies, scars due to plastic surgery, and the lactating breast. (UWA). 648 figs., 25 tabs.

  10. Technology evaluation center assessment synopsis: full-field digital mammography.

    Science.gov (United States)

    Rothenberg, Barbara M; Ziegler, Kathleen M; Aronson, Naomi

    2006-08-01

    Full-field digital mammography (FFDM) is proposed as an alternative to screen-film mammography (SFM). The ability to separate and optimize the acquisition, storage, and display of images may allow greater visualization of breast cancers at equal or lower radiation doses, especially in younger women and those with denser breasts. This is a synopsis of a systematic review by the Blue Cross Blue Shield Association Technology Evaluation Center. This updated systematic review primarily incorporated the results of the ACR Imaging Network(R) Digital Mammographic Imaging Screening Trial (DMIST), which provided results on 42,760 asymptomatic women who underwent both FFDM and SFM and showed with reasonable certainty that there was no difference in the accuracy of the 2 modalities for asymptomatic women in general, with some advantages of FFDM in certain subgroups. There were no strong, new studies on the use of digital mammography compared with film mammography in a diagnostic population. However, the DMIST results indicated that tumors detected by FFDM, but not by SFM, were likely to be invasive carcinomas or medium-grade to high-grade ductal carcinoma in situ. On the basis of the suppositions that these are the cancers of greatest interest and the ones more likely to be found in a diagnostic population and that the diagnostic population may be younger on average than the screening population, it was concluded that there is sufficient evidence to support the use of FFDM for diagnostic purposes.

  11. Intervention to increase mammography utilization in a public hospital.

    Science.gov (United States)

    Davis, T C; Berkel, H J; Arnold, C L; Nandy, I; Jackson, R H; Murphy, P W

    1998-04-01

    To study the effects of three approaches to increasing utilization of screening mammography in a public hospital setting in Northwest Louisiana. Randomized intervention study. Four hundred forty-five women aged 40 years and over, predominantly low-income and with low literacy skills, who had not had a mammogram in the preceding year. All interventions were chosen to motivate women to get a mammogram. Group 1 received a personal recommendation from one of the investigators. Group 2 received the recommendation plus an easy-to-read National Cancer Institute (NCI) brochure. Group 3 received the recommendation, the brochure, and a 12-minute interactive educational and motivational program, including a soap-opera-style video, developed in collaboration with women from the target population. Mammography utilization was determined at 6 months and 2 years after intervention. A significant increase (p = .05) in mammography utilization was observed after the intervention designed in collaboration with patients (29%) as compared with recommendation alone (21%) or recommendation with brochure (18%) at 6 months. However, at 2 years the difference favoring the custom-made intervention was no longer significant. At 6 months there was at least a 30% increase in the mammography utilization rate in the group receiving the intervention designed in collaboration with patients as compared with those receiving the recommendation alone or recommendation with brochure. Giving patients an easy-to-read NCI brochure and a personal recommendation was no more effective than giving them a recommendation alone, suggesting that simply providing women in a public hospital with a low-literacy-level, culturally appropriate brochure is not sufficient to increase screening mammography rates. In a multivariate analysis, the only significant predictor of mammography use at 6 months was the custom-made intervention.

  12. Screening of repeated dose toxicity data present in SCC(NF)P/SCCS safety evaluations of cosmetic ingredients.

    Science.gov (United States)

    Vinken, Mathieu; Pauwels, Marleen; Ates, Gamze; Vivier, Manon; Vanhaecke, Tamara; Rogiers, Vera

    2012-03-01

    Alternative methods, replacing animal testing, are urgently needed in view of the European regulatory changes in the field of cosmetic products and their ingredients. In this context, a joint research initiative called SEURAT was recently raised by the European Commission and COLIPA, representing the European cosmetics industry, with the overall goal of developing an animal-free repeated dose toxicity testing strategy for human safety assessment purposes. Although cosmetic ingredients are usually harmless for the consumer, one of the initial tasks of this research consortium included the identification of organs that could potentially be affected by cosmetic ingredients upon systemic exposure. The strategy that was followed hereof is described in the present paper and relies on the systematic evaluation, by using a self-generated electronic databank, of published reports issued by the scientific committee of DG SANCO responsible for the safety of cosmetic ingredients. By screening of the repeated dose toxicity studies present in these reports, it was found that the liver is potentially the most frequently targeted organ by cosmetic ingredients when orally administered to experimental animals, followed by the kidney and the spleen. Combined listing of altered morphological, histopathological, and biochemical parameters subsequently indicated the possible occurrence of hepatotoxicity, including steatosis and cholestasis, triggered by a limited number of cosmetic compounds. These findings are not only of relevance for the in vitro modeling efforts and choice of compounds to be tested in the SEURAT project cluster, but also demonstrate the importance of using previously generated toxicological data through an electronic databank for addressing specific questions regarding the safety evaluation of cosmetic ingredients.

  13. Thyroid absorbed dose using TLDs during mammography

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez A, M.; Melendez L, M. [IPN, Centro de Investigacion y de Estudios Avanzados, Av. IPN 2508, Col. San Pedro Zacatenco, 07360 Mexico D. F. (Mexico); Davila M, P., E-mail: biomedica.sst@gmail.com [UNEME-DEDICAM de Ciudad Victoria, Circuito Medico s/n, 87087 Ciudad Victoria, Tamaulipas (Mexico)

    2015-10-15

    Full text: In this study, the mean glandular dose (MGD) and the thyroid dose (D Thy) were measured in 200 women screened with mammography in Cranio caudal (Cc) and mediolateral oblique projections. All mammograms were performed with Giotto-Ims (6000-14-M2 Model) equipment, which was verified to meet the criteria of quality of NOM-229-Ssa-2002. During audits performance and HVL, for each anode filter combinations was measured with the camera Radcal mammography equipment 10 X 6-6M (HVL = 0.26 mm Al). D Thy measurements were performed with TLD dosimeters (LiF:Mn) , that were read with the Harshaw 3500 TLD reader. The MGD, was obtained according to the UK and European protocols for mammographic dosimetry using a plane parallel chamber (Standard Imaging, Model A-600) calibrated by a radiation beam UW-23-Mo (= 0.279 mm Al HVL). A comparative statistical analysis was carried out with the measured MGD and D thy. The thyroid mean dose was 0.063 mGy and 0.078 mGy for Cc and mediolateral oblique respectively. There is a linear correlation between the MGD and the D Thy slightly influenced by the anode-filter combination. Using a 95% for the confidence interval in MGD (1.07 mGy), the 90% of measurements are in agreement with the established uncertainty limits. The D Thy are lower than the MGD. There is no risk for cancer induction in thyroid in women due to mammography screening. (Author)

  14. Prospective study on the determinants of repeat attendance and attendance patterns in breast cancer screening using the Theory of Planned Behaviour

    NARCIS (Netherlands)

    Drossaert, C.H.C.; Boer, H.; Seydel, E.R.

    2003-01-01

    This prospective study, using the Theory of Planned Behaviour (TPB) as a theoretical framework, was carried out to identify the determinants of repeat attendance and attendance patterns in organised breast screening. A group of 2657 women filled out a baseline questionnaire, approximately 8 weeks af

  15. Time for a re-evaluation of mammography in the young? Results of an audit of mammography in women younger than 40 in a resource restricted environment.

    Science.gov (United States)

    Taylor, Liezel; Basro, Sarinah; Apffelstaedt, Justus P; Baatjes, Karin

    2011-08-01

    Mammography in younger women is considered to be of limited value. In a resource restricted environment without access to magnetic resonance imaging (MRI) and with a high incidence of breast cancer in the young, mammography remains an important diagnostic tool. Recent technical advances and better regulation of mammography make a reassessment of its value in these conditions necessary. Data of all the mammograms performed at a tertiary hospital and private breast clinic between January 2003 and July 2009 in women less than 40 years of age were collected. Indications were the presence of a mass, follow-up after primary cancer therapy, and screening for patients perceived at high risk due to a family history or the presence of atypical hyperplasia. Data acquired were as follows: Demographics, prior breast surgery, indication for mammography, outcome of mammography, diagnostic procedures, and their results. Of 2,167 mammograms, 393 were performed for a palpable mass, diagnostic mammography. In these, the overall cancer detection rate was 40%. If the mammography was reported as breast imaging reporting and data system (BIRADS(®)) 5 versus BIRADS(®) 3 and 4 versus BIRADS(®) 1 and 2, a final diagnosis of malignancy was established in 96, 48, and 5%, respectively. Of 367 mammograms done for the follow-up after primary treatment of breast cancer, seven cancers were diagnosed for a detection rate of 1.9%. Of 1,312 mammograms performed for screening, the recall rate was 4%; the biopsy rate 2%, and the cancer diagnosis rate 3/1,000 examinations. In contrast to past series, this series has shown that recent advances in mammography have made it a useful tool in the management of breast problems in young women, notably in a resource-restricted environment. Women for screening should be selected carefully.

  16. Should we screen BRCA1 mutation carriers only with MRI? A multicenter study

    NARCIS (Netherlands)

    Obdeijn, I.-M.; Winter-Warnars, G.A.O.; Mann, R.M.; Hooning, M.J.; Hunink, M.G.M.; Tilanus-Linthorst, M.M.

    2014-01-01

    BRCA1 mutation carriers are offered screening with MRI and mammography. Aim of the study was to investigate the additional value of digital mammography over MRI screening. BRCA1 mutation carriers, who developed breast cancer since the introduction of digital mammography between January 2003 and Marc

  17. Health insurance and household income associated with mammography utilization among American women, 2000-2008

    Institute of Scientific and Technical Information of China (English)

    ZHAO Da-hai; ZHANG Zhi-ruo; RAO Ke-qin

    2011-01-01

    Background National Breast and Cervical Cancer Early Detection Program (NBCCEDP) has provided free or low-costmammograms to low-income or no health insurance women in all of the states of the United States (US) since 1997.The objective of this study was to understand whether health insurance and annual household income impacted the mammography utilization since the implementation of NBCCEDP,in order to evaluate how the implementation of NBCCEDP impacted mammography utilization among American women.Methods Data were from the database of Behavioral Risk Factor Surveillance System (BRFSS) of the CDC in US.Mammography utilization was measured by whether the American woman aged 40 to 64 years had the mammography within the last two years.The chi square test and multivariate Logistic regression were used to evaluate the associations between mammography utilization and health insurance,annual household income,and other factors for any given year.Results From 2000 to 2008,the rate of mammography utilization among participants had a steady decrease on the whole from 86.7% to 83.8%.The results showed that the mammography utilization correlated significantly with health insurance and annual household income for any given year.The results also showed that compared with participants who were uninsured,those who were insured had a greater times higher rate of mammography in 2008 than any other year from 2000 to 2008,and compared with participants whose annual household income was below $15 000,those whose annual household income was above $50 000 had a greater times higher rate of mammography in 2008 than in 2004 and 2006.Conclusions Health insurance and annual household income impacted the mammography utilization for any given year from 2000 to 2008,and the implementation of NBCCEDP has not achieved its original goal on breast cancer screening.

  18. [Prevalence in the performance of mammographies in Spain: Analysis by Communities 2006-2014 and influencing factors].

    Science.gov (United States)

    Carmona-Torres, Juan Manuel; Cobo-Cuenca, Ana Isabel; Martín-Espinosa, Noelia María; Piriz-Campos, Rosa María; Laredo-Aguilera, José Alberto; Rodríguez-Borrego, María Aurora

    2017-07-18

    To determine the frequency of the performance of mammography with preventive purpose of the screening of breast cancer in Spanish women, the evolution between the years 2006-2014, the sociodemographic profile of the women who undergo the mammography and to analyze the factors that influence in their adhesion. Transversal study. Spain. A total of 53.628 women over 15 years old that are surveyed in the National Health Survey in Spain 2006 and 2011/12 and the European Health Survey in Spain 2009 and 2014. The following variables were used: mammography, frequency of mammography performance and the reason for the realization, as well as sociodemographic variables. Social class was obtained from the last occupation of the main family supporter. A logistic regression analysis was performed with sociodemographic variables. The prevalence of mammography has been increasing from 2006 to 2014, and also for the reason that the participants had received a letter, they were telephoned or offered in their Health Center to undergo this test. There are significant differences in the performance of mammography in the different autonomous communities. Performing mammography has increased significantly from 2006 to 2014, although there are still differences between autonomous communities, with Ceuta and Melilla being the least percentage of performed mammography. The factors that are related to greater performed mammography are: higher educational level, higher social class, married civil status, Spanish nationality and age. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  19. 乳腺筛查X射线成像参数与辐射剂量和影像质量的相关性研究%Correlation between image quality and radiation dose on screening mammography

    Institute of Scientific and Technical Information of China (English)

    苗英; 宋俊峰; 陈卫飞; 王柏林; 向绪文; 蔡葱; 王利青

    2011-01-01

    目的 探讨乳腺筛查X射线摄影参数对辐射剂量与影像质量的影响,以获取辐射剂量与影像质量的最佳匹配.方法 回顾性分析接受数字乳腺X射线筛查摄影的507例受检者的曝光参数与平均腺体剂量的相关性.对不同厚度的亚克力板进行曝光,获取乳腺压迫厚度对辐射剂量的影响.通过对比度细节测试模体( CDMAM3.4)与不同厚度亚克力板的组合测试,分析其与影像质量的相关性.结果 在507例受检者中,30~49岁为乳腺筛查影像受检者的主体人群,占67.06%.3种曝光模式下,平均腺体剂量(AGD)的均值以对比度优先模式最高,为标准模式的137.5%.标准模式靶物质/滤过板组合是Mo/Mo、Mo/Rh、Rh/Rh共3种,各占1/3;剂量优先模式选择的是Mo/Rh、Rh/Rh 2种组合,各占50%;对比度优先模式则以选择Mo/Mo组合为主,占52%.乳腺压迫厚度与平均腺体剂量之间均呈正相关.3种曝光模式的逆影像质量指数( IQFinv)分别为98.32、95.41和107.02,其中对比度优先模式的IQFinv值最高;但当亚克力板增加到≥5 cm时,3种曝光模式下的IQFinv值很接近.结论 当受检者乳腺属于致密型乳腺且压迫厚度<4 cm时,应选择剂量优先曝光模式;>4 cm而<6 cm时,选择标准曝光模式;>6 cm选择手动.%Objective To obtain the matched parameters between image quality and radiation dose by exploring the influence of the exposure parameters of screening mammography on both the image quality and radiation dose.Methods The correlation between the exposure parameters and average glandular doses to 507 patients undergoing screening mammography were retrospectively analyzed.The influence of breast compression thickness on radiation dose by exposing different thickness of PMMA was obtained.The correlation with image quality was analyzed by combined testing of contrast detail test mode ( CDMAM3.4 )and different thickness of PMMAs.Results The groups aged 30

  20. Mammography usage with relevant factors among women with mental disabilities in Taiwan: a nationwide population-based study.

    Science.gov (United States)

    Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

    2015-02-01

    Women with mental illness are at increased risk of developing and dying from breast cancer and are thus in urgent need of breast cancer preventive care. This study examined the use of screening mammography by Taiwanese women with mental disabilities and analyzed factors affecting this use. 17,243 Taiwanese women with mental disabilities aged 50-69 years were retrospectively included as study subjects. Linked patient data were obtained from three national databases in Taiwan (the 2008 database of physically and mentally disabled persons, the Health Promotion Administration's 2007-2008 mammography screening data, and claims data from the National Health Insurance Research Database). Besides descriptive statistics and bivariate analysis, logistic regression analysis was also performed to examine factors affecting screening mammography use. The 2007-2008 mammography screening rate for Taiwanese women with mental disabilities was 8.79% (n=1515). Variables that significantly influenced screening use were income, education, presence of catastrophic illness/injury, severity of mental disability, and usage of other preventive care services. Screening was positively correlated with income and education. Those with catastrophic illness/injury were more likely to be screened (odds ratio [OR], 1.40; 95% CI=1.15-1.72). Severity of disability was negatively correlated with screening, with very severe, severe, and moderate disability being associated with 0.34-0.69 times the odds of screening as mild disability. In Taiwan, women with mental disabilities receive far less mammography screening than women in general.

  1. Uncertainty modeling for ontology-based mammography annotation with intelligent BI-RADS scoring.

    Science.gov (United States)

    Bulu, Hakan; Alpkocak, Adil; Balci, Pinar

    2013-05-01

    This paper presents an ontology-based annotation system and BI-RADS (Breast Imaging Reporting and Data System) score reasoning with Semantic Web technologies in mammography. The annotation system is based on the Mammography Annotation Ontology (MAO) where the BI-RADS score reasoning works. However, ontologies are based on crisp logic and they cannot handle uncertainty. Consequently, we propose a Bayesian-based approach to model uncertainty in mammography ontology and make reasoning possible using BI-RADS scores with SQWRL (Semantic Query-enhanced Web Rule Language). First, we give general information about our system and present details of mammography annotation ontology, its main concepts and relationships. Then, we express uncertainty in mammography and present approaches to handle uncertainty issues. System is evaluated with a manually annotated dataset DEMS (Dokuz Eylul University Mammography Set) and DDSM (Digital Database for Screening Mammography). We give the result of experimentations in terms of accuracy, sensitivity, precision and uncertainty level measures. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Análise de Custo-efetividade do rastreamento do câncer de mama com mamografia convencional, digital e ressonância Analysis of Cost-effectiveness of screening for breast cancer with conventional mammography, digital and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Antonio Augusto de Freitas Peregrino

    2012-01-01

    Full Text Available O objetivo deste trabalho foi realizar análise de custo efetividade da intervenção das mamografias convencional e digital e da ressonância magnética no rastreamento de câncer de mama, comparando com o não rastreamento. Foi construído um modelo markoviano, numa uma coorte hipotética de 100 mil mulheres com rastreamento bianual, cuja linha de base é a história natural da doença. Modelaram-se quatro cenários distintos: (1 a história natural do câncer de mama como linha de base; (2 mamografia com filme convencional; (3 mamografia digital e (4 e ressonância magnética. Os custos dos cenários modelados variaram desde R$ 194.216,68 para a história natural, até R$ 48.614.338,31 para o rastreamento com ressonância magnética. As diferenças de efetividade entre as intervenções variaram de 300 até 78.000 anos de vida ganhos, na coorte de 100 mil mulheres. Em relação à Razão de Custo-Efetividade Incremental, em termos de custo por ano de vida ganhos, a estratégia do rastreamento mamográfico convencional produziu um ano extra por R$ 13.573,07. A Razão de Custo Efetividade Incremental (ICER da ressonância magnética foi de R$ 2.904.328,88 em relação ao não rastreamento. O estudo mostrou que é mais custo-efetivo realizar o rastreamento com a mamografia convencional do que as outras tecnologias de intervenção.A cost-effectiveness analysis was conducted in screening for breast cancer. The use of conventional mammography, digital and magnetic resonance imaging were compared with natural disease history as a baseline. A Markov model projected breast cancer in a group of 100,000 women for a 30 year period, with screening every two years. Four distinct scenarios were modeled: (1 the natural history of breast cancer, as a baseline, (2 conventional film mammography, (3 digital mammography and (4 magnetic resonance imaging. The costs of the scenarios modeled ranged from R$ 194.216,68 for natural history, to R$ 48.614.338,31, for

  3. The promise of computer aided detection in digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Roehrig, Jimmy E-mail: jimmy@enrico.r2tech.com; Castellino, Ronald A. E-mail: castellr@mskcc.org

    1999-07-01

    Computer-aided detection (CAD) is a new technology now being implemented in many clinics to reduce the false negative rate in mammography screening. A large clinical study has been completed which shows that a substantial false negative (miss) rate exists in screening mammography, a significant fraction of the missed cancers are not subtle, and CAD has high sensitivity to these missed cancers. Full field digital mammography is now coming on the scene, but has not yet been proven in clinical practice. The authors believe that full acceptance of the new digital technology depends not merely on demonstrations of 'substantial equivalence' to film-screen technology, but rather on more complete exploitation of the unique advantages of digital technology, and that CAD can play a key role. These advantages derive from CAD's ability to quickly (in near real-time) perform analytical computations on digital information that is not readily available to the radiologist until after the cost of film-processing has occurred.

  4. Breast cancer detection: Radiologists' performance using mammography with and without automated whole-breast ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Kevin M. [Hall Center, Santa Monica, CA (United States); Lee, Sung-Jae; Comulada, W.S. [University of California, Semel Institute Center for Community Health, Los Angeles, CA (United States); Dean, Judy

    2010-11-15

    Radiologist reader performance for breast cancer detection using mammography plus automated whole-breast ultrasound (AWBU) was compared with mammography alone. Screenings for non-palpable breast malignancies in women with radiographically dense breasts with contemporaneous mammograms and AWBU were reviewed by 12 radiologists blinded to the diagnoses; half the studies were abnormal. Readers first reviewed the 102 mammograms. The American College of Radiology (ACR) Breast Imaging Reporting and Data System (BIRADS) and Digital Mammographic Imaging Screening Trial (DMIST) likelihood ratings were recorded with location information for identified abnormalities. Readers then reviewed the mammograms and AWBU with knowledge of previous mammogram-only evaluation. We compared reader performance across screening techniques using absolute callback, areas under the curve (AUC), and figure of merit (FOM). True positivity of cancer detection increased 63%, with only a 4% decrease in true negativity. Reader-averaged AUC was higher for mammography plus AWBU compared with mammography alone by BIRADS (0.808 versus 0.701) and likelihood scores (0.810 versus 0.703). Similarly, FOM was higher for mammography plus AWBU compared with mammography alone by BIRADS (0.786 versus 0.613) and likelihood scores (0.791 versus 0.614). Adding AWBU to mammography improved callback rates, accuracy of breast cancer detection, and confidence in callbacks for dense-breasted women. (orig.)

  5. A study on color Doppler sonography combined with digital mammography for micro breast cancer screening%全数字化乳腺X线摄影联合彩色多普勒超声对诊断微小乳腺癌的研究

    Institute of Scientific and Technical Information of China (English)

    刘国荣; 程传虎; 李坚; 陈超; 杨清绪; 李丽红; 林翠君

    2009-01-01

    Objective To evaluate the efficacy of color Doppler sonography combined with digital mammography for micro breast cancer screening.Methods Both of color Doppler sonography and digital mammography were performed in 66 patients with micro breast cancer less than 1.5 cm in diameter and 20 patients with benign lesion less than 1.5 cm in diameter.The images of sonography and mammography were analyzed respectively.A comparative study on the results of sonography,mammography and pathological finding of specimen in breast lesions was made.Results Fifty-five of 66 Cases with micro breast cancer were detected by digital mammography.52 of 66 cases by color Doppler sonography and 65 of 66 cases by sonography combined with mammography.The color Doppler sonography combined with digital mammography provided higher sensitivity,specificity and accuracy[98.5%(65/66),100.0%(20/20)and 98.8%(85/86)respectively]than color Doppler sonography[78.8%(52/66),75.0%(15/20),77.9% (67/86)respectively]and digital mammography alone[83.3%(55/66),90.0%(18/20)and 84.9%(73/86)respectively](P<0.05).The peak flow velocities and the mean resistant index were higher in malignant lesion than those in benign lesion(P<0.05).Conclusions The color Doppler sonography combined with digital mammography can increase the sensitivity and accuracy of diagnosing micro breast cancer.Digital mammography is recommended to identify micro breast cancer.It is helpful of color Doppler sonography in differentiation of benign and malignant breast lesion.%目的 探讨全数字化乳腺X线摄影联合彩色多普勒超声(彩超)检查对微小乳腺癌的诊断价值.方法 66例直径≤1.5 cm的微小乳腺癌患者(恶性组)和20例直径≤1.5 cm的乳腺良性病变患者(良性组)均行全数字化乳腺X线摄影和彩超检查,进行定性诊断,最后与手术病理结果对照.结果 恶性组:全数字化乳腺X线摄影诊断微小乳腺癌55例,其敏感度和特异度分别为83.3%(55,66)、90.0%(18/20),

  6. Breast cancer screening outreach effectiveness: Mammogram-specific reminders vs. comprehensive preventive services birthday letters.

    Science.gov (United States)

    Buist, Diana S M; Gao, Hongyuan; Anderson, Melissa L; Onega, Tracy; Brandzel, Susan; Rabelhofer, Melissa A; Bradford, Susan Carol; Aiello Bowles, Erin J

    2017-09-01

    We compared the effectiveness of two outreach strategies on timely mammography adherence: a mammogram-specific reminder letter (sent just before a woman was due) to a birthday letter (addresses multiple preventive services and not timed around due dates). We evaluated screening mammography adherence following 79,848 mammogram-specific and 151,626 birthday letters mailed between 2002 and 2012 to women aged 40-74years enrolled in Kaiser Permanente Washington. Screening mammogram adherence was specifically tied to due date and was evaluated separately by age group and up-to-date or overdue status at the time of mailing. We used generalized estimating equations to account for correlation between repeated observations, to model the odds of screening mammography adherence by letter type. Among women up-to-date, adherence following birthday letters was 22-76% lower compared to the mammogram-specific reminders, with the greatest decreases in adherence in women aged 70-74. Birthday letters were more effective at activating screening uptake among some subgroups of overdue women aged 50-69 and most overdue women aged 70-74, but universally low adherence rates were observed in overdue women. Increasing number of recommended services for women aged 50-74 who were up-to-date resulted in 12-17% lower mammography adherence, but had no effect in women aged 40-49 or in overdue women. Birthday letters are less effective than mammogram-specific reminder letters at prompting women to undergo timely breast cancer screening, particularly among women up-to-date with screening. Birthday letters may be effective at increasing overall preventive care; however, supplemental outreach may be needed around the due date to increase timely preventive services receipt. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Testing the feasibility of a DVD-based intervention to promote preparedness for mammography in women with intellectual disabilities.

    Science.gov (United States)

    Greenwood, Nechama W; Wang, Claire Tienwey; Bowen, Deborah; Wilkinson, Joanne

    2014-03-01

    Women with intellectual disabilities (ID, formerly mental retardation) have a similar breast cancer incidence as the general population, but they have higher breast cancer mortality and lower rates of regular screening mammography. We conducted a feasibility study evaluating acceptability, demand, and limited efficacy of a health education DVD about mammography for women with ID. The DVD was developed in order to address disability-specific barriers to mammography identified in prior studies, such as anxiety related to navigating the logistics of obtaining a mammogram. The DVD was found to be acceptable and feasible, and led to a moderate increase in mammography preparedness in this population. Study results suggest that this DVD-based intervention is an appropriate candidate for further study measuring efficacy and effectiveness in increasing regular mammography in women with ID, a disparity population.

  8. BIRADS{sup TM} classification in mammography

    Energy Technology Data Exchange (ETDEWEB)

    Balleyguier, Corinne [Department of Radiology, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France)]. E-mail: balleyguier@igr.fr; Ayadi, Salma [Department of Radiology, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Van Nguyen, Kim [Department of Radiology, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Vanel, Daniel [Department of Radiology, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Dromain, Clarisse [Department of Radiology, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France); Sigal, Robert [Department of Radiology, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif (France)

    2007-02-15

    The Breast Imaging Report and Data System (BIRADS) of the American College of Radiology (ACR) is today largely used in most of the countries where breast cancer screening is implemented. It is a tool defined to reduce variability between radiologists when creating the reports in mammography, ultrasonography or MRI. Some changes in the last version of the BIRADS{sup TM} have been included to reduce the inaccuracy of some categories, especially for category 4. The BIRADS{sup TM} includes a lexicon and descriptive diagrams of the anomalies, recommendations for the mammographic report as well as councils and examples of mammographic cases. This review describes the mammographic items of the BIRADS classification with its more recent developments, while detailing the advantages and limits of this classification.

  9. X-ray source for mammography

    Science.gov (United States)

    Logan, Clinton M.

    1994-01-01

    An x-ray source utilizing anode material which shifts the output spectrum to higher energy and thereby obtains higher penetrating ability for screening mammography application, than the currently utilized anode material. The currently used anode material (molybdenum) produces an energy x-ray spectrum of 17.5/19.6 keV, which using the anode material of this invention (e.g. silver, rhodium, and tungsten) the x-ray spectrum would be in the 20-35 keV region. Thus, the anode material of this invention provides for imaging of breasts with higher than average x-ray opacity without increase of the radiation dose, and thus reduces the risk of induced breast cancer due to the radiation dose administered for mammograms.

  10. Expanded DMPK repeats in dizygotic twins referred for diagnosis of autism versus absence of expanded DMPK repeats at screening of 330 children with autism

    Directory of Open Access Journals (Sweden)

    Musova Z

    2016-09-01

    Full Text Available Zuzana Musova,1 Miroslava Hancarova,1 Marketa Havlovicova,1 Radka Pourova,1 Michal Hrdlicka,2 Josef Kraus,3 Marie Trkova,4 David Stejskal,4 Zdenek Sedlacek1 1Department of Biology and Medical Genetics, 2Department of Child Psychiatry, 3Department of Child Neurology, Charles University 2nd Faculty of Medicine and University Hospital Motol, 4Gennet, Centre for Fetal Medicine, Prague, Czech Republic Abstract: Myotonic dystrophy type 1 (DM1 belongs to the broad spectrum of genetic disorders associated with autism spectrum disorders (ASD. ASD were reported predominantly in congenital and early childhood forms of DM1. We describe dizygotic twin boys with ASD who were referred for routine laboratory genetic testing and in whom karyotyping, FMR1 gene testing, and single nucleotide polymorphism array analysis yielded negative results. The father of the boys was later diagnosed with suspected DM1, and testing revealed characteristic DMPK gene expansions in his genome as well as in the genomes of both twins and their elder brother, who also suffered from ASD. In accord with previous reports on childhood forms of DM1, our patients showed prominent neuropsychiatric phenotypes characterized especially by hypotonia, developmental and language delay, emotional and affective lability, lowered adaptability, and social withdrawal. The experience with this family and multiple literature reports of ASD in DM1 on the one side but the lack of literature data on the frequency of DMPK gene expansions in ASD patients on the other side prompted us to screen the DMPK gene in a sample of 330 patients with ASD who were first seen by a geneticist before they were 10 years of age, before the muscular weakness, which may signal DM1, usually becomes obvious. The absence of any DMPK gene expansions in this cohort indicates that targeted DMPK gene testing can be recommended only in ASD patients with specific symptoms or family history suggestive of DM1. Keywords: autism, myotonic

  11. Experience with breast cancer, pre-screening perceived susceptibility and the psychological impact of screening

    DEFF Research Database (Denmark)

    Absetz, Pilvikki; Aro, Arja R; Sutton, Stephen R

    2003-01-01

    This prospective study examined whether the psychological impact of organized mammography screening is influenced by women's pre-existing experience with breast cancer and perceived susceptibility (PS) to the disease. From a target population of 16,886, a random sample of women with a normal...... responded to the follow-ups. Psychological impact was measured as anxiety (STAI-S), depression (BDI), health-related concerns (IAS), and breast cancer-specific beliefs and concerns. Data was analyzed with repeated measures analyses of variance, with estimates of effect size based on Eta-squared. Women...... normal mammograms. Experience and PS did not influence responses to different screening findings. Of the finding groups, false positives experienced most adverse effects: their risk perception increased and they reported most post-screening breast cancer-specific concerns. Furthermore, they became more...

  12. Predicting Malignancy from Mammography Findings and Surgical Biopsies.

    Science.gov (United States)

    Ferreira, Pedro; Fonseca, Nuno A; Dutra, Inês; Woods, Ryan; Burnside, Elizabeth

    2011-11-01

    Breast screening is the regular examination of a woman's breasts to find breast cancer earlier. The sole exam approved for this purpose is mammography. Usually, findings are annotated through the Breast Imaging Reporting and Data System (BIRADS) created by the American College of Radiology. The BIRADS system determines a standard lexicon to be used by radiologists when studying each finding. Although the lexicon is standard, the annotation accuracy of the findings depends on the experience of the radiologist. Moreover, the accuracy of the classification of a mammography is also highly dependent on the expertise of the radiologist. A correct classification is paramount due to economical and humanitarian reasons. The main goal of this work is to produce machine learning models that predict the outcome of a mammography from a reduced set of annotated mammography findings. In the study we used a data set consisting of 348 consecutive breast masses that underwent image guided or surgical biopsy performed between October 2005 and December 2007 on 328 female subjects. The main conclusions are threefold: (1) automatic classification of a mammography, independent on information about mass density, can reach equal or better results than the classification performed by a physician; (2) mass density seems to be a good indicator of malignancy, as previous studies suggested; (3) a machine learning model can predict mass density with a quality as good as the specialist blind to biopsy, which is one of our main contributions. Our model can predict malignancy in the absence of the mass density attribute, since we can fill up this attribute using our mass density predictor.

  13. Postmortem validation of breast density using dual-energy mammography

    Energy Technology Data Exchange (ETDEWEB)

    Molloi, Sabee, E-mail: symolloi@uci.edu; Ducote, Justin L.; Ding, Huanjun; Feig, Stephen A. [Department of Radiological Sciences, University of California, Irvine, California 92697 (United States)

    2014-08-15

    Purpose: Mammographic density has been shown to be an indicator of breast cancer risk and also reduces the sensitivity of screening mammography. Currently, there is no accepted standard for measuring breast density. Dual energy mammography has been proposed as a technique for accurate measurement of breast density. The purpose of this study is to validate its accuracy in postmortem breasts and compare it with other existing techniques. Methods: Forty postmortem breasts were imaged using a dual energy mammography system. Glandular and adipose equivalent phantoms of uniform thickness were used to calibrate a dual energy basis decomposition algorithm. Dual energy decomposition was applied after scatter correction to calculate breast density. Breast density was also estimated using radiologist reader assessment, standard histogram thresholding and a fuzzy C-mean algorithm. Chemical analysis was used as the reference standard to assess the accuracy of different techniques to measure breast composition. Results: Breast density measurements using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean algorithm, and dual energy were in good agreement with the measured fibroglandular volume fraction using chemical analysis. The standard error estimates using radiologist reader assessment, standard histogram thresholding, fuzzy C-mean, and dual energy were 9.9%, 8.6%, 7.2%, and 4.7%, respectively. Conclusions: The results indicate that dual energy mammography can be used to accurately measure breast density. The variability in breast density estimation using dual energy mammography was lower than reader assessment rankings, standard histogram thresholding, and fuzzy C-mean algorithm. Improved quantification of breast density is expected to further enhance its utility as a risk factor for breast cancer.

  14. Contrast-enhanced digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Dromain, Clarisse [Department of Radiology, Institut Gustave-Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dromain@igr.fr; Balleyguier, Corinne; Adler, Ghazal [Department of Radiology, Institut Gustave-Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex (France); Garbay, Jean Remi [Department of Surgery, Institut Gustave-Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex (France); Delaloge, Suzette [Department of Medicine, Institut Gustave-Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2009-01-15

    CEDM is a recent development of digital mammography using the intra-venous injection of an iodinated contrast agent in conjunction with a mammography examination. Two techniques have been developed to perform CEDM examinations: the temporal subtraction technique with acquisition of high-energy images before and after contrast medium injection and the dual energy technique with acquisition of a pair of low and high-energy images only after contrast medium injection. The temporal subtraction technique offered the possibility to analyze the kinetic curve of enhancement of breast lesions, similarly to breast MRI. The dual energy technique do not provide information about the kinetic of tumor enhancement but allows the acquisition of multiples views of the same breast or bilateral examination and is less sensitive to patient motion than temporal CEDM. Initial clinical experience has shown the ability of CEDM to map the distribution of neovasculature induced by cancer using mammography. Moreover, previous studies have shown a superiority of MX + CEDM, either for the assessment of the probability of malignancy than for BIRADS assessment comparing to MX alone. The potential clinical applications are the clarification of mammographically equivocal lesions, the detection of occult lesions on standard mammography, particularly in dense breast, the determination of the extent of disease, the assessment of recurrent disease and the monitoring of the response to chemotherapy. CEDM should result in a simple way to enhance the detection and the characterization of breast lesions.

  15. Breast cancer screening controversies: who, when, why, and how?

    Science.gov (United States)

    Chetlen, Alison; Mack, Julie; Chan, Tiffany

    2016-01-01

    Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening.

  16. Development of the mammography beliefs and attitudes questionnaire for low-health-literacy Mexican-American women.

    Science.gov (United States)

    Lopez-McKee, Gloria

    2010-11-24

    Low-income, low-health-literacy Mexican-American women exhibit poor mammography screening participation and are being diagnosed at later stages of breast cancer than are non-Hispanic white women. No instrument has been available to measure the impact of cultural and psycho-social factors on the intent to seek mammography screening participation in this population. In this article the author describes the development process of the English Mammography Beliefs and Attitudes Questionnaire (MBAQ) and the Spanish Mammography Beliefs and Attitudes Questionnaire (SMBAQ). The Theory of Planned Behavior is the theoretical framework underlying these instruments designed to measure intent to seek mammography screening in low-health-literacy Mexican-American women. The process of developing the MBAQ utilized input from low-health-literacy Mexican-American women and an expert committee. The MBAQ was translated into Spanish and assessed for content validity and reading level. In the discussion, the author explains why the MBAQ and SMBAQ are appropriate tools for use with low-health-literacy Mexican-American women to measure their intentions to seek mammography screening. Limitations of the study and implications for practice and research are presented.

  17. Measurement of half-value layer in mammography

    CERN Document Server

    Yagi, H; Saruwatari, R; Doi, N; Yamane, E

    2003-01-01

    The half-value layer (HVL) of an X-ray beam for film-screen mammography is considered an important parameter for image quality and patient dose. Thus, HVL must be measured in accordance with The Manual of Accuracy for Mammography printed by the Japanese Society of Radiological Technology. The manual prescribes exactly the geometry of measurement, chamber position of measurement in the field, selection of chamber, and so on. However, the measurement of HVL is difficult in the actual clinical setting. This study examined the results of failure to perform the measurement of HVL in accordance with the manual for measuring HVL in the clinical setting. The investigation indicated that serious problems do not arise when measuring HVL for routine quality control even if the chamber in the field is not always set according to the manual and if a chamber for radiotherapy or diagnosis is used that is not recommended for soft X-ray by the manual. (author)

  18. The quality control of mammography imaging and equipment in Minas Gerais, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, M.S.; Oliveira, M.; Guedes, E.; Andrade, M.C.; Peixoto, J.E.; Joana, G.S. [Cento de Desenvolvimento da Tecnologia Nuclear (CDTN)- Comissao Nacional de Energia Nuclear (CNEN) Rua Prof. Mario Werneck, s/n - Cidade Universitaria - Pampulha 30123-970 Belo Horizonte, MG, (Brazil)

    2007-07-01

    Full text: Cancer is the second cause of death in the Brazilian female population and breast cancer is the most frequent neoplasm amongst women. Mammography is an essential tool for diagnosis and early detection of this disease. In order to be effective, the mammography must be of good quality. Doses in mammography should be maintained as low as possible without reducing the high image quality needed to the early detection of the breast cancer. The-breast is composed of tissues with very close composition and densities. It increases the difficulty to detect small changes in the normal anatomical structures which may be associated with breast cancer. To achieve the standards of definition and contrast for mammography, the quality and intensity of the x ray beam, the breast positioning and compression, the film-screen system, and the film processing have to be in optimal operational conditions. This study sought to evaluate the entrance surface kerma and the image quality on a phantom in 180 mammography units in the state of Minas Gerais, Brazil, between December 2004 and October 2006. The results showed that 54.5% of the facilities did not achieve the minimum performance level for image quality and 42% of the mammography units, the reference range for entrance surface kerma of 10 {+-} 3 mGy was exceeded. (Author)

  19. Mammography equipment performance, image quality and mean glandular dose in Malta.

    Science.gov (United States)

    Borg, M; Badr, I; Royle, G J

    2013-09-01

    In this first Maltese national mammography survey, the effectiveness of direct digital (DR) mammography in breast cancer screening has been confirmed. Patient data were made available from three clinics out of the participating nine. A dose survey of mean glandular dose (MGD) calculated for 759 patients examined in the state-owned mammography facilities was performed. An MGD national diagnostic reference level was set at 1.87 mGy for patients with breast compression thicknesses (BCT) between 5.0 and 7.0 cm. This range was selected since patient data were retrieved from three clinics only and the results showed that other international BCT reference levels may be unsuitable for the Maltese population. In fact, the overall average BCT was 5.75 ± 1.4 cm. The survey results have shown that the technical standard of mammographic equipment in the Malta National Breast Screening Programme is on a par with other countries, including its Western European counterparts.

  20. Promoting mammography: results of a randomized trial of telephone counseling and a medical practice intervention.

    Science.gov (United States)

    Costanza, M E; Stoddard, A M; Luckmann, R; White, M J; Spitz Avrunin, J; Clemow, L

    2000-07-01

    Despite widespread promotion of mammography screening, a distinct minority of women have remained underusers of this effective preventive measure. We sought to measure the effects of barrier-specific telephone counseling (BSTC) and a physician-based educational intervention (MD-ED) on mammography utilization among underusers of mammography screening. This was a randomized controlled trial. Women meeting criteria for mammography underuse at baseline (grouped by practice affiliation) were randomized to a reminder control condition (RC group received annual mailed reminders), BSTC or MD-ED interventions and followed for 3 years. Underuse was defined by failure to get two annual or biannual mammograms over a 2- to 4-year period prior to a baseline survey. The study included 1655 female underusers of mammography aged 50-80 years who were members of two health maintenance organizations (HMO) in central Massachusetts. BSTC consisted of periodic brief, scripted calls from trained counselors to women who had not had a mammogram in the preceding 15 months. Women could receive up to three annual calls during the study. MD-ED consisted of physician and office staff trainings aimed at improving counseling skills and office reminder systems. Self-report of mammography use during the study period was the main outcome measure. Regular use was defined as > or =1 mammogram every 24 months. Forty-four percent in each intervention group became regular users compared to 42% in the RC group. Among subjects who had prior but not recent mammograms at baseline, BSTC was effective (OR=1.48; 95% CI=1.04; 2. 10), and MD-ED marginally effective (OR=1.28; 95% CI=0.88, 1.85). Most recent users at baseline and few never users became regular users (61% and 17%, respectively) regardless of intervention status. Among mammography underusers BSTC modestly increases utilization for former users at a reasonable cost ($726 per additional regular user).

  1. A task-based quality control metric for digital mammography

    Science.gov (United States)

    Maki Bloomquist, A. K.; Mainprize, J. G.; Mawdsley, G. E.; Yaffe, M. J.

    2014-11-01

    A reader study was conducted to tune the parameters of an observer model used to predict the detectability index (dʹ ) of test objects as a task-based quality control (QC) metric for digital mammography. A simple test phantom was imaged to measure the model parameters, namely, noise power spectrum, modulation transfer function and test-object contrast. These are then used in a non-prewhitening observer model, incorporating an eye-filter and internal noise, to predict dʹ. The model was tuned by measuring dʹ of discs in a four-alternative forced choice reader study. For each disc diameter, dʹ was used to estimate the threshold thicknesses for detectability. Data were obtained for six types of digital mammography systems using varying detector technologies and x-ray spectra. A strong correlation was found between measured and modeled values of dʹ, with Pearson correlation coefficient of 0.96. Repeated measurements from separate images of the test phantom show an average coefficient of variation in dʹ for different systems between 0.07 and 0.10. Standard deviations in the threshold thickness ranged between 0.001 and 0.017 mm. The model is robust and the results are relatively system independent, suggesting that observer model dʹ shows promise as a cross platform QC metric for digital mammography.

  2. Digital Mammography with Storage Phosphors

    Science.gov (United States)

    1993-12-31

    considerations. Proc AAPM Summer School: Specification, Acceptance Testing and Quality Control of Diagnostic X-ray Imaging Equipment 1991. 95. Melles...derived from the same cases. Radiol 1983; 148:839-843. 100. Kelsey CA, Mettler FA. ROC analysis can reveal best diagnostic method. Diagnost Imag 1989; 155 ...Madison, WI, 1991. 111. AAPM Report No. 29: Equipment requirement and quality control for mammography, Ed. by M. J. Yaffe et al, Published for the

  3. Rayleigh imaging in spectral mammography

    Science.gov (United States)

    Berggren, Karl; Danielsson, Mats; Fredenberg, Erik

    2016-03-01

    Spectral imaging is the acquisition of multiple images of an object at different energy spectra. In mammography, dual-energy imaging (spectral imaging with two energy levels) has been investigated for several applications, in particular material decomposition, which allows for quantitative analysis of breast composition and quantitative contrast-enhanced imaging. Material decomposition with dual-energy imaging is based on the assumption that there are two dominant photon interaction effects that determine linear attenuation: the photoelectric effect and Compton scattering. This assumption limits the number of basis materials, i.e. the number of materials that are possible to differentiate between, to two. However, Rayleigh scattering may account for more than 10% of the linear attenuation in the mammography energy range. In this work, we show that a modified version of a scanning multi-slit spectral photon-counting mammography system is able to acquire three images at different spectra and can be used for triple-energy imaging. We further show that triple-energy imaging in combination with the efficient scatter rejection of the system enables measurement of Rayleigh scattering, which adds an additional energy dependency to the linear attenuation and enables material decomposition with three basis materials. Three available basis materials have the potential to improve virtually all applications of spectral imaging.

  4. General strategies to increase the repeatability in non-target screening by liquid chromatography-high resolution mass spectrometry.

    Science.gov (United States)

    Bader, Tobias; Schulz, Wolfgang; Kümmerer, Klaus; Winzenbacher, Rudi

    2016-09-01

    This article focuses on the data evaluation of non-target high-resolution LC-MS profiles of water samples. Taking into account multiple technical replicates, the difficulties in peak recognition and the related problems of false positive and false negative findings are systematically demonstrated. On the basis of a combinatorial approach, different models involving sophisticated workflows are evaluated, particularly with regard to the repeatability. In addition, the improvement resulting from data processing was systematically taken into consideration where the recovery of spiked standards emphasized that real peaks of interest were barely or not removed by the derived filter criteria. The comprehensive evaluation included different matrix types spiked with up to 263 analytical standards which were analyzed repeatedly leading to a total number of more than 250 injections that were incorporated in the assessment of different models of data processing. It was found that the analysis of multiple replicates is the key factor as, on the one hand, it provides the option of integrating valuable filters in order to minimize the false positive rate and, on the other hand, allows correcting partially false negative findings occurring during the peak recognition. The developed processing strategies including replicates clearly point to an enhanced data quality since both the repeatability as well as the peak recognition could be considerably improved. As proof of concept, four different matrix types, including a wastewater treatment plant (WWTP) effluent, were spiked with 130 isotopically labeled standards at different concentration levels. Despite the stringent filter criteria, at 100 ng L(-1) recovery rates of up to 93% were reached in the positive ionization mode. The proposed model, comprising three technical replicates, filters less than 5% and 2% of the standards recognized at 100 and 500 ng L(-1), respectively and thus indicates the general applicability of the

  5. Patient willingness for repeat screening and preference for CT colonography and optical colonoscopy in ACRIN 6664: the National CT Colonography trial.

    Science.gov (United States)

    Gareen, Ilana F; Siewert, Bettina; Vanness, David J; Herman, Benjamin; Johnson, C D; Gatsonis, Constantine

    2015-01-01

    Current American Cancer Society recommendations for colon cancer screening include optical colonoscopy every 10 years or computed tomography colonography (CTC) every 5 years. Bowel preparation (BP) is currently required for both screening modalities. To compare ACRIN 6664: the National CT Colonography Trial (NCTCT) participant experiences with CTC and optical colonoscopy (OC), procedure preference, and willingness to return for each procedure. Participants from fifteen NCTCT sites, who underwent CTC followed by OC under sedation, were invited to complete questionnaires 2 weeks postexam, asking about procedure preference, physical discomfort, and embarrassment experienced and whether that discomfort and embarrassment was better or worse than expected during BP, CTC, and OC, as well as willingness to return for repeat CTC and OC at different time intervals. A total of 2,310 of 2,600 patients (89%) returned their questionnaires. Of patients reporting a preference, 1,058 (46.6%) preferred CTC, 569 (25.0%) preferred OC, and 626 (27.6%) reported no preference. Participant-reported discomfort worse than expected differed significantly between CTC (32.9%) and OC (5.0%) (Pembarrassment worse than expected with OC were associated with increased intention to adhere with CTC in the future. Conversely, embarrassment experienced during CTC and discomfort worse than expected on CTC were associated with increased intention to adhere with OC in the future. While a larger proportion of participants indicated that they preferred CTC to OC, willingness to undergo repeat CTC compared to OC was limited by unanticipated exam discomfort and embarrassment and CTC's shorter screening interval.

  6. Study on knowledge, experiences and barriers to mammography among working women from Delhi

    Directory of Open Access Journals (Sweden)

    A Khokhar

    2015-01-01

    Full Text Available INTRODUCTION: Mammography is not a popular screening tool for deducting breast cancer in India although regular screening is associated with reduced mortality from breast cancer. OBJECTIVE: The objective of this study is to find out knowledge, experiences and barriers to mammography among working women of Delhi. MATERIALS AND METHODS: Cross-sectional descriptive study was conducted from October 2012 to March 2013 among working women from Delhi, India. The study was conducted as a part of ongoing training workshops organized for women on early detection of breast cancer. Total of eight such programs were organized and were attended by a total of 439 women. Each participant got a self-administered questionnaire to fill. Data was entered in Microsoft Excel and analysis was done using Statistical product and service solutions (SPSS version 21 (IBM. RESULTS: A total of 439 participants were included in the study. 230 (52.4% of the women were more than 40 years of age. Only four participants (1% had not heard about the term mammography before. Less than half (45.1% of the participants knew correctly the purpose of a mammogram. Only 11.8% of the women knew correctly about the age of getting the first baseline mammogram. Knowledge of frequency of getting the mammogram was also low only 95 (21.6% correctly knew about it. Only 59 (11.9% correctly responded that one needs to go to an imaging facility located either in a hospital or elsewhere to get mammogram done. Main experience shared by the women regarding mammography was that 42 (95.45% did not know anything about the procedure when they went for this investigation. Out of a total of 230 women over 40 years of age only 38 (16.5% had ever got a mammogram carried out. There is a statistically significant association between education status and practice of mammography (P < 0.05. There were 18 women with family history of breast cancer out, of which 10 (55.5% had got mammography carried out. 192 out of

  7. Development of Automatic Cluster Algorithm for Microcalcification in Digital Mammography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seok Yoon [Dept. of Medical Engineering, Korea University, Seoul (Korea, Republic of); Kim, Chang Soo [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Pusan (Korea, Republic of)

    2009-03-15

    Digital Mammography is an efficient imaging technique for the detection and diagnosis of breast pathological disorders. Six mammographic criteria such as number of cluster, number, size, extent and morphologic shape of microcalcification, and presence of mass, were reviewed and correlation with pathologic diagnosis were evaluated. It is very important to find breast cancer early when treatment can reduce deaths from breast cancer and breast incision. In screening breast cancer, mammography is typically used to view the internal organization. Clusterig microcalcifications on mammography represent an important feature of breast mass, especially that of intraductal carcinoma. Because microcalcification has high correlation with breast cancer, a cluster of a microcalcification can be very helpful for the clinical doctor to predict breast cancer. For this study, three steps of quantitative evaluation are proposed : DoG filter, adaptive thresholding, Expectation maximization. Through the proposed algorithm, each cluster in the distribution of microcalcification was able to measure the number calcification and length of cluster also can be used to automatically diagnose breast cancer as indicators of the primary diagnosis.

  8. Characteristics of YouTube™ Videos Related to Mammography.

    Science.gov (United States)

    Basch, Corey H; Hillyer, Grace Clarke; MacDonald, Zerlina L; Reeves, Rachel; Basch, Charles E

    2015-12-01

    With a monthly total of more than one billion unique visitors, YouTube™ is one of the Internet's most visited websites and contributes to the growing amount of health-related information on the Internet. The purpose of this study was to analyze coverage of mammography screening in popular YouTube™ videos. A total of 173 videos were included in the analysis. Compared with professionally created videos, consumer-created videos had a significantly greater number of comments (>9 comments 38.0% for consumer vs. 11.8% for professional videos, p=<0.001). Videos created by professionals more often portrayed general mammography information (97.1 vs. 88.7%) compared to those created by consumers. The vast majority of videos presented general information (93.6%) related to mammography, and almost two thirds addressed preparing for the test. Less than 20% dealt with other types of examinations. Approximately 30% discussed pain associated with the examination (35.3%) and addressed issues of anxiety (32.4%) and fear (29.5%). Nearly half of the videos presented information about the test results (46.2%). Over 25% covered medical or family history. The majority did not pertain to a specific age group. Future research should focus on analyzing the accuracy of the information in the videos.

  9. Community Partnerships, Food Pantries, and an Evidence-Based Intervention to Increase Mammography among Rural Women

    Science.gov (United States)

    Bencivenga, Marcyann; DeRubis, Susan; Leach, Patricia; Lotito, Lisa; Shoemaker, Charles; Lengerich, Eugene J.

    2008-01-01

    Context: Multiple national agencies and organizations recommend that women age 40 years and older have an annual screening mammogram. Women who are poor, less educated, lack a usual source of care, and reside in rural Appalachia are less likely to have had a recent mammogram. Purpose: To increase use of mammography among a rural Appalachian…

  10. Mammography utilization among california women age 40-49 in a managed care environment.

    Science.gov (United States)

    Liu, X; Sennett, C; Legorreta, A P

    2001-05-01

    To examine the utilization of screening mammography and the relationship between risk factors and mammography use in women age 40-49 in a managed care environment. Retrospective observational study based on a mailed survey. A large HMO in California. The study population included respondents age 40-49 who completed a breast health assessment questionnaire mailed to all women age 34-49 and enrolled in a California HMO in early 1997. About 67.6% of the 20,391 women age 40-49 had at least one mammogram during 1995 and 1996. Logistic regression revealed that women age 40-44 were less likely (odds ratio: 0.83-0.90) than women age 45-49 to obtain mammography. Family history of breast cancer (odds ratio: 1.12-1.16), breast biopsy (odds ratio: 1.14-1.18), and a mammogram in the previous three years (odds ratio: 1.15-1.18) were associated with an increased likelihood of taking a mammogram. However, monthly breast self-exams (odds ratio: 0.996-1.04), having a child at or after age 30 (odds ratio: 0.97-1.02), and having menarche at age 12 or younger (odds ratio: 0.96-1.01) had no significant effect on the screening mammography rates. A relatively higher percentage of younger HMO members receive screening mammography than that of general population. However, some higher-risk groups, especially women whose first pregnancies were late in life, do not show a higher rate of using mammography.

  11. Screening of repetitive motifs inside the genome of the flat oyster (Ostrea edulis): Transposable elements and short tandem repeats.

    Science.gov (United States)

    Vera, Manuel; Bello, Xabier; Álvarez-Dios, Jose-Antonio; Pardo, Belen G; Sánchez, Laura; Carlsson, Jens; Carlsson, Jeanette E L; Bartolomé, Carolina; Maside, Xulio; Martinez, Paulino

    2015-12-01

    The flat oyster (Ostrea edulis) is one of the most appreciated molluscs in Europe, but its production has been greatly reduced by the parasite Bonamia ostreae. Here, new generation genomic resources were used to analyse the repetitive fraction of the oyster genome, with the aim of developing molecular markers to face this main oyster production challenge. The resulting oyster database, consists of two sets of 10,318 and 7159 unique contigs (4.8 Mbp and 6.8 Mbp in total length) representing the oyster's genome (WG) and haemocyte transcriptome (HT), respectively. A total of 1083 sequences were identified as TE-derived, which corresponded to 4.0% of WG and 1.1% of HT. They were clustered into 142 homology groups, most of which were assigned to the Penelope order of retrotransposons, and to the Helitron and TIR DNA-transposons. Simple repeats and rRNA pseudogenes, also made a significant contribution to the oyster's genome (0.5% and 0.3% of WG and HT, respectively).The most frequent short tandem repeats identified in WG were tetranucleotide motifs while trinucleotide motifs were in HT. Forty identified microsatellite loci, 20 from each database, were selected for technical validation. Success was much lower among WG than HT microsatellites (15% vs 55%), which could reflect higher variation in anonymous regions interfering with primer annealing. All microsatellites developed adjusted to Hardy-Weinberg proportions and represent a useful tool to support future breeding programmes and to manage genetic resources of natural flat oyster beds.

  12. Waiting time and the psychosocial consequences of false-positive mammography

    DEFF Research Database (Denmark)

    Heleno, Bruno M.; Siersma, Volkert; Brodersen, John

    2015-01-01

    Background: There is wide variation in the psychosocial response to false-positive mammography. We aimed to assess whether women having to wait longer to exclude cancer had increased psychosocial consequences that persisted after cancer was ruled out. Findings: We selected women with false......-positive mammography (n = 272), screened for breast cancer in Copenhagen and Funen (Denmark) over a 1-year period. We measured psychosocial consequences immediately before women attended their recall visit and 1, 6, 18 and 36 months after women received their final diagnosis. After women were told that cancer had been...

  13. Patient willingness for repeat screening and preference for CT colonography and optical colonoscopy in ACRIN 6664: the National CT Colonography trial

    Directory of Open Access Journals (Sweden)

    Gareen IF

    2015-07-01

    Full Text Available Ilana F Gareen,1,2 Bettina Siewert,3 David J Vanness,4 Benjamin Herman,2 CD Johnson,5 Constantine Gatsonis2,6 1Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; 2Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA; 3Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA; 4Population Health Sciences, University of Wisconsin, Madison, WI, USA; 5Mayo Clinic, Scottsdale, AZ, USA; 6Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA Background: Current American Cancer Society recommendations for colon cancer screening include optical colonoscopy every 10 years or computed tomography colonography (CTC every 5 years. Bowel preparation (BP is currently required for both screening modalities.Purpose: To compare ACRIN 6664: the National CT Colonography Trial (NCTCT participant experiences with CTC and optical colonoscopy (OC, procedure preference, and willingness to return for each procedure.Materials and methods: Participants from fifteen NCTCT sites, who underwent CTC followed by OC under sedation, were invited to complete questionnaires 2 weeks postexam, asking about procedure preference, physical discomfort, and embarrassment experienced and whether that discomfort and embarrassment was better or worse than expected during BP, CTC, and OC, as well as willingness to return for repeat CTC and OC at different time intervals.Results: A total of 2,310 of 2,600 patients (89% returned their questionnaires. Of patients reporting a preference, 1,058 (46.6% preferred CTC, 569 (25.0% preferred OC, and 626 (27.6% reported no preference. Participant-reported discomfort worse than expected differed significantly between CTC (32.9% and OC (5.0% (P<0.001. About 79.3% were willing to be screened again with CTC in 5 years, and 96.6% with OC in 10 years. Discomfort and embarrassment worse than expected with OC were associated

  14. Early breast cancer detection using techniques other than mammography

    Energy Technology Data Exchange (ETDEWEB)

    Kopans, D.B.

    1984-09-01

    X-ray mammography is the only imaging method currently available with any proven efficacy for screening to detect early-stage, clinically occult breast cancer. Sonography has a limited role in the differentiation of cystic from solid masses and as a guide for aspiration and preoperative localization of selected breast lesions. Computed tomography has a more limited role to determine the spatial orientation of a lesion detected only in the lateral mammographic position. All other imaging methods should be considered experimental at this time.

  15. [Usefulness and risks of routine mammography for the detection of breast cancer].

    Science.gov (United States)

    Hernández-Valencia, Marcelino; Hernández-Quijano, Tomás; Zárate, Arturo; Saucedo, Renata

    2014-01-01

    It has been accepted that preclinicall detection of breast cancer by means of the routine practice of mammography could discover the disease at its initial stage; therefore, practicing a mammography annually became widespread as a preventive health measure to diagnose the disease and prevent death due to breast cancer. Over time, the benefit of detection tests has been questioned and demonstration of their benefit, as well as that of the undesirable effects they might cause, has been demanded. There is recent information with regard to an absence of difference in terms of breast cancer mortality as final index between women with or without routine mammography. Additionally, a 20 % frequency has been observed in false-positive diagnoses, with high numbers of women undergoing unnecessary diagnostic procedures due to suspicion of a non-clinically apparent presumed cancer. In Mexico, from 2004 on, the popularity of mammography to detect and effectively cure cancer has increased. Acceptance can be attributted to how easily detection campaigns can be promoted, since most women accept that mastography can offer the opportunity of receiving an early treatment that reduces dissemination and prevents early mortality. The age at which it is convenient to perform the first mammography, how frequently it should be repeated and even the age for its discontinuation is still under debate and no consensus has been reached.

  16. Studies of breast masses in Korean woman using tungsten anode mammography

    Energy Technology Data Exchange (ETDEWEB)

    Suh, C. O.; Oh, K. K.; Lee, K. S. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Mammography is the oldest and most popular method in the diagnosis of breast disease and received the special attention as the powerful instrument in early detection of breast cancer. In Korea, the mammography has not been widely used, yet, but nowadays, increasing incidence of breast cancer and good prognosis after early detection and proper treatment need the clinical application of mammography for management of patient with breast disease and for the detection of occult cancer. The technique obtaining the good quality film is essential for improving the diagnostic accuracy of mammography in breast disease and in general, excellent film radiographs of breast can be obtained with proper combination of Kvp, processing, selection of fine grained film, fine focus tube and compression. In present study, radiographic technique was used in which 36-40 Kvp and 200 mAs were derived from a small focus Tungsten Anode tube. Medio-lateral and Cranio-caudad view were taken using Acryl compression device, which was specially designed by authors in order to properly examine the small, dense breasts of Korean women. Non-screen fine grained mammographic films was used and processing was manual.The materials consisted of 150 cases of mammography performed at Yonsei University Medical College, Severance Hospital, since January, 1978. We analyzed the diagnostic accuracy of mammography and mammographic findings in pathologically confirmed 39 cases. The conclusions are as follows: 1. Because women are sensitive to her breast changes, mammography is very useful not only in diagnosis of breast disease and early detection of cancer, but also management of patients with breast symptom and sign. 2. We obtained the relatively good quality film and high diagnostic accuracy with our own method, using conventional Tungsten Anode tube, compression device and hand processing. 3. We also applied specimen radiography in diagnosis of breast disease, which was helpful in verification of the adequacy

  17. Survey of health beliefs of women about performing mammography in thehealth servic centers of Sari

    Directory of Open Access Journals (Sweden)

    K. Abedian

    2006-01-01

    Full Text Available Background and purpose: Breast cancer is one of the most important non contagious disease with high incidence and mortality in females. It is the most commonly reported cancer and consists 18.9% of all reported cancer cases. Screening is a very important method for early diagnosis of breast cancer. Considering the important role of beliefs in performing as the most effective available method in diagnosis, this study was designed and done about the health beliefs of women towards mammography.Materials and Methods: This descriptive study was performed on 400 randomly selected women above 40 years of age referring to the health service centers in Sari. Their health beliefs about mammography was assessed by a questionnaire using Champion method. The obtained data were analyzed by inferential and descriptive statistical methods.Results: Majority of the women (69.5% did not practice mammography until the time of this study but 13.9% of their first family members did it. About 55.8% of them accepted that mammography insures individuals of their breast health. About 41.6% of them believed that early diagnosis of breast cancer prevents mastectomy. The most common obstacle of mammography was the concept that lack of any mass observation in breast self examination rejects requirement for mammography. About 34.5% of the patients, agreed that breast cancer affects their job activity and 34.7% agreed that breast cancer may lead to masteatomy. Statistical analysis did not reveal any relation between the occupation of the women and their beliefs about benefit of mammography and their vulnerability to breast cancer and its severity. Statistically significant relationship was observed between the education and the concepts of the women about the benefit and barrier of mammography (p<0.05.Conclusion: Despite positive concept, about mammography, it is not routinely performed in the society. Hence, it is recommended to encourage women to take advantage of this

  18. Future of mammography-based imaging; Zukunft mammographiebasierter Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Schulz-Wendtland, R.; Brehm, B.; Meier-Meitinger, M.; Uder, M. [Klinikum der Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Gynaekologische Radiologie, Radiologisches Institut, Erlangen (Germany); Wittenberg, T. [Fraunhofer-Institut fuer Integrierte Schaltkreise IIS, Erlangen (Germany); Michel, T.; Anton, G. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Erlangen Centre for Astroparticle Physics, Erlangen (Germany); Hartmann, A. [Klinikum der Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institut fuer Pathologie, Erlangen (Germany); Beckmann, M.W.; Rauh, C.; Jud, S.M.; Fasching, P.A. [Klinikum der Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Frauenklinik, Comprehensive Cancer Center Erlangen-EMN, Erlangen (Germany)

    2014-03-15

    Mammography is the central diagnostic method for clinical diagnostics of breast cancer and the breast cancer screening program. In the clinical routine complementary methods, such as ultrasound, tomosynthesis and optional magnetic resonance imaging (MRI) are already combined for the diagnostic procedure. Future developments will utilize investigative procedures either as a hybrid (combination of several different imaging modalities in one instrument) or as a fusion method (the technical fusion of two or more of these methods) to implement fusion imaging into diagnostic algorithms. For screening there are reasonable hypotheses to aim for studies that individualize the diagnostic process within the screening procedure. Individual breast cancer risk prediction and individualized knowledge about sensitivity and specificity for certain diagnostic methods could be tested. The clinical implementation of these algorithms is not yet in sight. (orig.) [German] Die Mammographie ist die zentrale diagnostische Methode der klinischen symptombezogenen Abklaerung von Brusterkrankungen und des Brustkrebsscreenings. In der klinischen Diagnostik wird sie heute schon oft durch zusaetzliche Untersuchungsmethoden wie dem Ultraschall, der Tomosynthese und ggf. auch der MRT-Bildgebung unterstuetzt. Zukuenftige Entwicklungen gehen in die Richtung, dass diese Kombination aus 2 oder mehr Untersuchungsverfahren entweder in Hybrid- (Aufnahme mehrerer unterschiedlicher Bildmodalitaeten in einem einzigen Geraet) oder in Fusionsmethoden (Zusammenfuehrung und Registrierung von Bilddaten aus verschiedenen Modalitaeten) technisch professionalisiert werden. Des Weiteren koennten an subgruppenbezogene Erkrankungsrisiken und individuelle Sensitivitaeten und Spezifitaeten angepasste Diagnostikkombinationen fuer eine Screeningdiagnostik Gegenstand kuenftiger Studien sein. Wir stellen die aktuellen Entwicklungen auf diesen Gebieten und deren momentane Relevanz fuer die klinische Praxis und

  19. Unbiased screen for interactors of leucine-rich repeat kinase 2 supports a common pathway for sporadic and familial Parkinson disease

    Science.gov (United States)

    Beilina, Alexandria; Rudenko, Iakov N.; Kaganovich, Alice; Civiero, Laura; Chau, Hien; Kalia, Suneil K.; Kalia, Lorraine V.; Lobbestael, Evy; Chia, Ruth; Ndukwe, Kelechi; Ding, Jinhui; Nalls, Mike A.; Olszewski, Maciej; Hauser, David N.; Kumaran, Ravindran; Lozano, Andres M.; Baekelandt, Veerle; Greene, Lois E.; Taymans, Jean-Marc; Greggio, Elisa; Cookson, Mark R.; Nalls, Mike A.; Plagnol, Vincent; Martinez, Maria; Hernandez, Dena G; Sharma, Manu; Sheerin, Una-Marie; Saad, Mohamad; Simón-Sánchez, Javier; Schulte, Claudia; Lesage, Suzanne; Sveinbjörnsdóttir, Sigurlaug; Arepalli, Sampath; Barker, Roger; Ben-Shlomo, Yoav; Berendse, Henk W; Berg, Daniela; Bhatia, Kailash; de Bie, Rob M A; Biffi, Alessandro; Bloem, Bas; Bochdanovits, Zoltan; Bonin, Michael; Bras, Jose M; Brockmann, Kathrin; Brooks, Janet; Burn, David J; Charlesworth, Gavin; Chen, Honglei; Chong, Sean; Clarke, Carl E; Cookson, Mark R; Cooper, J Mark; Corvol, Jean Christophe; Counsell, Carl; Damier, Philippe; Dartigues, Jean-François; Deloukas, Panos; Deuschl, Günther; Dexter, David T; van Dijk, Karin D; Dillman, Allissa; Durif, Frank; Dürr, Alexandra; Edkins, Sarah; Evans, Jonathan R; Foltynie, Thomas; Gao, Jianjun; Gardner, Michelle; Gibbs, J Raphael; Goate, Alison; Gray, Emma; Guerreiro, Rita; Gústafsson, Ómar; Harris, Clare; van Hilten, Jacobus J; Hofman, Albert; Hollenbeck, Albert; Holton, Janice; Hu, Michele; Huang, Xuemei; Huber, Heiko; Hudson, Gavin; Hunt, Sarah E; Huttenlocher, Johanna; Illig, Thomas; München, Helmholtz Zentrum; Jónsson, Pálmi V; Lambert, Jean-Charles; Langford, Cordelia; Lees, Andrew; Lichtner, Peter; München, Helmholtz Zentrum; Limousin, Patricia; Lopez, Grisel; Lorenz, Delia; McNeill, Alisdair; Moorby, Catriona; Moore, Matthew; Morris, Huw R; Morrison, Karen E; Mudanohwo, Ese; O’Sullivan, Sean S; Pearson, Justin; Perlmutter, Joel S; Pétursson, Hjörvar; Pollak, Pierre; Post, Bart; Potter, Simon; Ravina, Bernard; Revesz, Tamas; Riess, Olaf; Rivadeneira, Fernando; Rizzu, Patrizia; Ryten, Mina; Sawcer, Stephen; Schapira, Anthony; Scheffer, Hans; Shaw, Karen; Shoulson, Ira; Sidransky, Ellen; Smith, Colin; Spencer, Chris C A; Stefánsson, Hreinn; Steinberg, Stacy; Stockton, Joanna D; Strange, Amy; Talbot, Kevin; Tanner, Carlie M; Tashakkori-Ghanbaria, Avazeh; Tison, François; Trabzuni, Daniah; Traynor, Bryan J; Uitterlinden, André G; Velseboer, Daan; Vidailhet, Marie; Walker, Robert; van de Warrenburg, Bart; Wickremaratchi, Mirdhu; Williams, Nigel; Williams-Gray, Caroline H; Winder-Rhodes, Sophie; Stefánsson, Kári; Hardy, John; Heutink, Peter; Brice, Alexis; Gasser, Thomas; Singleton, Andrew B; Wood, Nicholas W; Chinnery, Patrick F; Arepalli, Sampath; Cookson, Mark R; Dillman, Allissa; Ferrucci, Luigi; Gibbs, J Raphael; Hernandez, Dena G; Johnson, Robert; Longo, Dan L; Majounie, Elisa; Nalls, Michael A; O’Brien, Richard; Singleton, Andrew B; Traynor, Bryan J; Troncoso, Juan; van der Brug, Marcel; Zielke, H Ronald; Zonderman, Alan B

    2014-01-01

    Mutations in leucine-rich repeat kinase 2 (LRRK2) cause inherited Parkinson disease (PD), and common variants around LRRK2 are a risk factor for sporadic PD. Using protein–protein interaction arrays, we identified BCL2-associated athanogene 5, Rab7L1 (RAB7, member RAS oncogene family-like 1), and Cyclin-G–associated kinase as binding partners of LRRK2. The latter two genes are candidate genes for risk for sporadic PD identified by genome-wide association studies. These proteins form a complex that promotes clearance of Golgi-derived vesicles through the autophagy–lysosome system both in vitro and in vivo. We propose that three different genes for PD have a common biological function. More generally, data integration from multiple unbiased screens can provide insight into human disease mechanisms. PMID:24510904

  20. Barriers and facilitators related to mammography use among lower educated Mexican women in the USA.

    Science.gov (United States)

    Tejeda, Silvia; Thompson, Beti; Coronado, Gloria D; Martin, Diane P

    2009-03-01

    This study explores barriers to and facilitators of breast cancer screening and how people in a woman's social network influence these screening behaviors. A total of 40 semi-structured qualitative interviews were conducted in rural Washington State (USA) among Mexican women aged 50 and over. Eligible women reported either having had a mammogram within the last two years, over two years ago, or never. We found that lack of health insurance, the perception that the mammogram is painful, and fear of finding cancer were cited as barriers to participation in mammography screening. Women who had lived in the US for a shorter period were more likely to report never having had a mammogram than women who had lived in the US for a longer period. Women often cited daughters and female friends as those from whom they received advice or encouragement to receive a mammogram. Few differences were found related to network size and mammography use among the groups. These findings may be useful in designing interventions to promote mammography use. Including daughters in intervention activities may help facilitate mammography use among Mexican women.

  1. The Transition from Analog to Digital Mammography: Overall Considerations

    Directory of Open Access Journals (Sweden)

    A. Sardo

    2007-05-01

    Full Text Available In the last decades a continuous growth of the infor-matics process around the world has been observed: paper documents, data, images…, converted into a “digital format” allow an easier and safer manage-ment, making possible its compatibility and access to internet networking. This migration confirms the huge technology progresses made especially in the image capture ways: from photography to graphic arts, from movie to healthcare imaging, where the end user/radiologist requires, at least, a digital clinical image with a quality equivalent to the previous ana-log film image. In women’s breast imaging care mammography is acknowledged as the most effective method to detect a breast cancer at an earlier stage and it is currently the only imaging modality, which has been proven to reduce mortality in women screened from 50 to 69 years. The transition to Digital Mammography represents a challenge to decide when to change the first concern is to get the money availability to purchase a Digital Mammography system and the well-trained human resources (radiologist, technician and physicist for using it. A digital system must satisfy actual needs such as the diagnostic accuracy, dose and regulatory requirements, productivity and archive issues. The new digital modality must be integrated in a fully digital environment (PACS and the presence of CR or DR systems for general radiography could condi-tion the choice of CR or DR Digital Mammography system. The Primary goal of mammography (both analog and digital is to provide to the radiologist clinical images for confident interpretation. Certainly the confidence derives from radiologist’s experience in reading mammograms, but many other factors can increase it, for instance correct patient positioning, excellent and consistent image quality (photographic and artifacts free, easy use and interpretation aid (e.g. lens, CAD use of imaging system. However, the habit in read-ing film-images on view box

  2. The effects of gray scale image processing on digital mammography interpretation performance.

    Science.gov (United States)

    Cole, Elodia B; Pisano, Etta D; Zeng, Donglin; Muller, Keith; Aylward, Stephen R; Park, Sungwook; Kuzmiak, Cherie; Koomen, Marcia; Pavic, Dag; Walsh, Ruth; Baker, Jay; Gimenez, Edgardo I; Freimanis, Rita

    2005-05-01

    To determine the effects of three image-processing algorithms on diagnostic accuracy of digital mammography in comparison with conventional screen-film mammography. A total of 201 cases consisting of nonprocessed soft copy versions of the digital mammograms acquired from GE, Fischer, and Trex digital mammography systems (1997-1999) and conventional screen-film mammograms of the same patients were interpreted by nine radiologists. The raw digital data were processed with each of three different image-processing algorithms creating three presentations-manufacturer's default (applied and laser printed to film by each of the manufacturers), MUSICA, and PLAHE-were presented in soft copy display. There were three radiologists per presentation. Area under the receiver operating characteristic curve for GE digital mass cases was worse than screen-film for all digital presentations. The area under the receiver operating characteristic for Trex digital mass cases was better, but only with images processed with the manufacturer's default algorithm. Sensitivity for GE digital mass cases was worse than screen film for all digital presentations. Specificity for Fischer digital calcifications cases was worse than screen film for images processed in default and PLAHE algorithms. Specificity for Trex digital calcifications cases was worse than screen film for images processed with MUSICA. Specific image-processing algorithms may be necessary for optimal presentation for interpretation based on machine and lesion type.

  3. Building an intranet digital mammography case library

    Science.gov (United States)

    Zhang, Hong; Lou, Shyhliang A.; Fan, Yu; Sickles, Edward A.; Huang, H. K.

    2000-05-01

    To practice mammography diagnosis effectively, radiologists expect convenient access to well-organized and authoritative mammography related information, especially when there is case in question. The purpose of this study is to build infrastructural diagnosis support by incorporating various clinical information into a digital mammography case library, and allow user to search the library based on mammographic findings. The digital mammography case library has a three- tier architecture: (1) Back-end mammography databases integrate multimedia clinical information from various operational systems, including RIS and PACS. Cases are stored in a finding index database powered by an object-relational database with finding-coded reports, which are modeled around the ACR BI-RADS (American College of Radiology, Breast Imaging Report and Data System) standard. (2) The middle-end application controllers process application logic, such as user authorization, HTTP request handling, database connection and dynamic HTML page generation. (3) Web-based user interface is developed for authorized Intranet personnel to formulate query based on radiological finding (such as mass, calcification and architectural distortion), shape and assessment, using ACR BI-RADS specified lexicon. The case library so far has 103 cases selected from over 800 digital mammography studies carried out at the Mt. Zion hospital, UCSF, during an on-going digital telemammography project. We believe that an Intranet based digital mammography case library with mammographic finding search capability facilitates continuous medical education and online decision support, by providing exemplary study to compare with case in question.

  4. Mammography performance in Oman: Review of factors influencing cancer yield and positive predictive value.

    Science.gov (United States)

    Taif, Sawsan; Tufail, Fatma; Alnuaimi, Ahmed Sameer

    2016-06-01

    The aim of this study is to assess mammography performance in Oman by estimating the breast cancer rate and the positive predictive value (PPV) with the influence of some variables. This cross-sectional study was conducted on mammograms done in one of the three main breast imaging centers in Oman between January 2008 and July 2012. Diagnostic and screening groups were identified and assessed separately. Rate of abnormal mammograms, rate of breast cancer and the PPV were estimated according to Breast Imaging Reporting and Data System (BIRADS) score, presence of breast lump and patient's age. Total of 653 mammograms were included, 254 diagnostic and 399 screening. Abnormal mammograms (BIRADS 4 and 5) form 31.9% of the diagnostic examinations compared with 6.8% of screening examinations. Breast cancer was present in 17.9% of the diagnostic compared with 1.0% of the screening group. The PPV of BIRADS 5 was 94.1%, and for BIRADS 4 was 37.1 and 26.7% for diagnostic and screening studies. Overall PPV for abnormal mammograms was 65.2% in the diagnostic and 26.7% in the screening group. Mammography PPV shows positive association with age (P = 0.039) while presence of breast lump has no significant effect on the PPV (P = 0.38). BIRADS 5 score was found to have a high cancer yield making it a strong predictor of cancer. Different results were obtained in the diagnostic compared with screening mammography with higher rates of abnormal mammograms and breast cancer. Mammography performance should be better in the older women. © 2014 Wiley Publishing Asia Pty Ltd.

  5. Is the false-positive rate in mammography in North America too high?

    Science.gov (United States)

    Le, Michelle T; Mothersill, Carmel E; Seymour, Colin B; McNeill, Fiona E

    2016-09-01

    The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions.

  6. Screening and prevention of breast cancer in primary care.

    Science.gov (United States)

    Tice, Jeffrey A; Kerlikowske, Karla

    2009-09-01

    Mammography remains the mainstay of breast cancer screening. There is little controversy that mammography reduces the risk of dying from breast cancer by about 23% among women between the ages of 50 and 69 years, although the harms associated with false-positive results and overdiagnosis limit the net benefit of mammography. Women in their 70s may have a small benefit from screening mammography, but overdiagnosis increases in this age group as do competing causes of death. While new data support a 16% reduction in breast cancer mortality for 40- to 49-year-old women after 10 years of screening, the net benefit is less compelling in part because of the lower incidence of breast cancer in this age group and because mammography is less sensitive and specific in women younger than 50 years. Digital mammography is more sensitive than film mammography in young women with similar specificity, but no improvements in breast cancer outcomes have been demonstrated. Magnetic resonance imaging may benefit the highest risk women. Randomized trials suggest that self-breast examination does more harm than good. Primary prevention with currently approved medications will have a negligible effect on breast cancer incidence. Public health efforts aimed at increasing mammography screening rates, promoting regular exercise in all women, maintaining a healthy weight, limiting alcohol intake, and limiting postmenopausal hormone therapy may help to continue the recent trend of lower breast cancer incidence and mortality among American women.

  7. Impact of the elimination of cost sharing for mammographic breast cancer screening among rural US women: A natural experiment.

    Science.gov (United States)

    Peppercorn, Jeffrey; Horick, Nora; Houck, Kevin; Rabin, Julia; Villagra, Victor; Lyman, Gary H; Wheeler, Stephanie B

    2017-07-01

    Rural US women experience disparities in breast cancer screening and outcomes. In 2006, a national rural health insurance provider, the National Rural Electric Cooperative Association (NRECA), eliminated out-of-pocket costs for screening mammography. This study evaluated the elimination of cost sharing as a natural experiment: it compared trends in screening before and after the policy change. NRECA insurance claims data were used to identify all women aged 40 to 64 years who were eligible for breast cancer screening, and mammography utilization from 1998 through 2011 was evaluated. Repeated measures regression models were used to evaluate changes in utilization over time and the association between screening and sociodemographic factors. The analysis was based on 45,738 women enrolled in the NRECA membership database for an average of 6.1 years and included 279,940 person-years of enrollment. Between 1998 and 2011, the annual screening rate increased from 35% to a peak of 50% among women aged 40 to 49 years and from 49% to 58% among women aged 50 to 64 years. The biennial screening rate increased from 56% to 66% for women aged 40 to 49 years and from 68% to 73% for women aged 50 to 64 years. Screening rates increased significantly (P < .0001) after the elimination of cost sharing and then declined slightly after changes to government screening guidelines in 2009. Younger women experienced greater increases in both annual screening (6.2%) and biennial screening (5.6%) after the elimination of cost sharing in comparison with older women (3.0% and 2.6%, respectively). In a multivariate analysis, rural residence, lower population income, and lower population education were associated with modestly lower screening. In a national sample of predominantly rural working-age women, the elimination of cost sharing correlated with increased breast cancer screening. Cancer 2017;123:2506-15. © 2017 American Cancer Society. © 2017 American Cancer Society.

  8. Short communication: A printed image quality test phantom for mammography.

    Science.gov (United States)

    Kotre, C J; Porter, D J T

    2005-08-01

    This communication describes a novel design for a mammographic image quality test phantom, the final design of which was produced as a radiographer weekly quality assurance phantom for breast screening and symptomatic mammography. The phantom is based on low contrast test features which are built up by superimposing sheets of Mylar overhead projector transparency, on which the test features are printed using a standard LaserJet printer. The required radiation contrast at mammographic energies is produced by the approximately 50% by weight component of iron oxide (Fe(3)O(4)) present in the toner. An easily replicated design of mammographic image quality phantom based on LaserJet printed test features is described. Approximately 40 of these phantoms were constructed, and these have been used successfully for 5 years in both breast screening and symptomatic mammography. The phantom design offers a performance similar to much more expensive mammographic contrast-detail phantoms, but suffers from the disadvantage that high contrast resolution bar patterns cannot be produced using the standard printing process.

  9. Validation of the English and Spanish Mammography Beliefs and Attitudes Questionnaire.

    Science.gov (United States)

    Lopez-McKee, Gloria; Bader, Julia

    2011-03-21

    Breast cancer is the leading cause of cancer deaths among Hispanic women in the United States. Unfortunately Hispanic women exhibit poor mammography screening participation, are diagnosed at later stages of the disease, and have lower survival rates than non-Hispanic white women. Several cultural and psycho-social factors have been found to influence mammography screening participation among Hispanic women. We will begin by presenting the theoretical framework that grounded this research program to develop an instrument to assess factors contributing to poor mammography participation among Hispanic women. We will also summarize the early stages in the development of the English and Spanish Mammography Beliefs and Attitudes Questionnaire (MBAQ and SMBAQ) for use with low-health-literacy Mexican-American women. Next we will describe the initial psychometric testing of the MBAQ/SMBAQ, after which we will present the psychometric testing of the SMBAQ with low-health-literacy women. This will be followed by a discussion of the modification of the MBAQ and SMBAQ subscales. We'll conclude with a discussion of the instruments and share our assessment regarding the limitations of this research program, where the program stands to date, and the implications for practice and future research.

  10. Psychosocial Determinants of Mammography Follow-up after Receipt of Abnormal Mammography Results in Medically Underserved Women

    Science.gov (United States)

    Fair, Alecia Malin; Wujcik, Debra; Lin, Jin-Mann Sally; Zheng, Wei; Egan, Kathleen M.; Grau, Ana M.; Champion, Victoria L.; Wallston, Kenneth A.

    2010-01-01

    This article targets the relationship between psychosocial determinants and abnormal screening mammography follow-up in a medically underserved population. Health belief scales were modified to refer to diagnostic follow-up versus annual screening. A retrospective cohort study design was used. Statistical analyses were performed examining relationships among sociodemographic factors, psychosocial determinants, and abnormal mammography follow-up. Women with lower mean internal health locus of control scores (3.14) were two times more likely than women with higher mean internal health locus of control scores (3.98) to have inadequate follow-up (OR = 2.53, 95% CI = 1.12–5.36). Women with less than a high school education had lower cancer fatalism scores than women who had completed high school (47.5 vs. 55.2, p-value = .02) and lower mean external health locus of control scores (3.0 vs. 5.3) (p-valueconcepts is warranted. PMID:20173286

  11. Engaging diverse underserved communities to bridge the mammography divide

    Directory of Open Access Journals (Sweden)

    Cully Angelia

    2011-01-01

    Full Text Available Abstract Background Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. Methods/Design In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas - Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2 intervention or a

  12. Breast Cancer Screening: What are the Last Changes?

    Directory of Open Access Journals (Sweden)

    Selda Secginli

    2011-04-01

    Full Text Available Mammography, clinical breast-examination (CBE and breast self-examination (BSE are the mainly recommended screening methods for early diagnosis of breast cancer. In recent years, guidelines concerning screening methods were revised. To date, CBE and BSE are not routinely recommended for early diagnosis of breast cancer in western countries. Due to important value in decreasing breast cancer mortality rate, mammography, is the recommended breast cancer screening method; but the changes related with the time of mammography screening is rised to notice. In 2010, the US Preventive Services Task Force (USPSTF which is one of the important health authority, guidelines concerning screening mammography were revised. Accordingly, while the mammography that is recommended for women starting aged 40 years by many health authorities, the USPSTF no longer advises routine screening mammography for women aged 40–49 and for those aged ≥75.; and biennial screening is advised for those aged 50–74. It is necessary for health professionals working in breast health area to learn the last changes concerning about breast cancer screening methods. Together with CBE and BSE, it is also important to encourage women to participate mammography screening with an understanding of its benefits and risks. In this article, it is aimed to critique new guidelines about breast cancer screening methods. It is also critiqued the potential benefits and risks of mammography that is currently considered the ‘‘gold standard’’ for breast cancer screening for women. [TAF Prev Med Bull 2011; 10(2.000: 193-200

  13. The field study of the mammography in Fukuoka prefecture. Second report. Investigation of glandular tissue dose and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Akashi, Kaoru; Nakahara, Hiroko [Social Insurance Kurume Daiichi Hospital, Fukuoka (Japan); Tanaka, Isamu [Hakuaikai Hospital, Fukuoka (Japan)] [and others

    2003-02-01

    The research of the glandular tissue dose and image quality of the mammography in Fukuoka prefecture was performed from April to October 2000 at 50 mammography sites. Effects of the technical parameters, such as screen-film combinations, antiscatter grids, processing conditions, x-ray beam qualities, on the average glandular tissue dose and image quality were analyzed under two exposure conditions: The standard radiographic condition for a RMI156 phantom in each facility (Standard Radiographic Condition). The radiographic condition for obtaining the radiographic density of 1.40{+-}0.15 with RMI156 phantom (Canonical Radiographic Condition). In the investigation in Fukuoka prefecture, facilities of 3 mGy or less at the average mammary gland dosage were 98%. In the meantime, image quality of 54% facilities was insufficient. Analysis of technical parameters affecting the glandular tissue dose and image quality will be useful for the establishment of breast cancer screening system using mammography. (author)

  14. Evaluation of average glandular dose in mammography services in 10 cities of Colombia; Avaliacao de dose glandular media em servicos de mamografia de 10 cidades de Colombia

    Energy Technology Data Exchange (ETDEWEB)

    Alejo-Martinez, H.; Salazar-Hurtado, E.; Puerto-Jimenez, D. [Grupo de Prevencion Temprana Del Cancer, Instituto Nacional de Cancerologia, Bogota D.C. (Colombia)

    2016-07-01

    The objective of this study was to conduct an assessment of dose in 60 mammography services that have screening programs for breast cancer in 10 cities of Colombia. The third quartile of the average glandular dose was 2,29 mGy, range between 1,0 and 5,6 mGy, for the phantom equivalent to a standard breast. This study included mammography units with conventional and digital technology. (author)

  15. Mammography

    Science.gov (United States)

    ... shades of gray and air appears black. Until recently, x-ray images were maintained on large film ... evaluation with additional views or a special imaging technique. A follow-up examination may also be necessary ...

  16. Mammography

    Science.gov (United States)

    ... tomosynthesis, the x-ray tube moves in an arc over the breast, capturing multiple images from different ... your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ...

  17. Effectiveness of two strategies to follow-up ASC-US and LSIL screening results in The Netherlands using repeat cytology with or without additional hrHPV testing: a retrospective cohort study

    NARCIS (Netherlands)

    Siebers, A.G.; Arbyn, M.; Melchers, W.J.; Kemenade, F.J. van; Vedder, J.E.; Linden, H. van der; Ballegooijen, M. van; Bekkers, R.L.; Bulten, J.

    2014-01-01

    PURPOSE: The purpose of the study was to assess the effectiveness of repeat cytology with and without additional high-risk human papilloma virus (hrHPV) testing after atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (ASC-US/LSIL) screening results.

  18. Relationship between the arterial calcification detected in mammography and coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Topal, Ugur [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)], E-mail: utopal@uludag.edu.tr; Kaderli, Aysel [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Topal, Naile Bolca [Department of Radiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ozdemir, Buelent; Yesilbursa, Dilek; Cordan, Jale [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Ediz, Buelent [Department of Statistics, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey); Aydinlar, Ali [Department of Cardiology, Uludag University, Medical School, Goeruekle Campus, 16059 Bursa (Turkey)

    2007-09-15

    Objective: Arterial calcification is frequently encountered in mammography. The frequency of breast arterial calcification (BAC) increases with increasing age. Studies have shown that BAC is seen more frequently among the people who are under the risk of coronary artery diseases (CAD) such as diabetes and hypertension. The objective of this study is to investigate the relationship between the arterial calcification detected in mammography and the CAD. Material and methods: Screening mammography was performed in 123 women above the age of 40 years who had been examined with coronary angiography for the evaluation of CAD. The presence of BAC, number of affected vessels, and the distribution of calcification in the vessel wall were evaluated in the mammography. Subjects were questioned in terms of the cardiovasculary risk factors. The severity of CAD was evaluated according to the Gensini scoring. In addition, the number of blood vessels with stenosis of more than 50% was used as the vascular score. The correlation between Gensini and the vascular scores, and BAC was statistically evaluated using Mann-Whitney U and Kruskal-Wallis tests. Results: Eighty (65%) of 123 patients had CAD. BAC was detected in the mammography of 49 (39.8%) subjects. The ages and duration of menopause of the cases with BAC were significantly higher than those without BAC (p < 0.001). There was an almost significant correlation between the BAC and Gensini scores (p = 0.059). There was a significant increase in the frequency of BAC among subjects with more than two vessels with stenosis (p = 0.033). Conclusion: Frequency of BAC increases with increasing age. BAC is also frequently seen in subjects having severe coronary artery disease. Although increasing age may be a factor increasing the frequency of BAC, BAC may also be an indicator of CAD. Therefore, the mentioning of arterial calcification in mammography reports may be important in warning the clinician in terms of CAD.

  19. Family/Friend Recommendations and Mammography Intentions: The Roles of Perceived Mammography Norms and Support

    Science.gov (United States)

    Molina, Yamile; Ornelas, India J.; Doty, Sarah L.; Bishop, Sonia; Beresford, Shirley A. A.; Coronado, Gloria D.

    2015-01-01

    Identifying factors that increase mammography use among Latinas is an important public health priority. Latinas are more likely to report mammography intentions and use, if a family member or friend recommends that they get a mammogram. Little is known about the mechanisms underlying the relationship between social interactions and mammography…

  20. Impact of full field digital mammography on the classification and mammographic characteristics of interval breast cancers

    Energy Technology Data Exchange (ETDEWEB)

    Knox, Mark, E-mail: marktknox@gmail.com; O’Brien, Angela, E-mail: angelaobrien@doctors.org.uk; Szabó, Endre, E-mail: endrebacsi@freemail.hu; Smith, Clare S., E-mail: csmith@mater.ie; Fenlon, Helen M., E-mail: helen.fenlon@cancerscreening.ie; McNicholas, Michelle M., E-mail: michelle.mcnicholas@cancerscreening.ie; Flanagan, Fidelma L., E-mail: fidelma.flanagan@cancerscreening.ie

    2015-06-15

    Highlights: • Digital mammography has changed the presentation of interval breast cancer. • Less interval breast cancers are associated with microcalcifications following FFDM. • Interval breast cancer audit remains a key feature of any breast screening program. - Abstract: Objective: Full field digital mammography (FFDM) is increasingly replacing screen film mammography (SFM) in breast screening programs. Interval breast cancers are an issue in all screening programs and the purpose of our study is to assess the impact of FFDM on the classification of interval breast cancers at independent blind review and to compare the mammographic features of interval cancers at FFDM and SFM. Materials and methods: This study included 138 cases of interval breast cancer, 76 following an FFDM screening examination and 62 following screening with SFM. The prior screening mammogram was assessed by each of five consultant breast radiologists who were blinded to the site of subsequent cancer. Subsequent review of the diagnostic mammogram was performed and cases were classified as missed, minimal signs, occult or true interval. Mammographic features of the interval cancer at diagnosis and any abnormality identified on the prior screening mammogram were recorded. Results: The percentages of cancers classified as missed at FFDM and SFM did not differ significantly, 10.5% (8 of 76) at FFDM and 8.1% (5 of 62) at SFM (p = .77). There were significantly less interval cancers presenting as microcalcifications (alone or in association with another abnormality) following screening with FFDM, 16% (12 of 76) than following a SFM examination, 32% (20 of 62) (p = .02). Conclusion: Interval breast cancers continue to pose a problem at FFDM. The switch to FFDM has changed the mammographic presentation of interval breast cancer, with less interval cancers presenting in association with microcalcifications.

  1. Initial Image Quality and Clinical Experience with New CR Digital Mammography System: A Phantom and Clinical Study

    Science.gov (United States)

    Gaona, Enrique; Alfonso, Beatriz Y. Álvarez; Castellanos, Gustavo Casian; Enríquez, Jesús Gabriel Franco

    2008-08-01

    The goal of the study was to evaluate the first CR digital mammography system (® Konica-Minolta) in Mexico in clinical routine for cancer detection in a screening population and to determine if high resolution CR digital imaging is equivalent to state-of-the-art screen-film imaging. The mammograms were evaluated by two observers with cytological or histological confirmation for BIRADS 3, 4 and 5. Contrast, exposure and artifacts of the images were evaluated. Different details like skin, retromamillary space and parenchymal structures were judged. The detectability of microcalcifications and lesions were compared and correlated to histology. The difference in sensitivity of CR Mammography (CRM) and Screen Film Mammography (SFM) was not statistically significant. However, CRM had a significantly lower recall rate, and the lesion detection was equal or superior to conventional images. There is no significant difference in the number of microcalcifications and highly suspicious calcifications were equally detected on both film-screen and digital images. Different anatomical regions were better detectable in digital than in conventional mammography.

  2. Mammography calibration qualities establishment in a Mo- Mo clinical system

    Science.gov (United States)

    Corrêa, E. L.; dos Santos, L. R.; Vivolo, V.; Potiens, M. P. A.

    2016-07-01

    In this study the mammography calibration qualities were established in a clinical mammography system. The objective is to provide the IPEN instruments calibration laboratory with both mammography calibration methods (using a clinical and an industrial system). The results showed a good behavior of mammography equipment, in terms of kVp, PPV and exposure time. The additional filtration of molybdenum is adequate, air-kerma rates were determined and spectra were obtained.

  3. Mammographic density measurements are not affected by mammography system.

    Science.gov (United States)

    Damases, Christine N; Brennan, Patrick C; McEntee, Mark F

    2015-01-01

    Mammographic density (MD) is a significant risk factor for breast cancer and has been shown to reduce the sensitivity of mammography screening. Knowledge of a woman's density can be used to predict her risk of developing breast cancer and personalize her imaging pathway. However, measurement of breast density has proven to be troublesome with wide variations in density recorded using radiologists' visual Breast Imaging Reporting and Data System (BIRADS). Several automated methods for assessing breast density have been proposed, each with their own source of measurement error. The use of differing mammographic imaging systems further complicates MD measurement, especially for the same women imaged over time. The purpose of this study was to investigate whether having a mammogram on differing manufacturer's equipment affects a woman's MD measurement. Raw mammographic images were acquired on two mammography imaging systems (General Electric and Hologic) one year apart and processed using VolparaDensity™ to obtain the Volpara Density Grade (VDG) and average volumetric breast density percentage (AvBD%). Visual BIRADS scores were also obtained from 20 expert readers. BIRADS scores for both systems showed strong positive correlation ([Formula: see text]; [Formula: see text]), while the VDG ([Formula: see text]; [Formula: see text]) and AvBD% ([Formula: see text]; [Formula: see text]) showed stronger positive correlations. Substantial agreement was shown between the systems for BIRADS ([Formula: see text]; [Formula: see text]), however, the systems demonstrated an almost perfect agreement for VDG ([Formula: see text]; [Formula: see text]).

  4. Breast cancer screening with digital breast tomosynthesis.

    Science.gov (United States)

    Skaane, Per

    2017-01-01

    To give an overview of studies comparing full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in breast cancer screening. The implementation of tomosynthesis in breast imaging is rapidly increasing world-wide. Experimental clinical studies of relevance for DBT screening have shown that tomosynthesis might have a great potential in breast cancer screening, although most of these retrospective reading studies are based on small populations, so that final conclusions are difficult to draw from individual reports. Several retrospective studies and three prospective trials on tomosynthesis in breast cancer screening have been published so far, confirming the great potential of DBT in mammography screening. The main results of these screening studies are presented. The retrospective screening studies from USA have all shown a significant decrease in the recall rate using DBT as adjunct to mammography. Most of these studies have also shown an increase in the cancer detection rate, and the non-significant results in some studies might be explained by a lack of statistical power. All the three prospective European trials have shown a significant increase in the cancer detection rate. The retrospective and the prospective screening studies comparing FFDM and DBT have all demonstrated that tomosynthesis has a great potential for improving breast cancer screening. DBT should be regarded as a better mammogram that could improve or overcome limitations of the conventional mammography, and tomosynthesis might be considered as the new technique in the next future of breast cancer screening.

  5. Use of rapid HIV assays as supplemental tests in specimens with repeatedly reactive screening immunoassay results not confirmed by HIV-1 Western blot.

    Science.gov (United States)

    Wesolowski, Laura G; Delaney, Kevin P; Meyer, William A; Blatt, Amy J; Bennett, Berry; Chavez, Pollyanna; Granade, Timothy C; Owen, Michele

    2013-09-01

    An alternate HIV testing algorithm has been proposed which includes a fourth-generation immunoassay followed by an HIV-1/HIV-2 antibody differentiation supplemental test for reactive specimens and a nucleic acid test (NAT) for specimens with discordant results. To evaluate the performance of five rapid tests (Alere Clearview, Bio-Rad Multispot, OraSure OraQuick, MedMira Reveal, and Trinity Biotech Unigold) as the supplemental antibody assay in the algorithm. A total of 3273 serum and plasma specimens that were third-generation immunoassay repeatedly reactive and Western blot (WB) negative or indeterminate were tested with rapid tests and NAT. Specimens were classified by NAT: (1) HIV-1 infected (NAT-reactive; n=184, 5.6%), (2) HIV-status unknown (NAT nonreactive; n=3078, 94.2%) or by Multispot, (3) HIV-2 positive (n=5), and (4) HIV-1 and HIV-2 positive (n=6). Excluding HIV-2 positive specimens, we calculated the proportion of reactive rapid tests among specimens with reactive and nonreactive NAT. The proportion of infected specimens with reactive rapid test results and negative or indeterminate WB ranged from 30.4% (56) to 47.8% (88) depending on the rapid test. From 1% to 2% of NAT-negative specimens had reactive rapid test results. In these diagnostically challenging specimens, all rapid tests identified infections that were missed by the Western blot, but only Multispot could differentiate HIV-1 from HIV-2. Regardless of which rapid test is used as a supplemental test in the alternative algorithm, false-positive algorithm results (i.e., reactive screening and rapid test in uninfected person) may occur, which will need to be resolved during the baseline medical evaluation. Published by Elsevier B.V.

  6. Breast cancer induced by radiation. Relation to mammography and treatment of acne

    Energy Technology Data Exchange (ETDEWEB)

    Simon, N.

    1977-02-21

    A report is given of cases of 16 women in whom cancer of the breast developed after radiation therapy for acne or hirsutism, suggesting another group at higher risk than is generally expected for cancer of the breast. It is prudent to regard the carcinogenic effect of radiation on the breast as proportional to dose without a threshold. Mammography in young women should be ordered only selectively, not for screening.

  7. Breast Cancer Screening in a Low Income Managed Care Population

    Science.gov (United States)

    1998-10-01

    the morbidity and mortality of breast cancer among the population of low income women who have incomes less than 200% of the national poverty level...34Journal for Health Care for the Poor and Underserved" (see appendix). Entitled "Difficulty in Reaching Low Income Women for Screening Mammography...useful insights for future program planning and research design. Keywords: screening mammography, low income , managed care and barriers Poverty is

  8. Grid infrastructures for developing mammography CAD systems.

    Science.gov (United States)

    Ramos-Pollan, Raul; Franco, Jose M; Sevilla, Jorge; Guevara-Lopez, Miguel A; de Posada, Naimy Gonzalez; Loureiro, Joanna; Ramos, Isabel

    2010-01-01

    This paper presents a set of technologies developed to exploit Grid infrastructures for breast cancer CAD, that include (1) federated repositories of mammography images and clinical data over Grid storage, (2) a workstation for mammography image analysis and diagnosis and (3) a framework for data analysis and training machine learning classifiers over Grid computing power specially tuned for medical image based data. An experimental mammography digital repository of approximately 300 mammograms from the MIAS database was created and classifiers were built achieving a 0.85 average area under the ROC curve in a dataset of 100 selected mammograms with representative pathological lesions and normal cases. Similar results were achieved with classifiers built for the UCI Breast Cancer Wisconsin dataset (699 features vectors). Now these technologies are being validated in a real medical environment at the Faculty of Medicine in Porto University after a process of integrating the tools within the clinicians workflows and IT systems.

  9. Performance of First Mammography Examination in Women Younger Than 40 Years

    Science.gov (United States)

    Haneuse, Sebastien; Kapp, Julie M.; Kerlikowske, Karla; Geller, Berta; Buist, Diana S. M.

    2010-01-01

    Background Few data have been published on mammography performance in women who are younger than 40 years. Methods We pooled data from six mammography registries across the United States from the Breast Cancer Surveillance Consortium. We included 117 738 women who were aged 18–39 years when they had their first screening or diagnostic mammogram during 1995–2005 and followed them for 1 year to determine accuracy of mammography assessment. We measured the recall rate for screening examinations and the sensitivity, specificity, positive predictive value, and cancer detection rate for all mammograms. Results For screening mammograms, no cancers were detected in 637 mammograms for women aged 18–24 years. For women aged 35–39 years who had the largest number of screening mammograms (n = 73 335) in this study, the recall rate was 12.7% (95% confidence interval [CI] = 12.4% to 12.9%), sensitivity was 76.1% (95% CI = 69.2% to 82.6%), specificity was 87.5% (95% CI = 87.2% to 87.7%), positive predictive value was 1.3% (95% CI = 1.1% to 1.5%), and cancer detection rate was 1.6 cancers per 1000 mammograms (95% CI = 1.3 to 1.9 cancers per 1000 mammograms). Most (67 468 [77.7%]) of the 86 871 women screened reported no family history of breast cancer. For diagnostic mammograms, the age-adjusted rates across all age groups were: sensitivity of 85.7% (95% CI = 82.7% to 88.7%), specificity of 88.8% (95% CI = 88.4% to 89.1%), positive predictive value of 14.6% (95% CI = 13.3% to 15.8%), and cancer detection rate of 14.3 cancers per 1000 mammograms (95% CI = 13.0 to 15.7 cancers per 1000 mammograms). Mammography performance, except for specificity, improved in the presence of a breast lump. Conclusions Younger women have very low breast cancer rates but after mammography experience high recall rates, high rates of additional imaging, and low cancer detection rates. We found no cancers in women younger than 25 years and poor performance for the large group of women aged

  10. Analysis of medical exposures in digital mammography; Analise das exposicoes medicas em mamografia digital

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Sergio R., E-mail: oliveirasr@fiocruz.br [Escola Politecnica de Saude Joaquim Venancio (EPSJV/FIOCRUZ), Rio de Janeiro, RJ (Brazil); Mantuano, Natalia O.; Albrecht, Afonso S., E-mail: nataliamantuano@gmail.com, E-mail: afonsofismed@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Instituto de Fisica; Flor, Leonardo S., E-mail: leonardo.flor@hsvp.org.br [Hospital Sao Vicente de Paulo (HSVP), Rio de Janeiro, RJ (Brazil)

    2014-07-01

    Currently, the use of digital mammography in the early diagnosis of breast cancer is increasingly common due to the production of high definition image that allows to detect subtle changes in breast images profiles. However it is necessary to be an improvement of the technique used since some devices offer minimization parameters of entrance dose to the skin. Thus, this study seeks to examine how the qualification of technical professionals in radiology interferes with the use of the techniques applied in mammography. For this, survey was carried out in a hospital in the city of Rio de Janeiro, which evaluated the scans of 1190 patients undergoing routine mammography (It is considered routinely the 4 basic exhibitions: with 2 flow skull and 2 medium oblique side, excluding repeats and supplements) in 2013. The medical exposures analyzed obtained from a single full digital equipment, model Senographe DS were compared with three different procedures performed by professionals in mammography techniques. The images were classified according to exposure techniques available in the equipment: Standard (STD), contrast (CNT) and dose (dose), and to be selected as breast density of the patient. Comparing the variation of the radiographic technique in relation to the professional who made the exhibition, what is observed is that the professional B presented the best conduct in relation to radiological protection, because she considered breast density in the choice of technical equipment parameter. The professional A, which is newly formed, and C, which has more service time, almost did not perform variations in the pattern of exposure, even for different breast densities. Thus, we can conclude that there is a need to update the professionals so that the tools available of dose limitation and mamas variability to digital mammography are efficiently employed in the service routine and thus meet the requirements of current legislation.

  11. Simultaneous Objective Measurements Of Dose And Image Quality In Mammography

    Science.gov (United States)

    Pochon, Y.; Depeursinge, Ch.; Hessler, Ch.; Raimondi, S.; Valley, J.-F.

    1982-12-01

    The performance of a radiological system can be evaluated on the one hand by an objective determination of the quality of the produced image and, on the other hand, by the dose delivered to the patient. In order to measure these two factors in a single exposure a Kodak breast phantom has been modified so as to simulate the breast absorption. The dose distribution is measured with thermoluminescent detectors. By consideration of a theoretical model of the X-ray imaging in mammography, a single quality factor is computed from the contrast, the spatial resolution and the noise measured on the phantom image. We present results obtained in various working conditions, i.e. variable X-ray tube voltages, use of different screen-film combinations, use of a grid.

  12. Data acquisition electronics for positron emission mammography (PEM) detectors

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, J.D. [Digital Systems Design Group, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022 Valencia (Spain)]. E-mail: jormarp1@doctor.upv.es; Sebastia, A. [Digital Systems Design Group, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022 Valencia (Spain); Cerda, J. [Digital Systems Design Group, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022 Valencia (Spain); Esteve, R. [Digital Systems Design Group, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022 Valencia (Spain); Mora, F.J. [Digital Systems Design Group, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022 Valencia (Spain); Toledo, J.F. [Digital Systems Design Group, Universidad Politecnica de Valencia, Camino de Vera s/n, 46022 Valencia (Spain); Benlloch, J.M. [Nuclear Medical Physics Group, Instituto de Fisica Corpuscular (CSIC-UV), Poligono de la Coma s/n, 46980 Paterna, Valencia (Spain); Gimenez, N. [Nuclear Medical Physics Group, Instituto de Fisica Corpuscular (CSIC-UV), Poligono de la Coma s/n, 46980 Paterna, Valencia (Spain); Gimenez, M. [Nuclear Medical Physics Group, Instituto de Fisica Corpuscular (CSIC-UV), Poligono de la Coma s/n, 46980 Paterna, Valencia (Spain); Lerche, Ch. W. [Nuclear Medical Physics Group, Instituto de Fisica Corpuscular (CSIC-UV), Poligono de la Coma s/n, 46980 Paterna, Valencia (Spain); Pavon, N. [Nuclear Medical Physics Group, Instituto de Fisica Corpuscular (CSIC-UV), Poligono de la Coma s/n, 46980 Paterna, Valencia (Spain); Sanchez, F. [Nuclear Medical Physics Group, Instituto de Fisica Corpuscular (CSIC-UV), Poligono de la Coma s/n, 46980 Paterna, Valencia (Spain)

    2005-01-21

    Positron emission mammography (PEM) is an innovative technique to increase sensitivity and overcome the main drawbacks of conventional X-ray screening. However, dedicated PET imaging systems demand specific hardware solutions for data acquisition and processing that can take advantage of the reduction in the number of channels. Data acquisition issues can affect PEM scanners performance and they should be exhaustively addressed in order to exploit the increment in the event count rate. This is crucial in order to reduce both the scanning time and the total injected dose. This paper presents the electronics for our PEM camera prototype that enables us to achieve very high-count rates and perform comprehensive online processing. Results about acquisition in our detector for a typical clinical setup are studied using Monte Carlo simulation of hot lesion phantoms.

  13. Using the Theory of Planned Behaviour and implementation intentions to predict and facilitate upward family communication about mammography.

    Science.gov (United States)

    Browne, J L; Chan, A Y C

    2012-01-01

    Regular mammography facilitates early detection of breast cancer, and thus increases the chances of survival from this disease. Daughter-initiated (i.e. upward) communication about mammography within mother-daughter dyads may promote mammography to women of screening age. The current study examined this communication behaviour within the context of the Theory of Planned Behaviour (TPB), and aimed to bridge the intention-behaviour gap by trialling an implementation intention (II) intervention that aimed to facilitate upward family communication about mammography. Young women aged 18-39 (N=116) were assigned to either a control or experimental condition, and the latter group formed IIs about initiating a conversation with an older female family member about mammography. Overall, those who formed IIs were more likely to engage in the target communication behaviour, however the intervention was most effective for those who reported low levels of intention at baseline. Perceived behavioural control emerged as the most important variable in predicting the target behaviour. The altruistic nature of this behaviour, and the fact that it is not wholly under volitional control, may have contributed to this finding. Future studies that systematically explore the relative roles of intention and perceived behavioural control in behaviours of this nature are warranted.

  14. SU-E-I-04: A Mammography Phantom to Measure Mean Glandular Dose and Image Quality

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Pineda, E; Ruiz-Trejo, C; E, Brandan M [Instituto de Fisica UNAM, Mexico City, DF (Mexico)

    2014-06-01

    Purpose: To evaluate mean glandular dose (MGD) and image quality in a selection of mammography systems using a novel phantom based on thermoluminescent dosemeters and the ACR wax insert. Methods: The phantom consists of two acrylic, 19 cm diameter, 4.5 cm thick, semicircular modules, used in sequence. The image quality module contains the ACR insert and is used to obtain a quality control image under automatic exposure conditions. The dosimetric module carries 15 TLD-100 chips, some under Al foils, to determine air kerma and half-value-layer. TL readings take place at our laboratory under controlled conditions. Calibration was performed using an ionization chamber and a Senographe 2000D unit for a variety of beam qualities, from 24 to 40 kV, Mo and Rh anodes and filters. Phantom MGD values agree, on the average, within 3% with ionization chamber data, and their precision is better than 10% (k=1). Results: MGD and image quality have been evaluated in a selection of mammography units currently used in Mexican health services. The sample includes analogic (screen/film), flexible digital (CR), and full-field digital image receptors. The highest MDG are associated to the CR technology. The most common image quality failure is due to artifacts (dust, intensifying screen scratches, and processor marks for film/screen, laser reader defects for CR). Conclusion: The developed phantom permits the MGD measurement without the need of a calibrated ionization chamber at the mammography site and can be used by a technician without the presence of a medical physicist. The results indicate the urgent need to establish quality control programs for mammography.

  15. Conversion factors between human and automatic readouts of CDMAM phantom images of CR mammography systems.

    Science.gov (United States)

    Figl, Michael; Homolka, Peter; Osanna-Elliott, Angelika; Semturs, Friedrich; Kaar, Marcus; Hummel, Johann

    2016-09-21

    In mammography screening, profound assessment of technical image quality is imperative. The European protocol for the quality control of the physical and technical aspects of mammography screening (EPQCM) suggests using an alternate fixed choice contrast-detail phantom-like CDMAM. For the evaluation of technical image quality, human or automated readouts can be used. For automatic evaluation, a software (cdcom) is provided by EUREF. If the automated readout indicates unacceptable image quality, additional human readout may be performed overriding the automated readout. As the latter systematically results in higher image quality ratings, conversion factors between both methods are regularly applied. Since most image quality issues with mammography systems arise within CR systems, an assessment restricted to CR systems with data from the Austrian Reference Center in the mammography screening program has been conducted. Forty-five CR systems were evaluated. Human readouts were performed with a randomisation software to avoid bias due to learning effects. Additional automatic evaluation allowed for the computation of conversion factors between human and automatic readouts. These factors were substantially lower compared to those suggested by EUREF, namely 1.21 compared to 1.62 (EUREF UK method) and 1.42 (EUREF EU method) for 0.1 mm, and 1.40 compared to 1.83 (EUREF UK) and 1.73 (EUREF EU) for 0.25 mm structure size, respectively. Using either of these factors to adjust patient dose in order to comply with image quality requirements results in differences in the dose increase of up to 90%. This necessitates a consensus on their proper application and limits the validity of the assessment methods. Clear criteria for CR systems based on appropriate studies should be promoted.

  16. Conversion factors between human and automatic readouts of CDMAM phantom images of CR mammography systems

    Science.gov (United States)

    Figl, Michael; Homolka, Peter; Osanna-Elliott, Angelika; Semturs, Friedrich; Kaar, Marcus; Hummel, Johann

    2016-09-01

    In mammography screening, profound assessment of technical image quality is imperative. The European protocol for the quality control of the physical and technical aspects of mammography screening (EPQCM) suggests using an alternate fixed choice contrast-detail phantom-like CDMAM. For the evaluation of technical image quality, human or automated readouts can be used. For automatic evaluation, a software (cdcom) is provided by EUREF. If the automated readout indicates unacceptable image quality, additional human readout may be performed overriding the automated readout. As the latter systematically results in higher image quality ratings, conversion factors between both methods are regularly applied. Since most image quality issues with mammography systems arise within CR systems, an assessment restricted to CR systems with data from the Austrian Reference Center in the mammography screening program has been conducted. Forty-five CR systems were evaluated. Human readouts were performed with a randomisation software to avoid bias due to learning effects. Additional automatic evaluation allowed for the computation of conversion factors between human and automatic readouts. These factors were substantially lower compared to those suggested by EUREF, namely 1.21 compared to 1.62 (EUREF UK method) and 1.42 (EUREF EU method) for 0.1 mm, and 1.40 compared to 1.83 (EUREF UK) and 1.73 (EUREF EU) for 0.25 mm structure size, respectively. Using either of these factors to adjust patient dose in order to comply with image quality requirements results in differences in the dose increase of up to 90%. This necessitates a consensus on their proper application and limits the validity of the assessment methods. Clear criteria for CR systems based on appropriate studies should be promoted.

  17. Mammographic Screening Downstages Breast Carcinomas at Time of Diagnosis: A Community-Based Experience.

    Science.gov (United States)

    Parker, Robert G.; Leung, Kwan-Moon; Rees, Karen S.; Bassett, Lawrence W.; Legorreta, Antonio P.

    1999-11-01

    To determine the effectiveness of screening mammography in a community medical setting, data from a population-based, retrospective study was analyzed. Medical records of 827 patients with newly diagnosed breast cancer in California between October 1994 and March 1996 were reviewed. The primary care physician's record was abstracted for clinical history, including recommendation of screening mammography. The facility records where final diagnosis was made were abstracted for stage and treatment data. Among the patients who did not have previous screening mammography, 65.7% were diagnosed with "advanced" breast cancer (stages II, III, IV), while only 39.9% who had previous screening mammography were diagnosed with advanced breast cancer (p < 0.001). This study has reaffirmed that screening mammography of adult females generates downstaging at the time of diagnosis of breast cancer. Despite possession of a health insurance program and receiving educational materials, only 65% of patients over 50 years of age had screening mammography. As opposed to the once-a-year mailing of general reminders to all women 40 years old and older, developing a longitudinal electronic medical record in the managed care setting will support a more coordinated and individualized intervention based on age, date of last mammogram, and relative risk, among other factors. Continuing education efforts must also be directed to referring physicians, who may not yet recognize the value of screening mammography.

  18. Impact of invitation schemes on screening coverage

    DEFF Research Database (Denmark)

    Jacobsen, Katja Kemp; von Euler Chelpin, My; Vejborg, Ilse

    2017-01-01

    BACKGROUND: The porpuse of mammography screening is to decrease breast cancer mortality. To achieve this a high coverage by examination is needed. Within an organized screening programme, we examined the impact of changes in the invitation schedule on the interplay between coverage and participat...

  19. 钼靶X线应用对早期乳腺癌筛查诊断价值的研究%Study on diagnosis value of applying mammography for early breast cancer screening

    Institute of Scientific and Technical Information of China (English)

    陈文; 包忠英

    2016-01-01

    Objective To explore the molybdenum target X-ray application value in the diagnosis of early breast cancer screening. Methods To molybdenum target X-ray of 280 cases with early breast cancer screening, retrospective analysis of molybdenum target X-ray results.Results 280 cases of patients with a total of 49 patients with breast tumor detection detection rate was 17.5%,41 cases of malignant tumors, 8 cases of benign tumor; Final diagnosis of malignant tumor 43 cases,10 cases of benign tumors, positive coincidence rate was 92.4%, 2 patients in diagnosis.Conclusion Line of molybdenum target X is used for early diagnosis of breast cancer lesions, early detection and timely treatment, can help patients to improve the cure rate and improve patients prognosis of breast cancer and the quality of life, has high diagnostic value.%目的:探讨钼靶X线应用在早期乳腺癌筛查诊断中的价值。方法对280例患者进行钼靶X线早期乳腺癌筛查,回顾分析钼靶X线检查结果。结果280例患者共检出乳腺肿瘤患者49例,检出率为17.5%,其中恶性肿瘤41例,良性肿瘤8例;最终诊断结果为恶性肿瘤43例,良性肿瘤10例,阳性符合率为92.4%,2例患者漏诊。结论钼靶X线用于早期乳腺癌诊断能够帮助患者尽早发现病变、及时治疗,在提高乳腺癌的治愈率和改善患者预后及生活质量,具有较高的诊断价值。

  20. Pressure-standardized breast compression in mammography

    NARCIS (Netherlands)

    de Groot, J.E.

    2015-01-01

    In current mammography practice, similar compression forces are applied to all breasts. Women with smaller and/or firmer breasts are disadvantaged because they receive a much higher pressure: The same force is applied on a much smaller contact area (pressure = force / contact area). Our solution is

  1. SCREENING FOR EARLY DETECTION OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    E. A. Rasskazova

    2014-01-01

    Full Text Available The article presents a brief overview of the main methods of breast cancer screening. Proven effectiveness of mammography as a screening method in reducing mortality from breast cancer, specified limits of the method. The main trend of increasing the effectiveness of screening is the transition to digital technologies. Properly organized screening with the active participation of the population reduces mortality from breast cancer by 30%.

  2. Exploratory survey of image quality on CR digital mammography imaging systems in Mexico.

    Science.gov (United States)

    Gaona, E; Rivera, T; Arreola, M; Franco, J; Molina, N; Alvarez, B; Azorín, C G; Casian, G

    2014-01-01

    The purpose of this study was to assess the current status of image quality and dose in computed radiographic digital mammography (CRDM) systems. Studies included CRDM systems of various models and manufacturers which dose and image quality comparisons were performed. Due to the recent rise in the use of digital radiographic systems in Mexico, CRDM systems are rapidly replacing conventional film-screen systems without any regard to quality control or image quality standards. Study was conducted in 65 mammography facilities which use CRDM systems in the Mexico City and surrounding States. The systems were tested as used clinically. This means that the dose and beam qualities were selected using the automatic beam selection and photo-timed features. All systems surveyed generate laser film hardcopies for the radiologist to read on a scope or mammographic high luminance light box. It was found that 51 of CRDM systems presented a variety of image artefacts and non-uniformities arising from inadequate acquisition and processing, as well as from the laser printer itself. Undisciplined alteration of image processing settings by the technologist was found to be a serious prevalent problem in 42 facilities. Only four of them showed an image QC program which is periodically monitored by a medical physicist. The Average Glandular Dose (AGD) in the surveyed systems was estimated to have a mean value of 2.4 mGy. To improve image quality in mammography and make more efficient screening mammographic in early detection of breast cancer is required new legislation.

  3. Increase in mammography detected breast cancer over time at a community based regional cancer center: a longitudinal cohort study 1990–2005

    Directory of Open Access Journals (Sweden)

    Malmgren Judith A

    2008-05-01

    Full Text Available Abstract Background Coincident with the advent of mammography screening, breast carcinoma in situ has increased in the US population. Methods We conducted a prospective cohort study of all women presenting with primary breast cancer, aged 21–94, and biopsy confirmed Stage 0-IV from 1990–2005 identified and tracked by our registry. Clinical presentation characteristics including age, race, TNM stage, family and pregnancy history, histologic type and method of detection by patient (PtD, physician (PhysD or mammography (MgD were chart abstracted at time of diagnosis. Cases with unknown or other method of detection (n = 84, or unusual cell types (n = 26 were removed (n = 6074. Results From 1990 to 1998 the percentage of PtD and MgD cases was roughly equivalent. In 1999 the percentage of MgD cases increased to 56% and PtD dropped to 37%, a significant 20% differential, constant to 2005 (Pearson chi square = 120.99, p Conclusion In our cohort the relative proportion of mammography detected breast cancer increased over time with a higher increase among women age 50+ and an increase of breast carcinoma in situ exclusively among MgD cases. The increase among women currently targeted by mammography screening programs (age ≥ 50 combined with an increase of breast carcinoma in situ most often detected by mammography screening indicates a possible incidence shift to lower stage breast cancer as a result of mammographic detection.

  4. Thermoluminescence dosimetry in quality imaging in CR mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Gaona, E.; Franco E, J.G. [UAM-Xochimilco, 04960 Mexico D.F. (Mexico); Azorin N, J. [UAM-Iztapalapa, 09340 Mexico D.F. (Mexico); Diaz G, J.A.I. [CICATA, Unidad Legaria, Av. Legaria 694, 11599 mexico D.F. (Mexico); Arreola, M. [Department of Radiology, Shands Hospital at UF, PO Box 100374, Gainesville, FL 32610-0374 (United States)

    2006-07-01

    The aim of this work is to estimate the average glandular dose with Thermoluminescence Dosimetry (TLD) and comparison with quality imaging in CR mammography. For measuring dose, FDA and ACR use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, Full Field Digital Mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one CR mammography system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium fluoro halide. We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated x-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose that overcomes 3.0 mGy and it doesn't improve the image quality and dose to the breast will be excessive. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement. (Author)

  5. Thermoluminescence dosimetry in quality imaging in CR mammography systems

    Energy Technology Data Exchange (ETDEWEB)

    Gaona, E.; Franco E, J.G. [UAM-Xochimilco, 04960 Mexico D.F. (Mexico); Azorin N, J. [UAM-Iztapalapa, 09340 Mexico D.F. (Mexico); Diaz G, J.A.I. [CICATA, Unidad Legaria, Av. Legaria 694, 11599 mexico D.F. (Mexico); Arreola, M. [Department of Radiology, Shands Hospital at UF, PO Box 100374, Gainesville, FL 32610-0374 (United States)

    2006-07-01

    The aim of this work is to estimate the average glandular dose with Thermoluminescence Dosimetry (TLD) and comparison with quality imaging in CR mammography. For measuring dose, FDA and ACR use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, Full Field Digital Mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one CR mammography system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium fluoro halide. We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated x-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose that overcomes 3.0 mGy and it doesn't improve the image quality and dose to the breast will be excessive. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement. (Author)

  6. Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA Mamografia e teste Papanicolau em mulheres latinas de baixa renda nos Estados Unidos

    Directory of Open Access Journals (Sweden)

    Maria E. Fernandez

    1998-01-01

    Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomesEste estudo determinou os fatores que influenciam a conduta de mulheres latinas de baixa renda nos EUA, em face do monitoramento pela mamografia (MM e por meio do teste de Papanicolau (TP, em uma amostra de 148 mulheres latinas, residentes na região metropolitana de Washington DC. A idade média na amostra foi de 46,2 anos (desvio padrão 11,5, e 84% relatavam renda familiar anual menor que quinze mil dólares. Todas as mulheres falavam espanhol e apresentavam níveis reduzidos de aculturação; 96% destas informavam ter realizado TP, mas 24% não relatavam adesão às normas recomendadas de rastreamento. Entre aquelas com quarenta anos ou mais, 62% haviam realizado MM, mas somente 33% de acordo com as normas de rotina. A freqüência de conceitos equivocados sobre o câncer neste grupo de mulheres foi maior que a observada para mulheres latinas em outros estudos. Modelos logísticos multivariados para variáveis correlacionadas à conduta no rastreamento pelo TP e MM indicam que fatores como o medo do teste, vergonha e desconhecimento tiveram influência. Concluiu-se que as mulheres nesse estudo apresentaram menor freqüência de rastreamento por MM que mulheres não latinas, além de apresentarem também níveis mais reduzidos de adesão às normas de rastreamento por TP e MM.

  7. A socioecological approach to improving mammography rates in a tribal community.

    Science.gov (United States)

    English, Kevin C; Fairbanks, Jo; Finster, Carolyn E; Rafelito, Alvin; Luna, Jolene; Kennedy, Marianna

    2008-06-01

    This article highlights the processes and intermediate outcomes of a pilot project to increase mammography rates of women in an American Indian tribe in New Mexico. Using a socioecological framework and principles of community-based participatory research, a community coalition was able to (a) bolster local infrastructure to increase access to mammography services; (b) build public health knowledge and skills among tribal health providers; (c) identify community-specific knowledge, attitudes, and beliefs related to breast cancer; (d) establish interdependent partnerships among community health programs and between the tribe and outside organizations; and (e) adopt local policy initiatives to bolster tribal cancer control. These findings demonstrate the value of targeting a combination of individual, community, and environmental factors, which affect community breast cancer screening rates and incorporating cultural strengths and resources into all facets of a tribal health promotion intervention.

  8. [Equity regarding early breast cancer screening according to health insurance status in Colombia].

    Science.gov (United States)

    Charry, Ligia Constanza de; Carrasquilla, Gabriel; Roca, Sandra

    2008-01-01

    Evaluating equity regarding early breast cancer detection by comparing real access to and opportunity for mammography screening according to women's social health insurance status. A retrospective follow-up study was conducted on women receiving breast cancer treatment in Bogotá, Cali, Medellin, Bucaramanga and Barranquilla between January 2005 and June 2006. A survey was carried out for collecting data about real access to and the opportunity of having mammography screening. OR and 95% confidence intervals were calculated (adjusted by multivariate logistical regression models) for establishing differences according to health insurance status. Possible interactions were investigated through verisimilarity log-like test. Women belonging to the contributory regime had a lower probability of real access to mammography screening for early detection of breast cancer than those affiliated to the subsidised regimen (OR=0,46; 0,26-0,72 95 %CI) and poor uninsured women (OR=0,36; 0,13-0,65 95 %CI). Educational level was also associated with real access to mammography, illiterate women having a lower probability of receiving mammography screening than literate women (OR=0,13; 0,02-0,30 95 %CI). Women having government-subsidised health insurance had a lower probability of accessing timely mammography screening (OR=0,10; 0,04-0,41 95 %CI). Mammography screening for the early detection of breast cancer is not equitable and such inequality particularly affects the most vulnerable women.

  9. FDA & digital mammography: why has FDA required full field digital mammography systems to be regulated as potentially dangerous devices for more than 10 years?

    Science.gov (United States)

    Nields, Morgan W

    2010-05-01

    Digital mammography is routinely used in the US to screen asymptomatic women for breast cancer and currently over 50% of US screening centers employ the technology. In spite of FDAs knowledge that digital mammography requires less radiation than film mammography and that its equivalence has been proven in a prospective randomized trial, the agency has failed to allow the technology market access via the 510(k) pre market clearance pathway. As a result of the restrictive Pre Market Approval process, only four suppliers have received FDA approval. The resulting lack of a competitive market has kept costs high, restricted technological innovation, and impeded product improvements as a result of PMA requirements. Meanwhile, at least twelve companies are on the market in the EU and the resulting competitive market has lowered costs and provided increased technological choice. A cultural change with new leadership occurred in the early 90's at FDA. The historical culture at the Center for Devices and Radiological Health of collaboration and education gave way to one characterized by a lack of reliance on outside scientific expertise, tolerance of decision making by unqualified reviewers, and an emphasis on enforcement and punishment. Digital mammography fell victim to this cultural change and as a result major innovations like breast CT and computer aided detection technologies are also withheld from the market. The medical device law, currently under review by the Institute of Medicine, should be amended by the Congress so that new technologies can be appropriately classified in accordance with the risk based assessment classification system detailed in Chapter V of the Federal Food, Drug, and Cosmetic Act. A panel of scientific experts chartered by the NIH or IOM should determine the classification appropriate for new technologies that have no historical regulatory framework. This would be binding on FDA. Unless the law is changed we will likely again experience

  10. 76 FR 60848 - National Mammography Quality Assurance Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-09-30

    ... HUMAN SERVICES Food and Drug Administration National Mammography Quality Assurance Advisory Committee... be open to the public. Name of Committee: National Mammography Quality Assurance Advisory Committee...) Proposed changes to the Mammography Quality Standard Act (MQSA) policies and inspection procedures;...

  11. 75 FR 11542 - Agency Information Collection Activities; Proposed Collection; Comment Request; Mammography...

    Science.gov (United States)

    2010-03-11

    ... Collection; Comment Request; Mammography Quality Standards Act Requirements AGENCY: Food and Drug... Mammography Quality Standards Act requirements. DATES: Submit written or electronic comments on the collection... techniques, when appropriate, and other forms of information technology. The Mammography Quality...

  12. 78 FR 13681 - Agency Information Collection Activities; Proposed Collection; Comment Request; Mammography...

    Science.gov (United States)

    2013-02-28

    ... Collection; Comment Request; Mammography Quality Standards Act Requirements AGENCY: Food and Drug... associated with the Mammography Quality Standards Act requirements. DATES: Submit either electronic or... of information technology. Mammography Quality Standards Act Requirements--21 CFR Part 900...

  13. Diagnostic performance of a near-infrared breast imaging system as adjunct to mammography versus X-ray mammography alone

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Martin, J.C.; Diekmann, F.; Fallenberg, E.; Engelken, F.; Kroencke, T.J.; Hamm, B. [Charite Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Ponder, S. [Imaging Diagnostic Systems, Inc, Fort Lauderdale, FL (United States); Poellinger, A. [Charite Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Charite, Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany)

    2012-02-15

    Radiologist reader performance for breast cancer detection using mammography plus Near-Infrared Breast Imaging (NIBI) was compared with mammography alone. Two hundred seventy-six consecutive patients with suspected breast lesions underwent both mammography and NIBI. Four blinded radiologists independently first reviewed the mammograms alone. Readers subsequently reviewed the mammograms in combination with NIBI. The diagnostic benefit of NIBI as an adjunct to mammography was determined by performing receiver operating characteristics (ROC) analyses for each reader based on BI-RADS categories (Breast Imaging Reporting and Data System) and LOS (level of suspicion) scores. Additionally, a multireader-multicase (ROC) analysis of variance (ANOVA) was carried out. For the LOS-based analysis, the combination of mammography and NIBI resulted in a slightly larger area under the curve (AUC) for all four readers. The analysis based on BI-RADS categories also demonstrated a slight increase in AUC for three readers for the combination of mammography and NIBI compared with mammography alone. For the fourth reader, AUC was smaller for the combination compared with mammography alone. Neither for the separate ROC-analyses nor for the ANOVA, significant differences between the two methods were obtained. The combination of mammography and NIBI did not perform significantly better than mammography alone. (orig.)

  14. Persuasive Interventions for Controversial Cancer Screening Recommendations: Testing a Novel Approach to Help Patients Make Evidence-Based Decisions.

    Science.gov (United States)

    Saver, Barry G; Mazor, Kathleen M; Luckmann, Roger; Cutrona, Sarah L; Hayes, Marcela; Gorodetsky, Tatyana; Esparza, Nancy; Bacigalupe, Gonzalo

    2017-01-01

    We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009). We created recorded vignettes of physician-patient discussions about prostate cancer screening and mammography, accompanied by illustrative slides, based on principles derived from preceding qualitative work and behavioral science literature. We conducted a randomized crossover study with repeated measures with 27 men aged 50 to 74 years and 35 women aged 40 to 49 years. All participants saw a video intervention and a more traditional, paper-based decision aid intervention in random order. At entry and after seeing each intervention, they were surveyed about screening intentions, perceptions of benefits and harm, and decisional conflict. Changes in screening intentions were analyzed without regard to order of intervention after an initial analyses showed no evidence of an order effect. At baseline, 69% of men and 86% of women reported wanting screening, with 31% and 6%, respectively, unsure. Mean change on a 3-point, yes, unsure, no scale was -0.93 (P = <.001) for men and -0.50 (P = <.001) for women after seeing the video interventions vs 0.0 and -0.06 (P = .75) after seeing the print interventions. At the study end, 33% of men and 49% of women wanted screening, and 11% and 20%, respectively, were unsure. Our novel, persuasive video interventions significantly changed the screening intentions of substantial proportions of viewers. Our approach needs further testing but may provide a model for helping patients to consider and accept evidence-based, counterintuitive recommendations. © 2017 Annals of Family Medicine, Inc.

  15. Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland

    DEFF Research Database (Denmark)

    Sardanelli, Francesco; Aase, Hildegunn S; Álvarez, Marina

    2017-01-01

    EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 % for women aged 50-69 years...... national breast radiology bodies support screening mammography. • A first priority is double-reading biennial mammography for women aged 50-69 years. • Extension to 73-75 and from 40-45 to 49 years is also encouraged. • Digital mammography (not film-screen or computer radiography) should be used. • DBT...

  16. Digital Mammography Imaging: Breast Tomosynthesis and Advanced Applications

    Science.gov (United States)

    Helvie, Mark A.

    2011-01-01

    Synopsis This article discusses recent developments in advanced derivative technologies associated with digital mammography. Digital breast tomosynthesis – its principles, development, and early clinical trials are reviewed. Contrast enhanced digital mammography and combined imaging systems with digital mammography and ultrasound are also discussed. Although all these methods are currently research programs, they hold promise for improving cancer detection and characterization if early results are confirmed by clinical trials. PMID:20868894

  17. Comparison of the Mammography, Contrast-Enhanced Spectral Mammography and Ultrasonography in a Group of 116 patients.

    Science.gov (United States)

    Luczyńska, Elzbieta; Heinze, Sylwia; Adamczyk, Agnieszka; Rys, Janusz; Mitus, Jerzy W; Hendrick, Edward

    2016-08-01

    Mammography (MG) is the gold-standard in breast cancer detection - the only method documented to reduce breast cancer mortality. Breast ultrasound (US) has been shown to increase sensitivity to breast cancers in screening women with dense breasts. Contrast-enhanced spectral mammography (CESM) is a novel technique intensively developed in the last few years. The goal of this study was to compare the sensitivity, specificity and accuracy of MG, US and CESM in detecting malignant breast lesions. The study included 116 patients. All patients were symptomatic and underwent MG, US and CESM. A radiologist with 20 years of experience in US and MG breast imaging and 1 year of experience in CESM reviewed images acquired in each of the three modalities separately, within an interval of 14-30 days. All identified lesions were confirmed at core biopsy. BI-RADS classifications on US, MG and CESM were compared to histopathology. MG, CESM and US were compared among 116 patients with 137 lesions encountered. Sensitivity of CESM was 100%, significantly higher than that of MG (90%, p<0.004) or US (92%, p<0.01). CESM accuracy was 78%, also higher than MG (69%, p<0.004) and US (70%, p=0.03). There was no statistically significant difference between AUCs for CESM and US (both 0.83). The AUCs of both US and CESM, however, were significantly larger than that of MG (p<0.0004 for each). CESM permitted better detection of malignant lesions than both MG and US, read individually. CESM found lesion enhancement in some benign lesions, as well, yielding a rate of false-positive diagnoses similar to that of MG and US.

  18. Differences between first and subsequent rounds of the MRISC breast cancer screening program for women with a familial or genetic predisposition

    NARCIS (Netherlands)

    Kriege, M; Brekelmans, CTM; Boetes, C; Muller, SH; Zonderland, HM; Obdeijn, IM; Manoliu, RA; Kok, T; Rutgers, EJT; de Koning, HJ; Klijn, JGM

    2006-01-01

    BACKGROUND. within the Dutch MRI Screening (MRISC) study, a Dutch multicenter screening study for hereditary breast cancer, the authors investigated whether previously reported increased diagnostic accuracy of magnetic resonance imaging (MRI) compared with mammography would be maintained during subs

  19. Discrepancies between film and digital mammography interpretations

    Science.gov (United States)

    Malhotra, Poonam; Kallergi, Maria; Alexander, Dominik; Berman, Claudia G.; Gardner, Mary; Hersh, Marla R.; Hooper, Lisa; Kim, Jihai J.; Venugopal, Priya

    2002-04-01

    The purpose of this study was to evaluate the frequency and reasons of disagreement between film and full-field digital mammography (FFDM) interpretations observed in a prospective clinical trial performed with the GE Senographe 2000D system. The data from 643 mammography examinations comprising both digital and film mammograms were analyzed for this purpose. Reports indicated that 455 findings were identified on the digital softcopy reading and 457 findings on the standard film mammography with 408 discrepancies. Findings with discrepancies were matched and analyzed. A reason was identified and a relative conspicuity score of 0 to 10 was assigned to each finding at the time of resolution; 0 corresponded to a finding highly conspicuous on digital, 10 to a finding highly conspicuous on film, and 5 denoted equal visibility on both. After review, agreement was established between the two modalities in 73.3% of the findings; 13.5% of findings were seen better on digital and 13.2% of the findings were seen better on film. Approximately 63% of the discrepancies occurred due to variability in the reporting style of the radiologists and/or unavailability of prior films for comparison. Three cancer cases were identified in this study; two were seen on both modalities and one only on film. In conclusion, no statistically significant differences were observed between digital and film mammography, a result that despite the small size of our dataset is in agreement with previous reports. Inter-observer variability, display differences, and presentation disagreements are the main reasons for interpretation differences that are primarily identified in the classification and BIRADS assignment.

  20. BIRADS{sup TM} mammography: Exercises

    Energy Technology Data Exchange (ETDEWEB)

    Balleyguier, Corinne [Radiology Department, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)]. E-mail: balleyguier@igr.fr; Bidault, Francois [Radiology Department, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Mathieu, Marie Christine [Biopathology Department, Institut de Cancerologie Gustave-Roussy, 94805 Villejuif (France); Ayadi, Salma [Radiology Department, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Couanet, Dominique [Radiology Department, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Sigal, Robert [Radiology Department, Institut de Cancerologie Gustave-Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2007-02-15

    Some radiological cases are presented in this article to train the reader to the BIRADS{sup TM} classification in mammography. Each case is described according to Fourth American version of the BIRADS{sup TM} lexicon. Some classifications difficulties will also be presented, in order to show the complexity and the observer variability, commonly encountered in BIRADS{sup TM} 3 and 4 categories.

  1. Testing the Feasibility of a Culturally Tailored Breast Cancer Screening Intervention with Native Hawaiian Women in Rural Churches

    Science.gov (United States)

    Ka'opua, Lana Sue I.; Park, Soon H.; Ward, Margaret E.; Braun, Kathryn L.

    2011-01-01

    The authors report on the feasibility of delivering a church-based breast cancer screening intervention tailored on the cultural strengths of rural-dwelling Hawaiians. Native Hawaiian women are burdened by disproportionately high mortality from breast cancer, which is attributed to low participation in routine mammography. Mammography is proven to…

  2. AAPM/RSNA physics tutorial for residents: digital mammography: an overview.

    Science.gov (United States)

    Mahesh, Mahadevappa

    2004-01-01

    Recent advances in digital detector technology have paved the way to full-field digital mammography (FFDM) systems. The performance of these systems has evolved to the point where replacement of screen-film mammography (SFM) systems is becoming realistic. Despite some commonality between the two techniques, there are fundamental differences in how images are recorded, displayed, and stored. These differences necessitate an understanding of the principles of detection and the characteristics of digital images. Several approaches have been taken in the development of FFDM systems: (a) slot scanning with a scintillator and a charge-coupled device (CCD) array, (b) a flat-panel scintillator and an amorphous silicon diode array, (c) a flat-panel amorphous selenium array, (d) a tiled scintillator with fiberoptic tapers and a CCD array, and (e) photostimulable phosphor plates (computed radiography). Although the initial cost of an FFDM system is high compared with that of an SFM system, digital mammography has inherent advantages, such as wide dynamic range, reduction in recall rates, potential for reduction in radiation dose, increased patient throughput, postprocessing capability, and digital acquisition. These advantages and the rapidly occurring technologic developments will help establish FFDM as a mainstay of breast evaluation.

  3. Computational assessment of mammography accreditation phantom images and correlation with human observer analysis

    Science.gov (United States)

    Barufaldi, Bruno; Lau, Kristen C.; Schiabel, Homero; Maidment, D. A.

    2015-03-01

    Routine performance of basic test procedures and dose measurements are essential for assuring high quality of mammograms. International guidelines recommend that breast care providers ascertain that mammography systems produce a constant high quality image, using as low a radiation dose as is reasonably achievable. The main purpose of this research is to develop a framework to monitor radiation dose and image quality in a mixed breast screening and diagnostic imaging environment using an automated tracking system. This study presents a module of this framework, consisting of a computerized system to measure the image quality of the American College of Radiology mammography accreditation phantom. The methods developed combine correlation approaches, matched filters, and data mining techniques. These methods have been used to analyze radiological images of the accreditation phantom. The classification of structures of interest is based upon reports produced by four trained readers. As previously reported, human observers demonstrate great variation in their analysis due to the subjectivity of human visual inspection. The software tool was trained with three sets of 60 phantom images in order to generate decision trees using the software WEKA (Waikato Environment for Knowledge Analysis). When tested with 240 images during the classification step, the tool correctly classified 88%, 99%, and 98%, of fibers, speck groups and masses, respectively. The variation between the computer classification and human reading was comparable to the variation between human readers. This computerized system not only automates the quality control procedure in mammography, but also decreases the subjectivity in the expert evaluation of the phantom images.

  4. Complete internal audit of a mammography service in a reference institution for breast imaging.

    Science.gov (United States)

    Badan, Gustavo Machado; Roveda Júnior, Décio; Ferreira, Carlos Alberto Pecci; de Noronha Junior, Ozeas Alves

    2014-01-01

    Undertaking of a complete audit of the service of mammography, as recommended by BI-RADS(®), in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature. Retrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012. The radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%. The complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates.

  5. Mammography dose in relation to body mass index, race, and menopausal status

    Energy Technology Data Exchange (ETDEWEB)

    Schubauer-Berigan, M.K.; Frey, G.D.; Baron, L.; Hoel, D.G

    2002-07-01

    Mammography dose increases with compressed breast thickness (CBT), but few studies have examined other correlates of dose. The purpose of this study was to evaluate the relation between factors such as race, age, body mass index (BMI), CBT, and menopausal status and mammography screening dose, measured for 509 women in a US population. A multiple linear regression model was developed for dose, based on consideration of these factors as well as examination characteristics. BMI and number of films during examination were positively related to dose. After adjusting for these factors, high CBT also leads to higher dose. Whites receive lower doses than black women, but differences are slight after controlling for the effects of CBT and BMI, which were significantly higher among black women. Pre-menopausal women receive higher doses, after adjusting for all other factors, than post-menopausal women. Jointly, these factors account for approximately 75% to 80% of the variability in dose among this study population. Because rates of overweight are increasing in the US, average doses from mammography may be increasing as well. (author)

  6. Psychosocial predictors of first attendance for organised mammography screening

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    1999-01-01

    Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance. RESULTS: Those most likely to attend were working, middle income, and averagely educated women, who had...

  7. Image-quality performance of an a-Si H-based X-ray imaging system for digital mammography

    CERN Document Server

    Darambara, D G; Speller, R D

    2002-01-01

    We have been investigating the potential of large area active matrix flat-panel a-Si : H imaging arrays for full-field digital X-ray mammography. To optimise the overall performance of such an imaging system under mammographic conditions, four different Gd sub 2 O sub 2 S : Tb phosphor screens (i.e. Lanex Fast-Back, Regular, Fine and MinR-2000) were employed and our full-field detector was integrated with the Feinfocus DIMA (Direct Magnification) PLUS MII mammographic unit. The spatial resolution and the image noise of the digital detector were measured and the X-ray imaging performance of the whole system was also evaluated with two mammographic phantoms. It was deduced from the results of this study that Regular screen offers the best compromise between sensitivity and spatial resolution and exhibits better overall image-quality performance than that of a conventional mammography system.

  8. A semiparametric censoring bias model for estimating the cumulative risk of a false-positive screening test under dependent censoring.

    Science.gov (United States)

    Hubbard, Rebecca A; Miglioretti, Diana L

    2013-03-01

    False-positive test results are among the most common harms of screening tests and may lead to more invasive and expensive diagnostic testing procedures. Estimating the cumulative risk of a false-positive screening test result after repeat screening rounds is, therefore, important for evaluating potential screening regimens. Existing estimators of the cumulative false-positive risk are limited by strong assumptions about censoring mechanisms and parametric assumptions about variation in risk across screening rounds. To address these limitations, we propose a semiparametric censoring bias model for cumulative false-positive risk that allows for dependent censoring without specifying a fixed functional form for variation in risk across screening rounds. Simulation studies demonstrated that the censoring bias model performs similarly to existing models under independent censoring and can largely eliminate bias under dependent censoring. We used the existing and newly proposed models to estimate the cumulative false-positive risk and variation in risk as a function of baseline age and family history of breast cancer after 10 years of annual screening mammography using data from the Breast Cancer Surveillance Consortium. Ignoring potential dependent censoring in this context leads to underestimation of the cumulative risk of false-positive results. Models that provide accurate estimates under dependent censoring are critical for providing appropriate information for evaluating screening tests.

  9. A survey of short-term and long-term stability of tube parameters in a mammography unit

    Directory of Open Access Journals (Sweden)

    Praskalo Jovica Ž.

    2014-01-01

    Full Text Available In order to set up a successful mammography screening program in the Republic of Srpska, a Siemens Mammomat 1000 X-ray machine was selected for analysis as the said mammography system is widely used in clinical practice. The variations in tube parameters (specific air kerma, high-voltage accuracy and reproducibility, linearity between exposure and dose exposure time were monitored over a five-year period, from 2008 to 2012. In addition, due to observed daily fluctuations for chosen parameters, a series of measurements were performed three times a day within a single-month period (mainly October 2012. The goal of such an experimental set up is to assess short-term and long-term stability of tube parameters in the given mammography unit and to make a comparison between them. The present paper shows how an early detection of significant parameter fluctuations can help eliminate irregularities and optimize the performance of mammography systems. [Projekat Ministarstva nauke Republike Srbije, br. 171007

  10. Mobile measurement setup according to IEC 62220-1-2 for DQE determination on digital mammography systems

    Science.gov (United States)

    Greiter, Matthias B.; Hoeschen, Christoph

    2010-04-01

    The international standard IEC 62220-1-2 defines the measurement procedure for determination of the detective quantum efficiency (DQE) of digital x-ray imaging devices used in mammography. A mobile setup complying to this standard and adaptable to most current systems was constructed in the Helmholtz Zentrum München to allow for an objective technical comparison of current full field digital mammography units employed in mammography screening in Germany. This article demonstrates the setup's capabilities with a focus on the measurement uncertainties of all quantities contributing to DQE measurements. Evaluation of uncertainties encompasses results from measurements on a Sectra Microdose Mammography in clinical use, as well as on a prototype of a Fujifilm Amulet system at various radiation qualities. Both systems have a high spatial resolution of 50 μm × 50 μm. The modulation transfer function (MTF), noise power spectrum (NPS) and DQE of the Sectra MDM are presented in comparison to results previously published by other authors.

  11. Obesity and Cancer Screening according to Race and Gender

    Directory of Open Access Journals (Sweden)

    Heather Bittner Fagan

    2011-01-01

    Full Text Available The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC screening, the relationship between weight and screening in men is inconsistent, while there is a trend towards lower CRC screening in higher weight women.

  12. THE VALUE OF ULTRASOUND MAMMOGRAPHY IN PALPABLE BREAST MASSES

    NARCIS (Netherlands)

    VANOORD, JC; VANDERVLIET, AM; THYN, CJP; MAK, B; HOOGEBOOM, GJ

    1991-01-01

    Between January 1987 and May 1988 a prospective study was carried out on 232 women with a palpable breast mass. They underwent physical examination, x-ray mammography and ultrasound mammography. The results of each study were interpreted independently by separate observers, and consensus was achieve

  13. Does Reader Performance with Digital Breast Tomosynthesis Vary according to Experience with Two-dimensional Mammography?

    Science.gov (United States)

    Tucker, Lorraine; Gilbert, Fiona J; Astley, Susan M; Dibden, Amanda; Seth, Archana; Morel, Juliet; Bundred, Sara; Litherland, Janet; Klassen, Herman; Lip, Gerald; Purushothaman, Hema; Dobson, Hilary M; McClure, Linda; Skippage, Philippa; Stoner, Katherine; Kissin, Caroline; Beetles, Ursula; Lim, Yit Yoong; Hurley, Emma; Goligher, Jane; Rahim, Rumana; Gagliardi, Tanja J; Suaris, Tamara; Duffy, Stephen W

    2017-05-01

    Purpose To assess whether individual reader performance with digital breast tomosynthesis (DBT) and two-dimensional (2D) mammography varies with number of years of experience or volume of 2D mammograms read. Materials and Methods After written informed consent was obtained, 8869 women (age range, 29-85 years; mean age, 56 years) were recruited into the TOMMY trial (A Comparison of Tomosynthesis with Digital Mammography in the UK National Health Service Breast Screening Program), an ethically approved, multicenter, multireader, retrospective reading study, between July 2011 and March 2013. Each case was read prospectively for clinical assessment and to establish ground truth. A retrospective reading data set of 7060 cases was created and randomly allocated for independent blinded review of (a) 2D mammograms, (b) DBT images and 2D mammograms, and (c) synthetic 2D mammograms and DBT images, without access to previous examinations. Readers (19 radiologists, three advanced practitioner radiographers, and two breast clinicians) who had 3-25 (median, 10) years of experience in the U.K. National Health Service Breast Screening Program and read 5000-13 000 (median, 8000) cases per annum were included in this study. Specificity was analyzed according to reader type and years and volume of experience, and then both specificity and sensitivity were analyzed by matched inference. The median duration of experience (10 years) was used as the cutoff point for comparison of reader performance. Results Specificity improved with the addition of DBT for all readers. This was significant for all staff groups (56% vs 68% and 49% vs 67% [P readers and was significantly higher for those with less than 10 years of experience (91% vs 86%; P = .03) and those with total mammographic experience of fewer than 80 000 cases (88% vs 86%; P = .03). Conclusion The addition of DBT to conventional 2D screening mammography improved specificity for all readers, but the gain in sensitivity was greater

  14. Introduction of breast cancer screening in Chernihiv Oblast in the Ukraine: report of a PATH Breast Cancer Assistance Program experience.

    Science.gov (United States)

    Zotov, Vladimir; Shyyan, Roman

    2003-01-01

    The incidence of breast cancer and mortality from this disease remain high in countries with limited resources such as the Ukraine. Because of a lack of mammography equipment and formal screening programs, as well as educational and other factors, breast cancer is usually diagnosed in late stages in such countries. We report the experience of the PATH Breast Cancer Assistance Program in introducing a pilot breast cancer screening program in one territory of the Ukraine, the Chernihiv oblast. The program entailed educating the public, training health care providers in clinical breast examination (CBE) and mammography, opening a dedicated mammography facility, designating a center for breast cancer care, building diagnostic capacity, and fostering the formation of support groups. From 1998 to 2002, 18,000 women underwent screening with CBE and 8778 women underwent screening with mammography. When implementing the program we encountered various cultural, economic, and logistic difficulties, such as reservations about showing bare breasts in educational materials, the lack of an established system for collecting screening data, and barriers to follow-up in women with positive screening results. Screening mammography proved to be more effective in detecting small and nonpalpable lesions; 8.7% of cancers detected in the mammography group were in situ, compared with 0% in the CBE group. However, introduction of CBE as a screening modality required fewer financial resources compared with mammography and was recommended as a transitional method before the introduction of mammography screening programs in countries with limited resources. The introduction of screening was associated with favorable changes in indicators of breast cancer care, including an increase in the percentage of breast-preserving operations and new legislation to provide funding for breast cancer services. We conclude that this successful pilot program of breast cancer screening in a limited

  15. Reproducibility of Mammography Units, Film Processing and Quality Imaging

    Science.gov (United States)

    Gaona, Enrique

    2003-09-01

    The purpose of this study was to carry out an exploratory survey of the problems of quality control in mammography and processors units as a diagnosis of the current situation of mammography facilities. Measurements of reproducibility, optical density, optical difference and gamma index are included. Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the Mexican Republic. Mammography is a radiographic examination specially designed for detecting breast pathology. We found that the problems of reproducibility of AEC are smaller than the problems of processors units because almost all processors fall outside of the acceptable variation limits and they can affect the mammography quality image and the dose to breast. Only four mammography units agree with the minimum score established by ACR and FDA for the phantom image.

  16. Digital mammography in the radio-dense and complex pattern breast

    Science.gov (United States)

    Freedman, Matthew T.; Steller Artz, Dorothy E.; Jafroudi, Hamid; Hogge, Jacquelyn; Zuurbier, Rebecca A.; Lin, Jyh-Shyan; Katial, Raj; Mun, Seong K.

    1996-04-01

    The sensitivity of mammography for the detection of breast cancer is decreased in the radiodense breast. Storage phosphor digital radiographic systems have a wider latitude of exposure than conventional mammographic screen film systems. By using low resolution histogram equalization one can produce a mammographic image of the breast that retains the high frequency information that defines the edges of microcalcifications, architectural distortion and some masses but which, at the same time, allows one to look through into regions of increased breast radiodensity and identify microcalcifications within them. This paper demonstrates the effect of this special form of image processing.

  17. TL dosimetry for quality control of CR mammography imaging systems

    Science.gov (United States)

    Gaona, E.; Nieto, J. A.; Góngora, J. A. I. D.; Arreola, M.; Enríquez, J. G. F.

    The aim of this work is to estimate the average glandular dose with thermoluminescent (TL) dosimetry and comparison with quality imaging in computed radiography (CR) mammography. For a measuring dose, the Food and Drug Administration (FDA) and the American College of Radiology (ACR) use a phantom, so that dose and image quality are assessed with the same test object. The mammography is a radiological image to visualize early biological manifestations of breast cancer. Digital systems have two types of image-capturing devices, full field digital mammography (FFDM) and CR mammography. In Mexico, there are several CR mammography systems in clinical use, but only one system has been approved for use by the FDA. Mammography CR uses a photostimulable phosphor detector (PSP) system. Most CR plates are made of 85% BaFBr and 15% BaFI doped with europium (Eu) commonly called barium flourohalideE We carry out an exploratory survey of six CR mammography units from three different manufacturers and six dedicated X-ray mammography units with fully automatic exposure. The results show three CR mammography units (50%) have a dose greater than 3.0 mGy without demonstrating improved image quality. The differences between doses averages from TLD system and dosimeter with ionization chamber are less than 10%. TLD system is a good option for average glandular dose measurement for X-rays with a HVL (0.35-0.38 mmAl) and kVp (24-26) used in quality control procedures with ACR Mammography Accreditation Phantom.

  18. Racial and ethnic disparities among state Medicaid programs for breast cancer screening.

    Science.gov (United States)

    Tangka, Florence K; Subramanian, Sujha; Mobley, Lee Rivers; Hoover, Sonja; Wang, Jiantong; Hall, Ingrid J; Singh, Simple D

    2017-09-01

    Breast cancer screening by mammography has been shown to reduce breast cancer morbidity and mortality. The use of mammography screening though varies by race, ethnicity, and, sociodemographic characteristics. Medicaid is an important source of insurance in the US for low-income beneficiaries, who are disproportionately members of racial or ethnic minorities, and who are less likely to be screened than women with higher socioeconomic statuses. We used 2006-2008 data from Medicaid claims and enrollment files to assess racial or ethnic and geographic disparities in the use of breast cancer screening among Medicaid-insured women at the state level. There were disparities in the use of mammography among racial or ethnic groups relative to white women, and the use of mammography varied across the 44 states studied. African American and American Indian women were significantly less likely than white women to use mammography in 30% and 39% of the 44 states analyzed, respectively, whereas Hispanic and Asian American women were the minority groups most likely to receive screening compared with white women. There are racial or ethnic disparities in breast cancer screening at the state level, which indicates that analyses conducted by only using national data not stratified by insurance coverage are insufficient to identify vulnerable populations for interventions to increase the use of mammography, as recommended. Copyright © 2017. Published by Elsevier Inc.

  19. Colour application on mammography image segmentation

    Science.gov (United States)

    Embong, R.; Aziz, N. M. Nik Ab.; Karim, A. H. Abd; Ibrahim, M. R.

    2017-09-01

    The segmentation process is one of the most important steps in image processing and computer vision since it is vital in the initial stage of image analysis. Segmentation of medical images involves complex structures and it requires precise segmentation result which is necessary for clinical diagnosis such as the detection of tumour, oedema, and necrotic tissues. Since mammography images are grayscale, researchers are looking at the effect of colour in the segmentation process of medical images. Colour is known to play a significant role in the perception of object boundaries in non-medical colour images. Processing colour images require handling more data, hence providing a richer description of objects in the scene. Colour images contain ten percent (10%) additional edge information as compared to their grayscale counterparts. Nevertheless, edge detection in colour image is more challenging than grayscale image as colour space is considered as a vector space. In this study, we implemented red, green, yellow, and blue colour maps to grayscale mammography images with the purpose of testing the effect of colours on the segmentation of abnormality regions in the mammography images. We applied the segmentation process using the Fuzzy C-means algorithm and evaluated the percentage of average relative error of area for each colour type. The results showed that all segmentation with the colour map can be done successfully even for blurred and noisy images. Also the size of the area of the abnormality region is reduced when compare to the segmentation area without the colour map. The green colour map segmentation produced the smallest percentage of average relative error (10.009%) while yellow colour map segmentation gave the largest percentage of relative error (11.367%).

  20. A PET imaging system dedicated to mammography

    CERN Document Server

    Varela, J

    2007-01-01

    The imaging system Clear-PEM for positron emission mammography, under development within the framework of the Crystal Clear Collaboration at CERN, is presented. The detector is based on pixelized LYSO crystals optically coupled to avalanche photodiodes (APD) and readout by a fast low-noise electronic system. A dedicated digital trigger and data acquisition system is used for on-line selection of coincidence events with high efficiency, large bandwidth and negligible dead-time. The detector module performance was characterized in detail.

  1. [Organized breast cancer screening].

    Science.gov (United States)

    Rouëssé, Jacques; Sancho-Garnier, Hélèn

    2014-02-01

    Breast screening programs are increasingly controversial, especially regarding two points: the number of breast cancer deaths they avoid, and the problem of over-diagnosis and over-treatment. The French national breast cancer screening program was extended to cover the whole country in 2004. Ten years later it is time to examine the risk/benefit ratio of this program and to discuss the need for change. Like all forms of cancer management, screening must be regularly updated, taking into account the state of the art, new evidence, and uncertainties. All screening providers should keep themselves informed of the latest findings. In the French program, women aged 50-74 with no major individual or familial risk factors for breast cancer are offered screening mammography and clinical breast examination every two years. Images considered non suspicious of malignancy by a first reader are re-examined by a second reader. The devices and procedures are subjected to quality controls. Participating radiologists (both public and private) are required to read at least 500 mammographies per year. The program's national participation rate was 52.7 % in 2012. When individual screening outside of the national program is taken into account (nearly 15 % of women), coverage appears close to the European recommendation of 65 %. Breast cancer mortality has been falling in France by 0.6 % per year for over 30 years, starting before mass screening was implemented, and by 1.5 % since 2005. This decline can be attributed in part to earlier diagnosis and better treatment, so that the specific impact of screening cannot easily be measured. Over-treatment, defined as the detection and treatment of low-malignancy tumors that would otherwise not have been detected in a person's lifetime, is a major negative effect of screening, but its frequency is not precisely known (reported to range from 1 % to 30 %). In view of these uncertainties, it would be advisable to modify the program in order to

  2. The effect of system geometry and dose on the threshold detectable calcification diameter in 2D-mammography and digital breast tomosynthesis

    Science.gov (United States)

    Hadjipanteli, Andria; Elangovan, Premkumar; Mackenzie, Alistair; Looney, Padraig T.; Wells, Kevin; Dance, David R.; Young, Kenneth C.

    2017-02-01

    Digital breast tomosynthesis (DBT) is under consideration to replace or to be used in combination with 2D-mammography in breast screening. The aim of this study was the comparison of the detection of microcalcification clusters by human observers in simulated breast images using 2D-mammography, narrow angle (15°/15 projections) and wide angle (50°/25 projections) DBT. The effects of the cluster height in the breast and the dose to the breast on calcification detection were also tested. Simulated images of 6 cm thick compressed breasts were produced with and without microcalcification clusters inserted, using a set of image modelling tools for 2D-mammography and DBT. Image processing and reconstruction were performed using commercial software. A series of 4-alternative forced choice (4AFC) experiments was conducted for signal detection with the microcalcification clusters as targets. Threshold detectable calcification diameter was found for each imaging modality with standard dose: 2D-mammography: 2D-mammography (165  ±  9 µm), narrow angle DBT (211  ±  11 µm) and wide angle DBT (257  ±  14 µm). Statistically significant differences were found when using different doses, but different geometries had a greater effect. No differences were found between the threshold detectable calcification diameters at different heights in the breast. Calcification clusters may have a lower detectability using DBT than 2D imaging.

  3. Attitudes of women about breast cancer and cervical cancern screening

    Directory of Open Access Journals (Sweden)

    ilknur Aydin Avci

    2015-06-01

    Conclusion: This research revealed that the women had moderate knowlege about breast and cervical cancer screening and artcipation in screening is low. Beside, the women who had BSE and mammography had more PAP smear. [TAF Prev Med Bull 2015; 14(3.000: 235-239

  4. Seamless lesion insertion in digital mammography: methodology and reader study

    Science.gov (United States)

    Pezeshk, Aria; Petrick, Nicholas; Sahiner, Berkman

    2016-03-01

    Collection of large repositories of clinical images containing verified cancer locations is costly and time consuming due to difficulties associated with both the accumulation of data and establishment of the ground truth. This problem poses a significant challenge to the development of machine learning algorithms that require large amounts of data to properly train and avoid overfitting. In this paper we expand the methods in our previous publications by making several modifications that significantly increase the speed of our insertion algorithms, thereby allowing them to be used for inserting lesions that are much larger in size. These algorithms have been incorporated into an image composition tool that we have made publicly available. This tool allows users to modify or supplement existing datasets by seamlessly inserting a real breast mass or micro-calcification cluster extracted from a source digital mammogram into a different location on another mammogram. We demonstrate examples of the performance of this tool on clinical cases taken from the University of South Florida Digital Database for Screening Mammography (DDSM). Finally, we report the results of a reader study evaluating the realism of inserted lesions compared to clinical lesions. Analysis of the radiologist scores in the study using receiver operating characteristic (ROC) methodology indicates that inserted lesions cannot be reliably distinguished from clinical lesions.

  5. NPS comparison of anatomical noise characteristics in mammography, tomosynthesis, and breast CT images using power law metrics

    Science.gov (United States)

    Chen, Lin; Boone, John M.; Nosratieh, Anita; Abbey, Craig K.

    2011-03-01

    Digital mammography is the current standard for breast cancer screening, however breast tomosynthesis and breast CT (bCT) have been studied in clinical trials. At our institution, 30 women (BIRADS 4 and 5) underwent IRB-approved imaging by mammography, breast tomosynthesis, and bCT on the same day. Twenty three data sets were used for analysis. The 2D noise power spectrum (NPS) was computed and averaged for each data set. The NPS was computed for different slice thicknesses of dx × N, where dx ~ 0.3 mm and N=1-64, on the bCT data. Each 2D NPS was radially averaged, and the 1D data were fit using a power law function as proposed by Burgess: NPS(f) = αf-β. The value of β was determined over a range of frequencies corresponding to anatomical noise, for each patient and each modality. Averaged over the 30 women (26 for bCT, 28 for tomosynthesis, 28 for mammography), for mammography β=3.06 (0.25), for CC tomosynthesis β=2.91 (0.35), and for axial bCT β=1.72 (0.47). For sagittal bCT β=1.77 (0.36) and for coronal bCT, β=1.88 (0.45). The computation of β versus slice thickness on the coronal bCT data set led to β~1.7 for N=1, asymptotically reaching β ~ 3 for larger slice thickness. These results suggest that there is a fundamental difference in breast anatomic noise as characterized by β, between thin slices (<2 mm) and thicker slices. Tomosynthesis was found to have anatomic noise properties closer to mammography than breast CT, most likely due to the relatively thick slice sensitivity profile of tomosynthesis.

  6. Recording of hormone therapy and breast density in breast screening programs: summary and recommendations of the International Cancer Screening Network.

    NARCIS (Netherlands)

    Cox, B.; Ballard-Barbash, R.; Broeders, M.J.M.; Dowling, E.; Malila, N.; Shumak, R.; Taplin, S.; Buist, D.; Miglioretti, D.

    2010-01-01

    Breast density and the use of hormone therapy (HT) for menopausal symptoms alter the risk of breast cancer and both factors influence screening mammography performance. The International Cancer Screening Network (ICSN) surveyed its 29 member countries and found that few programs record breast densit

  7. Recording of hormone therapy and breast density in breast screening programs: summary and recommendations of the International Cancer Screening Network.

    NARCIS (Netherlands)

    Cox, B.; Ballard-Barbash, R.; Broeders, M.J.M.; Dowling, E.; Malila, N.; Shumak, R.; Taplin, S.; Buist, D.; Miglioretti, D.

    2010-01-01

    Breast density and the use of hormone therapy (HT) for menopausal symptoms alter the risk of breast cancer and both factors influence screening mammography performance. The International Cancer Screening Network (ICSN) surveyed its 29 member countries and found that few programs record breast densit

  8. Mammography and ultrasound in the evaluation of male breast disease

    Energy Technology Data Exchange (ETDEWEB)

    Munoz Carrasco, Rafaela; Alvarez Benito, Marina; Raya Povedano, Jose Luis [Hospital Universitario ' Reina Sofia' , Radiology Department, Cordoba (Spain); Munoz Gomariz, Elisa [Hospital Universitario ' Reina Sofia' , Support Unit for Research, Cordoba (Spain); Martinez Paredes, Maria [University of Cordoba, Radiology and Physical Medicine Area, Cordoba (Spain)

    2010-12-15

    To assess clinical variables that may be useful in differentiating gynaecomastia from carcinoma and to analyse the contribution of mammography and ultrasound to the evaluation of male breast disease. All men who underwent mammography and/or ultrasound between 1993 and 2006 in our hospital were retrospectively evaluated. Clinical characteristics in patients with gynaecomastia and those with carcinoma were compared. Radiological findings were classified according to the BI-RADS (Breast Imaging Reporting and Data System) criteria. The diagnostic performance of physical examination, mammography and ultrasound was determined and compared. A total of 628 patients with 518 mammograms and 423 ultrasounds were reviewed. The final diagnoses were: 19 carcinomas, 526 gynaecomastias, 84 other benign conditions and 25 normal. There were statistically significant differences in age, bilateral involvement, clinical presentation and physical examination between patients with carcinoma and those with gynaecomastia. The diagnostic performance of physical examination was lower than that of mammography and ultrasound (p < 0.05 for specificity). Mammography was the most sensitive (94.7%) and ultrasound the most specific (95.3%) for detection of malignancy (p > 0.05). We propose an algorithm for the use of mammography and ultrasound in men. Mammography and ultrasound, with a negative predictive value close to 100%, make it possible to avoid very many unnecessary surgical procedures in men. (orig.)

  9. Quality control in digital mammography: the noise components

    Energy Technology Data Exchange (ETDEWEB)

    Leyton, Fernando [Universidade de Tarapaca, Arica (Chile). Centro de Estudios en Ciencias Radiologicas; Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Nogueira, Maria do Socorro, E-mail: mnogue@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Duran, Maria Paz [Clinica Alemana, Santiago (Chile). Dept. de Radiologia; Dantas, Marcelino, E-mail: marcelino@inb.gov.b [Industrias Nucleares do Brasil (INB), Caldas, MG (Brazil). Unidade de Tratamento de Minerios; Ubeda, Carlos, E-mail: cubeda@uta.c [Universidade de Tarapaca, Arica (Chile). Fac. de Ciencias de la Salud

    2011-07-01

    To measure the linearity of the detector and determine the noise components (quantum, electronic and structural noise) that contributed to losing image quality and to determine the signal noise ratio (SNR) and contrast noise ratio (CNR). This paper describes the results of the implementation of a protocol for quality control in digital mammography performed in two direct digital mammography equipment (Hologic, Selenia) in Santiago of Chile. Shows the results of linearity and noise analysis of the images which establishes the main cause of noise in the image of the mammogram to ensure the quality and optimize procedures. The study evaluated two digital mammography's Selenia, Hologic (DR) from Santiago, Chile. We conducted the assessment of linearity of the detector, the signal noise ratio, contrast noise ratio and was determined the contribution of different noise components (quantum, electronics and structural noise). Used different thicknesses used in clinical practice according to the protocol for quality control in digital mammography of Spanish society of medical physics and NHSBSP Equipment Report 0604 Version 3. The Selenia mammography software was used for the analysis of images and Unfors Xi detector for measuring doses. The mammography detector has a linear performance, the CNR and SNR did not comply with the Protocol for the thicknesses of 60 and 70 mm. The main contribution of the noise corresponds to the quantum noise, therefore it is necessary to adjust and optimize the mammography system. (author)

  10. Computer Aided Diagnosis in Digital Mammography

    Directory of Open Access Journals (Sweden)

    "H. Mirzaalian

    2005-08-01

    Full Text Available Introduction & Background: Breast cancer is a lead-ing cause of cancer deaths among women.Early de-tection is the most effective way to reduce mortality. Mammography is the best method for early detection. In order to improve the accuracy of interpretation of mammogram, Computer Aided Diagnosis (CAD sys-tems have been proposed. The main goal of this re-search is to implement one of the algorithms and techniques for the enhancement of mammogram for easier detection of abnormalities. Patients & Methods: In the presented algorithm, morphological methods are used first for removing artifacts. Then thresholding, labeling, and active con-tours methods are used to extract the breast region, which allow the search for abnormalities to be lim-ited to the region of the breast. Finally, Gaussian fil-ter and White Top Hat Transform is used for contrast enhancement of mammogram. This algorithm has been applied on 50 images from Mammography Im-age Analysis Society (MIAS. An expert radiologist then verified improvement on the processed images. Results and Conclusions: Implementing the presented algorithm causes easier and better interpretation of mammogram without increasing the number of false positive and false negative results. Because of the spe-cial shapes and statistical features of abnormal tex-tures, it is possible to apply pattern recognition and artificial intelligence techniques as an aid for diagnos-ing suspicious regions. Research on using some of these techniques to distinguish benign abnormalities from malignant ones is on the way.

  11. Classification of breast microcalcifications using spectral mammography

    Science.gov (United States)

    Ghammraoui, B.; Glick, S. J.

    2017-03-01

    Purpose: To investigate the potential of spectral mammography to distinguish between type I calcifications, consisting of calcium oxalate dihydrate or weddellite compounds that are more often associated with benign lesions, and type II calcifications containing hydroxyapatite which are predominantly associated with malignant tumors. Methods: Using a ray tracing algorithm, we simulated the total number of x-ray photons recorded by the detector at one pixel from a single pencil-beam projection through a breast of 50/50 (adipose/glandular) tissues with inserted microcalcifications of different types and sizes. Material decomposition using two energy bins was then applied to characterize the simulated calcifications into hydroxyapatite and weddellite using maximumlikelihood estimation, taking into account the polychromatic source, the detector response function and the energy dependent attenuation. Results: Simulation tests were carried out for different doses and calcification sizes for multiple realizations. The results were summarized using receiver operating characteristic (ROC) analysis with the area under the curve (AUC) taken as an overall indicator of discrimination performance and showing high AUC values up to 0.99. Conclusion: Our simulation results obtained for a uniform breast imaging phantom indicate that spectral mammography using two energy bins has the potential to be used as a non-invasive method for discrimination between type I and type II microcalcifications to improve early breast cancer diagnosis and reduce the number of unnecessary breast biopsies.

  12. Diagnostic Yield of High-Resolution Breast Sonography in Detecting Microcalcifications Compared to Mammography

    Directory of Open Access Journals (Sweden)

    N Ahmadinejad

    2009-08-01

    Full Text Available Background/Objective: Mammography remains the most suitable screening test in detecting microcalcifications as the earliest manifestation of breast malignancy. By means of highfrequency transducers yielding high-resolution breast imaging, some researchers have reported that ultrasonography is capable of depicting microcalcifications in the breast tissue. Therefore, this study has been designed to compare the diagnostic yield of high-resolution"nbreast ultrasonography (HRS versus conventional mammography."nPatients and Methods: Seventy-four consecutive patients who had breast microcalcifications (hyperdense foci < 0.5mm according to standard mammograms, without a prior history of breast disease, surgery, biopsy, chest wall radiation or systemic chemotherapy were enrolled. Considering mammograms as a reference, 46 patients without a mass, voluntarily underwent high-resolution bilateral breast ultrasonography."nResults: The mean age was 50.7±10 years (range, 35-85 ye