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Sample records for repeated mammographic screening

  1. Screening outcome in women repeatedly recalled for the same mammographic abnormality before, during and after the transition from screen-film to full-field digital screening mammography.

    Science.gov (United States)

    van Bommel, Rob; Voogd, Adri C; Louwman, Marieke W; Strobbe, Luc J; Venderink, Dick; Duijm, Lucien E M

    2017-02-01

    The aim of this study was to retrospectively determine screening outcome in women recalled twice for the same mammographic lesion before, during, and after transition from screen-film (SFM) to full-field digital screening mammography (FFDM). We included women with a repeated recall for the same mammographic abnormality (37 at subsequent SFM-screening, obtained between January 2000-April 2010; respectively 54 and 65 women with a prior SFM-screen or FFDM-screen followed by subsequent FFDM-screening, obtained between May 2009-July 2013). At SFM-screening, repeated recalls for the same lesion comprised 1.2 % of recalls (37/3217), including 13 malignancies (positive predictive value (PPV), 35.1 %). During the SFM to FFDM transition (SFM-screen followed by FFDM-screen), FFDM recalls comprised more repeated recalls for the same lesion (2.2 %, P = 0.002), with a lower PPV (14.8 %, P = 0.02). This proportion increased to 2.8 % after transition to FFDM (i.e., two successive FFDM-screens), with 16 malignancies (PPV, 24.6 %). Invasive cancers at repeated recall were smaller than interval cancers (T1a-c, 79.4 versus 46.8 %, P = 0.001), with less lymph node involvement (20.6 versus 46.5 %, P = 0.007). More women are repeatedly recalled for the same mammographic abnormality during and after the transition from SFM to FFDM-screening, with comparable cancer risks before and after the transition. These cancers show better prognostic characteristics than interval cancers. • FFDM-screening increases the number of repeated recalls for the same mammographic abnormality. • The PPV of these recalls is comparable before and after transition to FFDM-screening. • Cancers diagnosed after a repeated recall are smaller than interval cancers. • These cancers also show less lymph node involvement than interval cancers.

  2. Mammographic screening programmes in Europe

    DEFF Research Database (Denmark)

    Giordano, Livia; von Karsa, Lawrence; Tomatis, Mariano

    2012-01-01

    To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe.......To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe....

  3. Hormone replacement therapy and mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A

    2002-07-01

    The benefits of hormone replacement therapy (HRT) with oestrogen are well known and have led to widespread usage of HRT in post-menopausal women. There is an increased relative risk of breast cancer with prolonged HRT use of 1.7 at worst and this does not warrant more frequent screening. HRT itself makes mammographic screening less effective by adversely affecting both the sensitivity and specificity of screening mammography. A number of large studies have shown a reduction in the sensitivity of screening mammography of between 7% and 21% in current HRT users. This reduction in sensitivity is seen only in women over the age of 50 and is more marked when using single view mammography. The reduction in sensitivity is largely confined to those women who have a dense mammographic background pattern while on HRT. HRT use is also associated with a reduction in specificity of between 12% and almost 50%. This reduction in specificity is mainly found at incident screens. What can be done to minimize the adverse effects of HRT on mammographic screening? The imminent introduction of two views at all screens within the National Health Breast Screening Programme will be helpful. Short-term cessation of HRT use may deter attendance for screening by HRT users and is unproven. Combined oestrogen and progesterone preparations taken continuously appear to be particularly associated with adverse breast screening performance, while tibolone may have little effect on mammographic density. Manipulation of the type of HRT preparations used may allow the adverse effects of HRT on breast screening to be reduced. Evans, A. (2002)

  4. Overdiagnosis in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

    Puliti, Donella; Duffy, Stephen W; Miccinesi, Guido

    2012-01-01

    Overdiagnosis, the detection through screening of a breast cancer that would never have been identified in the lifetime of the woman, is an adverse outcome of screening. We aimed to determine an estimate range for overdiagnosis of breast cancer in European mammographic service screening programmes....

  5. Effective biennial mammographic screening in women aged 40-49.

    NARCIS (Netherlands)

    Schoor, G. van; Moss, S.M.; Otten, J.D.M.; Donders, R.; Paap, E.; Heeten, G.J. den; Holland, R.; Broeders, M.J.M.; Verbeek, A.L.M.

    2010-01-01

    BACKGROUND: The United Kingdom is currently moving the age limit for invitation in its national breast screening programme downwards from 50 to 47. In contrast, the US Preventive Services Task Force concluded that, because of borderline statistical significance on effectiveness of mammographic

  6. Pathological axillary lymph nodes detected at mammographic screening

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    Lim, E. T.; O' Doherty, A.; Hill, A. D.; Quinn, C. M. E-mail: c.quinn@st-vincents.ie

    2004-01-01

    AIM: To investigate the significance of abnormal axillary lymph nodes detected at mammographic screening in the absence of a concomitant breast lesion. METHODS: Twenty-three thousand, seven hundred and seven women were screened at the Merrion Unit as part of the Irish National Breast Screening Programme ('BreastCheck') in the period June 2000 to July 2002. Nine women (0.4 per 1000 women screened) were found to have an abnormal axillary lymph node(s) in the absence of a mammographic breast lesion and were recalled for assessment. The radiological criteria for recall included: size greater than or equal to 15 mm, round or irregular shape, increased node density and absence of hilar lucency. Each woman underwent further mammographic views, ultrasound examination of axilla and breast, clinical examination and lymph node biopsy either by 14 G needle core biopsy (NCB) or open excision. RESULTS: The final pathological diagnoses in the nine patients were oestrogen receptor (OR) positive metastatic breast carcinoma (two patients), metastatic malignant melanoma (one patient), malignant lymphoma (two patients), caseating granulomatous lymphadenitis suggestive of tuberculosis (one patient), and other benign conditions (three patients). CONCLUSION: Abnormal axillary lymph nodes, in the absence of an accompanying breast lesion, are rarely identified on screening mammogram, but may harbour significant pathology and their presence on screening mammogram merits further investigation including biopsy.

  7. False-positive results in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

    Hofvind, Solveig; Ponti, Antonio; Patnick, Julietta

    2012-01-01

    To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment.......To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment....

  8. Extrapolation of pre-screening trends: Impact of assumptions on overdiagnosis estimates by mammographic screening

    NARCIS (Netherlands)

    Ripping, T.M.; Verbeek, A.L.M.; Haaf, K. Ten; Ravesteyn, N.T. van; Broeders, M.J.M.

    2016-01-01

    BACKGROUND: Overdiagnosis by mammographic screening is defined as the excess in breast cancer incidence in the presence of screening compared to the incidence in the absence of screening. The latter is often estimated by extrapolating the pre-screening incidence trend. The aim of this theoretical

  9. Mammographic screening: evidence from randomised controlled trials

    NARCIS (Netherlands)

    H.J. de Koning (Harry)

    2003-01-01

    textabstractBACKGROUND: All randomised breast cancer screening trials have shown a reduction in breast cancer mortality in the 'invited for mammography' screening arm compared with the 'control arm' for women aged 50 years and older at randomisation (overall 25%). However,

  10. Evaluation of mammographic screen-film systems.

    Science.gov (United States)

    Arnold, B A; Webster, E W; Kalisher, L

    1978-10-01

    Four screen-film systems were evaluated for their imaging properties in mammography, Modulation-transfer functions were measured at 40 kVp. Absolute screen-film sensitivities in mR and entrance exposures were measured with tungsten and molybdenum target tubes. Five radiologists viewed radiographs of a phantom containing microgranules of SiC ranging in diameter from 590 to 120 micrometer. The Rarex-B screen--composed of yttrium oxysulfide--performed best, allowing phantom radiographs at 185 mR with image quality sufficient to demonstrate microgranules greater than 330 micrometer in dimension.

  11. The impact of mammographic screening on breast cancer mortality in Europe

    DEFF Research Database (Denmark)

    Broeders, Mireille; Moss, Sue; Nyström, Lennarth

    2012-01-01

    To assess the impact of population-based mammographic screening on breast cancer mortality in Europe, considering different methodologies and limitations of the data.......To assess the impact of population-based mammographic screening on breast cancer mortality in Europe, considering different methodologies and limitations of the data....

  12. Reported mammographic density: film-screen versus digital acquisition.

    Science.gov (United States)

    Harvey, Jennifer A; Gard, Charlotte C; Miglioretti, Diana L; Yankaskas, Bonnie C; Kerlikowske, Karla; Buist, Diana S M; Geller, Berta A; Onega, Tracy L

    2013-03-01

    To test the hypothesis that American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories for breast density reported by radiologists are lower when digital mammography is used than those reported when film-screen (FS) mammography is used. This study was institutional review board approved and HIPAA compliant. Demographic data, risk factors, and BI-RADS breast density categories were collected from five mammography registries that were part of the Breast Cancer Surveillance Consortium. Active, passive, or waiver of consent was obtained for all participants. Women aged 40 years and older who underwent at least two screening mammographic examinations less than 36 months apart between January 1, 2000, and December 31, 2009, were included. Women with prior breast cancer, augmentation, or use of agents known to affect density were excluded. The main sample included 89 639 women with both FS and digital mammograms. The comparison group included 259 046 women with two FS mammograms and 87 066 women with two digital mammograms. BI-RADS density was cross-tabulated according to the order in which the two types of mammogram were acquired and by the first versus second interpretation. Regardless of acquisition method, the percentage of women with a change in density from one reading to the next was similar. Breast density was lower in 19.8% of the women who underwent FS before digital mammography and 17.1% of those who underwent digital before FS mammography. Similarly, lower density classifications were reported on the basis of the second mammographic examination regardless of acquisition method (15.8%-19.8%). The percentage of agreement between density readings was similar regardless of mammographic types paired (67.3%-71.0%). The study results showed no difference in reported BI-RADS breast density categories according to acquisition method. Reported BI-RADS density categories may be useful in the development of breast cancer risk models in

  13. Decision trees and integrated features for computer aided mammographic screening

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    Kegelmeyer, W.P. Jr.; Groshong, B.; Allmen, M.; Woods, K.

    1997-02-01

    Breast cancer is a serious problem, which in the United States causes 43,000 deaths a year, eventually striking 1 in 9 women. Early detection is the only effective countermeasure, and mass mammography screening is the only reliable means for early detection. Mass screening has many shortcomings which could be addressed by a computer-aided mammographic screening system. Accordingly, we have applied the pattern recognition methods developed in earlier investigations of speculated lesions in mammograms to the detection of microcalcifications and circumscribed masses, generating new, more rigorous and uniform methods for the detection of both those signs. We have also improved the pattern recognition methods themselves, through the development of a new approach to combinations of multiple classifiers.

  14. The impact of mammographic screening on breast cancer mortality in Europe

    DEFF Research Database (Denmark)

    Moss, S M; Nyström, L; Jonsson, H.

    2012-01-01

    Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value.......Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value....

  15. Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country.

    Science.gov (United States)

    Lee, Marianne; Mariapun, Shivaani; Rajaram, Nadia; Teo, Soo-Hwang; Yip, Cheng-Har

    2017-01-28

    The incidence of breast cancer in Asia is increasing because of urbanization and lifestyle changes. In the developing countries in Asia, women present at late stages, and mortality is high. Mammographic screening is the only evidence-based screening modality that reduces breast cancer mortality. To date, only opportunistic screening is offered in the majority of Asian countries because of the lack of justification and funding. Nevertheless, there have been few reports on the effectiveness of such programmes. In this study, we describe the cancer detection rate and challenges experienced in an opportunistic mammographic screening programme in Malaysia. From October 2011 to June 2015, 1,778 asymptomatic women, aged 40-74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined. The mean age for screening was 50.8 years and seven cancers (0.39%) were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist's experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities. The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2-4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening are likely premenopausal and hence have denser breasts. Radiologists who

  16. Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country

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    Marianne Lee

    2017-01-01

    Full Text Available Abstract Background The incidence of breast cancer in Asia is increasing because of urbanization and lifestyle changes. In the developing countries in Asia, women present at late stages, and mortality is high. Mammographic screening is the only evidence-based screening modality that reduces breast cancer mortality. To date, only opportunistic screening is offered in the majority of Asian countries because of the lack of justification and funding. Nevertheless, there have been few reports on the effectiveness of such programmes. In this study, we describe the cancer detection rate and challenges experienced in an opportunistic mammographic screening programme in Malaysia. Methods From October 2011 to June 2015, 1,778 asymptomatic women, aged 40–74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined. Results The mean age for screening was 50.8 years and seven cancers (0.39% were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist’s experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities. Discussion The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2–4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening

  17. Mammographic positioning quality of newly trained versus experienced radiographers in the Dutch breast cancer screening programme

    NARCIS (Netherlands)

    van Landsveld-Verhoeven, Cary; den Heeten, Gerard J.; Timmers, Janine; Broeders, Mireille J. M.

    2015-01-01

    Our purpose was to compare mammographic positioning quality of new (NR) versus experienced screening radiographers (ER) in the Netherlands. Before starting to work in breast screening, NR must complete an education programme including a theoretical course (four days), practical training (six weeks),

  18. Immediate and delayed effects of mammographic screening on breast cancer mortality and incidence in birth cohorts

    NARCIS (Netherlands)

    Ripping, T. M.; Verbeek, A. L. M.; van der Waal, D.; Otten, J. D. M.; den Heeten, G. J.; Fracheboud, J.; de Koning, H. J.; Broeders, M. J. M.

    2013-01-01

    Trend studies investigating the impact of mammographic screening usually display age-specific mortality and incidence rates over time, resulting in an underestimate of the benefit of screening, that is, mortality reduction, and an overestimate of its major harmful effect, that is, overdiagnosis.

  19. Overdiagnosis in mammographic screening for breast cancer in Europe: A literature review

    NARCIS (Netherlands)

    D. Puliti (Donella); S.W. Duffy (Stephen); G. Miccinesi (Guido); H.J. de Koning (Harry); E. Lynge (Elsebeth); M. Zappa (Marco); E. Paci (Eugenio)

    2012-01-01

    textabstractObjectives Overdiagnosis, the detection through screening of a breast cancer that would never have been identified in the lifetime of the woman, is an adverse outcome of screening. We aimed to determine an estimate range for overdiagnosis of breast cancer in European mammographic service

  20. Overdiagnosis by mammographic screening for breast cancer studied in birth cohorts in The Netherlands

    NARCIS (Netherlands)

    Ripping, T.M.; Verbeek, A.L.; Fracheboud, J.; Koning, H.J. de; Ravesteyn, N.T. van; Broeders, M.J.

    2015-01-01

    A drawback of early detection of breast cancer through mammographic screening is the diagnosis of breast cancers that would never have become clinically detected. This phenomenon, called overdiagnosis, is ideally quantified from the breast cancer incidence of screened and unscreened cohorts of women

  1. Body mass index and participation in organized mammographic screening

    DEFF Research Database (Denmark)

    Hellmann, Sophie Sell; Njor, Sisse Helle; Lynge, Elsebeth

    2015-01-01

    BACKGROUND: Breast cancer is the leading cancer among women, and early diagnosis is essential for future prognosis. Evidence from mainly cross-sectional US studies with self-reported exposure and outcome found positive association of body mass index (BMI) with non-participation in mammographic...

  2. Extrapolation of pre-screening trends: Impact of assumptions on overdiagnosis estimates by mammographic screening.

    Science.gov (United States)

    Ripping, T M; Verbeek, A L M; Ten Haaf, K; van Ravesteyn, N T; Broeders, M J M

    2016-06-01

    Overdiagnosis by mammographic screening is defined as the excess in breast cancer incidence in the presence of screening compared to the incidence in the absence of screening. The latter is often estimated by extrapolating the pre-screening incidence trend. The aim of this theoretical study is to investigate the impact of assumptions in extrapolating the pre-screening incidence trend of invasive breast cancer on the estimated percentage of overdiagnosis. We extracted data on invasive breast cancer incidence and person-years by calendar year (1975-2009) and 5-year age groups (0-85 years) from Dutch databases. Different combinations of assumptions for extrapolating the pre-screening period were investigated, such as variations in the type of regression model, end of the pre-screening period, screened age range, post-screening age range and adjustment for a trend in women overdiagnosis, i.e. excess cancer incidence in the presence of screening as a proportion of the number of screen-detected and interval cancers. Most overdiagnosis percentages are overestimated because of inadequate adjustment for lead time. The overdiagnosis estimates range between -7.1% and 65.1%, with a median of 33.6%. The choice of pre-screening period has the largest influence on the estimated percentage of overdiagnosis: the median estimate is 17.1% for extrapolations using 1975-1986 as the pre-screening period and 44.7% for extrapolations using 1975-1988 as the pre-screening period. The results of this theoretical study most likely cover the true overdiagnosis estimate, which is unknown, and may not necessarily represent the median overdiagnosis estimate. This study shows that overdiagnosis estimates heavily depend on the assumptions made in extrapolating the incidence in the pre-screening period, especially on the choice of the pre-screening period. These limitations should be acknowledged when adopting this approach to estimate overdiagnosis. Copyright © 2016 Elsevier Ltd. All rights

  3. Fractal analysis of visual search activity for mass detection during mammographic screening.

    Science.gov (United States)

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

    2017-03-01

    The objective of this study was to assess the complexity of human visual search activity during mammographic screening using fractal analysis and to investigate its relationship with case and reader characteristics. The study was performed for the task of mammographic screening with simultaneous viewing of four coordinated breast views as typically done in clinical practice. Eye-tracking data and diagnostic decisions collected for 100 mammographic cases (25 normal, 25 benign, 50 malignant) from 10 readers (three board certified radiologists and seven Radiology residents), formed the corpus for this study. The fractal dimension of the readers' visual scanning pattern was computed with the Minkowski-Bouligand box-counting method and used as a measure of gaze complexity. Individual factor and group-based interaction ANOVA analysis was performed to study the association between fractal dimension, case pathology, breast density, and reader experience level. The consistency of the observed trends depending on gaze data representation was also examined. Case pathology, breast density, reader experience level, and individual reader differences are all independent predictors of the complexity of visual scanning pattern when screening for breast cancer. No higher order effects were found to be significant. Fractal characterization of visual search behavior during mammographic screening is dependent on case properties and image reader characteristics. © 2017 American Association of Physicists in Medicine.

  4. Interval breast cancers: Absolute and proportional incidence and blinded review in a community mammographic screening program

    Energy Technology Data Exchange (ETDEWEB)

    Carbonaro, Luca A., E-mail: luca.carbonaro@gmail.com [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Azzarone, Antonio [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Paskeh, Bijan Babaei [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Brambilla, Giorgio [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Brunelli, Silvia [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Calori, Anna [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Caumo, Francesca [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Malerba, Paolo [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Menicagli, Laura [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Sconfienza, Luca M. [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano (Italy); Vadalà, Giuseppe [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Brambilla, Gelma; Fantini, Luigi [Servizio di Medicina Preventiva delle Comunità, ASL Milano 2, Via Friuli 2, Lacchiarella (Mi) 20084 (Italy); Ciatto, Stefano [Screening Program, ULSS 16, Padova (Italy); and others

    2014-02-15

    Purpose: To evaluate the performance of the first years since the beginning of a mammographic population-based screening program. Materials and methods: Women aged 49–69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records. The proportional incidence of IC was determined considering breast cancers expected without screening. Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis, randomly mixed with negative mammograms (1:2 ratio). Cases unrecalled at review were considered as true ICs, those recalled by only one reviewer as minimal signs, and those recalled by two or three reviewers as missed cancers. T and N stage of the reviewed ICs were evaluated and compared. Results: A total of 86,276 first level mammograms were performed. Mean recall rate was 6.8% at first and 4.6% at repeat screening. We had 476 screen-detected cancers and 145 ICs (10 of them ductal carcinomas in situ). Absolute incidence was 17 per 10,000 screening examinations. Invasive proportional incidence was 19% (44/234) in the first year, 39% (91/234) in the second year, and 29% (135/468) in the two-year interval. Of 145 ICs, 130 (90%) were reviewed mixed with 287 negative controls: 55% (71/130) resulted to be true ICs, 24% (31/130) minimal signs, and 22% (28/130) missed cancers. The rate of ICs diagnosed in the first year interval was 21% (15/71) for true ICs, 46% (13/28) for missed cancers, and 39% (12/31) for minimal signs, with a significant difference of true ICs rate compared to missed cancers rate (p = 0.012). A higher rate of T3 and T4 stages was found for missed cancers (18%, 5/28) compared to minimal signs (6%, 2/31) or true ICs (8%, 6/71), while the rate of N2 and N3 stage for both minimal signs (19%, 6/31) or missed cancers (25

  5. Interval breast cancers: absolute and proportional incidence and blinded review in a community mammographic screening program.

    Science.gov (United States)

    Carbonaro, Luca A; Azzarone, Antonio; Paskeh, Bijan Babaei; Brambilla, Giorgio; Brunelli, Silvia; Calori, Anna; Caumo, Francesca; Malerba, Paolo; Menicagli, Laura; Sconfienza, Luca M; Vadalà, Giuseppe; Brambilla, Gelma; Fantini, Luigi; Ciatto, Stefano; Sardanelli, Francesco

    2014-02-01

    To evaluate the performance of the first years since the beginning of a mammographic population-based screening program. Women aged 49-69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records. The proportional incidence of IC was determined considering breast cancers expected without screening. Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis, randomly mixed with negative mammograms (1:2 ratio). Cases unrecalled at review were considered as true ICs, those recalled by only one reviewer as minimal signs, and those recalled by two or three reviewers as missed cancers. T and N stage of the reviewed ICs were evaluated and compared. A total of 86,276 first level mammograms were performed. Mean recall rate was 6.8% at first and 4.6% at repeat screening. We had 476 screen-detected cancers and 145 ICs (10 of them ductal carcinomas in situ). Absolute incidence was 17 per 10,000 screening examinations. Invasive proportional incidence was 19% (44/234) in the first year, 39% (91/234) in the second year, and 29% (135/468) in the two-year interval. Of 145 ICs, 130 (90%) were reviewed mixed with 287 negative controls: 55% (71/130) resulted to be true ICs, 24% (31/130) minimal signs, and 22% (28/130) missed cancers. The rate of ICs diagnosed in the first year interval was 21% (15/71) for true ICs, 46% (13/28) for missed cancers, and 39% (12/31) for minimal signs, with a significant difference of true ICs rate compared to missed cancers rate (p=0.012). A higher rate of T3 and T4 stages was found for missed cancers (18%, 5/28) compared to minimal signs (6%, 2/31) or true ICs (8%, 6/71), while the rate of N2 and N3 stage for both minimal signs (19%, 6/31) or missed cancers (25%, 7/28) was higher than that for true ICs (10

  6. Immediate and delayed effects of mammographic screening on breast cancer mortality and incidence in birth cohorts.

    Science.gov (United States)

    Ripping, T M; Verbeek, A L M; van der Waal, D; Otten, J D M; den Heeten, G J; Fracheboud, J; de Koning, H J; Broeders, M J M

    2013-10-29

    Trend studies investigating the impact of mammographic screening usually display age-specific mortality and incidence rates over time, resulting in an underestimate of the benefit of screening, that is, mortality reduction, and an overestimate of its major harmful effect, that is, overdiagnosis. This study proposes a more appropriate way of analysing trends. Breast cancer mortality (1950-2009) and incidence data (1975-2009) were obtained from Statistics Netherlands, 'Stg. Medische registratie' and the National Cancer Registry in the Netherlands for women aged 25-85 years. Data were visualised in age-birth cohort and age-period figures. Birth cohorts invited to participate in the mammographic screening programme showed a deflection in the breast cancer mortality rates within the first 5 years after invitation. Thereafter, the mortality rate increased, although less rapidly than in uninvited birth cohorts. Furthermore, invited birth cohorts showed a sharp increase in invasive breast cancer incidence rate during the first 5 years of invitation, followed by a moderate increase during the following screening years and a decline after passing the upper age limit. When applying a trend study to estimate the impact of mammographic screening, we recommend using a birth cohort approach.

  7. Mammographic positioning quality of newly trained versus experienced radiographers in the Dutch breast cancer screening programme.

    Science.gov (United States)

    van Landsveld-Verhoeven, Cary; den Heeten, Gerard J; Timmers, Janine; Broeders, Mireille J M

    2015-11-01

    Our purpose was to compare mammographic positioning quality of new (NR) versus experienced screening radiographers (ER) in the Netherlands. Before starting to work in breast screening, NR must complete an education programme including a theoretical course (four days), practical training (six weeks), and a portfolio-review of 50 mammographic screening examinations performed by the radiographer. Furthermore, Dutch screening has an extensive system of quality assurance, including an audit-review of positioning quality of mammograms by ER. We analysed 13,520 portfolio views (NR) and 14,896 audit views (ER) based on pre-specified criteria, e.g., depiction of inframammary angle. Overall positioning was more adequate for NR than ER (CC views: 97% versus 86%, p = 0.00; MLO views: 92% versus 84%, p = 0.00). NR scored better for most of the CC-criteria and showed, for instance, less folds (inadequate: 10% versus 16%, p = 0.00). In contrast, NR encountered more difficulties for MLO views in, for example, depiction of infra-mammary angle (inadequate: 38% versus 34%, p = 0.00). Overall, mammograms from NR were more often considered adequate, because of less severe errors. NR perform better than ER in overall positioning technique. These results stress the need for continuous monitoring and training in breast screening programmes to keep positioning skills up to date. • We evaluated positioning quality of new and experienced Dutch screening radiographers. • New radiographers outperform their experienced colleagues in mammographic positioning quality. • New radiographers make less severe errors compared to experienced colleagues. • There is a need for a continuous individual monitoring and feedback system.

  8. Reported Mammographic Density: Film-Screen versus Digital Acquisition

    OpenAIRE

    Harvey, Jennifer A.; Gard, Charlotte C.; Miglioretti, Diana L.; Yankaskas, Bonnie C.; Kerlikowske,Karla; Buist, Diana S.M.; Geller, Berta A.; Onega, Tracy L.

    2013-01-01

    Because the results of this study showed that Breast Imaging Reporting and Data System breast density categories reported do not differ according to acquisition method, these density categories could be used in the development of breast cancer risk models in which both film-screen and digital mammography are used.

  9. Breast cancer mortality in mammographic screening in Europe

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Nyström, Lennarth; Moss, Sue

    2012-01-01

    To estimate the impact of service mammography screening on breast cancer mortality using European incidence-based mortality (IBM) studies (or refined mortality studies). IBM studies include only breast cancer deaths occurring in women with breast cancer diagnosed after their first invitation...

  10. Non-attendance of mammographic screening: the roles of age and municipality in a population-based Swedish sample.

    Science.gov (United States)

    Zidar, Maria Norfjord; Larm, Peter; Tillgren, Per; Akhavan, Sharareh

    2015-12-30

    Inequality in health and health care is increasing in Sweden. Contributing to widening gaps are various factors that can be assessed by determinants, such as age, educational level, occupation, living area and country of birth. A health care service that can be used as an indicator of health inequality in Sweden is mammographic screening. The non-attendance rate is between 13 and 31 %, while the average is about 20 %. This study aims to shed light on three associations: between municipality and non-attendance, between age and non-attendance, and the interaction of municipality of residence and age in relation to non-attendance. The study is based on data from the register that identifies attenders and non-attenders of mammographic screening in a Swedish county, namely the Radiological Information System (RIS). Further, in order to provide a socio-demographic profile of the county's municipalities, aggregated data for women in the age range 40-74 in 2012 were retrieved from Statistics Sweden (SCB), the Public Health Agency of Sweden, the National Board of Health and Welfare, and the Swedish Social Insurance Agency. The sample consisted of 52,541 women. Analysis conducted of the individual data were multivariate logistic regressions, and pairwise chi-square tests. The results show that age and municipality of residence associated with non-attendance of mammographic screening. Municipality of residence has a greater impact on non-attendance among women in the age group 70 to 74. For most of the age categories there were differences between the municipalities in regard to non-attendance to mammographic screening. Age and municipality of residence affect attendance of mammographic screening. Since there is one sole and pre-selected mammographic screening facility in the county, distance to the screening facility may serve as one explanation to non-attendance which is a determinant of inequity. From an equity perspective, lack of equal access to health and health care

  11. GPCALMA: a Grid-based tool for Mammographic Screening

    OpenAIRE

    Cerello, P.(Sezione INFN, Turin, Italy); Bagnasco, S; Bottigli, U.; Cheran, SC; Delogu, P.; Fantacci, ME; Fauci, F.; Forni, G.; Lauria, A.; Lopez Torres, E.; Magro, R.; Masala, GL; Oliva, P.; Palmiero, R.; Ramello, L

    2004-01-01

    The next generation of High Energy Physics (HEP) experiments requires a GRID approach to a distributed computing system and the associated data management: the key concept is the Virtual Organisation (VO), a group of distributed users with a common goal and the will to share their resources. A similar approach is being applied to a group of Hospitals which joined the GPCALMA project (Grid Platform for Computer Assisted Library for MAmmography), which will allow common screening programs for e...

  12. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Alex C [ORNL; Hitt, Austin N [ORNL; Voisin, Sophie [ORNL; Tourassi, Georgia [ORNL

    2013-01-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  13. Demographic changes in breast cancer incidence, stage at diagnosis and age associated with population-based mammographic screening.

    Science.gov (United States)

    Verdial, Francys C; Etzioni, Ruth; Duggan, Catherine; Anderson, Benjamin O

    2017-04-01

    Breast cancer incidence and mortality are influenced by early-detection methods, including mammographic screening. Demographic changes in US statistics serve as a model for changes that can be anticipated in countries where mammographic screening has not been implemented. SEER statistics (1973-2013) for breast cancer mortality, incidence, stage at diagnosis, and age at diagnosis were examined. Temporal associations between screening changes and breast cancer demographics in the US were documented. Before 1982 (pre-screening), breast cancer incidence in the US remained stable, with similar incidence of localized and regional cancers, and with in-situ disease comprising breast cancer incidence increased. In 1991, breast cancer age-adjusted mortality rates began decreasing and have continued to decrease. In the post-screening phase, stage distribution stabilized, but now with localized and in-situ disease representing the majority of diagnosed cases. The median age at diagnosis has increased to 61 years. Mammographic screening increases breast cancer incidence, shifts the stage distribution toward earlier stage disease, and in high-income countries, is associated with improved survival. Whether similar improvement in breast cancer survival can be achieved in the absence of mammographic screening has yet to be conclusively demonstrated. © 2017 Wiley Periodicals, Inc.

  14. GPCALMA: a Grid-based tool for mammographic screening.

    Science.gov (United States)

    Cerello, P; Bagnasco, S; Bottigli, U; Cheran, S C; Delogu, P; Fantacci, M E; Fauci, F; Forni, G; Lauria, A; Lopez Torres, E; Magro, R; Masala, G L; Oliva, P; Palmiero, R; Ramello, L; Raso, G; Retico, A; Sitta, M; Stumbo, S; Tangaro, S; Zanon, E

    2005-01-01

    The next generation of high energy physics (HEP) experiments requires a GRID approach to a distributed computing system: the key concept is the Virtual ORGANISATION (VO), a group of distributed users with a common goal and the will to share their resources. A similar approach, applied to a group of hospitals that joined the GPCALMA project (Grid Platform for Computer Assisted Library for MAmmography), will allow common screening programs for early diagnosis of breast and, in the future, lung cancer. The application code makes use of neural networks for the image analysis and is useful in improving the radiologists' diagnostic performance. GRID services allow remote image analysis and interactive online diagnosis, with a potential for a relevant reduction of the delays presently associated with screening programs. A prototype of the system, based on AliEn GRID Services [1], is already available, with a central server running common services [2] and several clients connecting to it. Mammograms can be acquired in any location; the related information required to select and access them at any time is stored in a common service called Data Catalogue, which can be queried by any client. Thanks to the PROOF facility [3], the result of a query can be used as input for analysis algorithms, which are executed on the nodes where the input images are stored,. The selected approach avoids data transfers for all the images with a negative diagnosis and allows an almost real time diagnosis for the set of images with high cancer probability.

  15. Mammographic breast density: impact on breast cancer risk and implications for screening.

    Science.gov (United States)

    Freer, Phoebe E

    2015-01-01

    Mammographic breast density is rapidly becoming a hot topic in both the medical literature and the lay press. In the United States, recent legislative changes in 19 states now require radiologists to notify patients regarding breast density as well as the possible need for supplemental screening. Federal legislation regarding breast density notification has been introduced, and its passage is likely on the horizon. An understanding of the context, scientific evidence, and controversies surrounding the topic of breast density as a risk factor for breast cancer is critical for radiologists. The current state of evidence is presented regarding supplemental screening for women with dense breasts, including the use of digital breast tomosynthesis, whole-breast ultrasonography, and gadolinium-enhanced magnetic resonance imaging. A review of current practice guidelines and additional sources of information will improve radiologists' understanding of the relevant subject of breast density and enable them to respond appropriately to questions from patients, clinicians, and the media. (©)RSNA, 2015.

  16. Phantom evaluation of the effect of film processing on mammographic screen-film combinations.

    Science.gov (United States)

    McLean, D; Rickard, M T

    1994-08-01

    Mammographic image quality should be optimal for diagnosis, and the film contrast can be manipulated by altering development parameters. In this study phantom test objects were radiographed and processed for a given range of developer temperatures and times for four film-screen systems. Radiologists scored the phantom test objects on the resultant films to evaluate the effect on diagnosis of varying image contrast. While for three film-screen systems processing led to appreciable contrast differences, for only one film system did maximum contrast correspond with optimal phantom test object scoring. The inability to show an effect on diagnosis in all cases is possibly due to the variation in radiologist responses found in this study and in normal clinical circumstances. Other technical factors such as changes in film fog, grain and mottle may contribute to the study findings.

  17. GSTM1, GSTT1, and GSTP1 polymorphisms, breast cancer risk factors and mammographic density in women submitted to breast cancer screening Polimorfismos GSTM1, GSTT1 e GSTP1, fatores de risco para câncer de mama e densidade mamográfica em mulheres submetidas a rastreamento mamográfico

    National Research Council Canada - National Science Library

    Ernestina Silva de Aguiar; Juliana Giacomazzi; Aishameriane Venes Schmidt; Hugo Bock; Maria Luiza Saraiva-Pereira; Lavínia Schuler-Faccini; Dakir Duarte Filho; Pollyanna Almeida Costa dos Santos; Roberto Giugliani; Maira Caleffi; Suzi Alves Camey; Patrícia Ashton-Prolla

    2012-01-01

    ..., and GSTP1, and correlate these molecular findings with established risk factors for breast cancer including mammographic density, in a sample of 750 asymptomatic women undergoing mammographic screening...

  18. Stage distribution of breast cancer diagnosed before and after implementation of population-based mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Hofvind, S. [Cancer Registry of Norway, Oslo (Norway). Research; Skaane, P. [Oslo Univ. Hospital Ullevaal (Norway). Dept. of Radiology

    2012-05-15

    Purpose: The German mammographic screening program is very similar to the Norwegian Breast Cancer Screening Program (NBCSP), which started about 10 years earlier. This study analyzes the stage distribution of invasive breast cancers diagnosed in the pre-screening and screening period, and evaluates the overall mortality in women aged 55 - 74 in the pilot and non-pilot counties of the NBCSP. Materials and Methods: The NBCSP invites women aged 50 - 69 to participate in two-view mammography biennially. Chi-square statistics were used to compare percentages of the stage and treatment of invasive breast cancers diagnosed in women residing in the four pilot counties in the pre-screening (1984 - 1995) and screening (1996 - 2007) period. An ecological approach was used to analyze the age-specific mortality in the pilot and non-pilot counties for the period 1970 - 2007. Results: 50 % of the breast cancers diagnosed in the pre-screening period, 70 % of the cases detected with screening, 43 % of the interval cancers, and 52 % of the cancers diagnosed outside the NBCSP were stage I. Stage III + was present in 11 % of the cancers in the pre-screening period, and in 1 % of the cancers detected with screening. In the screening period, the breast cancer mortality rate decreased substantially more in the pilot counties than in the non-pilot counties. Conclusion: The stage distribution of breast cancer diagnosed in the NBCSP is prognostically favorable compared to cancers diagnosed outside the screening program. The reduction in the breast cancer mortality rate was more pronounced in the four pilot counties compared to the non-pilot counties. It is necessary to evaluate the program based on individual data. (orig.)

  19. Cost-effectiveness of annual versus biennial screening mammography for women with high mammographic breast density.

    Science.gov (United States)

    Pataky, Reka; Ismail, Zahra; Coldman, Andrew J; Elwood, Mark; Gelmon, Karen; Hedden, Lindsay; Hislop, Greg; Kan, Lisa; McCoy, Bonnie; Olivotto, Ivo A; Peacock, Stuart

    2014-12-01

    The sensitivity of screening mammography is much lower among women who have dense breast tissue, compared with women who have largely fatty breasts, and they are also at much higher risk of developing the disease. Increasing mammography screening frequency from biennially to annually has been suggested as a policy option to address the elevated risk in this population. The purpose of this study was to assess the cost-effectiveness of annual versus biennial screening mammography among women aged 50-79 with dense breast tissue. A Markov model was constructed based on screening, diagnostic, and treatment pathways for the population-based screening and cancer care programme in British Columbia, Canada. Model probabilities and screening costs were calculated from screening programme data. Costs for breast cancer treatment were calculated from treatment data, and utility values were obtained from the literature. Incremental cost-effectiveness was expressed as cost per quality adjusted life year (QALY), and probabilistic sensitivity analysis was conducted. Compared with biennial screening, annual screening generated an additional 0.0014 QALYs (95% CI: -0.0480-0.0359) at a cost of $819 ($ = Canadian dollars) per patient (95% CI: 506-1185), resulting in an incremental cost effectiveness ratio of $565,912/QALY. Annual screening had a 37.5% probability of being cost-effective at a willingness-to-pay threshold of $100,000/QALY. There is considerable uncertainty about the incremental cost-effectiveness of annual mammography. Further research on the comparative effectiveness of screening strategies for women with high mammographic breast density is warranted, particularly as digital mammography and density measurement become more widespread, before cost-effectiveness can be reevaluated. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Digital versus screen-film mammography: impact of mammographic density and hormone therapy on breast cancer detection.

    Science.gov (United States)

    Chiarelli, Anna M; Prummel, Maegan V; Muradali, Derek; Shumak, Rene S; Majpruz, Vicky; Brown, Patrick; Jiang, Hedy; Done, Susan J; Yaffe, Martin J

    2015-11-01

    Most studies that have examined the effects of mammographic density and hormone therapy use on breast cancer detection have included screen-film mammography. This study further examines this association in post-menopausal women screened by digital mammography. Approved by the University of Toronto Research Ethics Board, this study identified 688,418 women of age 50-74 years screened with digital or screen-film mammography from 2008 to 2009 within the Ontario Breast Screening Program. Of 2993 eligible women with invasive breast cancer, 2450 were contacted and 1421 participated (847 screen-film mammography, 574 digital direct radiography). Mammographic density was measured by study radiologists using the standard BI-RADS classification system and by a computer-assisted method. Information on hormone therapy use was collected by a telephone-administered questionnaire. Logistic regression and two-tailed tests for significance evaluated associations between factors and detection method by mammography type. Women with >75 % radiologist-measured mammographic density compared to those with film (OR = 6.40, 95 % CI 2.30-17.85) than digital mammography (OR = 2.41, 95 % CI 0.67-8.58) and aged 50-64 years screened with screen-film mammography (OR = 10.86, 95 % CI 2.96-39.57). Recent former hormone therapy users were also at an increased risk of having an interval cancer with the association being significant for women screened with digital mammography (OR = 2.08, 95 % CI 1.17-3.71). Breast screening using digital mammography lowers the risk of having an interval cancer for post-menopausal women aged 50-64 with greater mammographic density.

  1. Mammographic density and breast cancer risk in breast screening assessment cases and women with a family history of breast cancer.

    Science.gov (United States)

    Duffy, Stephen W; Morrish, Oliver W E; Allgood, Prue C; Black, Richard; Gillan, Maureen G C; Willsher, Paula; Cooke, Julie; Duncan, Karen A; Michell, Michael J; Dobson, Hilary M; Maroni, Roberta; Lim, Yit Y; Purushothaman, Hema N; Suaris, Tamara; Astley, Susan M; Young, Kenneth C; Tucker, Lorraine; Gilbert, Fiona J

    2018-01-01

    Mammographic density has been shown to be a strong independent predictor of breast cancer and a causative factor in reducing the sensitivity of mammography. There remain questions as to the use of mammographic density information in the context of screening and risk management, and of the association with cancer in populations known to be at increased risk of breast cancer. To assess the association of breast density with presence of cancer by measuring mammographic density visually as a percentage, and with two automated volumetric methods, Quantra™ and VolparaDensity™. The TOMosynthesis with digital MammographY (TOMMY) study of digital breast tomosynthesis in the Breast Screening Programme of the National Health Service (NHS) of the United Kingdom (UK) included 6020 breast screening assessment cases (of whom 1158 had breast cancer) and 1040 screened women with a family history of breast cancer (of whom two had breast cancer). We assessed the association of each measure with breast cancer risk in these populations at enhanced risk, using logistic regression adjusted for age and total breast volume as a surrogate for body mass index (BMI). All density measures showed a positive association with presence of cancer and all declined with age. The strongest effect was seen with Volpara absolute density, with a significant 3% (95% CI 1-5%) increase in risk per 10 cm 3 of dense tissue. The effect of Volpara volumetric density on risk was stronger for large and grade 3 tumours. Automated absolute breast density is a predictor of breast cancer risk in populations at enhanced risk due to either positive mammographic findings or family history. In the screening context, density could be a trigger for more intensive imaging. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Mammographic screening debate on study design: a need to move the field forward.

    Science.gov (United States)

    Ursin, Giske

    2012-12-12

    The mammographic screening debate has been running for decades. The temperature of this debate is unusually high, and all participants, regardless of viewpoint, seem to have a conflict of interest. Another unusual aspect of this debate is the focus on study design, and in particular on designs that some think exceeded their usefulness decades ago. What are the questions that remain to be answered in this debate? Are there methodological issues that have not been adequately addressed? Do we have the right tools to provide up-to-date answers to how women can best protect themselves against dying from breast cancer? This commentary discusses some of the current issues.See related Opinion articles http://www.biomedcentral.com/1741-7015/10/106 and http://www.biomedcentral.com/1741-7015/10/163.

  3. Radiological findings of screen-detected cancers in a multi-centre randomized, controlled trial of mammographic screening in women from age 40 to 48 years

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A.J. [Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom)]. E-mail: aevans@ncht.trent.nhs.uk; Kutt, E. [Avon Breast Cancer Screening Unit, Central Health Clinic, Tower Hill, Bristol, Avon (United Kingdom); Record, C. [Buckinghamshire Hospitals NHS Trust, Breast Screening Service, Stoke Mandeville Hospital, Mandeville Road, Aylesbury (United Kingdom); Waller, M. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom); Moss, S. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom)

    2006-09-15

    Aim: To elucidate the mammographic findings of screen-detected cancers in women screened between 40-48 years, and to establish the frequency and nature of abnormal findings on previous mammograms in women with screen-detected cancers. Methods: A radiology review panel consisting of three experienced breast radiologists viewed the screening mammograms in chronological order, confirming that any abnormalities detected corresponded to the cancers detected at later screens. An analysis correlating mammographic features with median invasive size and the proportion measuring less than 10 and 15 mm was performed. Results: Two hundred and thirty-two women had screen-detected invasive cancers with mammograms available for review. The most frequent features seen at diagnosis were spiculate mass, ill-defined mass, granular calcification, deformity and comedo calcification. Thirty-four percent of mammograms showed calcification. The mammographic sign associated with smallest median size was calcification. Calcification was also the mammographic abnormality most frequently associated with cancers <10 mm in size. In total there were 147 abnormal previous screens of 87 women. The most commonly missed features were granular microcalcification, deformity and ill-defined mass. Of the missed abnormalities 20% were classified as malignant, 43% as subtle change and 32% as non-specific. Conclusion: Compared with older women, screen-detected cancer in younger women more commonly manifests as calcification and less frequently a spiculate mass. Calcification is the sign most frequently associated with invasive cancers <10 mm in size. Calcification and deformity are the signs most frequently seen on the previous mammograms of women with screen-detected cancer.

  4. The relationship of mammographic density and age: implications for breast cancer screening.

    Science.gov (United States)

    Checka, Cristina M; Chun, Jennifer E; Schnabel, Freya R; Lee, Jiyon; Toth, Hildegard

    2012-03-01

    Breast density is increasingly recognized as an independent risk factor for the development of breast cancer, because it has been shown to be associated with a four- to sixfold increase in a woman's risk of malignant breast disease. Increased breast density as identified on mammography is also known to decrease the diagnostic sensitivity of the examination, which is of great concern to women at increased risk for breast cancer. Dense tissue has generally been associated with younger age and premenopausal status, with the assumption that breast density gradually decreases after menopause. However, the actual proportion of older women with dense breasts is unknown. The purpose of this study was to examine the relationship between age and breast density, particularly focusing on postmenopausal women. All screening mammograms completed at the New York University Langone Medical Center in 2008 were retrospectively reviewed. Analysis of variance and descriptive analyses were used to evaluate the relationship between patient age and breast density. A total of 7007 screening mammograms were performed. The median age of our cohort was 57 years. Within each subgroup categorized by decade of age, there was a normal distribution among the categories of breast density. There was a significant inverse relationship between age and breast density (p breasts. This percentage decreased to 57% of women in their 50s. However, 44% of women in their 60s and 36% of women in their 70s had dense breasts as characterized on their screening mammograms. In general, we found an inverse relationship between patient age and mammographic breast density. However, there were outliers at the extremes of age. A meaningful proportion of young women had predominantly fatty breasts and a subset of older women had extremely dense breasts. Increased density renders mammography a less sensitive tool for early detection. Breast density should be considered when evaluating the potential benefit of extended

  5. Storage phosphor and film-screen mammography: performance with different mammographic techniques.

    Science.gov (United States)

    Kheddache, S; Thilander-Klang, A; Lanhede, B; Månsson, L G; Bjurstam, N; Ackerholm, P; Björneld, L

    1999-01-01

    The aim of this study was to compare the image quality of storage phosphor plates with that in screen-film radiograms in mammography. Two anode/filter combinations were also compared--Mo/Mo and W/Rh. S Storage phosphor plates, generation IIIN (Fuji, Tokyo, Japan) and a conventional screen-film system (Kodak, Rochester, N. Y.) were evaluated using two mammographic units. One unit had a 0.6-mm focal spot, an anode/filter combination of Mo/Mo and no grid (AMo); the other had a 0.3-mm focal spot, a grid, and two possible combinations of anode/filter Mo/Mo (BMo) and W/Rh (BW). Simulated tumours and microcalcifications were randomly positioned in an anthropomorphic breast phantom (RMI model 165, no. 210-009, Radiation Measurements Inc., Middleton, Wisconsin). The image quality was evaluated using a modified version of receiver operating characteristics analysis. Five observers evaluated 300 films and 300 hard copy images each. Radiation doses were also determined. The image quality of the conventional screen-film images was significantly better than that for the storage phosphor plate mammograms. The BMo system rated best, for the detection of both tumours and microcalcifications, although it was not significantly different from the BW system. Systems BMo and BW rated significantly better than the AMo system for both image receptors studied. The mean absorbed dose was twice as high for the BMo system as for the AMo and BW systems for both conventional and digital technique. The mammograms produced with the screen-film combination gave a significantly better detectability than the storage phosphor plates used in this study. Substantial dose reduction could be achieved using an anode/filter combination of W/Rh instead of Mo/Mo with no significant loss of information in the images.

  6. A method for 3D electron density imaging using single scattered x-rays with application to mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Van Uytven, Eric [National Research Council Institute for Biodiagnostics, 435 Ellice Ave, Winnipeg, Manitoba, R3B 1Y6 (Canada); Pistorius, Stephen [Division of Medical Physics, CancerCare Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3A 1R9 (Canada); Gordon, Richard [Department of Radiology, University of Manitoba, Winnipeg, Manitoba (Canada)], E-mail: eric.vanuytven@nrc-cnrc.gc.ca, E-mail: Stephen.Pistorius@cancercare.mb.ca, E-mail: gordonr@cc.umanitoba.ca

    2008-10-07

    Screening mammography is the current standard in detecting breast cancer. However, its fundamental disadvantage is that it projects a 3D object into a 2D image. Small lesions are difficult to detect when superimposed over layers of normal, heterogeneous tissue. In this work, we examine the potential of single scattered photon electron density imaging in a mammographic environment. Simulating a low-energy (<20 keV) scanning pencil beam, we have developed an algorithm capable of producing 3D electron density images from a single projection. We have tested the algorithm by imaging parts of a simulated mammographic accreditation phantom containing lesions of various sizes. The results indicate that the group of imaged lesions differ significantly from background breast tissue (p < 0.005), confirming that electron density imaging may be a useful diagnostic test for the presence of breast cancer.

  7. False-positive results in the randomised controlled trial of mammographic screening from age 40 (‘Age’ trial)

    Science.gov (United States)

    Johns, Louise E; Moss, Sue; Cuckle, Howard; Bobrow, Lynda; Evans, Andrew; Kutt, Elisabeth; Record, Carol; Thomas, Barbara

    2010-01-01

    Background False-positive recall is a recognised disadvantage of mammographic breast screening and the rate of such recalls may be higher in younger women, potentially limiting the value of screening below age 50. Methods Attendance and screening outcome data for 53 884 women in the intervention arm of the UK Age trial were analysed to report observed false-positive recall rates during 13 years of trial fieldwork. The Age trial was a randomised controlled trial of the effect of mammographic screening from age 40 on breast cancer mortality, conducted in 23 NHS Screening centres between 1991 and 2004. Women randomised to the intervention arm were offered annual invitation to mammography from age 40/41 to age 48. Results Overall, 7893 women (14.6% of women the intervention arm and 18.1% of women attending at least one routine screen) experienced one or more false-positive screen during the trial. The rates of false-positive mammography at first and subsequent routine screens were 4.9% and 3.2%, respectively. The cumulative false-positive rate over seven screens was 20.5%. Eighty-nine percent of women who had a false-positive recall at their previous screen attended their next invitation to routine screening. Conclusions Rates of false-positive recall in the Age trial were comparable with the national screening programme, however, the positive predictive value of referral was lower. Experiencing a false-positive screen did not appear to lessen the likelihood of re-attendance in the trial. Impact The question of greatly increased false-positive rates in this age group and of their compromising re-attendance is refuted by the findings of this study. PMID:20837718

  8. Efficacy of mammographic screening of the elderly: a case-referent study in the Nijmegen program in The Netherlands.

    Science.gov (United States)

    van Dijck, J A; Holland, R; Verbeek, A L; Hendriks, J H; Mravunac, M

    1994-06-15

    Only a few small studies have been conducted to examine the usefulness of mammographic screening in elderly women. These studies suggest that the screening-related reduction in breast cancer mortality rates is less than the estimated 20%-40% reduction observed for women aged 50-70 years at the time of their first screening. We have studied the efficacy of continued mammographic screening for breast cancer of elderly women within our screening program. In 1975, a breast cancer screening program was started in the city of Nijmegen. The Netherlands. During each biennial screening round, approximately 30,000 women aged 40 years and older were personally invited to participate. Single-view mammography was administered. The present study was conducted using a case-referent design. In order to be eligible for inclusion in this study, women had to have been invited to participate in the mammography screening program at least twice, with the most recent invitation having occurred when each woman was 65 years or older. The cases studied comprised 33 women in this group who had died of breast cancer at some point during 1977 through 1988. Referents were matched for age at last invitation to screening prior to the diagnosis of breast cancer and for the number of previous invitations to screenings. Five referents were randomly selected for each case. Breast cancer mortality rate ratios (RR) were calculated for several categories of attendance to the screening. The RR of those who attended the last screening versus those who failed to do so was 0.58 (95% confidence interval [CI] = 0.24-1.41); for women aged 65-74, the RR was 0.34 (95% CI = 0.12-0.97) and for women aged 75 or over, 2.87 (95% CI = 0.62-13.2). The RR of those who attended the screening before and after the age of 65, relative to those who attended before 65 only, was 0.26 (95% CI = 0.05-1.32). Although self-selection bias was present in our data, it was not likely to be responsible for the beneficial effect in

  9. Tumour characteristics and survival in patients with invasive interval breast cancer classified according to mammographic findings at the latest screening

    DEFF Research Database (Denmark)

    Vitak, B; Olsen, K E; Månson, J C

    1999-01-01

    with invasive interval cancer detected from May 1978 to August 1995 (n = 544). The tumours were evaluated with regard to age, radiological category, interval between the latest screen and diagnosis and tumour characteristics at the time of diagnosis. We investigated possible relationships between the survival...... rate of patients with interval cancer and the interval between the latest screen and diagnosis, tumour characteristics and radiological category of the interval tumours. The study focused on comparison of patients with true interval and missed interval cancer. Women with mammographically occult tumours...

  10. Aspirin use is associated with lower mammographic density in a large screening cohort.

    Science.gov (United States)

    Wood, Marie E; Sprague, Brian L; Oustimov, Andrew; Synnstvedt, Marie B; Cuke, Melissa; Conant, Emily F; Kontos, Despina

    2017-04-01

    Observational and biologic studies suggest that aspirin is a promising prevention therapy for breast cancer. However, clinical trials to date have not corroborated this evidence, potentially due to study design. We evaluated the effect of aspirin on mammographic density (MD), an established modifiable risk factor for breast cancer. Electronic medical records from the University of Pennsylvania were evaluated for women who underwent screening mammography, saw their primary care provider, and had a confirmed list of medications during 2012-2013. Logistic regression was performed to test for associations between clinically recorded MD and aspirin use, after adjusting for age, body mass index (BMI), and ethnicity. We identified 26,000 eligible women. Mean age was 57.3, mean BMI was 28.9 kg/m 2 , 41% were African American, and 19.7% reported current aspirin use. Aspirin users were significantly older and had higher BMI. There was an independent, inverse association between aspirin use and MD (P trend  aspirin users than women with scattered fibroglandular density (OR 0.73; 95% CI 0.57-0.93). This association was stronger for younger women (P = 0.0002) and for African Americans (P = 0.011). The likelihood of having dense breasts decreased with aspirin dose (P trend  = 0.007), suggesting a dose response. We demonstrate an independent association between aspirin use and lower MD in a large, diverse screening cohort. This association was stronger for younger and African American women: two groups at greater risk for ER- breast cancer. These results contribute to the importance of investigating aspirin for breast cancer prevention.

  11. How reassuring is a normal breast ultrasound in assessment of a screen-detected mammographic abnormality? A review of interval cancers after assessment that included ultrasound evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, M.L. [Breastscreen WA, Perth (Australia); Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth (Australia); Welman, C.J. [Breastscreen WA, Perth (Australia); Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth (Australia); Department of Radiology, Fremantle Hospital and Health Service, Fremantle (Australia); Celliers, L.M., E-mail: liesl.celliers@health.wa.gov.au [Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth (Australia); Department of Radiology, Fremantle Hospital and Health Service, Fremantle (Australia)

    2011-10-15

    Aim: To review factors resulting in a false-negative outcome or delayed cancer diagnosis in women recalled for further evaluation, including ultrasound, after an abnormal screening mammogram. Materials and methods: Of 646,692 screening mammograms performed between 1 January 1995 and 31 December 2004, 34,533 women were recalled for further assessment. Nine hundred and sixty-four interval cancers were reported in this period. Forty-six of these women had been recalled for further assessment, which specifically included ultrasound evaluation in the preceding 24 months, and therefore, met the inclusion criteria for this study. Screening mammograms, further mammographic views, ultrasound scans, clinical findings, and histopathology results were retrospectively reviewed by two consultant breast radiologists. Results: The interval cancer developed in the contralateral breast (n = 9), ipsilateral breast, but different site (n = 6), and ipsilateral breast at the same site (n = 31) as the abnormality for which they had recently been recalled. In the latter group, 10 were retrospectively classified as a false-negative outcome, nine had a delay in obtaining a biopsy, and 12 had a delay due to a non-diagnostic initial biopsy. Various factors relating to these outcomes are discussed. Conclusion: Out of 34,533 women who attended for an assessment visit and the 46 women who subsequently developed an interval breast cancer, 15 were true interval cancers, 10 had a false-negative assessment outcome, and 21 had a delay to cancer diagnosis on the basis of a number of factors. When there is discrepancy between the imaging and histopathology results, a repeat biopsy rather than early follow-up would have avoided a delay in some cases. A normal ultrasound examination should not deter the radiologist from proceeding to stereotactic biopsy, if the index mammographic lesion is suspicious of malignancy.

  12. Risk stratification of women with false-positive test results in mammography screening based on mammographic morphology and density

    DEFF Research Database (Denmark)

    Winkel, Rikke Rass; von Euler-Chelpin, My Catarina; Lynge, Elsebeth

    2017-01-01

    a case-control study nested in the population-based screening programme in Copenhagen, Denmark. We included 288 cases and 288 controls based on a cohort of 4743 women with at least one FP-test result in 1991–2005 who were followed up until 17 April 2008. Film-based mammograms were assessed using......Background: The long-term risk of breast cancer is increased in women with false-positive (FP) mammography screening results. We investigated whether mammographic morphology and/or density can be used to stratify these women according to their risk of future breast cancer Methods: We undertook...... morphology or density, could segregate women with FP-screening results according to their risk of future breast cancer − using already available screening mammograms. Our findings need validation on digital mammograms, but may inform potential future risk stratification and tailored screening strategies...

  13. Microcalcification detectability for four mammographic detectors: flat-panel, CCD, CR, and screen/film).

    Science.gov (United States)

    Rong, Xiujiang J; Shaw, Chris C; Johnston, Dennis A; Lemacks, Michael R; Liu, Xinming; Whitman, Gary J; Dryden, Mark J; Stephens, Tanya W; Thompson, Stephen K; Krugh, Kerry T; Lai, Chao-Jen

    2002-09-01

    Amorphous silicon/cesium iodide (a-Si:H/CsI:Tl) flat-panel (FP)-based full-field digital mammography systems have recently become commercially available for clinical use. Some investigations on physical properties and imaging characteristics of these types of detectors have been conducted and reported. In this perception study, a phantom containing simulated microcalcifications (microCs) of various sizes was imaged with four detector systems: a FP system, a small field-of-view charge coupled device (CCD) system, a high resolution computed radiography (CR) system, and a conventional mammography screen/film (SF) system. The images were reviewed by mammographers as well as nonradiologist participants. Scores reflecting confidence ratings were given and recorded for each detection task. The results were used to determine the average confidence-rating scores for the four imaging systems. Receiver operating characteristics (ROC) analysis was also performed to evaluate and compare the overall detection accuracy for the four detector systems. For calcifications of 125-140 microm in size, the FP system was found to have the best performance with the highest confidence-rating scores and the greatest detection accuracy (Az = 0.9) in the ROC analysis. The SF system was ranked second while the CCD system outperformed the CR system. The p values obtained by applying a Student t-test to the results of the ROC analysis indicate that the differences between any two systems are statistically significant (p<0.005). Differences in microC detectability for the large (150-160 microm) and small (112-125 microm) size microC groups showed a wider range of p values (not all p values are smaller than 0.005, ranging from 0.6 to <0.001) compared to the p values obtained for the medium (125-140 microm) size microC group. Using the p values to assess the statistical significance, the use of the average confidence-rating scores was not as significant as the use of the ROC analysis p value for p

  14. Test Sensitivity in the Computer-Aided Detection of Breast Cancer from Clinical Mammographic Screening: a Meta-analysis

    CERN Document Server

    Levman, Jacob

    2013-01-01

    Objectives: To assess evaluative methodologies for comparative measurements of test sensitivity in clinical mammographic screening trials of computer-aided detection (CAD) technologies. Materials and Methods: This meta-analysis was performed by analytically reviewing the relevant literature on the clinical application of computer-aided detection (CAD) technologies as part of a breast cancer screening program based on x-ray mammography. Each clinical study's method for measuring the CAD system's improvement in test sensitivity is examined in this meta-analysis. The impact of the chosen sensitivity measurement on the study's conclusions are analyzed. Results: This meta-analysis demonstrates that some studies have inappropriately compared sensitivity measurements between control groups and CAD enabled groups. The inappropriate comparison of control groups and CAD enabled groups can lead to an underestimation of the benefits of the clinical application of computer-aided detection technologies. Conclusions: The po...

  15. Comparison of results from quality control of physical parameters and results from clinical evaluation of mammographic images for the mammography screening facilities in Poland.

    Science.gov (United States)

    Fabiszewska, E; Grabska, I; Jankowska, K; Wesolowska, E; Bulski, W

    2011-09-01

    The material for this study comprised control protocols from 248 mammography screening facilities, prepared by physicists employed at 16 Regional Coordinating Centres and the results from the clinical evaluation of mammographic images in 248 facilities in Poland. All mammograms were evaluated independently by three experts selected from a list approved by the national consultant of radiology and diagnostic imaging. The requirements for proper breast positioning, selection of appropriate parameters for exposure and absence of artefacts were fulfilled only in 38 % of inspected mammography facilities. The requirements of the clinical audit were met only in 15 % of the mammography facilities. The requirements for the physical parameters of mammographic equipment were met only in 28 % of them. The requirements of the quality control (QC) tests and clinical audit were not fulfilled only in 19 % of the mammography facilities. Results from the QC of physical parameters are comparable with results from clinical evaluation of mammographic images in 57 % of the mammography facilities in Poland.

  16. Mammographic casting-type calcification associated with small screen-detected invasive breast cancers: is this a reliable prognostic indicator?

    Energy Technology Data Exchange (ETDEWEB)

    Peacock, C.; Given-Wilson, R.M. E-mail: rosalind.given-wilson@stgeorges.nhs.uk; Duffy, S.W

    2004-02-01

    AIM: The aim of the present study was to establish whether mammographic casting-type calcification associated with small screen-detected invasive breast cancers is a reliable prognostic indicator. METHODS AND MATERIALS: We retrospectively identified 50 consecutive women diagnosed with an invasive cancer less than 15 mm who showed associated casting calcification on their screening mammograms. Controls were identified that showed no microcalcification and were matched for tumour size, histological type and lymph node status. A minimum of 5 years follow-up was obtained, noting recurrence and outcome. Conditional and unconditional logistic regression, depending on the outcome variable, were used to analyse the data, taking the matched design into account in both cases. Where small numbers prohibited the use of logistic regression, Fisher's exact test was used. RESULTS: Five deaths from breast cancer occurred out of the 50 cases, of which three were lymph node positive, two were lymph node negative and none were grade 3. None of the 78 control cases died from breast cancer. The difference in breast cancer death rates was significant by Fisher's exact test (p=0.02). Risk of recurrence was also significantly increased in the casting cases (OR=3.55, 95% CI 1.02-12.33, p=0.046). CONCLUSION: Although the overall outcome for small screen-detected breast cancers is good, our study suggests that casting calcification is a poorer prognostic factor. The advantage of a mammographic feature as an independent prognostic indicator lies in early identification of high-risk patients, allowing optimization of management.

  17. Neurofibromatosis and breast cancer: Do we need to revise the mammographic screening schedule in patients of neurofibromatosis?

    Directory of Open Access Journals (Sweden)

    Dinesh Pradhan

    2017-01-01

    Full Text Available Neurofibromatosis type 1 (NF-1 is a neurocutaneous syndrome with autosomal dominant mode of inheritance and has a high propensity to develop benign and malignant nervous system tumors. Although uncommon, case reports describing the association of NF-1 and breast cancer are available in the literature. We illustrate one such case of NF-1, with no family history of the disorder and presenting with multifocal invasive carcinoma of the right breast, in an attempt to describe the association between these two entities. We also attempt to extensively review the current literature on the subject. Since patients with NF-1 are at an increased risk of developing breast cancer, we recommend strict adherence to careful clinical breast examination and annual screening mammographic examination starting at 40 years of age in all patients of NF-1.

  18. A Comparison of the effectiveness of Mammographic Film-Screen and Standard Film-Screen in the Detection of Small Bone Fractures

    Science.gov (United States)

    Sani, Karim Ghazikhanlou; Jafari, Mahmoodreza; Rostampoor, Nima

    2011-01-01

    The use of mammography film-screen is limited in general radiography. The purpose of this study was to compare the effectiveness of mammographic film-screen and standard film-screen systems in the detection of small bone fractures. Radiographs were taken from patients' extremities and neck areas using mammography film-screen and standard film-screen (n=57 each). Fourteen other radiographs were taken from other views (predominantly oblique views), making a total number of 128 radiographs. Paired radiographs, taken from the same areas, were compared by two radiologists in terms of image visual sharpness, presence of bony fractures, and soft tissue injuries. The surface dose received by patients in the two systems was also compared. The radiographs taken by mammography film-screen had a statistically better visual sharpness compared to those taken by the standard film-screen system. However, there was no statistically significant difference between the diagnostic accuracy of the two systems. Mammography film-screen was able to detect only one out of 57 lesions, whereas standard film-screen system did not detec any lesion. The surface dose received by patients in mammography film-screen was higher than that in standard film-screen system. The findings of the present study suggest that mammography film-screen may be recommended as a diagnostic tool for the detection of small fractures of tinny parts of body such as fingers, hand or foot. They also suggest that mammography film-screen has no advantage over standard film-screen for radiography of thick body parts such as neck and knee. PMID:23115417

  19. 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 Catarina; 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...... and jointly with density can improve the ability to identify screening women at increased risk of breast cancer. METHODS: The study included 121 cases and 259 age- and time matched controls based on a cohort of 14,736 women with negative screening mammograms from a population-based screening programme...... individually able to segregate women into different risk groups showing significant ORs for BI-RADS D3 and D4 (OR: 2.37; 1.32-4.25 and 3.93; 1.88-8.20), Tabár's PIII and PIV (OR: 3.23; 1.20-8.75 and 4.40; 2.31-8.38), and the highest quartile of the texture score (3.04; 1.63-5.67). AUCs for BI-RADS, Tabár...

  20. Comparison of acquisition parameters and breast dose in digital mammography and screen-film mammography in the American College of Radiology Imaging Network digital mammographic imaging screening trial.

    Science.gov (United States)

    Hendrick, R Edward; Pisano, Etta D; Averbukh, Alice; Moran, Catherine; Berns, Eric A; Yaffe, Martin J; Herman, Benjamin; Acharyya, Suddhasatta; Gatsonis, Constantine

    2010-02-01

    The purpose of our study was to compare the technical performance of full-field digital mammography (FFDM) and screen-film mammography. The American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial enrolled 49,528 women to compare FFDM and screen-film mammography for screening. For quality assurance purposes, technical parameters including breast compression force, compressed breast thickness, mean glandular dose, and the number of additional views needed for complete breast coverage were recorded and analyzed for both FFDM and screen-film mammography on approximately 10% of study subjects at each site. Technical data were compiled on 5,102 study subjects at 33 sites. Clean data were obtained for 4,366 (88%) of those cases. Mean compression force was 10.7 dN for screen-film mammography and 10.1 dN for FFDM (5.5% difference, p film mammography and 5.4 cm for FFDM (1.7% difference, p film mammography and 1.86 mGy for FFDM, 22% lower for digital than screen-film mammography, with sizeable variations among digital manufacturers. Twelve percent of screen-film mammography cases required more than the normal four views, whereas 21% of FFDM cases required more than the four normal views to cover all breast tissue. When extra views were included, mean glandular dose per subject was 4.15 mGy for FFDM and 4.98 mGy for screen-film mammography, 17% lower for FFDM than screen-film mammography. Our results show that differences between screen-film mammography and FFDM in compression force and indicated compressed breast thickness were small. On average, FFDM had 22% lower mean glandular dose than screen-film mammography per acquired view, with sizeable variations in average FFDM doses by manufacturer.

  1. Automated analysis of mammographic densities.

    Science.gov (United States)

    Byng, J W; Boyd, N F; Fishell, E; Jong, R A; Yaffe, M J

    1996-05-01

    Information derived from mammographic parenchymal patterns provides one of the strongest indicators of the risk of developing breast cancer. To address several limitations of subjective classification of mammographic parenchyma into coarse density categories, we have been investigating more quantitative, objective methods of analysing the film-screen mammogram. These include measures of the skewness of the image brightness histogram, and of image texture characterized by the fractal dimension. Both measures were found to be strongly correlated with radiologists' subjective classifications of mammographic parenchyma (Spearman correlation coefficients, Rs = -0.88 and -0.76 for skewness and fractal dimension measurements, respectively). Further, neither measure was strongly dependent on simulated changes in mammographic technique. Correlation with subjective classification of mammographic density was better when both the skewness and fractal measures were used in combination than when either was used alone. This suggests that each feature provides some independent information.

  2. Mammographic features of screening detected pT1 (a–b) invasive breast cancer using BI-RADS lexicon

    Energy Technology Data Exchange (ETDEWEB)

    Bargalló, Xavier, E-mail: xbarga@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Santamaría, Gorane, E-mail: gsanta@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Velasco, Martín, E-mail: mvelasco@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Amo, Montse del, E-mail: mdelamo@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Arguis, Pedro, E-mail: parguis@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Burrel, Marta, E-mail: mburrel@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain); Capurro, Sebastian, E-mail: scapurro@clinic.ub.es [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/Villarroel, 170, 08036 Barcelona (Spain)

    2012-10-15

    Aim: To describe mammographic features in screening detected invasive breast cancer less than or equal to 10 mm using Breast Imaging Reporting and Data System lexicon in full-field digital mammography. Patients and methods: A retrospective analysis of 123 pT1 (a–b) invasive breast cancers in women aged 50–69 years from our screening program. Radiologic patterns were: masses, calcifications, distortions, asymmetries and mixed. Masses: shape, margins and density, and calcifications: morphology, number of flecks and size of the cluster were taken into account, following Breast Imaging Reporting and Data System terminology. Results: We found 61 masses (49.6%), 8 masses with calcifications (6.5%), 30 groups of calcifications (24.4%), 19 architectural distortions (15.4%), 1 architectural distortion with calcifications (0.8%), 4 asymmetries (3.2%). Sixty out of 69 masses were irregular in shape, 6 lobular, 2 ovals and 1 round. Thirty-four showed ill-defined margins, 29 spiculated and 6 microlobulated. Most of them showed a density similar to surrounding fibroglandular tissue. Calcifications were pleomorphic or fine linear in 24 of 30 (80%). Most of cases showed more than 10 flecks and a size greater than 1 cm. Conclusion: The predominant radiologic finding is an irregular, isodense mass those margins tend to share different descriptors, being ill-defined margins the most constant finding. Calcifications representing invasive cancer are predominantly pleomorphic with more than 10 flecks per cm. Architectural distortion and invasive tubular carcinoma are more common than reported in general series.

  3. Mammographic scanning equalization radiography.

    Science.gov (United States)

    Sabol, J M; Soutar, I C; Plewes, D B

    1993-01-01

    It is well recognized that variations in breast thickness and parenchymal composition can produce a range of exposure which exceeds the latitude of high contrast mammographic film/screen combinations. Optimal imaging of the dense breast is desired since 30%-60% of women present with dense breasts, and they are believed to be at the highest relative risk of developing breast cancer. The application of scanning equalization radiography to mammography has been investigated through the construction and characterization of a prototype mammographic scanning equalization radiography (MSER) system, designed to image mammographic phantoms. The MSER system exposes a Min-R/MRH cassette by raster scanning a 2.0 x 1.6 cm beam of pulsed x-rays across the cassette. A scanning detector behind the cassette measures the local x-ray transmission of the breast. Feedback of the transmission information is used to modulate the duration of each x-ray pulse, to equalize the film exposure. The effective dynamic range of the MSER system is 25 times greater than that of conventional mammography. Artifact-free images of mammographic phantoms show that MSER effectively overcomes the latitude limitations of film/screen mammography, enabling high contrast imaging over a wide range of object x-ray transmission. Anthropomorphic phantom images show that MSER offers up to a sixfold increase in film contrast in the normally underexposed regions of conventional mammograms. Characterization of the entrance exposure shows that there is not a significant difference in exposure between MSER and conventional mammographic techniques, suggesting that both would pose comparable risk to the patient. Calculations show that the construction of a clinical multiple beam MSER system is feasible with minor changes to existing technology.

  4. Risk of breast cancer after false-positive results in mammographic screening

    DEFF Research Database (Denmark)

    Roman, Marta; Castells, Xavier; Hofvind, Solveig

    2016-01-01

    Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level...... of 2.42 (95% CI: 2.21–2.64). The RR of breast cancer at the screening test after the false-positive result was 3.95 (95% CI: 3.71–4.21), whereas it decreased to 1.25 (95% CI: 1.17–1.34) three or more screens after the false-positive result. Women with false-positive results had a twofold risk of screen......-detected breast cancer compared to women with negative tests. The risk remained significantly higher three or more screens after the false-positive result. The increased risk should be considered when discussing stratified screening strategies....

  5. Perspectives of Aboriginal women on participation in mammographic screening: a step towards improving services

    Directory of Open Access Journals (Sweden)

    Leanne Pilkington

    2017-09-01

    Full Text Available Abstract Background Early detection of breast cancer using screening mammography provides an opportunity for treatment which can lead to significantly improved outcomes. Despite considerable efforts having been made, the rate at which Aboriginal and Torres Strait Islander (hereafter respectfully referred to as Aboriginal women in Western Australia participate in BreastScreen WA’s screening mammogram program remains below that for the overall female population of Western Australia. This study aimed to examine perspectives on breast screening amongst Aboriginal women in Western Australia. We explored the factors which impact on participation in breast screening and sought to identify potential initiatives to address lower participation in screening. Methods Semi-structured interviews, focus group discussions and yarning sessions were conducted with a total of 65 research participants. They were all Aboriginal and comprised consumers and health professionals from locations across the state. Results Our findings show that research participants generally were willing to have a mammogram. Key reasons given were having a genetic predisposition to breast cancer and a perception of investing in health for the sake of the next generation, as well as personal well-being. Barriers identified included lack of education about or understanding of screening, inadequacies in cultural appropriateness in the screening program, cultural beliefs around cancer in general and breast cancer in particular, and competing health and life priorities. However, many enablers were identified which can serve as potential strategies to assuage fear and increase screening uptake. These included increased education delivered by respected Aboriginal women, culturally appropriate promotion and the provision of care and support from other women in the community. Conclusion The higher participation rates for Aboriginal women in Western Australia than are found for Aboriginal women

  6. Justifying age thresholds for mammographic screening: an application of pragma-dialectical argumentation theory.

    Science.gov (United States)

    Schulz, Peter J; Meuffels, Bert

    2012-01-01

    Information campaigns on breast cancer screening in the Netherlands need to convince women above 50 years of age to have biannual mammography, and women below 50 years of age that regular mammograms are not recommended for them. This article reports the results of two experiments in which the construction of the persuasive messages was informed by argumentation-theoretical insights. No differences were found between either statistical and anecdotal evidence or gain- and loss-framing in the attempt to convince women under 50 that they normally do not need regular mammography. A striking contrast emerged, however, between the overwhelming acceptance of breast cancer screening for women above 50 and the relative restraint and reluctance to consent that mammography is usually not recommended for women under 50. The reluctance to accept that regular mammography is not recommended for women under 50 is traced back to ego involvement.

  7. Remote Patient Management in a Mammographic Screening Environment in Underserved Areas

    Science.gov (United States)

    2005-09-01

    Telemammography, Detection, CAD, Remote Management 16. SECURITY CLASSIFICATION OF: 17. LIMITATION 18. NUMBER 19a. NAME OF RESPONSIBLE PERSON OF ABSTRACT OF PAGES...that in principle one can perform effectively and efficiently remote management tasks and achieve a significant reduction in actual recall rates, with a...exceeded several of the performance goals we originally proposed. The concept of remote management of screening practices where a physician is not

  8. Likelihood of early detection of breast cancer in relation to false-positive risk in life-time mammographic screening: population-based cohort study.

    Science.gov (United States)

    Otten, J D M; Fracheboud, J; den Heeten, G J; Otto, S J; Holland, R; de Koning, H J; Broeders, M J M; Verbeek, A L M

    2013-10-01

    Women require balanced, high-quality information when making an informed decision on screening benefits and harms before attending biennial mammographic screening. The cumulative risk of a false-positive recall and/or (small) screen-detected or interval cancer over 13 consecutive screening examinations for women aged 50 from the start of screening were estimated using data from the Nijmegen programme, the Netherlands. Women who underwent 13 successive screens in the period 1975-1976 had a 5.3% cumulative chance of a screen-detected cancer, with a 4.2% risk of at least one false-positive recall. The risk of being diagnosed with interval cancer was 3.7%. Two decades later, these estimates were 6.9%, 7.3% and 2.9%, respectively. The chance of detection of a small, favourable invasive breast cancer, anticipating a normal life-expectancy, rose from 2.3% to 3.7%. Extrapolation to digital screening mammography indicates that the proportion of false-positive results will rise to 16%. Dutch women about to participate in the screening programme can be reassured that the chance of false-positive recall in the Netherlands is relatively low. A new screening policy and improved mammography have increased the detection of an early screening carcinoma and lowering the risk of interval carcinoma.

  9. Radiological and pathological findings of interval cancers in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-41 years

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A.J. [Breast Institute, Nottingham City Hospital, Nottingham (United Kingdom)]. E-mail: andrew.evans@nuh.nhs.uk; Kutt, E. [Avon Breast Cancer Screening Unit, Central Health Clinic, Tower Hill, Bristol, Avon (United Kingdom); Record, C. [Breast Screening Service, Stoke Mandeville Hospital, Aylesbury (United Kingdom); Waller, M. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom); Bobrow, L. [Histopathology, Addenbrookes Hospital, Cambridge (United Kingdom); Moss, S. [Cancer Screening Evaluation Unit, Institute of Cancer Research, London (United Kingdom)

    2007-04-15

    Aim: The aim of this study was to analyse the radiographic findings of the screening mammograms of women with interval cancer who participated in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-48 years. Materials and methods: The screening and diagnostic mammograms of 208 women with interval cancers were reviewed. Abnormalities were classified as malignant, subtle and non-specific. Results: Eighty-seven (42%) of women had true, 66 (32%) occult and 55 (26%) false-negative interval cancers. The features most frequently missed or misinterpreted were granular microcalcification (38%), asymmetric density (27%) and distortion (22%). Thirty-seven percent of abnormal previous screens were classified as malignant, 39% subtle change and 21% as non-specific. Granular calcifications were significantly more common on the diagnostic mammograms of false-negative interval cancers than those of true interval cancers (28 versus 14%, p = 0.04). Occult interval cancers were more likely to be <10 mm and <15 mm in invasive pathological size than other interval cancers (p = 0.03 and 0.005, respectively). True interval cancers were more likely to be histologically grade 3 than other interval cancers (p = 0.04). Women who developed true and false-negative interval cancers had similar background patterns, but women with occult cancers had a higher proportion of dense patterns (p < 0.05). Conclusion: Interval cancers in a young screening population have a high proportion of occult lesions that are small and occur in dense background patterns. The proportion of interval cancers that are false negative is similar that seen in older populations and granular microcalcification is the commonest missed mammographic feature.

  10. Associated factors with mammographic changes in women undergoing breast cancer screening.

    Science.gov (United States)

    Sant'Ana, Ricardo Soares de; Mattos, Jacó Saraiva de Castro; Silva, Anderson Soares da; Mello, Luanes Marques de; Nunes, Altacílio Aparecido

    2016-01-01

    To evaluate association of sociodemographic, anthropometric, and epidemiological factors with result of mammogram in women undergoing breast cancer screening. This is a cross-sectional study with data obtained through interviews, anthropometric measurements, and mammography of 600 women aged 40 to 69 years at the Preventive Medicine Department of Hospital de Câncer de Barretos, Brazil, in 2014. The results of these examinations in the BI-RADS categories 1 and 2 were grouped and classified in this study as normal mammogram outcome, and those of BI-RADS categories 3, 4A, 4B, 4C, and 5 were grouped and classified as altered mammogram outcome. The statistical analysis included the Student's t-test to compare means, as well as odds ratios (OR), with their corresponding 95% confidence intervals (95%CI), to verify an association by means of the multivariate analysis. Of 600 women evaluated, 45% belonged to the age group of 40-49 years-old and 60.2% were classified as BI-RADS category 2. The multivariate analysis showed that women with blood hypertension (OR: 2.64; 95%CI: 1.07-6.49; pDepartamento de Prevenção do Hospital de Câncer de Barretos, em 2014. Os resultados de tais exames nas categorias BI-RADS 1 e 2 foram agrupados e classificados neste estudo como achado mamográfico normal, e aqueles das categorias BI-RADS 3, 4A, 4B, 4C e 5 como achado mamográfico alterado. Na análise estatística, utilizou-se o teste t de Student para comparar as médias, bem como odds ratio (OR), com seus respectivos intervalos de confiança de 95% (IC95%), na verificação de associação por análise multivariada. Das 600 mulheres avaliadas, 45% pertenciam à faixa etária dos 40 a 49 anos e 60,2% foram classificadas na categoria BI-RADS 2. Na análise multivariada, verificou-se que as mulheres com hipertensão arterial (OR: 2,64; IC95%: 1,07-6,49; p<0,05) apresentaram maiores chances de alteração na mamografia, enquanto que atividade física foi associada à menor chance (OR: 0

  11. Quality assessment of the mammographic screening programme in the Azienda Sanitaria locale Provincia Milano 1 -- analysis of interval cancers and discussion of possible causes of diagnostic error.

    Science.gov (United States)

    Burani, Rossella; Caimi, Francesco; Maggioni, Carlo; Marinoni, Guia; Pellizzoni, Romana; Pirola, Maria Elena; Villa, Roberto; Ciatto, Stefano

    2005-03-01

    To evaluate the sensitivity of the mammographic screening programme and the causes of diagnostic fault in cases surfacing as interval cancers. Interval cancers (CI) were identified by linkage of the screening database for the years 2000-2002 to the database of hospital discharge records (HDR) for breast cancer during 2000-2002. Linkage between screening attenders during 2000-2001 and HDR (biennial follow-up for year 2000, one year follow-up for year 2001) was used to calculate the proportional rate of observed/expected IC. The observed/ expected rate was compared with international standards and literature data. Screening mammograms followed by IC, randomly admixtured with negative controls, underwent blind review by an independent radiologist, using the recommended classification criteria to evaluate causes of error (occult, minimal signs, screening error). The analysis of HDR during 2000-2002 allowed us to identify 31 out of 89 expected IC. Proportional observed/expected IC rate in the first or second year of screening interval was 26 or 67%, respectively. Screening mammograms for radiological review were available in 38 of 61 total IC: 20 cases (52.6%) were classified as occult, whereas minimal signs or screening errors were 2 (5.2%) or 16 (42.1%), respectively. Diagnostic suspicion had been reported at screening in 7 of 16 cases classified as screening error, but were not diagnosed at the subsequent diagnostic assessment. Proportional IC rate was higher than reported in the literature or currently recommended (<30% in the 1st, <50% in the 2nd year). The analysis of error causes shows an excess of screening errors with respect to current recommendations (<20% of IC should be classified as screening error at review), but also an excess of IC suspected at screening but misdiagnosed at assessment (7/38=18.4 %). Overall the analysis revealed a reduced sensitivity of the screening programme, as often observed in service screening as compared to excellence centres

  12. {sup 99m}Tc sestamibi scintimammography. Screening mammographic non-palpable suspicious breast lesions: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Bekis, R.; Derebek, E.; Degirmenci, B.; Durak, H. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Nuclear Medicine; Balci, P. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Radiology; Kocdor, M.A. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Surgery; Canda, T. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Pathology

    2004-02-01

    Aim: Investigation of the diagnostic role of technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc estamibi) scintimammography in non-palpable, suspicious breast lesions described as microcalcification, mass and increased density using mammography. Patients, method: 35 women with non-palpable breast lesions were enrolled in the study. Anterior, left and right lateral, ipsilateral posterior oblique images were obtained 15 min after the injection of 740 MBq of {sup 99m}Tc sestamibi. All scintigraphic images were evaluated visually and focal increased {sup 99m}Tc sestamibi uptake was accepted as malignant lesion. Breast lesions were classified as microcalcification (13 women), mammographic mass (16 women) and increased density (6 women). Excisional biopsy was performed in all of them irrespective of the scintigraphic results: Results: The focally increased {sup 99m}Tc sestamibi uptake was seen in 11 breast lesions with malignant lesions and in 4 breast lesions with benign lesions. The diffuse uptake of {sup 99m}Tc sestamibi was seen in 18 breast lesions with benign lesions and 2 breast lesions with malignant lesions. There was no false positive result of {sup 99m}Tc sestamibi in microcalcification group and three was no false negative result of the mammographic mass and increased density groups. Conclusion: Scintimammography might be a complementary method in decision making for the non-palpable, suspicious breast lesions that were evaluated as microcalcification, mass and increased density mammograpically. (orig.)

  13. Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems.

    Science.gov (United States)

    Burton, Anya; Byrnes, Graham; Stone, Jennifer; Tamimi, Rulla M; Heine, John; Vachon, Celine; Ozmen, Vahit; Pereira, Ana; Garmendia, Maria Luisa; Scott, Christopher; Hipwell, John H; Dickens, Caroline; Schüz, Joachim; Aribal, Mustafa Erkin; Bertrand, Kimberly; Kwong, Ava; Giles, Graham G; Hopper, John; Pérez Gómez, Beatriz; Pollán, Marina; Teo, Soo-Hwang; Mariapun, Shivaani; Taib, Nur Aishah Mohd; Lajous, Martín; Lopez-Riduara, Ruy; Rice, Megan; Romieu, Isabelle; Flugelman, Anath Arzee; Ursin, Giske; Qureshi, Samera; Ma, Huiyan; Lee, Eunjung; Sirous, Reza; Sirous, Mehri; Lee, Jong Won; Kim, Jisun; Salem, Dorria; Kamal, Rasha; Hartman, Mikael; Miao, Hui; Chia, Kee-Seng; Nagata, Chisato; Vinayak, Sudhir; Ndumia, Rose; van Gils, Carla H; Wanders, Johanna O P; Peplonska, Beata; Bukowska, Agnieszka; Allen, Steve; Vinnicombe, Sarah; Moss, Sue; Chiarelli, Anna M; Linton, Linda; Maskarinec, Gertraud; Yaffe, Martin J; Boyd, Norman F; Dos-Santos-Silva, Isabel; McCormack, Valerie A

    2016-12-19

    Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types. We obtained 1294 pairs of images saved in both raw and processed formats from Hologic and General Electric (GE) direct digital systems and a Fuji computed radiography (CR) system, and 128 screen-film and processed CR-digital pairs from consecutive screening rounds. Four readers performed Cumulus-based MD measurements (n = 3441), with each image pair read by the same reader. Multi-level models of square-root percent MD were fitted, with a random intercept for woman, to estimate processed-raw MD differences. Breast area did not differ in processed images compared with that in raw images, but the percent MD was higher, due to a larger dense area (median 28.5 and 25.4 cm 2 respectively, mean √dense area difference 0.44 cm (95% CI: 0.36, 0.52)). This difference in √dense area was significant for direct digital systems (Hologic 0.50 cm (95% CI: 0.39, 0.61), GE 0.56 cm (95% CI: 0.42, 0.69)) but not for Fuji CR (0.06 cm (95% CI: -0.10, 0.23)). Additionally, within each system, reader-specific differences varied in magnitude and direction (p processed digital on the subsequent screening round were consistent with expected time-related MD declines. MD was slightly higher when measured on processed than on raw direct digital mammograms. Comparisons of MD on these image formats should ideally control for this non-constant and reader-specific difference.

  14. Disparities in mammographic screening for Asian women in California: a cross-sectional analysis to identify meaningful groups for targeted intervention

    Directory of Open Access Journals (Sweden)

    Keegan Theresa HM

    2007-10-01

    Full Text Available Abstract Background Breast cancer is the most commonly diagnosed cancer among the rapidly growing population of Asian Americans; it is also the most common cause of cancer mortality among Filipinas. Asian women continue to have lower rates of mammographic screening than women of most other racial/ethnic groups. While prior studies have described the effects of sociodemographic and other characteristics of women on non-adherence to screening guidelines, they have not identified the distinct segments of the population who remain at highest risk of not being screened. Methods To better describe characteristics of Asian women associated with not having a mammogram in the last two years, we applied recursive partitioning to population-based data (N = 1521 from the 2001 California Health Interview Survey (CHIS, for seven racial/ethnic groups of interest: Chinese, Japanese, Filipino, Korean, South Asian, Vietnamese, and all Asians combined. Results We identified two major subgroups of Asian women who reported not having a mammogram in the past two years and therefore, did not follow mammography screening recommendations: 1 women who have never had a pap exam to screen for cervical cancer (68% had no mammogram, and 2 women who have had a pap exam, but have no women's health issues (osteoporosis, using menopausal hormone therapies, and/or hysterectomy nor a usual source of care (62% had no mammogram. Only 19% of Asian women who have had pap screening and have women's health issues did not have a mammogram in the past two years. In virtually all ethnic subgroups, having had pap or colorectal screening were the strongest delineators of mammography usage. Other characteristics of women least likely to have had a mammogram included: Chinese non-U.S. citizens or citizens without usual source of health care, Filipinas with no health insurance, Koreans without women's health issues and public or no health insurance, South Asians less than age 50 who were

  15. Effect of mammographic screening from age 40 years on breast cancer mortality in the UK Age trial at 17 years' follow-up: a randomised controlled trial.

    Science.gov (United States)

    Moss, Sue M; Wale, Christopher; Smith, Robert; Evans, Andrew; Cuckle, Howard; Duffy, Stephen W

    2015-09-01

    Age-specific effects of mammographic screening, and the timing of such effects, are a matter of debate. The results of the UK Age trial, which compared the effect of invitation to annual mammographic screening from age 40 years with commencement of screening at age 50 years on breast cancer mortality, have been reported at 10 years of follow-up and showed no significant difference in mortality between the trial groups. Here, we report the results of the UK Age trial after 17 years of follow-up. Women aged 39-41 from 23 UK NHS Breast Screening Programme units years were randomly assigned by individual randomisation (1:2) to either an intervention group offered annual screening by mammography up to and including the calendar year of their 48th birthday or to a control group receiving usual medical care (invited for screening at age 50 years and every 3 years thereafter). Both groups were stratified by general practice. We compared breast cancer incidence and mortality by time since randomisation. Analyses included all women randomly assigned who could be traced with the National Health Service Central Register and who had not died or emigrated before entry. The primary outcome measures were mortality from breast cancer (defined as deaths with breast cancer coded as the underlying cause of death) and breast cancer incidence, including in-situ, invasive, and total incidence. Because there is an interest in the timing of the mortality effect, we analysed the results in different follow-up periods. This trial is registered, number ISRCTN24647151. Between Oct 14, 1990, and Sept 25, 1997, 160 921 participants were randomly assigned; 53 883 women in the intervention group and 106 953 assigned to usual medical care were included in this analysis. After a median follow-up of 17 years (IQR 16·8-18·8), the rate ratio (RR) for breast cancer mortality was 0·88 (95% CI 0·74-1·04) from tumours diagnosed during the intervention phase. A significant reduction in breast cancer

  16. Nonpalpable breast cancer : mammographic and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Seung; Kim, Eun Kyung; Oh, Ki Keun; Cheon, Young Jik; Lee, Byung Chan [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-08-01

    To evaluate the mammographic and clinical findings of nonpalpable breast cancer. Materials and Methods : In 28 of 607 breast cancer patients examined between January 1994 and April 1997, lesions were nonpalpable. We retrospectively analyzed the mammographic, clinical and pathologic features of 25 patients (28 lesions) whose mammograms we obtained. Results : Among these 25 patients (28 lesions) screening was abnormal in 22; other symptoms were bloody nipple discharge(n=4), and nipple eczema(n=2). The patients were 34-62 (mean 52)years old. Invasive ductal carcinoma(n=13), DCIS(ductal carcinoma in situ, n-12), Paget's disease (n=2), and LCIS(lobular carcinoma in situ, n=1) were found during surgery. Six of 28 lesions(21%) showed evidence of axillary nodal metastasis;the majority arose from the upper outer quadrant of the breast (n=21). The mammographic findings were mass (50%), (and mass with microcalcification, 11%); microcalcification(29%); asymmetrical density(14%); and normal (7%). According to the mammographic density of breast parenchyma, the major finding in the low density group(N1+P1) was mass(9/9), and in the high density group(P2+DY) was microcalcification (12/19). Conclusion : The most common mammographic findings of nonpalpable breast cancer were mass (50%) and microcalcification(29%). Its features varied according to the mammographic density of breast parenchyma;mass was the main finding in the low density group and microcalcification in the high density group.

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

    OpenAIRE

    Wang, Ning; Zheng, Ying-Ming; Li, Lei; Jin, Fan

    2010-01-01

    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 ...

  18. Mammographic parenchymal pattern and breast cancer risk profile of Papua New Guinean women - A baseline study of the screening population.

    Science.gov (United States)

    Pape, R; Spuur, K; Umo, P

    2017-11-01

    The aim of this research is to evidence for the first time the breast density of Papua New Guinean (PNG) women as described by mammographic parenchymal patterns (MPPs) and profile breast cancer risk; to examine the relationship of age and MPPs. A retrospective analysis of 1161 screening mammograms of women who had undergone imaging at the Pacific International Hospital (PIH) was undertaken. Mammograms were classified into one of five Tabár MPPs; age was recorded in years. Descriptive analysis of the data for pattern distribution and a chi-square test, to test for relationships between age and pattern type were undertaken. The majority (51.42%) of women had Pattern I breasts; Pattern II (30.58%), Pattern III (4.31%), Pattern IV (7.24%), and Pattern V (6.46%). The mean age was 38.8 with a range of 30-80 years; there were no obvious differences in mean age across the categories of patterns. A chi-square test reported no evidence of a relationship between age and pattern type (p-value = 0.504). Pattern V differed from other patterns, with proportionally more women aged over 50 and less aged in their 40s. This study sets a baseline for future studies of the MPPs of PNG women, and demonstrated that in this snapshot of PNG women, there is no unique distribution of MPPs and no increased risk of breast cancer based on breast density profile. This result does not help to explain the high incidence of breast cancer in PNG. A more comprehensive study of the PNG screening population is required to validate this study. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  19. Re-attendance at biennial screening mammography following a repeated false positive recall

    NARCIS (Netherlands)

    Klompenhouwer, Elisabeth G.; Duijm, Lucien E. M.; Voogd, Adri C.; den Heeten, Gerard J.; Strobbe, Luc J.; Louwman, Marieke W.; Coebergh, Jan Willem; Venderink, Dick; Broeders, Mireille J. M.

    2014-01-01

    We determined the re-attendance rate at screening mammography after a single or a repeated false positive recall and we assessed the effects of transition from screen-film mammography (SFM) to full-field digital mammography (FFDM) on screening outcome in women recalled twice for the same

  20. Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees.

    Science.gov (United States)

    Nam, Su Youn; Choi, Il Ju; Park, Kyung Woo; Kim, Chan Gyoo; Lee, Jong Yeul; Kook, Myeong-Cherl; Lee, Jong Seok; Park, Sook Ryun; Lee, Jun Ho; Ryu, Keun Won; Kim, Young-Woo

    2009-08-01

    Early gastric cancer (EGC) can be treated by minimally invasive endoscopic resection and has an excellent prognosis. The aim of this study was to investigate whether repeated esophagogastroduodenoscopy (EGD) screening is an effective method for detecting EGC that can be treated by endoscopic resection. For patients diagnosed with gastric cancer in the Korean National Cancer Center screening program, we analyzed the incidence of gastric cancer, clinicopathological characteristics, and treatment modality according to whether they had (repeated screening group) or not (infrequent screening group) undergone EGD screening within 2 years before diagnosis. Of the 18,414 patients who underwent EGD, 81 (0.44%) were found to have gastric cancer. Incidence of gastric cancer in repeated screening group was lower than that of infrequent screening group (multiple adjusted odds ratio=0.45, 95% confidence interval: 0.26-0.77, P=0.004). The proportion of EGCs was 96% (25 of 26) n the repeated screening group and 71% (34 of 48) in the infrequent screening group (P=0.01). Mean (SD) tumor size was smaller [1.9 (1.2) vs. 3.0 (1.6) cm, P=0.01] and the proportion of intramucosal cancer was higher [81% (21 of 26) vs. 50% (24 of 48), P=0.02] in the former than in the latter. Endoscopic resection was performed more frequently in the repeated screening group [54% (14 of 26) vs. 23% (11 of 48), P=0.007]. Repeated endoscopic screening within 2 years decreased the incidence of gastric cancer and endoscopic resection could be applied to more patients who underwent EGD screening within 2 years.

  1. Use of simple sequence repeat (SSR) markers for screening blue ...

    African Journals Online (AJOL)

    The findings suggest the need for caution to be taken during introduction of exotic germplasm and recognize the value of resistance trait to susceptible Brazilian germplasm when breeding for blue disease resistance. Key words: Cotton blue disease, cotton single nucleotide polymorphisms (SNPs), simple sequence repeat

  2. An exploration of mammographers' attitudes towards the use of social media for providing breast screening information to clients.

    Science.gov (United States)

    Scragg, B; Shaikh, S; Shires, G; Stein Hodgins, J; Mercer, C; Robinson, L; Wray, J

    2017-08-01

    Increasingly patients and clients of health services are using social media to locate information about medical procedures and outcomes. There is increasing pressure for health professionals to engage in on-line spaces to provide clear and accurate information to their patient community. Research suggests there are some anxieties on the part of practitioners to do this. This study aimed to explore the attitudes of the NHS breast screening programme workforce towards engaging in online discussions with clients about breast screening. 78 practitioners, representing a range of professional roles within the NHS Breast Screening Programme, attended one of 4 workshops. We used a Nominal Group Technique to identify and rank responses to the question: "What are the challenges that practitioners face in using SoME as part of their role?" Responses were categorised into themes. Participants were also asked to identify solutions to these challenges. Challenges: We identified two overarching themes: (1) Working within boundaries: which was further categorised into (a) Professional/legal accountability; (b) Information accuracy and (c)Time as a boundary, and (2) Support: further categorised into (a) Employer and (b) Manager. Solutions: These included: training in technical and interactional aspects of on-line communication and a responsibility to better understand employer and professional body SoMe policies. The study participants appeared willing and motivated to engage in SoMe. However, in keeping with the literature from other disciplines, a number of challenges need to be overcome for its use to be adopted more widely by breast screening professionals. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  3. Mammographic screening in Sami speaking municipalities and a control group. Are early outcome measures influenced by ethnicity?

    Directory of Open Access Journals (Sweden)

    Jan Norum

    2012-04-01

    Full Text Available Objectives. Female citizens of Sami (the indigenous people of Norway municipalities in northern Norway have a low risk of breast cancer. The objective of this study was to describe the attendance rate and outcome of the Norwegian Breast Cancer Screening Program (NBCSP in the Sami-speaking municipalities and a control group. Study design. A retrospective registry-based study. Methods. The 8 municipalities included in the administration area of the Sami language law (Sami were matched with a control group of 11 municipalities (non-Sami. Population data were accessed from Statistics Norway. Data regarding invitations and outcome in the NBCSP during the period 2001–2010 was derived from the Cancer Registry of Norway (CRN. The NBCSP targets women aged 50–69 years. Rates and percentages were compared using chi-square test with a p-value<0.05 as statistical significant. Results. The attendance rate in the NBCSP was 78% in the Sami and 75% in the non-Sami population (p< 0.01. The recall rates were 2.4 and 3.3% in the Sami and non-Sami population, respectively (p<0.01. The rate of invasive screen detected cancer was not significantly lower in the Sami group (p=0.14. The percentage of all breast cancers detected in the NBCSP among the Sami (67% was lower compared with the non-Sami population (86%, p=0.06. Conclusion. Despite a lower risk of breast cancer, the Sami attended the NBCSP more frequently than the control group. The recall and cancer detection rate was lower among the Sami compared with the non-Sami group.

  4. Mammographic findings of women recalled for diagnostic work-up in digital versus screen-film mammography in a population-based screening program.

    Science.gov (United States)

    Lipasti, Seppo; Anttila, Ahti; Pamilo, Martti

    2010-06-01

    Limited information is available concerning differences in the radiological findings of women recalled for diagnostic work-up in digital mammography (DM) versus screen-film mammography (SFM) screening. To compare the radiological findings, their positive predictive values (PPVs) for cancer and other process indicators of DM screening performed by computed radiography (CR) technology and SFM screening in a population-based program. The material consisted of women, 50-59 years of age, who were invited for screening: 30 153 women with DM in 2007-2008 and 32 939 women with SFM in 1999-2000. The attendance rate was 77.7% (23 440) in the DM arm and 83.8% (27 593) in the SFM arm. In the DM arm, 1.71% of those screened (401) and in the SFM arm 1.59% (438) were recalled for further work-up. The images resulting in the recall were classified as: 1) tumor-like mass, 2) parenchymal distortion/asymmetry, 3) calcifications, and 4) combination of mass and calcifications. The distributions of the various radiological findings and their PPVs for cancer were compared in both study groups. The recall rates, cancer detection rates, test specificities, and PPVs of the DM and SFM groups were also compared. Women were recalled for diagnostic work-up most often due to tumor-like mass. It was more common in SFM (1.08% per woman screened) than in DM (0.93%). The second most common finding was parenchymal distortion and asymmetry, more often in DM (0.58%) than in SFM (0.37%). Calcifications were the third most common finding. DM exposed calcifications more often (0.49%) than SFM (0.26%). The PPVs for cancer of the recalls were higher in DM than in SFM in all subgroups of radiological findings. The test specificities were similar (DM 98.9%, SFM 98.8%). Significantly more cancers were detected by DM (cancer detection rate 0.623% per woman screened, n=146) than by SFM (cancer detection rate 0.406% per woman screened, n=112). The PPVs for cancer of all recalls for diagnostic work-up were

  5. Mammographic compression in Asian women

    Science.gov (United States)

    Lau, Susie; Abdul Aziz, Yang Faridah; Ng, Kwan Hoong

    2017-01-01

    Objectives To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study. Methods We retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35–80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs. Results Compression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (pimage quality (p>0.05). Conclusions Force-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD. PMID:28419125

  6. Effects of a Randomized Controlled Trial to Increase Repeat Mammography Screening in Iranian Women.

    Science.gov (United States)

    Taymoori, Parvaneh; Molina, Yamile; Roshani, Daem

    2015-01-01

    Although mammography use has increased in developed countries, regular screening in developing countries including Iran remains low. Multiple frameworks, including the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), have been used to understand screening practices among Iranians. The HBM includes intrapersonal constructs such as perceptions of breast cancer and mammography. The TPB includes interpersonal and environmental constructs, such as perceived control and subjective norms. The current study had 2 objectives: (1) to examine changes in the HBM and TPB constructs and repeat mammography screening in women receiving either intervention and women in the control group and (2) to compare changes in the HBM and TPB constructs and repeat mammography screening across the 2 interventions. One hundred eight-four women from 3 randomly selected health centers in Sanandaj, Iran, participated. Eligibility criteria were being 50 years or older, having received a mammogram in the past 2 to 3 years, and no intention to obtain a mammogram within the next year. The TPB and HBM participants exhibited greater changes in the HBM and TPB constructs and were more likely to have a mammogram relative to control participants. The TPB and HBM participants exhibited comparable changes in constructs and repeat mammography. Findings suggest both interventions equally improved mammography screening. Additional studies are furthermore warranted to address nonadherent Iranian women's needs in line with these conceptual models. Use of the HBM and TPB constructs in clinical practice may be helpful to promote continued screening among this population.

  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. 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.

  9. Association of infertility and fertility treatment with mammographic density in a large screening-based cohort of women: a cross-sectional study.

    Science.gov (United States)

    Lundberg, Frida E; Johansson, Anna L V; Rodriguez-Wallberg, Kenny; Brand, Judith S; Czene, Kamila; Hall, Per; Iliadou, Anastasia N

    2016-04-13

    Ovarian stimulation drugs, in particular hormonal agents used for controlled ovarian stimulation (COS) required to perform in vitro fertilization, increase estrogen and progesterone levels and have therefore been suspected to influence breast cancer risk. This study aims to investigate whether infertility and hormonal fertility treatment influences mammographic density, a strong hormone-responsive risk factor for breast cancer. Cross-sectional study including 43,313 women recruited to the Karolinska Mammography Project between 2010 and 2013. Among women who reported having had infertility, 1576 had gone through COS, 1429 had had hormonal stimulation without COS and 5958 had not received any hormonal fertility treatment. Percent and absolute mammographic densities were obtained using the volumetric method Volpara™. Associations with mammographic density were assessed using multivariable generalized linear models, estimating mean differences (MD) with 95 % confidence intervals (CI). After multivariable adjustment, women with a history of infertility had 1.53 cm(3) higher absolute dense volume compared to non-infertile women (95 % CI: 0.70 to 2.35). Among infertile women, only those who had gone through COS treatment had a higher absolute dense volume than those who had not received any hormone treatment (adjusted MD 3.22, 95 % CI: 1.10 to 5.33). No clear associations were observed between infertility, fertility treatment and percent volumetric density. Overall, women reporting infertility had more dense tissue in the breast. The higher absolute dense volume in women treated with COS may indicate a treatment effect, although part of the association might also be due to the underlying infertility. Continued monitoring of cancer risk in infertile women, especially those who undergo COS, is warranted.

  10. Unobtrusive evaluation of mammographer's eye movements during diagnosis of mammograms.

    Science.gov (United States)

    Barrett, J R; Johns, N G; Dwyer, S J; deParedes, E S; Hutchinson, T E

    1996-01-01

    The authors sought to evaluate the visual search patterns of mammographers to better understand the process by which a diagnosis is reached when mammographic images are viewed. An unobtrusive gaze tracking system was applied to track gaze direction and pupil size. Data were collected at 60 Hz and analyzed to evaluate how visual search patterns (location and duration of gaze dwells and pupil size changes) altered when mammograms were repeatedly displayed. Two tests were performed. In the first test, a mammographer was shown the same mammogram on two occasions, separated by a 1-year interval. The second test evaluated the visual search patterns of four mammographers during a 30-minute display period, in which four mammograms were shown a variable number of times. Analysis of the gaze dwell data demonstrated that, although general recognition of a mammogram can occur within 1 second, even though 1 year separated the two occasions when the image was shown, repeated display of a mammogram may result in changes in (a) the time taken to reach a diagnosis, (b) the length of gaze dwell, (c) the total number of correct and incorrect diagnoses, and (d) pupillary constriction. Results from these tests may yield important information about how mammographers view images and how this process can affect diagnostic accuracy.

  11. Single x-ray absorptiometry method for the quantitative mammographic measure of fibroglandular tissue volume

    Energy Technology Data Exchange (ETDEWEB)

    Malkov, Serghei; Wang, Jeff; Kerlikowske, Karla; Cummings, Steven R.; Shepherd, John A. [Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California 94143 (United States); Departments of Medicine and Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California 94143 (United States); Research Institute, California Pacific Medical Center, San Francisco, California 94143 (United States); Department of Radiology and Biomedical Imaging, University of California--San Francisco, San Francisco, California 94143 (United States)

    2009-12-15

    Purpose: This study describes the design and characteristics of a highly accurate, precise, and automated single-energy method to quantify percent fibroglandular tissue volume (%FGV) and fibroglandular tissue volume (FGV) using digital screening mammography. Methods: The method uses a breast tissue-equivalent phantom in the unused portion of the mammogram as a reference to estimate breast composition. The phantom is used to calculate breast thickness and composition for each image regardless of x-ray technique or the presence of paddle tilt. The phantom adheres to the top of the mammographic compression paddle and stays in place for both craniocaudal and mediolateral oblique screening views. We describe the automated method to identify the phantom and paddle orientation with a three-dimensional reconstruction least-squares technique. A series of test phantoms, with a breast thickness range of 0.5-8 cm and a %FGV of 0%-100%, were made to test the accuracy and precision of the technique. Results: Using test phantoms, the estimated repeatability standard deviation equaled 2%, with a {+-}2% accuracy for the entire thickness and density ranges. Without correction, paddle tilt was found to create large errors in the measured density values of up to 7%/mm difference from actual breast thickness. This new density measurement is stable over time, with no significant drifts in calibration noted during a four-month period. Comparisons of %FGV to mammographic percent density and left to right breast %FGV were highly correlated (r=0.83 and 0.94, respectively). Conclusions: An automated method for quantifying fibroglandular tissue volume has been developed. It exhibited good accuracy and precision for a broad range of breast thicknesses, paddle tilt angles, and %FGV values. Clinical testing showed high correlation to mammographic density and between left and right breasts.

  12. A Review on Automatic Mammographic Density and Parenchymal Segmentation

    Science.gov (United States)

    He, Wenda; Juette, Arne; Denton, Erika R. E.; Oliver, Arnau

    2015-01-01

    Breast cancer is the most frequently diagnosed cancer in women. However, the exact cause(s) of breast cancer still remains unknown. Early detection, precise identification of women at risk, and application of appropriate disease prevention measures are by far the most effective way to tackle breast cancer. There are more than 70 common genetic susceptibility factors included in the current non-image-based risk prediction models (e.g., the Gail and the Tyrer-Cuzick models). Image-based risk factors, such as mammographic densities and parenchymal patterns, have been established as biomarkers but have not been fully incorporated in the risk prediction models used for risk stratification in screening and/or measuring responsiveness to preventive approaches. Within computer aided mammography, automatic mammographic tissue segmentation methods have been developed for estimation of breast tissue composition to facilitate mammographic risk assessment. This paper presents a comprehensive review of automatic mammographic tissue segmentation methodologies developed over the past two decades and the evidence for risk assessment/density classification using segmentation. The aim of this review is to analyse how engineering advances have progressed and the impact automatic mammographic tissue segmentation has in a clinical environment, as well as to understand the current research gaps with respect to the incorporation of image-based risk factors in non-image-based risk prediction models. PMID:26171249

  13. Force balancing in mammographic compression

    Energy Technology Data Exchange (ETDEWEB)

    Branderhorst, W., E-mail: w.branderhorst@amc.nl; Groot, J. E. de; Lier, M. G. J. T. B. van; Grimbergen, C. A. [Department of Biomedical Engineering and Physics, Academic Medical Center, P.O. Box 22660, Amsterdam 1100 DD (Netherlands); Sigmascreening B.V., Meibergdreef 45, Amsterdam 1105 BA (Netherlands); Neeter, L. M. F. H.; Heeten, G. J. den [Department of Biomedical Engineering and Physics, Academic Medical Center, P.O. Box 22660, Amsterdam 1100 DD (Netherlands); Neeleman, C. [Sigmascreening B.V., Meibergdreef 45, Amsterdam 1105 BA (Netherlands)

    2016-01-15

    Purpose: In mammography, the height of the image receptor is adjusted to the patient before compressing the breast. An inadequate height setting can result in an imbalance between the forces applied by the image receptor and the paddle, causing the clamped breast to be pushed up or down relative to the body during compression. This leads to unnecessary stretching of the skin and other tissues around the breast, which can make the imaging procedure more painful for the patient. The goal of this study was to implement a method to measure and minimize the force imbalance, and to assess its feasibility as an objective and reproducible method of setting the image receptor height. Methods: A trial was conducted consisting of 13 craniocaudal mammographic compressions on a silicone breast phantom, each with the image receptor positioned at a different height. The image receptor height was varied over a range of 12 cm. In each compression, the force exerted by the compression paddle was increased up to 140 N in steps of 10 N. In addition to the paddle force, the authors measured the force exerted by the image receptor and the reaction force exerted on the patient body by the ground. The trial was repeated 8 times, with the phantom remounted at a slightly different orientation and position between the trials. Results: For a given paddle force, the obtained results showed that there is always exactly one image receptor height that leads to a balance of the forces on the breast. For the breast phantom, deviating from this specific height increased the force imbalance by 9.4 ± 1.9 N/cm (6.7%) for 140 N paddle force, and by 7.1 ± 1.6 N/cm (17.8%) for 40 N paddle force. The results also show that in situations where the force exerted by the image receptor is not measured, the craniocaudal force imbalance can still be determined by positioning the patient on a weighing scale and observing the changes in displayed weight during the procedure. Conclusions: In mammographic breast

  14. Force balancing in mammographic compression.

    Science.gov (United States)

    Branderhorst, W; de Groot, J E; Neeter, L M F H; van Lier, M G J T B; Neeleman, C; den Heeten, G J; Grimbergen, C A

    2016-01-01

    In mammography, the height of the image receptor is adjusted to the patient before compressing the breast. An inadequate height setting can result in an imbalance between the forces applied by the image receptor and the paddle, causing the clamped breast to be pushed up or down relative to the body during compression. This leads to unnecessary stretching of the skin and other tissues around the breast, which can make the imaging procedure more painful for the patient. The goal of this study was to implement a method to measure and minimize the force imbalance, and to assess its feasibility as an objective and reproducible method of setting the image receptor height. A trial was conducted consisting of 13 craniocaudal mammographic compressions on a silicone breast phantom, each with the image receptor positioned at a different height. The image receptor height was varied over a range of 12 cm. In each compression, the force exerted by the compression paddle was increased up to 140 N in steps of 10 N. In addition to the paddle force, the authors measured the force exerted by the image receptor and the reaction force exerted on the patient body by the ground. The trial was repeated 8 times, with the phantom remounted at a slightly different orientation and position between the trials. For a given paddle force, the obtained results showed that there is always exactly one image receptor height that leads to a balance of the forces on the breast. For the breast phantom, deviating from this specific height increased the force imbalance by 9.4 ± 1.9 N/cm (6.7%) for 140 N paddle force, and by 7.1 ± 1.6 N/cm (17.8%) for 40 N paddle force. The results also show that in situations where the force exerted by the image receptor is not measured, the craniocaudal force imbalance can still be determined by positioning the patient on a weighing scale and observing the changes in displayed weight during the procedure. In mammographic breast compression, even small changes in the

  15. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  16. Impact of mammographic screening on ethnic and socioeconomic inequities in breast cancer stage at diagnosis and survival in New Zealand: a cohort study.

    Science.gov (United States)

    Seneviratne, Sanjeewa; Campbell, Ian; Scott, Nina; Shirley, Rachel; Lawrenson, Ross

    2015-01-31

    Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of differences in rates of screen detected breast cancer on inequities in cancer stage at diagnosis and survival between Māori and NZ European women. All primary breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) during 1999-2012 in the Waikato area (n = 1846) were identified from the Waikato Breast Cancer Register and the National Screening Database. Stage at diagnosis and survival were compared for screen detected (n = 1106) and non-screen detected (n = 740) breast cancer by ethnicity and socioeconomic status. Indigenous Māori women were significantly more likely to be diagnosed with more advanced cancer compared with NZ European women (OR = 1.51), and approximately a half of this difference was explained by lower rate of screen detected cancer for Māori women. For non-screen detected cancer, Māori had significantly lower 10-year breast cancer survival compared with NZ European (46.5% vs. 73.2%) as did most deprived compared with most affluent socioeconomic quintiles (64.8% vs. 81.1%). No significant survival differences were observed for screen detected cancer by ethnicity or socioeconomic deprivation. The lower rate of screen detected breast cancer appears to be a key contributor towards the higher rate of advanced cancer at diagnosis and lower breast cancer survival for Māori compared with NZ European women. Among women with screen-detected breast cancer, Māori women do just as well as NZ European women, demonstrating the success of breast screening for Māori women who are able to access screening. Increasing breast cancer screening rates has the potential to improve survival for Māori women and reduce breast cancer survival inequity between Māori and NZ European women.

  17. Breast image pre-processing for mammographic tissue segmentation.

    Science.gov (United States)

    He, Wenda; Hogg, Peter; Juette, Arne; Denton, Erika R E; Zwiggelaar, Reyer

    2015-12-01

    During mammographic image acquisition, a compression paddle is used to even the breast thickness in order to obtain optimal image quality. Clinical observation has indicated that some mammograms may exhibit abrupt intensity change and low visibility of tissue structures in the breast peripheral areas. Such appearance discrepancies can affect image interpretation and may not be desirable for computer aided mammography, leading to incorrect diagnosis and/or detection which can have a negative impact on sensitivity and specificity of screening mammography. This paper describes a novel mammographic image pre-processing method to improve image quality for analysis. An image selection process is incorporated to better target problematic images. The processed images show improved mammographic appearances not only in the breast periphery but also across the mammograms. Mammographic segmentation and risk/density classification were performed to facilitate a quantitative and qualitative evaluation. When using the processed images, the results indicated more anatomically correct segmentation in tissue specific areas, and subsequently better classification accuracies were achieved. Visual assessments were conducted in a clinical environment to determine the quality of the processed images and the resultant segmentation. The developed method has shown promising results. It is expected to be useful in early breast cancer detection, risk-stratified screening, and aiding radiologists in the process of decision making prior to surgery and/or treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 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.

  19. Calcified trichinosis of pectoral muscle: mammographic appearance

    Energy Technology Data Exchange (ETDEWEB)

    Apesteguia, L. [Servicio de Radiologia, Hospital Virgen del Camino, Pamplona (Spain); Murillo, A. [Servicio de Radiologia, Hospital Virgen del Camino, Pamplona (Spain); Biurrun, J. [Servicio de Radiologia, Hospital Virgen del Camino, Pamplona (Spain); Garcia-Rostan, G. [Servicio Anatomia Patologica, Hospital Virgen del Camino, Pamplona (Spain); Reta, A. [Servicio de Analisis Clinicos, Hospital Virgen del Camino, Pamplona (Spain); Dominguez, F. [Servicio Cirugia, Hospital Virgen del Camino, Pamplona (Spain)

    1995-12-31

    By mammographic screening we had detected six asymptomatic women who showed numerious tiny and well-delineated round to ovoid microcalcification superimposed on pectoral shadows, in the oblique medio-lateral (OML) view. Our objective was to achieve a better evaluation of these calcifications and investigate their origin. Magnified mammograms of pectoral muscles were done in the six women. A questionnaire concerning the patients` diets was also administered. Trichinella antibody titres were quantified by sero-agglutination. Microcalcifications within pectoral muscle fibres were demonstrated in all the cases. Five women admitted to having eaten home-made pork products in the past. One of them showed a slightly elevated antibody titre. We confirmed the suspected diagnosis of calcified trichinosis by a surgical biopsy of the pectoral muscle performed on one of the patients. We conclude that chronic calcified trichinosis of the pectoral muscle can be visualised in the OML view of a conventional mammogram. The mammographic appearance of this entity is very characteristic and biopsy would not be required for its diagnosis in the future. (orig.)

  20. Mammographic interpretation training: how useful is handheld technology?

    Science.gov (United States)

    Chen, Yan; Gale, Alastair G.; Scott, Hazel

    2008-03-01

    In the UK a national self-assessment scheme (PERFORMS) for mammographers is undertaken as part of the National Health Search Breast Screening Programme. Where appropriate, further training is suggested to improve performance. Ideally, such training would be on-demand; that is whenever and wherever an individual decides to undertake it. To use a portable device for such a purpose would be attractive on many levels. However, it is not known whether handheld technology can be used effectively for viewing mammographic images. Previous studies indicate the potential for viewing medical images with fairly low spatial resolution (e.g. CT, MRI) on PDAs. In this study, we set out to investigate factors that might affect the feasibility of using PDAs as a training technology for examining large, high resolution mammographic images. Two studies are reported: 20 mammographers examined a series of mammograms presented on a PDA, specifying the location of any abnormality. Secondly, a group of technologists examined a series of mammograms presented at different sizes and resolutions to mimic presentation on a PDA and their eye movements were recorded. The results indicate the potential for using PDAs to show such large, high resolution images if suitable Human-computer Interaction (HCI) techniques are employed.

  1. 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

  2. Comparison of Danish dichotomous and BI-RADS classifications of mammographic density

    DEFF Research Database (Denmark)

    Hodge, Rebecca; Hellmann, Sophie Sell; von Euler-Chelpin, My

    2014-01-01

    , and which were in 2012 re-assessed and classified according to the BI-RADS classification system. We calculated inter-rater agreement between the Danish dichotomous mammographic classification as fatty or mixed/dense and the four-level BI-RADS classification by the linear weighted Kappa statistic. RESULTS......BACKGROUND: In the Copenhagen mammography screening program from 1991 to 2001, mammographic density was classified either as fatty or mixed/dense. This dichotomous mammographic density classification system is unique internationally, and has not been validated before. PURPOSE: To compare the Danish...... dichotomous mammographic density classification system from 1991 to 2001 with the density BI-RADS classifications, in an attempt to validate the Danish classification system. MATERIAL AND METHODS: The study sample consisted of 120 mammograms taken in Copenhagen in 1991-2001, which tested false positive...

  3. Utility of relative and absolute measures of mammographic density vs clinical risk factors in evaluating breast cancer risk at time of screening mammography.

    Science.gov (United States)

    Abdolell, Mohamed; Tsuruda, Kaitlyn M; Lightfoot, Christopher B; Payne, Jennifer I; Caines, Judy S; Iles, Sian E

    2016-01-01

    Various clinical risk factors, including high breast density, have been shown to be associated with breast cancer. The utility of using relative and absolute area-based breast density-related measures was evaluated as an alternative to clinical risk factors in cancer risk assessment at the time of screening mammography. Contralateral mediolateral oblique digital mammography images from 392 females with unilateral breast cancer and 817 age-matched controls were analysed. Information on clinical risk factors was obtained from the provincial breast-imaging information system. Breast density-related measures were assessed using a fully automated breast density measurement software. Multivariable logistic regression was conducted, and area under the receiver-operating characteristic (AUROC) curve was used to evaluate the performance of three cancer risk models: the first using only clinical risk factors, the second using only density-related measures and the third using both clinical risk factors and density-related measures. The risk factor-based model generated an AUROC of 0.535, while the model including only breast density-related measures generated a significantly higher AUROC of 0.622 (p risk factor model (p cancer compared with clinical risk factors. Breast cancer risk models based on density-related measures alone can outperform risk models based on clinical factors. Such models may support the development of personalized breast-screening protocols.

  4. Agreement of mammographic measures of volumetric breast density to MRI.

    Directory of Open Access Journals (Sweden)

    Jeff Wang

    Full Text Available Clinical scores of mammographic breast density are highly subjective. Automated technologies for mammography exist to quantify breast density objectively, but the technique that most accurately measures the quantity of breast fibroglandular tissue is not known.To compare the agreement of three automated mammographic techniques for measuring volumetric breast density with a quantitative volumetric MRI-based technique in a screening population.Women were selected from the UCSF Medical Center screening population that had received both a screening MRI and digital mammogram within one year of each other, had Breast Imaging Reporting and Data System (BI-RADS assessments of normal or benign finding, and no history of breast cancer or surgery. Agreement was assessed of three mammographic techniques (Single-energy X-ray Absorptiometry [SXA], Quantra, and Volpara with MRI for percent fibroglandular tissue volume, absolute fibroglandular tissue volume, and total breast volume.Among 99 women, the automated mammographic density techniques were correlated with MRI measures with R(2 values ranging from 0.40 (log fibroglandular volume to 0.91 (total breast volume. Substantial agreement measured by kappa statistic was found between all percent fibroglandular tissue measures (0.72 to 0.63, but only moderate agreement for log fibroglandular volumes. The kappa statistics for all percent density measures were highest in the comparisons of the SXA and MRI results. The largest error source between MRI and the mammography techniques was found to be differences in measures of total breast volume.Automated volumetric fibroglandular tissue measures from screening digital mammograms were in substantial agreement with MRI and if associated with breast cancer could be used in clinical practice to enhance risk assessment and prevention.

  5. Mammographic feature type and reader variability by occupation: an ROC study

    Science.gov (United States)

    Scott, Hazel J.; Gale, Alastair G.

    2010-02-01

    Previous work has outlined that certain mammographic appearances feature more prominently in reader's false negative responses on a self-assessment scheme. Bi-annually 600 breast-screening film-readers complete at least one round of the Personal Performance in Mammographic Screening (PERFORMS) self-assessment scheme in the UK. The main occupational groups in UK Breast Screening can be categorised thus, Radiologist, Technologists and Symptomatics. Previous work has shown that these groups can vary in their reading 'style' and accuracy on self-assessed cases. These groups could be said to contain individuals each with (arguably) pronounced differences in their real life reading experience, symptomatic readers routinely read a large number of cases with abnormal appearances and Technologists (specially trained to read films) do not have the same medical background as breast-screening Radiologists. We aimed to examine overall (national) and group (occupational) differences in terms of ROC analysis on those mammographic cases with different mammographic appearance (feature type). Several main feature types were identified namely; Well Defined Mass (WDM), Ill Defined Mass (IDM), Spiculate Mass (SPIC), Architectural Distortions (AD), Asymmetry (ASYM) and Calcification (CALC). Results are discussed in light of differences in real-life practice for each of the occupational groups and how this may impact on accuracy over certain mammographic appearances.

  6. Occupation and mammographic density: A population-based study (DDM-Occup).

    Science.gov (United States)

    García-Pérez, Javier; Pollán, Marina; Pérez-Gómez, Beatriz; González-Sánchez, Mario; Cortés Barragán, Rosa Ana; Maqueda Blasco, Jerónimo; González-Galarzo, María Carmen; Alba, Miguel Ángel; van der Haar, Rudolf; Casas, Silvia; Vicente, Cándida; Medina, Pilar; Ederra, María; Santamariña, Carmen; Moreno, María Pilar; Casanova, Francisco; Pedraz-Pingarrón, Carmen; Moreo, Pilar; Ascunce, Nieves; García, Montse; Salas-Trejo, Dolores; Sánchez-Contador, Carmen; Llobet, Rafael; Lope, Virginia

    2017-11-01

    High mammographic density is one of the main risk factors for breast cancer. Although several occupations have been associated with breast cancer, there are no previous occupational studies exploring the association with mammographic density. Our objective was to identify occupations associated with high mammographic density in Spanish female workers. We conducted a population-based cross-sectional study of occupational determinants of high mammographic density in Spain, based on 1476 women, aged 45-68 years, recruited from seven screening centers within the Spanish Breast Cancer Screening Program network. Reproductive, family, personal, and occupational history data were collected. The latest occupation of each woman was collected and coded according to the 1994 National Classification of Occupations. Mammographic density was assessed from the cranio-caudal mammogram of the left breast using a semi-automated computer-assisted tool. Association between mammographic density and occupation was evaluated by using mixed linear regression models, using log-transformed percentage of mammographic density as dependent variable. Models were adjusted for age, body mass index, menopausal status, parity, smoking, alcohol intake, educational level, type of mammography, first-degree relative with breast cancer, and hormonal replacement therapy use. Screening center and professional reader were included as random effects terms. Mammographic density was higher, although non-statistically significant, among secondary school teachers (e β = 1.41; 95%CI = 0.98-2.03) and nurses (e β = 1.23; 95%CI = 0.96-1.59), whereas workers engaged in the care of people (e β = 0.81; 95%CI = 0.66-1.00) and housewives (e β = 0.87; 95%CI = 0.79-0.95) showed an inverse association with mammographic density. A positive trend for every 5 years working as secondary school teachers was also detected (p-value = 0.035). Nurses and secondary school teachers were the occupations with the highest

  7. Breast cancer detection using sonography in women with mammographically dense breasts.

    Science.gov (United States)

    Okello, Jimmy; Kisembo, Harriet; Bugeza, Sam; Galukande, Moses

    2014-12-30

    Mammography, the gold standard for breast cancer screening misses some cancers, especially in women with dense breasts. Breast ultrasonography as a supplementary imaging tool for further evaluation of symptomatic women with mammographically dense breasts may improve the detection of mass lesions otherwise missed at mammography. The purpose of this study was to determine the incremental breast cancer detection rate using US scanning in symptomatic women with mammographically dense breasts in a resource poor environment. A cross sectional descriptive study. Women referred for mammography underwent bilateral breast ultrasound, and mammography for symptom evaluation. The lesions seen by both modalities were described using sonographic BI-RADS lexicon and categorized. Ultrasound guided core biopsies were performed. IRB approval was obtained and all participants provided informed written consent. In total 148 women with mammographically dense breasts were recruited over six months. The prevalence of breast cancer in symptomatic women with mammographically dense breasts was 22/148 (15%). Mammography detected 16/22 (73%) of these cases and missed 6/22 (27%). The six breast cancer cases missed were correctly diagnosed on breast ultrasonography. Sonographic features typical of breast malignancy were irregular shape, non-parallel orientation, non circumscribed margin, echogenic halo, and increased lesion vascularity (p values Breast ultrasound scan as a supplementary imaging tool detected 27% more malignant mass lesions otherwise missed by mammography among these symptomatic women with mammographically dense breasts. We recommend that ultra sound scanning in routine evaluation of symptomatic women with mammographically dense breasts.

  8. Study of digital mammographic equipments by phantom image quality.

    Science.gov (United States)

    Mayo, P; Rodenas, F; Verdú, G; Campayo, J M; Villaescusa, J I

    2006-01-01

    Nowadays, the digital radiographic equipments are replacing the traditional film-screen equipments and it is necessary to update the parameters to guarantee the quality of the process. Contrast-detail phantoms are applied to digital radiography to study the threshold contrast-detail sensitivity at operation conditions of the equipment. The phantom that is studied in this work is CDMAM 3.4. One of the most extended indexes to measure the image quality in an objective way is the image quality figure (IQF). The aim of this work is to study the image quality of different images contrast-detail phantom CDMAM 3.4, carrying out the automatic detection of the contrast-detail combination and to establish a parameter which characterize in an objective way the mammographic image quality. This is useful to compare images obtained at different digital mammographic equipments to study the functioning of the equipments that facilitates the evaluation of image contrast and detail resolution.

  9. Cumulative Incidence of False-Positive Results in Repeated, Multimodal Cancer Screening

    Science.gov (United States)

    Croswell, Jennifer Miller; Kramer, Barnett S.; Kreimer, Aimee R.; Prorok, Phil C.; Xu, Jian-Lun; Baker, Stuart G.; Fagerstrom, Richard; Riley, Thomas L.; Clapp, Jonathan D.; Berg, Christine D.; Gohagan, John K.; Andriole, Gerald L.; Chia, David; Church, Timothy R.; Crawford, E. David; Fouad, Mona N.; Gelmann, Edward P.; Lamerato, Lois; Reding, Douglas J.; Schoen, Robert E.

    2009-01-01

    PURPOSE Multiple cancer screening tests have been advocated for the general population; however, clinicians and patients are not always well-informed of screening burdens. We sought to determine the cumulative risk of a false-positive screening result and the resulting risk of a diagnostic procedure for an individual participating in a multimodal cancer screening program. METHODS Data were analyzed from the intervention arm of the ongoing Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, a randomized controlled trial to determine the effects of prostate, lung, colorectal, and ovarian cancer screening on disease-specific mortality. The 68,436 participants, aged 55 to 74 years, were randomized to screening or usual care. Women received serial serum tests to detect cancer antigen 125 (CA-125), transvaginal sonograms, posteroanterior-view chest radiographs, and flexible sigmoidoscopies. Men received serial chest radiographs, flexible sigmoidoscopies, digital rectal examinations, and serum prostate-specific antigen tests. Fourteen screening examinations for each sex were possible during the 3-year screening period. RESULTS After 14 tests, the cumulative risk of having at least 1 false-positive screening test is 60.4% (95% CI, 59.8%–61.0%) for men, and 48.8% (95% CI, 48.1%–49.4%) for women. The cumulative risk after 14 tests of undergoing an invasive diagnostic procedure prompted by a false-positive test is 28.5% (CI, 27.8%–29.3%) for men and 22.1% (95% CI, 21.4%–22.7%) for women. CONCLUSIONS For an individual in a multimodal cancer screening trial, the risk of a false-positive finding is about 50% or greater by the 14th test. Physicians should educate patients about the likelihood of false positives and resulting diagnostic interventions when counseling about cancer screening. PMID:19433838

  10. Image quality analysis of digital mammographic equipments

    Energy Technology Data Exchange (ETDEWEB)

    Mayo, P.; Pascual, A.; Verdu, G. [Valencia Univ. Politecnica, Chemical and Nuclear Engineering Dept. (Spain); Rodenas, F. [Valencia Univ. Politecnica, Applied Mathematical Dept. (Spain); Campayo, J.M. [Valencia Univ. Hospital Clinico, Servicio de Radiofisica y Proteccion Radiologica (Spain); Villaescusa, J.I. [Hospital Clinico La Fe, Servicio de Proteccion Radiologica, Valencia (Spain)

    2006-07-01

    The image quality assessment of a radiographic phantom image is one of the fundamental points in a complete quality control programme. The good functioning result of all the process must be an image with an appropriate quality to carry out a suitable diagnostic. Nowadays, the digital radiographic equipments are replacing the traditional film-screen equipments and it is necessary to update the parameters to guarantee the quality of the process. Contrast-detail phantoms are applied to digital radiography to study the threshold contrast detail sensitivity at operation conditions of the equipment. The phantom that is studied in this work is C.D.M.A.M. 3.4, which facilitates the evaluation of image contrast and detail resolution. One of the most extended indexes to measure the image quality in an objective way is the Image Quality Figure (I.Q.F.). This parameter is useful to calculate the image quality taking into account the contrast and detail resolution of the image analysed. The contrast-detail curve is useful as a measure of the image quality too, because it is a graphical representation in which the hole thickness and diameter are plotted for each contrast-detail combination detected in the radiographic image of the phantom. It is useful for the comparison of the functioning of different radiographic image systems, for phantom images under the same exposition conditions. The aim of this work is to study the image quality of different images contrast-detail phantom C.D.M.A.M. 3.4, carrying out the automatic detection of the contrast-detail combination and to establish a parameter which characterize in an objective way the mammographic image quality. This is useful to compare images obtained at different digital mammographic equipments to study the functioning of the equipments. (authors)

  11. 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.

  12. Investigating the iatrogenic effects of repeated suicidal ideation screening on suicidal and depression symptoms: A staggered sequential study.

    Science.gov (United States)

    Hom, Melanie A; Stanley, Ian H; Rogers, Megan L; Gallyer, Austin J; Dougherty, Sean P; Davis, Lisa; Joiner, Thomas E

    2018-02-21

    Research suggests that screening for suicidality does not have iatrogenic effects; however, less is known regarding the impact of repeatedly screening for suicidal ideation among individuals with varying levels of exposure to these screenings. This staggered sequential study evaluated whether suicidal ideation severity increases with repeated screening for suicidal ideation and depression symptoms. Undergraduates (N = 207) were recruited at one of four time points (baseline [n = 37], 1 month later [n = 61], 4 months later [n = 55], and 12 months later [n = 54]) to complete the self-report Beck Depression Inventory (BDI). Participants completed the BDI at the time point at which they were recruited and all subsequent study time points. Non-parametric tests were employed to compare suicidal ideation severity (BDI Item 9) and depression symptom severity (BDI total score): (1) within each group across time points and (2) within each time point across groups. Suicidal ideation severity did not significantly differ within any group across time points, and for two groups, depression symptom severity decreased over time. For analyses between groups, suicidal ideation and depression symptom scores were, at times, significantly lower during subsequent BDI completion time points. This study utilized a relatively small sample size and participants of low clinical severity. Findings align with prior research indicating that suicidality screening is not iatrogenic. This study also expanded upon previous studies by leveraging a staggered sequential design to compare suicidal ideation and depression symptom severity among individuals with varying exposure to suicidal ideation screenings. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. 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....

  14. Quality assessment of the mammographic screening programme in the 'Azienda Sanitaria Locale Provincia Milano' 1 - Analysis of interval cancers and discussion of possible causes of diagnostic error; Controllo di qualita' del programma screening mammografico nella Azienda Sanitaria Locale Provincia Milano 1 - Analisi dei carcinomi di intervallo e discussione delle possibili cause di errore diagnostico

    Energy Technology Data Exchange (ETDEWEB)

    Burani, Rossella; Maggioni, Carlo; Pirola, Maria Elena [Azienda Sanitaria Locale Provincia Milano 1, Milano, (Italy); Caimi, Francesco; Marinoni, Guia [Azienda Ospedaliera Ospedali Civili, Legnano (Italy); Pellizzoni, Romana; Villa, Roberto [Azienda Ospedaliera Salvini, Garbignate Milanese (Italy); Ciatto, Stefano [Centro per lo Studio e la Prevenzione Oncologica, Firenze (Italy)

    2005-03-01

    Purpose: To evaluate the sensitivity of the mammographic screening programme and the causes of diagnostic fault in cases surfacing as interval cancers. Materials and methods: Interval cancers (CI) were identified by linkage of the screening databases for the years 2000-2002 to the database of hospital discharge records (HDR) for breast cancer during 2000-2002. Linkage between screening attenders during 2000-2001 and HDR (biennal follow-up for year 2000, one year follow-up for year 2001) was used to calculate the proportional rate of observed/expected IC. The observed/expected rate was compared with international standards and literature data. Screening mammograms followed by IC, randomly admixtured with negative controls, underwent blind review by an independent radiologist, using the recommended classification criteria to evaluate causes of error (occult, minimal signs, screening error). Results: The analysis of HDR during 2000-2002 allowed to identify 31 out of 89 expected IC. Proportional observed/expected IC rate in the first or second year of screening interval was 26 or 67%, respectively. Screening mammograms for radiological review were available in 38 of 61 total IC: 20 cases (52.6%) were classified as occult, whereas minimal signs or screening errors were 2 (5.2%) or 16 (42.1%), respectively. Diagnostic suspicion had been reported at screening in 7 of 16 cases classified as screening error, but were not diagnosed at the subsequent diagnostic assessment. Conclusions: Proportional IC rate was higher than reported in literature or currently recommended (<30% in the 1st., <50% in the 2nd year). The analysis of error causes shows an excess of screening errors with respect to current recommendations (<20% of IC should be classified as screening error at review), but also an excess of IC suspected at screening but misdiagnosed at assessment (7/38=18.4%). Overall the analysis revealed a reduced sensitivity of the screening programme , as often observed in service

  15. Incorporation of an iterative, linear segmentation routine into a mammographic mass CAD system.

    Science.gov (United States)

    Catarious, David M; Baydush, Alan H; Floyd, Carey E

    2004-06-01

    In previous research, we have developed a computer-aided detection (CAD) system designed to detect masses in mammograms. The previous version of our system employed a simple but imprecise method to localize the masses. In this research, we present a more robust segmentation routine for use with mammographic masses. Our hypothesis is that by more accurately describing the morphology of the masses, we can improve the CAD system's ability to distinguish masses from other mammographic structures. To test this hypothesis, we incorporated the new segmentation routine into our CAD system and examined the change in performance. The developed iterative, linear segmentation routine is a gray level-based procedure. Using the identified regions from the previous CAD system as the initial seeds, the new segmentation algorithm refines the suspicious mass borders by making estimates of the interior and exterior pixels. These estimates are then passed to a linear discriminant, which determines the optimal threshold between the interior and exterior pixels. After applying the threshold and identifying the object's outline, two constraints on the border are applied to reduce the influence of background noise. After the border is constrained, the process repeats until a stopping criterion is reached. The segmentation routine was tested on a study database of 183 mammographic images extracted from the Digital Database for Screening Mammography. Eighty-three of the images contained 50 malignant and 50 benign masses; 100 images contained no masses. The previously developed CAD system was used to locate a set of suspicious regions of interest (ROIs) within the images. To assess the performance of the segmentation algorithm, a set of 20 features was measured from the suspicious regions before and after the application of the developed segmentation routine. Receiver operating characteristic (ROC) analysis was employed on the ROIs to examine the discriminatory capabilities of each

  16. Relationship between breast sound speed and mammographic percent density

    Science.gov (United States)

    Sak, Mark; Duric, Nebojsa; Boyd, Norman; Littrup, Peter; Myc, Lukasz; Faiz, Muhammad; Li, Cuiping; Bey-Knight, Lisa

    2011-03-01

    Despite some shortcomings, mammography is currently the standard of care for breast cancer screening and diagnosis. However, breast ultrasound tomography is a rapidly developing imaging modality that has the potential to overcome the drawbacks of mammography. It is known that women with high breast densities have a greater risk of developing breast cancer. Measuring breast density is accomplished through the use of mammographic percent density, defined as the ratio of fibroglandular to total breast area. Using an ultrasound tomography (UST) prototype, we created sound speed images of the patient's breast, motivated by the fact that sound speed in a tissue is proportional to the density of the tissue. The purpose of this work is to compare the acoustic performance of the UST system with the measurement of mammographic percent density. A cohort of 251 patients was studied using both imaging modalities and the results suggest that the volume averaged breast sound speed is significantly related to mammographic percent density. The Spearman correlation coefficient was found to be 0.73 for the 175 film mammograms and 0.69 for the 76 digital mammograms obtained. Since sound speed measurements do not require ionizing radiation or physical compression, they have the potential to form the basis of a safe, more accurate surrogate marker of breast density.

  17. Effects of processing conditions on mammographic image quality.

    Science.gov (United States)

    Braeuning, M P; Cooper, H W; O'Brien, S; Burns, C B; Washburn, D B; Schell, M J; Pisano, E D

    1999-08-01

    Any given mammographic film will exhibit changes in sensitometric response and image resolution as processing variables are altered. Developer type, immersion time, and temperature have been shown to affect the contrast of the mammographic image and thus lesion visibility. The authors evaluated the effect of altering processing variables, including film type, developer type, and immersion time, on the visibility of masses, fibrils, and speaks in a standard mammographic phantom. Images of a phantom obtained with two screen types (Kodak Min-R and Fuji) and five film types (Kodak Min-R M, Min-R E, Min-R H; Fuji UM-MA HC, and DuPont Microvision-C) were processed with five different developer chemicals (Autex SE, DuPont HSD, Kodak RP, Picker 3-7-90, and White Mountain) at four different immersion times (24, 30, 36, and 46 seconds). Processor chemical activity was monitored with sensitometric strips, and developer temperatures were continuously measured. The film images were reviewed by two board-certified radiologists and two physicists with expertise in mammography quality control and were scored based on the visibility of calcifications, masses, and fibrils. Although the differences in the absolute scores were not large, the Kodak Min-R M and Fuji films exhibited the highest scores, and images developed in White Mountain and Autex chemicals exhibited the highest scores. For any film, several processing chemicals may be used to produce images of similar quality. Extended processing may no longer be necessary.

  18. 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.)

  19. Assessment of two mammographic density related features in predicting near-term breast cancer risk

    Science.gov (United States)

    Zheng, Bin; Sumkin, Jules H.; Zuley, Margarita L.; Wang, Xingwei; Klym, Amy H.; Gur, David

    2012-02-01

    In order to establish a personalized breast cancer screening program, it is important to develop risk models that have high discriminatory power in predicting the likelihood of a woman developing an imaging detectable breast cancer in near-term (e.g., breast cancer risk models, mammographic density is considered the second highest breast cancer risk factor (second to woman's age). In this study we explored a new feature, namely bilateral mammographic density asymmetry, and investigated the feasibility of predicting near-term screening outcome. The database consisted of 343 negative examinations, of which 187 depicted cancers that were detected during the subsequent screening examination and 155 that remained negative. We computed the average pixel value of the segmented breast areas depicted on each cranio-caudal view of the initial negative examinations. We then computed the mean and difference mammographic density for paired bilateral images. Using woman's age, subjectively rated density (BIRADS), and computed mammographic density related features we compared classification performance in estimating the likelihood of detecting cancer during the subsequent examination using areas under the ROC curves (AUC). The AUCs were 0.63+/-0.03, 0.54+/-0.04, 0.57+/-0.03, 0.68+/-0.03 when using woman's age, BIRADS rating, computed mean density and difference in computed bilateral mammographic density, respectively. Performance increased to 0.62+/-0.03 and 0.72+/-0.03 when we fused mean and difference in density with woman's age. The results suggest that, in this study, bilateral mammographic tissue density is a significantly stronger (prisk indicator than both woman's age and mean breast density.

  20. Novel multiresolution mammographic density segmentation using pseudo 3D features and adaptive cluster merging

    Science.gov (United States)

    He, Wenda; Juette, Arne; Denton, Erica R. E.; Zwiggelaar, Reyer

    2015-03-01

    Breast cancer is the most frequently diagnosed cancer in women. Early detection, precise identification of women at risk, and application of appropriate disease prevention measures are by far the most effective ways to overcome the disease. Successful mammographic density segmentation is a key aspect in deriving correct tissue composition, ensuring an accurate mammographic risk assessment. However, mammographic densities have not yet been fully incorporated with non-image based risk prediction models, (e.g. the Gail and the Tyrer-Cuzick model), because of unreliable segmentation consistency and accuracy. This paper presents a novel multiresolution mammographic density segmentation, a concept of stack representation is proposed, and 3D texture features were extracted by adapting techniques based on classic 2D first-order statistics. An unsupervised clustering technique was employed to achieve mammographic segmentation, in which two improvements were made; 1) consistent segmentation by incorporating an optimal centroids initialisation step, and 2) significantly reduced the number of missegmentation by using an adaptive cluster merging technique. A set of full field digital mammograms was used in the evaluation. Visual assessment indicated substantial improvement on segmented anatomical structures and tissue specific areas, especially in low mammographic density categories. The developed method demonstrated an ability to improve the quality of mammographic segmentation via clustering, and results indicated an improvement of 26% in segmented image with good quality when compared with the standard clustering approach. This in turn can be found useful in early breast cancer detection, risk-stratified screening, and aiding radiologists in the process of decision making prior to surgery and/or treatment.

  1. GSTM1, GSTT1, and GSTP1 polymorphisms, breast cancer risk factors and mammographic density in women submitted to breast cancer screening Polimorfismos GSTM1, GSTT1 e GSTP1, fatores de risco para câncer de mama e densidade mamográfica em mulheres submetidas a rastreamento mamográfico

    Directory of Open Access Journals (Sweden)

    Ernestina Silva de Aguiar

    2012-06-01

    Full Text Available Genetic polymorphisms in genes related to the metabolism of xenobiotics, such as genes of the glutathione S-transferases (GSTM1, GSTT1, and GSTP1 superfamily have been associated with an increased risk for breast cancer (BC. Considering the high incidence of BC in the city of Porto Alegre in southern Brazil, the purpose of this study was to characterize genotypic and allelic frequencies of polymorphisms in GSTM1, GSTT1, and GSTP1, and correlate these molecular findings with established risk factors for breast cancer including mammographic density, in a sample of 750 asymptomatic women undergoing mammographic screening. Molecular tests were performed using the multiplex polymerase chain reaction (PCR for GSTM1 and GSTT1, and quantitative PCR for GSTP1 polymorphisms. Overall, the frequencies of GSTM1 and GSTT1 null genotypes were 45% and 21%, respectively. For GSTP1 polymorphism, genotypic frequencies were 44% for the Ile/Ile genotype, 44% for the Ile/Val genotype, and 12% for Val/Val genotype, with an allelic frequency of 66% for the wild type allele in this population, similar to results of previous international publications. There was a statistically significant association between the combined GSTM1 and GSTT1 null genotypes (M-/T- and mammographic density in post menopausal women (p = 0.031. When the GSTT1 null (T- genotype was analyzed isolated, the association with mammographic density in post menopausal women and in the overall sample was also statistically significant (p = 0.023 and p = 0.027, respectively. These findings suggest an association of GSTM1 and GSTT1 null genotypes with mammographic density.Polimorfismos genéticos em genes relacionados com o metabolismo de xenobióticos, como os genes da superfamília das glutationa S-transferases (GSTM1, GSTT1 e GSTP1 têm sido associados com o aumento do risco para câncer de mama (CM. Considerando a alta incidência de CM na cidade de Porto Alegre, região Sul do Brasil, a proposta deste

  2. A Computer Aided Detection system for mammographic images implemented on a GRID infrastructure

    OpenAIRE

    Bottigli, U.; Cerello, P.(Sezione INFN, Turin, Italy); Delogu, P.; Fantacci, ME; Fauci, F.; Forni, G.; Golosio, B.; Indovina, PL; Lauria, A.; Torres, EL; Magro, R.; Masala, GL; Oliva, P.; Palmiero, R.; Raso, G

    2003-01-01

    5 pages, 5 figures, to appear in the Proceedings of the 13th IEEE-NPSS Real Time Conference 2003, Montreal, Canada, May 18-23 2003 The use of an automatic system for the analysis of mammographic images has proven to be very useful to radiologists in the investigation of breast cancer, especially in the framework of mammographic-screening programs. A breast neoplasia is often marked by the presence of microcalcification clusters and massive lesions in the mammogram: hence the need for tools...

  3. 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.

  4. Evaluation of a new mammographic film: methods and considerations.

    Science.gov (United States)

    Tsalafoutas, Oannis A; Kolovos, Christos A; Tsapaki, Virginia; Betsou, Sofia; Koliakou, Eleni; Maniatis, Petros N; Xenofos, Stelios

    2008-04-01

    In this study the performance of a new mammographic film, the XMA (Retina), was evaluated in comparison with HT (Agfa). The comparison was made in terms of sensitometric characteristics and in terms of image quality and speed when combined with four different cassettes-HDS (Agfa), Min-R 2000 and Min-R 2190 (Kodak), and AD-MA (Fuji)-using the Leeds TOR(MAX) Mammographic Quality Control phantom. The entrance surface air kerma was calculated from exposure factors and the relative speed of each screen-film combination was determined. These tests revealed that XMA requires about 40% less dose than HT when combined with the same intensifying screen, at a penalty of less than 8% in image quality. When combined with AD-MA the XMA presents the greatest speed, whereas the Min-R 2190 is the best compromise between image quality and breast dose. The above values are indicative of the dilemma that medical physicists and radiologists face when it comes to the selection of a screen-film combination for mammography. Both image quality and breast dose should be considered, but strict instructions on what weight should be assigned to each parameter have not been established yet. Health Phys. 94(4):338-344; 2008.

  5. Screening for the C9ORF72 repeat expansion in a greek frontotemporal dementia cohort.

    Science.gov (United States)

    Kartanou, Chrisoula; Karadima, Georgia; Koutsis, Georgios; Breza, Marianthi; Papageorgiou, Sokratis G; Paraskevas, George P; Kapaki, Elisabeth; Panas, Marios

    2018-02-01

    The C9orf72 repeat expansion is a common genetic cause of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) in European populations. A previous study has reported a high frequency of the expansion in Greek ALS. However, no data have been reported on the frequency of the expansion in Greek FTD. Currently, we investigated the frequency of the C9orfF72 expansion in a well-characterized cohort of 64 Greek FTD patients. We detected the C9orf72 repeat expansion in 9.3% of cases. Overall, 27.7% of familial and 2.2% of sporadic cases were expansion-positive. Five out of 6 cases had a diagnosis of behavioral variant FTD. All expansion-positive cases had fairly typical FTD presentations. Clinical features included motor neuron disease, Parkinsonism and hallucinations. We conclude that the overall frequency of C9orf72-positive cases in Greek FTD is high, comparable to Greek ALS, similar to some Western European, but significantly higher than some Mediterranean FTD populations.

  6. Repeat cytology and human papillomavirus screening strategies in detecting preinvasive cervical lesions.

    Science.gov (United States)

    Li, Kemin; Yin, Rutie

    2015-02-01

    The aim of the present study was to determine the value of human papillomavirus (HPV) testing in screening patients with preinvasive cervical lesions. Seven hundred thirty-four women diagnosed with atypical squamous cells of undetermined significance (ASCUS+) cervical cytology during routine screening had additional cytologic testing and HPV DNA testing within 6 months of their diagnosis, after which all women who tested positive were referred for colposcopy and biopsy. The test findings were then used to determine the screening value of HPV for diagnosing preinvasive cervical lesions. Cytology and HPV testing were compared by conventional cytology. The odds ratio (OR) of sensitivity using ASCUS+ or low-grade squamous intraepithelial neoplasia (LSIL+) as a cutoff for detecting cervical intraepithelial neoplasia (CIN) II+ was, respectively, 0.78 (0.72, 0.85) and 0.82 (0.70, 0.95) (P ASCUS+ or LSIL+ as the cutoff (P ASCUS+, LSIL+, or high-grade squamous intraepithelial neoplasia (HSIL+) as the cutoff (P ASCUS+ or LSIL+ as the cutoff for the detection of CIN II+ was 1.97 (1.68, 2.31) and 1.10 (1.02, 1.18), respectively (P ASCUS+ or LSIL+ was used as the cutoff (P ASCUS+, LSIL+, or HSIL+ was used as the cutoff (P < 0.01). Cytology and HPV testing and cytology for triage improved the specificity of detecting CIN II+, but this did not improve the sensitivity. Additionally, cytology or HPV testing improved the sensitivity of detecting CIN II+ but not the specificity.

  7. A GAA repeat expansion reporter model of Friedreich's ataxia recapitulates the genomic context and allows rapid screening of therapeutic compounds.

    Science.gov (United States)

    Lufino, Michele M P; Silva, Ana M; Németh, Andrea H; Alegre-Abarrategui, Javier; Russell, Angela J; Wade-Martins, Richard

    2013-12-20

    Friedreich's ataxia (FRDA) is caused by large GAA expansions in intron 1 of the frataxin gene (FXN), which lead to reduced FXN expression through a mechanism not fully understood. Understanding such mechanism is essential for the identification of novel therapies for FRDA and this can be accelerated by the development of cell models which recapitulate the genomic context of the FXN locus and allow direct comparison of normal and expanded FXN loci with rapid detection of frataxin levels. Here we describe the development of the first GAA-expanded FXN genomic DNA reporter model of FRDA. We modified BAC vectors carrying the whole FXN genomic DNA locus by inserting the luciferase gene in exon 5a of the FXN gene (pBAC-FXN-Luc) and replacing the six GAA repeats present in the vector with an ∼310 GAA repeat expansion (pBAC-FXN-GAA-Luc). We generated human clonal cell lines carrying the two vectors using site-specific integration to allow direct comparison of normal and expanded FXN loci. We demonstrate that the presence of expanded GAA repeats recapitulates the epigenetic modifications and repression of gene expression seen in FRDA. We applied the GAA-expanded reporter model to the screening of a library of novel small molecules and identified one molecule which up-regulates FXN expression in FRDA patient primary cells and restores normal histone acetylation around the GAA repeats. These results suggest the potential use of genomic reporter cell models for the study of FRDA and the identification of novel therapies, combining physiologically relevant expression with the advantages of quantitative reporter gene expression.

  8. Quantitative interaction screen of telomeric repeat-containing RNA reveals novel TERRA regulators.

    Science.gov (United States)

    Scheibe, Marion; Arnoult, Nausica; Kappei, Dennis; Buchholz, Frank; Decottignies, Anabelle; Butter, Falk; Mann, Matthias

    2013-12-01

    Telomeres are actively transcribed into telomeric repeat-containing RNA (TERRA), which has been implicated in the regulation of telomere length and heterochromatin formation. Here, we applied quantitative mass spectrometry (MS)-based proteomics to obtain a high-confidence interactome of TERRA. Using SILAC-labeled nuclear cell lysates in an RNA pull-down experiment and two different salt conditions, we distinguished 115 proteins binding specifically to TERRA out of a large set of background binders. While TERRA binders identified in two previous studies showed little overlap, using quantitative mass spectrometry we obtained many candidates reported in these two studies. To test whether novel candidates found here are involved in TERRA regulation, we performed an esiRNA-based interference analysis for 15 of them. Knockdown of 10 genes encoding candidate proteins significantly affected total cellular levels of TERRA, and RNAi of five candidates perturbed TERRA recruitment to telomeres. Notably, depletion of SRRT/ARS2, involved in miRNA processing, up-regulated both total and telomere-bound TERRA. Conversely, knockdown of MORF4L2, a component of the NuA4 histone acetyltransferase complex, reduced TERRA levels both globally and for telomere-bound TERRA. We thus identified new proteins involved in the homeostasis and telomeric abundance of TERRA, extending our knowledge of TERRA regulation.

  9. Textural Classification of Mammographic Parenchymal Patterns with the SONNET Selforganizing Neural Network

    Directory of Open Access Journals (Sweden)

    Daniel Howard

    2008-01-01

    Full Text Available In nationwide mammography screening, thousands of mammography examinations must be processed. Each consists of two standard views of each breast, and each mammogram must be visually examined by an experienced radiologist to assess it for any anomalies. The ability to detect an anomaly in mammographic texture is important to successful outcomes in mammography screening and, in this study, a large number of mammograms were digitized with a highly accurate scanner; and textural features were derived from the mammograms as input data to a SONNET selforganizing neural network. The paper discusses how SONNET was used to produce a taxonomic organization of the mammography archive in an unsupervised manner. This process is subject to certain choices of SONNET parameters, in these numerical experiments using the craniocaudal view, and typically produced O(10, for example, 39 mammogram classes, by analysis of features from O(103 mammogram images. The mammogram taxonomy captured typical subtleties to discriminate mammograms, and it is submitted that this may be exploited to aid the detection of mammographic anomalies, for example, by acting as a preprocessing stage to simplify the task for a computational detection scheme, or by ordering mammography examinations by mammogram taxonomic class prior to screening in order to encourage more successful visual examination during screening. The resulting taxonomy may help train screening radiologists and conceivably help to settle legal cases concerning a mammography screening examination because the taxonomy can reveal the frequency of mammographic patterns in a population.

  10. Impact of full-field digital mammography on pre-operative diagnosis and surgical treatment of mammographic microcalcification.

    Science.gov (United States)

    Bundred, S M; Zhou, J; Whiteside, S; Morris, J; Wilson, M; Hurley, E; Bundred, N

    2014-01-01

    Accurate pre-operative diagnosis of impalpable breast lesions correlates closely with the number of surgical procedures required for treatment. Correct diagnosis of mammographic microcalcification (MM) as ductal carcinoma in situ (DCIS) or invasive breast cancer is important because lesions upgraded to malignant diagnosis at surgery require repeat surgical procedures in 44 % of cases. Despite correct pre-operative diagnosis of MM, 26 % require second therapeutic operations to achieve surgical clearance. Theoretically, improved conspicuity of malignant MM using digital mammography could improve diagnostic work-up and improve surgical outcomes for MM. To determine the impact of full-field digital mammography (FFDM) on the diagnostic accuracy and positive predictive value (PPV) of biopsy of MM and surgical management of MM, screening and symptomatic cases with MM (n = 1,479) were reviewed for women imaged between August 2007 and March 2010 using screen-film mammography (SFM) (n = 711), and using FFDM, imaged between April 2010 to March 2012 (n = 768). Demographic information including pre and postoperative diagnosis, and number and types of surgical procedures were recorded. Overall, 302 (128 invasive) and 251 (110 invasive) malignant lesions were diagnosed using SFM and FFDM, respectively. Reduction in PPV of biopsy was observed (SFM 42.5 %; FFDM 32.7 %, p cancers over two centimetres. This will increase concerns about treatment of lesions detected in the screening programme with widespread use of digital mammography.

  11. 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.

  12. Mammographic compression--a need for mechanical standardization.

    Science.gov (United States)

    Branderhorst, Woutjan; de Groot, Jerry E; Highnam, Ralph; Chan, Ariane; Böhm-Vélez, Marcela; Broeders, Mireille J M; den Heeten, Gerard J; Grimbergen, Cornelis A

    2015-04-01

    A lack of consistent guidelines regarding mammographic compression has led to wide variation in its technical execution. Breast compression is accomplished by means of a compression paddle, resulting in a certain contact area between the paddle and the breast. This procedure is associated with varying levels of discomfort or pain. On current mammography systems, the only mechanical parameter available in estimating the degree of compression is the physical entity of force (daN). Recently, researchers have suggested that pressure (kPa), resulting from a specific force divided by contact area on a breast, might be a more appropriate parameter for standardization. Software has now become available which enables device-independent cross-comparisons of key mammographic metrics, such as applied compression pressure (force divided by contact area), breast density and radiation dose, between patient populations. To compare the current compression practice in mammography between different imaging sites in the Netherlands and the United States from a mechanical point of view, and to investigate whether the compression protocols in these countries can be improved by standardization of pressure (kPa) as an objective mechanical parameter. We retrospectively studied the available parameters of a set of 37,518 mammographic compressions (9188 women) from the Dutch national breast cancer screening programme (NL data set) and of another set of 7171 compressions (1851 women) from a breast imaging centre in Pittsburgh, PA (US data set). Both sets were processed using VolparaAnalytics and VolparaDensity to obtain the applied average force, pressure, breast thickness, breast volume, breast density and average glandular dose (AGD) as a function of the size of the contact area between the breast and the paddle. On average, the forces and pressures applied in the NL data set were significantly higher than in the US data set. The relative standard deviation was larger in the US data set

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

    Science.gov (United States)

    Hu, Minxia; Yip, Rowena; Yankelevitz, David Y; Henschke, Claudia I

    2016-12-01

    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 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 Adrenal enlargement increased with increasing pack-years of smoking. Adrenal enlargement was an independent predictor of a subsequent diagnosis of lung cancer. • Adrenal enlargement was seen in 4 % of participants at baseline screening. • Age and currently smoking were significantly associated with adrenal enlargement. • 0.04 % of participants were newly identified with adrenal enlargement. • Annual follow-up for adrenal enlargement Adrenal enlargement was an independent predictor of a diagnosis of lung cancer.

  14. Predicting invasion in mammographically detected microcalcifcation: a preliminary report

    Directory of Open Access Journals (Sweden)

    Okugawa Homa

    2004-04-01

    Full Text Available Abstract Background With the increased use of mammography for breast cancer screening, the diagnosis of ductal carcinoma in situ (DCIS too has increased. This study was carried out to identify clinical and radiological factors that may predict the presence of invasive disease within mammographically detected microcalcifcation. Materials and methods A retrospective analysis of 13 vacuum-assisted breast biopsies (Mammotome® of mammographic calcification, which were reported to be either DCIS or invasive disease on final histopathology, was carried out. Final surgical pathology was correlated with pre-operative features (clinical, radiological and core histology to predict the presence of an invasive component. Results The overall sensitivity of Mammotome® was 81.8%, while for invasion it was 50%. Small size, granular morphology, increased number and area of calcification cluster may help in predicting invasion on mammography. Conclusions Mammotome® biopsy fails to detect invasion correctly in half the cases despite ascertaining correctness of biopsy with post biopsy x-ray.

  15. Epidemiologic Studies of Isoflavones & Mammographic Density

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Tice

    2010-01-01

    Full Text Available Isoflavones, phytoestrogens in soy beans with estrogen-like properties, have been examined for their cancer protective effects. Mammographic density is a strong predictor of breast cancer. This review summarizes studies that have examined the association between isoflavones and breast density. Observational investigations in Hawaii and Singapore suggest slightly lower breast density among women of Asian descent with regular soy intake, but two larger studies from Japan and Singapore did not observe a protective effect. The findings from seven randomized trials with primarily Caucasian women indicate that soy or isoflavones do not modify mammographic density. Soy foods and isoflavone supplements within a nutritional range do not appear to modify breast cancer risk as assessed by mammographic density.

  16. Age-related changes in mammographic density and breast cancer risk.

    Science.gov (United States)

    Lokate, Mariëtte; Stellato, Rebecca K; Veldhuis, Wouter B; Peeters, Petra H M; van Gils, Carla H

    2013-07-01

    High mammographic density is a strong breast cancer risk factor. Density normally declines with aging. We investigated whether the level of decline in mammographic density is related to breast cancer risk using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Prospect cohort. This cohort was recruited among participants of a population-based breast cancer screening program in the Netherlands between 1993 and 1997. We examined whether age-related changes in mammographic density were different for 533 cases and 1,367 controls who were 49-69 years of age at the time of recruitment into the cohort. We used mixed models with linear and quadratic terms for age and interaction terms between age terms and case status. The percent mammographic density at the first available mammogram was higher for cases than for controls (25.2% vs. 22.5%) (P = 0.003). The average decline in density over 10 years was 11% in both cases and controls (P = 0.56). When studying changes among 4 categories of density, we saw some indication that large changes may influence breast cancer risk. Although no difference was seen in the average decline, we cannot exclude that large changes may influence breast cancer risk.

  17. Association of mammographic image feature change and an increasing risk trend of developing breast cancer: an assessment

    Science.gov (United States)

    Tan, Maxine; Leader, Joseph K.; Liu, Hong; Zheng, Bin

    2015-03-01

    We recently investigated a new mammographic image feature based risk factor to predict near-term breast cancer risk after a woman has a negative mammographic screening. We hypothesized that unlike the conventional epidemiology-based long-term (or lifetime) risk factors, the mammographic image feature based risk factor value will increase as the time lag between the negative and positive mammography screening decreases. The purpose of this study is to test this hypothesis. From a large and diverse full-field digital mammography (FFDM) image database with 1278 cases, we collected all available sequential FFDM examinations for each case including the "current" and 1 to 3 most recently "prior" examinations. All "prior" examinations were interpreted negative, and "current" ones were either malignant or recalled negative/benign. We computed 92 global mammographic texture and density based features, and included three clinical risk factors (woman's age, family history and subjective breast density BIRADS ratings). On this initial feature set, we applied a fast and accurate Sequential Forward Floating Selection (SFFS) feature selection algorithm to reduce feature dimensionality. The features computed on both mammographic views were individually/ separately trained using two artificial neural network (ANN) classifiers. The classification scores of the two ANNs were then merged with a sequential ANN. The results show that the maximum adjusted odds ratios were 5.59, 7.98, and 15.77 for using the 3rd, 2nd, and 1st "prior" FFDM examinations, respectively, which demonstrates a higher association of mammographic image feature change and an increasing risk trend of developing breast cancer in the near-term after a negative screening.

  18. Physical evaluation of computed radiography as a mammographic X-ray imaging system.

    Science.gov (United States)

    Workman, A; Cowen, A R; Brettle, D S

    1994-10-01

    The physical imaging properties of a computed radiography (CR) system operating under mammographic exposure conditions have been measured. These measurements include modulation transfer function (MTF), sensitometric response and noise power spectrum (NPS). These figures were used to derive signal-to-noise ratio (SNR) descriptors of the system performance. The same measures were derived for a mammographic film-screen system. The SNR properties of the CR system indicate superior low frequency performance over a wider dynamic range than the film-screen system. The spatial frequency dependent SNR properties of the CR system are, however, limited. The results of a psychophysical test support the results obtained from physical measurements. These results indicate that despite its limited sharpness, details of dimensions relevant to diagnosis in mammography (circular details 0.25 mm diameter to represent microcalcifications and 3 mm diameter to represent small masses) are reproduced using CR with SNRs which are at least comparable with those of a mammographic film-screen system.

  19. Mammographic findings and occupational exposure to pesticides currently in use on Crete.

    Science.gov (United States)

    Dolapsakis, G; Vlachonikolis, I G; Varveris, C; Tsatsakis, A M

    2001-08-01

    This is a preliminary report of an outreach mammographic-screening programme on Crete. The screening is part of a study to test if occupational exposure to pesticides in greenhouses (mainly organophosphates and organocarbamates), may increase the risk of malignant or premalignant findings in mammographic examination. A total of 1062 women (aged 40--75 years) were recruited between 1988 and 1993 and followed-up until 1998: 522 worked for at least 10 years in greenhouses for more than 4 h daily (exposed), and 540 never worked in agriculture (non-exposed). Statistics include detection rates and relative risks of mammographic findings. 'Exposed' women had a significantly (Pfibroadenoma, ductal hyperplasia, sclerotic adenosis, fibrohyperplastic disease, cystic disease and inflammatory mastitis. There were no significant differences in the detection rates of fibrocystic changes, lipoma and malignant changes or malignant tumours. Compared with older women (aged 50--75 years), younger women (aged 40--49 years), particularly in the 'exposed' group, had a higher detection rate of malignant tumours. These preliminary results indicate that 'exposed' women may have higher risks of incidence for a number of lesions, which are risk markers for subsequent invasive breast cancers. They confirm also that early screening for breast cancer is effective and provides an opportunity for a reduction in breast cancer mortality.

  20. An evaluation of contrast enhancement techniques for mammographic breast masses.

    Science.gov (United States)

    Singh, Sameer; Bovis, Keir

    2005-03-01

    The main aim of this paper is to propose a novel set of metrics that measure the quality of the image enhancement of mammographic images in a computer-aided detection framework aimed at automatically finding masses using machine learning techniques. Our methodology includes a novel mechanism for the combination of the metrics proposed into a single quantitative measure. We have evaluated our methodology on 200 images from the publicly available digital database for screening mammograms. We show that the quantitative measures help us select the best suited image enhancement on a per mammogram basis, which improves the quality of subsequent image segmentation much better than using the same enhancement method for all mammograms.

  1. Radiologists' preferences for digital mammographic display. The International Digital Mammography Development Group.

    Science.gov (United States)

    Pisano, E D; Cole, E B; Major, S; Zong, S; Hemminger, B M; Muller, K E; Johnston, R E; Walsh, R; Conant, E; Fajardo, L L; Feig, S A; Nishikawa, R M; Yaffe, M J; Williams, M B; Aylward, S R

    2000-09-01

    To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for screening and diagnostic imaging tasks. Twenty-eight images representing histologically proved masses or calcifications were obtained by using three clinically available digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mixture model intensity windowing, peripheral equalization, multiscale image contrast amplification (MUSICA), contrast-limited adaptive histogram equalization, Trex processing, and unsharp masking. Twelve radiologists compared the processed digital images with screen-film mammograms obtained in the same patient for breast cancer screening and breast lesion diagnosis. For the screening task, screen-film mammograms were preferred to all digital presentations, but the acceptability of images processed with Trex and MUSICA algorithms were not significantly different. All printed digital images were preferred to screen-film radiographs in the diagnosis of masses; mammograms processed with unsharp masking were significantly preferred. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms. When digital mammograms were preferred to screen-film mammograms, radiologists selected different digital processing algorithms for each of three mammographic reading tasks and for different lesion types. Soft-copy display will eventually allow radiologists to select among these options more easily.

  2. Optimal Interval for Repeated Gastric Cancer Screening in Normal-Risk Healthy Korean Adults: A Retrospective Cohort Study.

    Science.gov (United States)

    Bae, Jong-Myon; Shin, Sang Yop; Kim, Eun Hee

    2015-10-01

    This retrospective cohort study was conducted to estimate the optimal interval for gastric cancer screening in Korean adults with initial negative screening results. This study consisted of voluntary Korean screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative in the baseline screening performed between January 2007 and December 2011. A new case was defined as the presence of gastric cancer cells in biopsy specimens obtained upon gastroscopy. The follow-up periods were calculated during the months between the date of baseline screening gastroscopy and positive findings upon subsequent screenings, stratified by sex and age group. The mean sojourn time (MST) for determining the screening interval was estimated using the prevalence/incidence ratio. Of the 293,520 voluntary screenees for the gastric cancer screening program, 91,850 (31.29%) underwent subsequent screening gastroscopies between January 2007 and December 2011. The MSTs in men and women were 21.67 months (95% confidence intervals [CI], 17.64 to 26.88 months) and 15.14 months (95% CI, 9.44 to 25.85 months), respectively. These findings suggest that the optimal interval for subsequent gastric screening in both men and women is 24 months, supporting the 2-year interval recommended by the nationwide gastric cancer screening program.

  3. Posterior breast cancer: Mammographic and ultrasonographic features

    Directory of Open Access Journals (Sweden)

    Janković Ana

    2013-01-01

    Full Text Available Background/Aim. Posterior breast cancers are located in the prepectoral region of the breast. Owing to this distinctive anatomical localization, physical examination and mammographic or ultrasonographic evaluation can be difficult. The purpose of the study was to assess possibilities of diagnostic mammography and breast ultrasonography in detection and differentiation of posterior breast cancers. Methods. The study included 40 women with palpable, histopathological confirmed posterior breast cancer. Mammographic and ultrasonographic features were defined according to Breast Imaging Reporting and Data System (BI-RADS lexicon. Results. Based on standard two-view mammography 87.5%, of the cases were classified as BI-RADS 4 and 5 categories, while after additional mammographic views all the cases were defined as BIRADS 4 and 5 categories. Among 96 mammographic descriptors, the most frequent were: spiculated mass (24.0%, architectural distortion (16.7%, clustered microcalcifications (12.6% and focal asymmetric density (12.6%. The differentiation of the spiculated mass was significantly associated with the possibility to visualize the lesion at two-view mammography (p = 0.009, without the association with lesion diameter (p = 0.083 or histopathological type (p = 0.055. Mammographic signs of invasive lobular carcinoma were significantly different from other histopathological types (architectural distortion, p = 0.003; focal asymmetric density, p = 0.019; association of four or five subtle signs of malignancy, p = 0.006. All cancers were detectable by ultrasonography. Mass lesions were found in 82.0% of the cases. Among 153 ultrasonographic descriptors, the most frequent were: irregular mass (15.7%, lobulated mass (7.2%, abnormal color Doppler signals (20.3%, posterior acoustic attenuation (18.3%. Ultrasonographic BI-RADS 4 and 5 categories were defined in 72.5% of the cases, without a significant difference among various histopathological types (p = 0

  4. Mammographic image enhancement using wavelet transform and homomorphic filter

    OpenAIRE

    Majidi, F.; Latif, A. M.; J. Malakouti; H Kasayi

    2015-01-01

    Mammography is the most effective method for the early diagnosis of breast cancer diseases. As mammographic images contain low signal to noise ratio and low contrast, it becomes too difficult for radiologists to analyze mammogram. To deal with the above stated problems, it is very important to enhance the mammographic images using image processing methods. This paper introduces a new image enhancement approach for mammographic images which uses the modified mathematical morphology, wavelet tr...

  5. Mammographic density and breast cancer risk: current understanding and future prospects

    Science.gov (United States)

    2011-01-01

    Variations in percent mammographic density (PMD) reflect variations in the amounts of collagen and number of epithelial and non-epithelial cells in the breast. Extensive PMD is associated with a markedly increased risk of invasive breast cancer. The PMD phenotype is important in the context of breast cancer prevention because extensive PMD is common in the population, is strongly associated with risk of the disease, and, unlike most breast cancer risk factors, can be changed. Work now in progress makes it likely that measurement of PMD will be improved in the near future and that understanding of the genetics and biological basis of the association of PMD with breast cancer risk will also improve. Future prospects for the application of PMD include mammographic screening, risk prediction in individuals, breast cancer prevention research, and clinical decision making. PMID:22114898

  6. Refinement of a viral transmission risk model for blood donations in seroconversion window phase screened by nucleic acid testing in different pool sizes and repeat test algorithms.

    Science.gov (United States)

    Weusten, Jos; Vermeulen, Marion; van Drimmelen, Harry; Lelie, Nico

    2011-01-01

    In minipool nucleic acid test (MP-NAT) screening protocols, the donations implicated in reactive test pools are released for transfusion when they are nonreactive in a repeat test on the individual samples, but in individual-donation (ID)-NAT screening algorithms the release of nonrepeatable reactive (NRR) donations is under discussion. A previously developed window phase (WP) transmission risk model for NAT-screened blood transfusions has been refined to take the effect of repeat tests of initially reactive (IR) MP- or ID-NAT results into account. The model has then been applied to simulate the effect of different screening algorithms with ULTRIO and the new-generation ULTRIO Plus assay (Novartis Diagnostics) on transmission risk for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). We calculated WP risk-day equivalents for MP16-, MP8-, and ID-NAT with and without duplicate retesting of IR results of 3.1, 2.7, 1.5, and 1.3 days for HCV; 6.3, 5.5, 3.3, and 2.9 days for HIV; and 24.4, 22.2, 15.6, and 14.1 days for HBV, respectively. These latter infectious HBV WPs reduced to 20.4, 18.2, 11.6, and 10.3 days, respectively, with the more sensitive ULTRIO Plus assay. ULTRIO Plus ID-NAT screening reduces the virus transmission risk in the WP by 54% to 58% compared to ULTRIO MP16-NAT, while the incremental risk caused by releasing donations with duplicate ID-NAT NRR results is 5% to 6%. To achieve maximum safety and specificity a similar repeat test algorithm can be applied to ID-NAT as used for serologic assays. © 2010 American Association of Blood Banks.

  7. Evaluation of mammographic density patterns: reproducibility and concordance among scales

    Directory of Open Access Journals (Sweden)

    Garrido-Estepa Macarena

    2010-09-01

    .32% respectively, while this percentage was lower for the quantitative scales (21.89% for BI-RADS and 21.86% for Boyd. Conclusions Visual scales of mammographic density show a high reproducibility when appropriate training is provided. Their ability to distinguish between high and low risk render them useful for routine use by breast cancer screening programs. Quantitative-based scales are more specific than pattern-based scales in classifying populations in the high-risk group.

  8. How are false negative cases perceived by mammographers? Which abnormalities are misinterpreted and which go undetected?

    Science.gov (United States)

    Scott, Hazel J.; Gale, Alastair G.; Hill, Sue

    2008-03-01

    A radiographic 'false negative' or a case which has been 'missed' can be categorised in terms of errors of search (where gaze does not fall upon the abnormality); detection (a perceptual error where the abnormality may be physically 'seen' but remains undetected) and misinterpretation (a perceptual error whereby an abnormality, although detected, is not deemed worthy of further assessment). This study aims to investigate perceptual errors in mammographic film-reading and will focus on the later of the two error types, namely errors of misinterpretation and errors of non-detection. Previous research has shown, on a self-assessment scheme of recent and difficult breast-screening cases, that certain feature types are susceptible to errors of misinterpretation and others to errors of non-detection. This self assessment scheme, 'PERFORMS' (Personal Performance in Mammographic Screening), is undertaken by the majority (at present over 90%) of breast-screening mammographers in the UK Breast Screening Programme. The scheme is completed biannually and confidentially and participants receive immediate and detailed feedback on their performance. Feedback from the scheme includes information detailing their false negative decisions including case classifications (benign or malignant), feature type (masses, calcification, asymmetries, architectural distortions and others) and case perception error (percentage of misinterpretation and percentage of non-detection). Results from a recent round of PERFORMS (n=506), revealed that certain feature types had significantly higher percentages of error overall (including architectural distortion and asymmetries), and that these feature types also showed significant differences for error type. Implications for real-life screening practice were explored using real-life self-reported data on years of screening experience.

  9. Randomized controlled trial of stereotactic 11-G vacuum-assisted core biopsy for the diagnosis and management of mammographic microcalcification.

    Science.gov (United States)

    Bundred, Sara M; Maxwell, Anthony J; Morris, Julie; Lim, Yit Y; Harake, Md Janick; Whiteside, Sigrid; Bundred, Nigel J

    2016-01-01

    To compare the accuracy of 11-G vacuum-assisted biopsy (VAB) with 14-G core needle biopsy (CNB) to diagnose mammographic microcalcification (MM) and effect on surgical outcomes. Following ethical approval, VAB and CNB (control) were compared in a randomized prospective study for first-line diagnosis of MM and subsequent surgical outcomes in two breast-screening units. Participants gave written informed consent. Exclusions included comorbidity precluding surgery, prior ipsilateral breast cancer and lesions >40 mm requiring mastectomy as first surgical procedure. The final pathological diagnosis was compared with the initial biopsy result. Quality-of-life (QOL) questionnaires were administered at baseline, 2, 6 and 12 months. 110 participants were required to show a 25% improvement in diagnosis with VAB compared with CNB (90% power). Eligibility was assessed for 787 cases; 129 females recalled from the National Health Service breast screening programme were randomized. Diagnostic accuracy of VAB was 86% and that of CNB was 84%. Using VAB, 2/14 (14.3%) cases upgraded from ductal carcinoma in situ to invasion at surgery and 3/19 (15.8%) using CNB. Following VAB 7/16 (44%) cases required repeat surgery vs 7/24 (29%) after CNB. Both groups recorded significant worsening of functional QOL measures and increased breast pain at follow-up. VAB and CNB were equally accurate at diagnosing MM, and no significant differences in surgical outcomes were observed. The first randomized controlled study of VAB for diagnosis of microcalcification using digital mammography showed no difference in diagnostic accuracy of VAB and CNB, or in the proportion of participants needing repeat non-operative biopsy or second therapeutic operation to treat malignancy.

  10. Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities

    Directory of Open Access Journals (Sweden)

    Trocchi Pietro

    2012-11-01

    Full Text Available Abstract Background As high percentage of mammographic densities complicates the assessment of imaging findings, mammographic density may influence the histopathological evaluation of core-biopsies of the breast. We measured the influence of mammographic density on the inter-observer variability of histopathological findings of breast biopsies. Methods Histological slides of 695 women who underwent core biopsies of the breast at University of Halle between 2006 and 2008 were evaluated in a blinded fashion by two pathologists using the five levels of the B-categorization scheme (B1-B5. To quantify mammographic density, we used a computer-based threshold method (Madena. We calculated observed and chance-corrected agreements (weighted kappa and 95% confidence intervals (95% CI according to four categories of mammographic density ( Results The weighted kappa decreased monotonically from 89.6% (95% CI: 85.8%, 93.3% among women with less than 10% of mammographic density to 80.4% (95% CI: 69.9%, 90.9% for women with more than 50% of mammographic density, respectively. Results of a kappa regression analysis showed that agreement of pathologists on clinically relevant categories (B1-B2 versus B3-B5 decreased with mammographic density. Conclusions Mammographic density is a relevant modifier of the agreement between pathologists who assess breast biopsies using the B-categorization scheme. The influence of mammographic density on the inter-observer variability can be explained to some extent by varying prevalences of histological entities across B categories that have typically different inter-observer agreement. Women with high mammographic density are at higher risk of inter-observer variability compared to women with low mammographic density and should possibly undergo a second pathology review.

  11. A comprehensive tool for measuring mammographic density changes over time.

    Science.gov (United States)

    Eriksson, Mikael; Li, Jingmei; Leifland, Karin; Czene, Kamila; Hall, Per

    2018-02-01

    Mammographic density is a marker of breast cancer risk and diagnostics accuracy. Density change over time is a strong proxy for response to endocrine treatment and potentially a stronger predictor of breast cancer incidence. We developed STRATUS to analyse digital and analogue images and enable automated measurements of density changes over time. Raw and processed images from the same mammogram were randomly sampled from 41,353 healthy women. Measurements from raw images (using FDA approved software iCAD) were used as templates for STRATUS to measure density on processed images through machine learning. A similar two-step design was used to train density measures in analogue images. Relative risks of breast cancer were estimated in three unique datasets. An alignment protocol was developed using images from 11,409 women to reduce non-biological variability in density change. The protocol was evaluated in 55,073 women having two regular mammography screens. Differences and variances in densities were compared before and after image alignment. The average relative risk of breast cancer in the three datasets was 1.6 [95% confidence interval (CI) 1.3-1.8] per standard deviation of percent mammographic density. The discrimination was AUC 0.62 (CI 0.60-0.64). The type of image did not significantly influence the risk associations. Alignment decreased the non-biological variability in density change and re-estimated the yearly overall percent density decrease from 1.5 to 0.9%, p density measures was not influenced by mammogram type. The alignment protocol reduced the non-biological variability between images over time. STRATUS has the potential to become a useful tool for epidemiological studies and clinical follow-up.

  12. Mammographic image restoration using maximum entropy deconvolution

    OpenAIRE

    Jannetta, Adrian; Jackson, John; Birch, Ian; Kotre, John; Robson, Kevin; Padgett, Rod

    2004-01-01

    An image restoration approach based on a Bayesian maximum entropy method (MEM) has been applied to a radiological image deconvolution problem, that of reduction of geometric blurring in magnification mammography. The aim of the work is to demonstrate an improvement in image spatial resolution in realistic noisy radiological images with no associated penalty in terms of reduction in the signal-to-noise ratio perceived by the observer. Images of the TORMAM mammographic image quality phantom wer...

  13. Ultrasonographic Findings of Mammographic Architectural Distortion

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Jeong Hyun; Kang, Bong Joo; Cha, Eun Suk; Hwangbo, Seol; Kim, Hyeon Sook; Park, Chang Suk; Kim, Sung Hun; Choi, Jae Jeong; Chung, Yong An [Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2008-06-15

    To review the sonographic findings of various diseases showing architectural distortion depicted under mammography. We collected and reviewed architectural distortions observed under mammography at our health institution between 1 March 2004, and 28 February 2007. We collected 23 cases of sonographically-detected mammographic architectural distortions that confirmed lesions after surgical resection. The sonographic findings of mammographic architectural distortion were analyzed by use of the BI-RADS lexicon for shape, margin, lesion boundary, echo pattern, posterior acoustic feature and orientation. There were variable diseases that showed architectural distortion depicted under mammography. Fibrocystic disease was the most common presentation (n = 6), followed by adenosis (n = 2), stromal fibrosis (n = 2), radial scar (n = 3), usual ductal hyperplasia (n = 1), atypical ductal hyperplasia (n = 1) and mild fibrosis with microcalcification (n = 1). Malignant lesions such as ductal carcinoma in situ (DCIS) (n = 2), lobular carcinoma in situ (LCIS) (n = 2), invasive ductal carcinoma (n = 2) and invasive lobular carcinoma (n = 1) were observed. As observed by sonography, shape was divided as irregular (n = 22) and round (n = 1). Margin was divided as circumscribed (n = 1), indistinct (n = 7), angular (n = 1), microlobulated (n = 1) and sipculated (n = 13). Lesion boundary was divided as abrupt interface (n = 11) and echogenic halo (n = 12). Echo pattern was divided as hypoechoic (n = 20), anechoic (n = 1), hyperechoic (n = 1) and isoechoic (n = 1). Posterior acoustic feature was divided as posterior acoustic feature (n = 7), posterior acoustic shadow (n = 15) and complex posterior acoustic feature (n = 1). Orientation was divided as parallel (n = 12) and not parallel (n = 11). There were no differential sonographic findings between benign and malignant lesions. This study presented various sonographic findings of mammographic architectural distortion and that it is

  14. Bilateral breast cancer : mammographic and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Oh, Ki Keun; Jun, Hwang Yoon; Lee, Byung Chan; Lee, Kyong Sik; Lee, Yong Hee [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-06-01

    To evaluate the mammographic and clinical features of bilateral breast cancer. We retrospectively reviewed clinical records(n=23) and mammograms (n=15) of 23 patients with bilateral breast cancer. Patients' age, location of the tumor and pathologic staging were determined from clinical records. Mammographic features were classified as spiculated mass, nonspiculated mass, mass with microcalcification, microcalcification only, asymmetric density, and normal. Of the 23 cases of bilateral breast cancer, 8(34.8%) were synchronous and 15(65.2%) were metachronous. Age at diagnosis of cancer in the first breast was between 27 and 59(mean 43) years ; there was no statistically significant difference in mean age between patients with synchronous and metachronous cancer. The mean interval between the diagnosis of each lesion of the metachronous pairs was 9.1 years. In 11 of 23 cases(48%), tumors were locaated in the same quadrant, and in the other 12 cases(52%), they were in different quadrant. At mammography, five of 15 metachronous cancers(33%) were similar in appearance and 10 pairs(67%) were different. In 4 of 23 cases(17%), cancer in the first breast was at stage 0 and stage 1, and in 13 of 23(57%), cancer in the second breast was at this same stage. In bilateral breast cancer, the two breasts frequently show different mammographic features. Cancer of the second breast was at an early stage; this suggest that regular examination and mammography are important and can allow early detection of contralateral breast cancer.

  15. Promoting cervical screening after introduction of the human papillomavirus vaccine: the effect of repeated mass media campaigns.

    Science.gov (United States)

    Mullins, R; Coomber, K; Broun, K; Wakefield, M

    2013-03-01

    In 2007, Australia implemented an ongoing, school-based human papillomavirus (HPV) vaccination programme for school-aged girls, and a catch-up programme for 18-26-year-old women that ran until the end of 2009. The availability of what is widely known as the 'cervical cancer vaccine' means there is the potential for women to believe, incorrectly, that they no longer require regular cervical screening, and this risk needs to be addressed. The current study aimed to assess the effect of three mass media campaigns to promote cervical screening on the rate of cervical screening tests in the Australian state of Victoria, after HPV vaccine became available. Seasonal time series assessed the effect of media campaigns broadcast in 2007, 2009 and 2010 on the rate of weekly cervical screening tests in Victorian women from 2006 to 2010, stratified by time since last screening test. The 2007 and 2009 media campaigns significantly increased the number of cervical screening tests per week. The 2007 campaign had a significant impact on lapsed screeners (>36 months since last test), overdue screeners (28-36 months since last test), and women never previously screened. The 2009 campaign significantly increased screening tests for overdue screeners, and the 2010 media campaign was associated with a significant increase in screening tests for lapsed screeners. A well-researched and carefully pretested television advertising campaign with accurate, actionable messages can elicit appropriate screening behaviour among some of the appropriate groups even in a changed environment of complex, and potentially competing, messages.

  16. 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

  17. Mammographic compression – A need for mechanical standardization

    Energy Technology Data Exchange (ETDEWEB)

    Branderhorst, Woutjan, E-mail: w.branderhorst@amc.nl [Academic Medical Center, Department of Biomedical Engineering & Physics, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Sigmascreening B.V., Meibergdreef 45, 1105 BA Amsterdam (Netherlands); Groot, Jerry E. de, E-mail: jerry.degroot@sigmascreening.com [Academic Medical Center, Department of Biomedical Engineering & Physics, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Highnam, Ralph, E-mail: ralph.highnam@volparasolutions.com [Volpara Solutions Limited, P.O. Box 24404, Manners St Central, Wellington 6142 (New Zealand); Chan, Ariane, E-mail: ariane.chan@volparasolutions.com [Volpara Solutions Limited, P.O. Box 24404, Manners St Central, Wellington 6142 (New Zealand); Böhm-Vélez, Marcela, E-mail: marcelabvelez@gmail.com [Weinstein Imaging Associates, 5850 Centre Avenue, Pittsburgh, PA 15206 (United States); Broeders, Mireille J.M., E-mail: mireille.broeders@radboudumc.nl [Radboud University Medical Center, Department for Health Evidence, P.O. Box 9101, 6500 HB Nijmegen (Netherlands); LRCB Dutch Reference Center for Screening, P.O. Box 6873, 6503 GJ Nijmegen (Netherlands); Heeten, Gerard J. den, E-mail: g.denheeten@lrcb.nl [Academic Medical Center, Department of Radiology, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); LRCB Dutch Reference Center for Screening, P.O. Box 6873, 6503 GJ Nijmegen (Netherlands); Grimbergen, Cornelis A., E-mail: c.a.grimbergen@amc.uva.nl [Academic Medical Center, Department of Biomedical Engineering & Physics, P.O. Box 22660, 1100 DD Amsterdam (Netherlands); Sigmascreening B.V., Meibergdreef 45, 1105 BA Amsterdam (Netherlands)

    2015-04-15

    Highlights: •We studied mechanical breast compression practice in two different clinical sites. •We visualized the distributions of not only the applied force but also the pressure. •The applied pressure was highly variable, both within and between the data sets. •The average applied pressure and the variation were higher for smaller breasts. •A proposal for improved individualization, by standardizing pressure, is discussed. -- Abstract: Background: A lack of consistent guidelines regarding mammographic compression has led to wide variation in its technical execution. Breast compression is accomplished by means of a compression paddle, resulting in a certain contact area between the paddle and the breast. This procedure is associated with varying levels of discomfort or pain. On current mammography systems, the only mechanical parameter available in estimating the degree of compression is the physical entity of force (daN). Recently, researchers have suggested that pressure (kPa), resulting from a specific force divided by contact area on a breast, might be a more appropriate parameter for standardization. Software has now become available which enables device-independent cross-comparisons of key mammographic metrics, such as applied compression pressure (force divided by contact area), breast density and radiation dose, between patient populations. Purpose: To compare the current compression practice in mammography between different imaging sites in the Netherlands and the United States from a mechanical point of view, and to investigate whether the compression protocols in these countries can be improved by standardization of pressure (kPa) as an objective mechanical parameter. Materials and methods: We retrospectively studied the available parameters of a set of 37,518 mammographic compressions (9188 women) from the Dutch national breast cancer screening programme (NL data set) and of another set of 7171 compressions (1851 women) from a breast imaging

  18. Mammographic breast density patterns among a group of women in ...

    African Journals Online (AJOL)

    Introduction: Mammographic breast density is a measure of parenchymal breast patterns on film and in part a marker of cumulative exposure to oestrogen. The risk of breast cancer for women with increased density is up to six fold more than in women with less dense tissues. The pattern of mammographic breast density ...

  19. Changes in mammographic density and breast cancer risk

    NARCIS (Netherlands)

    Lokate, A.J.M.

    2012-01-01

    Breast cancer is the most frequently occurring cancer among women worldwide. One of the most important risk factors for breast cancer is high mammographic density. Mammographic density represents the amount of fibroglandular tissue relative to the fat tissue in the breast. Women with >75% of their

  20. Artificial-neural-network-based classification of mammographic microcalcifications using image structure features

    Science.gov (United States)

    Dhawan, Atam P.; Chitre, Yateen S.; Moskowitz, Myron

    1993-07-01

    Mammography associated with clinical breast examination and self-breast examination is the only effective and viable method for mass breast screening. It is however, difficult to distinguish between benign and malignant microcalcifications associated with breast cancer. Most of the techniques used in the computerized analysis of mammographic microcalcifications segment the digitized gray-level image into regions representing microcalcifications. We present a second-order gray-level histogram based feature extraction approach to extract microcalcification features. These features, called image structure features, are computed from the second-order gray-level histogram statistics, and do not require segmentation of the original image into binary regions. Several image structure features were computed for 100 cases of `difficult to diagnose' microcalcification cases with known biopsy results. These features were analyzed in a correlation study which provided a set of five best image structure features. A feedforward backpropagation neural network was used to classify mammographic microcalcifications using the image structure features. The network was trained on 10 cases of mammographic microcalcifications and tested on additional 85 `difficult-to-diagnose' microcalcifications cases using the selected image structure features. The trained network yielded good results for classification of `difficult-to- diagnose' microcalcifications into benign and malignant categories.

  1. A comparison of five methods of measuring mammographic density: a case-control study.

    Science.gov (United States)

    Astley, Susan M; Harkness, Elaine F; Sergeant, Jamie C; Warwick, Jane; Stavrinos, Paula; Warren, Ruth; Wilson, Mary; Beetles, Ursula; Gadde, Soujanya; Lim, Yit; Jain, Anil; Bundred, Sara; Barr, Nicola; Reece, Valerie; Brentnall, Adam R; Cuzick, Jack; Howell, Tony; Evans, D Gareth

    2018-02-05

    High mammographic density is associated with both risk of cancers being missed at mammography, and increased risk of developing breast cancer. Stratification of breast cancer prevention and screening requires mammographic density measures predictive of cancer. This study compares five mammographic density measures to determine the association with subsequent diagnosis of breast cancer and the presence of breast cancer at screening. Women participating in the "Predicting Risk Of Cancer At Screening" (PROCAS) study, a study of cancer risk, completed questionnaires to provide personal information to enable computation of the Tyrer-Cuzick risk score. Mammographic density was assessed by visual analogue scale (VAS), thresholding (Cumulus) and fully-automated methods (Densitas, Quantra, Volpara) in contralateral breasts of 366 women with unilateral breast cancer (cases) detected at screening on entry to the study (Cumulus 311/366) and in 338 women with cancer detected subsequently. Three controls per case were matched using age, body mass index category, hormone replacement therapy use and menopausal status. Odds ratios (OR) between the highest and lowest quintile, based on the density distribution in controls, for each density measure were estimated by conditional logistic regression, adjusting for classic risk factors. The strongest predictor of screen-detected cancer at study entry was VAS, OR 4.37 (95% CI 2.72-7.03) in the highest vs lowest quintile of percent density after adjustment for classical risk factors. Volpara, Densitas and Cumulus gave ORs for the highest vs lowest quintile of 2.42 (95% CI 1.56-3.78), 2.17 (95% CI 1.41-3.33) and 2.12 (95% CI 1.30-3.45), respectively. Quantra was not significantly associated with breast cancer (OR 1.02, 95% CI 0.67-1.54). Similar results were found for subsequent cancers, with ORs of 4.48 (95% CI 2.79-7.18), 2.87 (95% CI 1.77-4.64) and 2.34 (95% CI 1.50-3.68) in highest vs lowest quintiles of VAS, Volpara and Densitas

  2. Pre-operative factors indicating risk of multiple operations versus a single operation in women undergoing surgery for screen detected breast cancer.

    Science.gov (United States)

    O'Flynn, E A M; Currie, R J; Mohammed, K; Allen, S D; Michell, M J

    2013-02-01

    We aim to identify preoperative factors at diagnosis which could predict whether women undergoing wide local excision (WLE) would require further operations. 1593 screen-detected invasive and non-invasive breast cancers were reviewed. Age, presence of ductal carcinoma in situ (DCIS), invasive cancer size on mammography, mammographic sign, tumour type, grade and confidence of the radiologist in malignancy were compared. 83%(1315/1593) of women had a WLE. Of these, 70%(919/1315) had a single operation, and 30%(396/1315) multiple operations. These included repeat WLE to clear margins (60%(238/396)), mastectomy (34%(133/396)) and axillary dissection (6%(25/396)). The presence of mammographic microcalcification, lobular carcinoma and grade 2 malignancy on core biopsy were independent risk factors for multiple operations on multivariate analysis. Women with mammographic DCIS >30 mm were 3.4 times more likely to undergo repeat surgery than those with smaller foci. The multidisciplinary team should pay particular attention to these factors when planning surgery. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. ORIGINAL ARTICLES Performance data of screening ...

    African Journals Online (AJOL)

    establishing the benefits of mammographic screening in defined populations.1 As a result, performance benchmarks have been established; any screening should adhere to these to minimise the harm resulting from increased anxiety, false- positive results and increased cost.5,6 If benchmarking for screening is undertaken ...

  4. Is the tide turning against breast screening?

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl

    2012-01-01

    ABSTRACT: Herein I argue that mammographic screening has not delivered on its fundamental premise: to reduce the incidence of advanced breast cancer. Indeed, achieving this goal is required if screening is to reduce breast cancer mortality or mastectomy use. Rather, screening has caused substanti...

  5. Mammographic image enhancement using wavelet transform and homomorphic filter

    Directory of Open Access Journals (Sweden)

    F Majidi

    2015-12-01

    Full Text Available Mammography is the most effective method for the early diagnosis of breast cancer diseases. As mammographic images contain low signal to noise ratio and low contrast, it becomes too difficult for radiologists to analyze mammogram. To deal with the above stated problems, it is very important to enhance the mammographic images using image processing methods. This paper introduces a new image enhancement approach for mammographic images which uses the modified mathematical morphology, wavelet transform and homomorphic filter to suppress the noise of images. For performance evaluation of the proposed method, contrast improvement index (CII and edge preservation index (EPI are adopted. Experimental results on mammographic images from Pejvak Digital Imaging Center (PDIC show that the proposed algorithm improves the two indexes, thereby achieving the goal of enhancing mammographic images.

  6. Effects of statin use on volumetric mammographic density: results from the KARMA study.

    Science.gov (United States)

    Skarping, Ida; Brand, Judith S; Hall, Per; Borgquist, Signe

    2015-05-28

    Epidemiological data on statins and breast cancer risk have been inconclusive. The aim of this study was to clarify the role of statins in breast cancer risk by studying their effect on mammographic density. The KARolinska MAmmography project for risk prediction of breast cancer (KARMA) includes 70,877 women who underwent either a screening or clinical mammography from January 2011 to December 2013. In total, 41,102 women responded to a web-based questionnaire, and had raw digital mammograms stored. Volumetric mammographic density was measured using Volpara™ and information on statin use was obtained through linkage with the Swedish National Prescription Register. Analysis of covariance was used to study the effect of statin use on mammographic density, adjusting for a large set of potential confounders. We also studied the effects of statin class and treatment duration and tested for potential effect modification by hormone replacement therapy (HRT). Statin use was recorded in 3,337 women (8.1 %) of the study population and lipophilic statins was the most commonly prescribed type (93.4 % of all statin users). After multivariable adjustment, percent dense volume was lower in statin users than in non-users (P < 0.001). This association was explained by a larger absolute non-dense volume in statin users (P < 0.001). Overall, no difference in absolute dense volume was detected, but interaction analyses revealed a larger dense volume among statin users who reported ever HRT use (P = 0.03). No differential effects were observed according to statin lipophilicity and treatment duration. We observed no overall effect of statin use on mammographic density in terms of absolute dense volume, although a larger absolute dense volume was observed in statin users who reported ever HRT use, which requires further investigation.

  7. Ethnic differences in mammographic densities: an Asian cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Shivaani Mariapun

    Full Text Available BACKGROUND: Mammographic density is a strong risk factor for breast cancer and is highly variable, but, to date, few studies have examined density in Asian women, particularly those in low and middle-income Asian countries where genetic and lifestyle determinants may be significantly different. METHODS: A total of 1,240 women who attended an opportunistic mammogram screening programme were eligible for analysis. Mammographic density was estimated using a fully-automated thresholding method and differences across ethnic groups were examined using linear regression in 205 randomly selected Chinese women, 138 Malay and 199 Indian women. RESULTS: Percent density was significantly higher in Chinese women (28.5%; 95% CI 27.0%, 30.0% compared to Malay (24.2%; 95% CI 22.5%, 26.0% and Indian (24.3%; 95% CI 22.8%, 25.7% women (p<0.001, after adjustment for age, BMI, menopausal status, parity and age at first full term pregnancy. Correspondingly, adjusted nondense area was significantly lower in Chinese (72.2cm2; 95% CI 67.9cm2, 76.5cm2 women compared to Malay (92.1cm2; 95% CI 86.9cm2, 97.2cm2 and Indian (97.7cm2; 95% CI 93.4cm2, 101.9cm2 women (p<0.001, but dense area did not differ across the three ethnic groups. CONCLUSIONS: Our study shows that higher percent density and lower nondense area reflect the higher incidence of breast cancer in Chinese compared to Malay and Indian women in Malaysia. Known lifestyle determinants of mammographic density do not fully account for the ethnic variations observed in mammographic density in this Asian cohort.

  8. Breast-Specific γ-Imaging for the Detection of Mammographically Occult Breast Cancer in Women at Increased Risk.

    Science.gov (United States)

    Brem, Rachel F; Ruda, Rachel C; Yang, Jialu L; Coffey, Caitrín M; Rapelyea, Jocelyn A

    2016-05-01

    Breast-specific γ-imaging (BSGI) is a physiologic imaging modality that can detect subcentimeter and mammographically occult breast cancer, with a sensitivity and specificity comparable to MRI. The purpose of this study was to determine the incremental increase in breast cancer detection when BSGI is used as an adjunct to mammography in women at increased risk for breast cancer. All patients undergoing BSGI from April 2010 through January 2014 were retrospectively reviewed. Eligible patients were identified as women at increased risk for breast cancer and whose most recent mammogram was benign. Examinations exhibiting focally increased radiotracer uptake were considered positive. Incremental increase in cancer detection was calculated as the percentage of mammographically occult BSGI-detected breast cancer and the number of mammographically occult breast cancers detected per 1,000 women screened. Included in this study were 849 patients in whom 14 BSGI examinations detected mammographically occult breast cancer. Patients ranged in age from 26 to 83 y, with a mean age of 57 y. Eleven of 14 cancers were detected in women with dense breasts. The addition of BSGI to the annual breast screen of asymptomatic women at increased risk for breast cancer yields 16.5 cancers per 1,000 women screened. When high-risk lesions and cancers were combined, BSGI detected 33.0 high-risk lesions and cancers per 1,000 women screened. BSGI is a reliable adjunct modality to screening mammography that increases breast cancer detection by 1.7% (14/849) in women at increased risk for breast cancer, comparable to results reported for breast MRI. BSGI is beneficial in breast cancer detection in women at increased risk, particularly in those with dense breasts. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  9. Mammographic density and epithelial histopathologic markers

    Directory of Open Access Journals (Sweden)

    Killeen Jeffrey

    2009-06-01

    Full Text Available Abstract Background We explored the association of mammographic density, a breast cancer risk factor, with hormonal and proliferation markers in benign tissue from tumor blocks of pre-and postmenopausal breast cancer cases. Methods Breast cancer cases were recruited from a case-control study on breast density. Mammographic density was assessed on digitized prediagnostic mammograms using a computer-assisted method. For 279 participants of the original study, we obtained tumor blocks and prepared tissue microarrays (TMA, but benign tissue cores were only available for 159 women. The TMAs were immunostained for estrogen receptor alpha (ERα and beta (ERβ, progesterone receptor (PR, HER2/neu, Ki-67, and Proliferating Cell Nuclear Antigen (PCNA. We applied general linear models to compute breast density according to marker expression. Results A substantial proportion of the samples were in the low or no staining categories. None of the results was statistically significant, but women with PR and ERβ staining had 3.4% and 2.4% higher percent density. The respective values for Caucasians were 5.7% and 11.6% but less in Japanese women (3.5% and -1.1%. Percent density was 3.4% higher in women with any Ki-67 staining and 2.2% in those with positive PCNA staining. Conclusion This study detected little evidence for an association between mammographic density and expression of steroid receptors and proliferation markers in breast tissue, but it illustrated the problems of locating tumor blocks and benign breast tissue samples for epidemiologic research. Given the suggestive findings, future studies examining estrogen effects in tissue, cell proliferation, and density in the breast may be informative.

  10. Long-term exposure to air pollution and mammographic density in the Danish Diet, Cancer and Health cohort

    DEFF Research Database (Denmark)

    Huynh, Stephanie; von Euler-Chelpin, My; Raaschou-Nielsen, Ole

    2015-01-01

    in Copenhagen (1993-2001), we used MD assessed at the first screening after cohort entry. MD was defined as mixed/dense or fatty. Traffic-related air pollution at residence was assessed by modeled levels of nitrogen oxides (NOx) and nitrogen dioxide (NO2). The association between mean NOx and NO2 levels since......BACKGROUND: Growing evidence suggests that air pollution may be a risk factor for breast cancer, but the biological mechanism remains unknown. High mammographic density (MD) is one of the strongest predictors and biomarkers of breast cancer risk, but it has yet to be linked to air pollution. We...... investigated the association between long-term exposure to traffic-related air pollution and MD in a prospective cohort of women 50 years and older. METHODS: For the 4,769 women (3,930 postmenopausal) participants in the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening...

  11. Simple Risk Stratification to Detect Prostate Cancer with High Gleason Score in Repeat Biopsies in a Population Screening Follow-up Study.

    Science.gov (United States)

    Kitagawa, Yasuhide; Urata, Satoko; Mizokami, Atsushi; Nakashima, Kazuyoshi; Koshida, Kiyoshi; Nakashima, Takao; Miyazaki, Kimiomi; Namiki, Mikio

    2015-09-01

    To investigate the clinical usefulness of percentage free prostate-specific antigen (%fPSA) and PSA velocity (PSAV) for detecting prostate cancer in repeat biopsies in a population-based screening cohort. In total, 178 men with serum PSA levels within 2.1-10 ng/ml who underwent repeat biopsies after initial negative biopsy results, were enrolled. Prostate cancer detection rates with a Gleason score of 7 or more according to age, serum PSA, %fPSA, and PSAV were investigated. The cumulative probability of detecting cancer according to risk factors was also investigated. Out of 178 men who underwent repeat biopsy, 48 (27.0%) were diagnosed with prostate cancer during the observation period, and pathological examination revealed prostate cancer with a Gleason score of 7 or more in 17 patients (35.4%). In the multivariate logistic regression analysis, %fPSA ≤ 12 at repeat biopsy and PSAV >0.40 ng/ml/year were determined to be independent risk factors for prostate cancer, and %fPSA ≤ 12 at initial biopsy and PSAV >0.40 for cancer of Gleason score 7 or greater. The cumulative probabilities of developing high-grade cancer after 5 years were 55.8% and 4.0% in men with %fPSA ≤ 12 at initial biopsy and PSAV >0.40, and in men without both, respectively. There was a statistically significant difference in probabilities between groups by the log-rank test. The present results demonstrated that %fPSA and PSAV were predictors of prostate cancer with a Gleason score of 7 or more in repeat biopsy after a negative initial biopsy on a population follow-up basis. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  12. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet

    DEFF Research Database (Denmark)

    Paci, Eugenio; Lynge, Elsebeth

    2012-01-01

    To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women.......To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women....

  13. Mammographic and sonographic features of tuberculous mastitis

    Energy Technology Data Exchange (ETDEWEB)

    Sakr, Ayman A. E-mail: fahmi.sakr@link.netaymansakr12345@hotmail.com; Fawzy, Rawya K.; Fadaly, Gylan; Baky, Moustafa Abdel

    2004-07-01

    From December 1999 to April 2001, 10 cases of tuberculous mastitis were presented to the Radiology Unit at the Medical Research Institute of Alexandria University for mammographic and sonographic evaluation. Sixty percent presented with masses, 50% mastalgia, 40% discharge, and 10% complained of skin sinus. In 30% of the patients the complaint was bilateral. All cases underwent full mammographic and ultrasonographic (US) studies, and US-guided fine needle aspiration. Also pathological, bacteriological analysis, and polymerase chain reaction (PCR) were done to all patients to prove the tuberculous nature of their lesions. Thirty percent of the cases had surgical excision on their masses. On mammography 30% were found to have mass lesion mimicking malignant tumors, 40% smooth bordered masses, 40% axillary or intramammary adenopathy, 30% asymmetric density, 30% duct ectasia, 20% with skin thickening and nipple retraction, 20% with macrocalcification, and 10% with skin sinus. On US 60% had hypoechoic masses, 40% focal or sectorial duct ectasia, and 50% axillary adenopathy. History of tuberculosis was found in 30% of the cases. Chest X-ray was positive in 20% and breast magnetic resonance imaging was done to one patient who had skin sinus.

  14. Computer-aided detection of breast carcinoma in standard mammographic projections with digital mammography

    Energy Technology Data Exchange (ETDEWEB)

    Destounis, Stamatia [Elizabeth Wende Breast Care, LLC, Rochester, NY (United States); University of Rochester, School of Medicine and Dentistry, Rochester, NY (United States); Hanson, Sarah; Morgan, Renee; Murphy, Philip; Somerville, Patricia; Seifert, Posy; Andolina, Valerie; Arieno, Andrea; Skolny, Melissa; Logan-Young, Wende [Elizabeth Wende Breast Care, LLC, Rochester, NY (United States)

    2009-06-15

    A retrospective evaluation of the ability of computer-aided detection (CAD) ability to identify breast carcinoma in standard mammographic projections. Forty-five biopsy proven lesions in 44 patients imaged digitally with CAD applied at examination were reviewed. Forty-four screening BIRADS {sup registered} category 1 digital mammography examinations were randomly identified to serve as a comparative normal/control population. Data included patient age; BIRADS {sup registered} breast density; lesion type, size, and visibility; number, type, and location of CAD marks per image; CAD ability to mark lesions; needle core and surgical pathologic correlation. The CAD lesion/case sensitivity of 87% (n=39), image sensitivity of 69% (n=31) for mediolateral oblique view and 78% (n=35) for the craniocaudal view was found. The average false positive rate in 44 normal screening cases was 2.0 (range 1-8). The 2.0 figure is based on 88 reported false positive CAD marks in 44 normal screening exams: 98% (n=44) lesions proceeded to excision; initial pathology upgraded at surgical excision from in situ to invasive disease in 24% (n=9) lesions. CAD demonstrated potential to detect mammographically visible cancers in standard projections for all lesion types. (orig.)

  15. Mammography workstation design: effect on mammographer behaviour and the risk of musculoskeletal disorders

    Science.gov (United States)

    Taylor-Phillips, S.; Wallis, M. G.; Gale, A. G.

    2008-03-01

    In the UK Breast Screening Programme there is a growing transition from film to digital mammography, and consequently a change in mammography workstation ergonomics. This paper investigates the effect of the change for radiologists including their comfort, likelihood of developing musculoskeletal disorders (MSD's), and work practices. Three workstations types were investigated: one with all film mammograms; one with digital mammograms alongside film mammograms from the previous screening round, and one with digital mammograms alongside digitised film mammograms from the previous screening round. Mammographers were video-taped whilst conducting work sessions at each of the workstations. Event based Rapid Upper Limb Assessment (RULA) postural analysis showed no overall increase in MSD risk level in the switch from the film to digital workstation. Average number of visual glances at the prior mammograms per case measured by analysis of recorded video footage showed an increase if the prior mammograms were digitised, rather than displayed on a multi-viewer (p<.05). This finding has potential implications for mammographer performance in the transition to digital mammography in the UK.

  16. 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. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Local mammographic density as a predictor of breast cancer

    Science.gov (United States)

    Otsuka, Mayu; Harkness, Elaine F.; Chen, Xin; Moschidis, Emmanouil; Bydder, Megan; Gadde, Soujanya; Lim, Yit Y.; Maxwell, Anthony J.; Evans, Gareth D.; Howell, Anthony; Stavrinos, Paula; Wilson, Mary; Astley, Susan M.

    2015-03-01

    High overall mammographic density is associated with both an increased risk of developing breast cancer and the risk of cancer being masked. We compared local density at cancer sites in diagnostic images with corresponding previous screening mammograms (priors), and matched controls. VolparaTM density maps were obtained for 54 mammograms showing unilateral breast cancer and their priors which had been previously read as normal. These were each matched to 3 controls on age, menopausal status, hormone replacement therapy usage, body mass index and year of prior. Local percent density was computed in 15mm square regions at lesion sites and similar locations in the corresponding images. Conditional logistic regression was used to predict case-control status. In diagnostic and prior images, local density was increased at the lesion site compared with the opposite breast (medians 21.58%, 9.18%, pcancer than those in the lowest tertile (OR 42.09, 95% CI 5.37-329.94). Those in the highest tertile of VolparaTM gland volume were also more likely to develop cancer (OR 2.89, 95% CI 1.30-6.42). Local density is increased where cancer will develop compared with corresponding regions in the opposite breast and matched controls, and its measurement could enhance computer-aided mammography.

  18. Reduction of false-positive recalls using a computerized mammographic image feature analysis scheme

    Science.gov (United States)

    Tan, Maxine; Pu, Jiantao; Zheng, Bin

    2014-01-01

    The high false-positive recall rate is one of the major dilemmas that significantly reduce the efficacy of screening mammography, which harms a large fraction of women and increases healthcare cost. This study aims to investigate the feasibility of helping reduce false-positive recalls by developing a new computer-aided diagnosis (CAD) scheme based on the analysis of global mammographic texture and density features computed from four-view images. Our database includes full-field digital mammography (FFDM) images acquired from 1052 recalled women (669 positive for cancer and 383 benign). Each case has four images: two craniocaudal (CC) and two mediolateral oblique (MLO) views. Our CAD scheme first computed global texture features related to the mammographic density distribution on the segmented breast regions of four images. Second, the computed features were provided to two artificial neural network (ANN) classifiers that were separately trained and tested in a ten-fold cross-validation scheme on CC and MLO view images, respectively. Finally, two ANN classification scores were combined using a new adaptive scoring fusion method that automatically determined the optimal weights to assign to both views. CAD performance was tested using the area under a receiver operating characteristic curve (AUC). The AUC=0.793±0.026 was obtained for this four-view CAD scheme, which was significantly higher at the 5% significance level than the AUCs achieved when using only CC (p = 0.025) or MLO (p = 0.0004) view images, respectively. This study demonstrates that a quantitative assessment of global mammographic image texture and density features could provide useful and/or supplementary information to classify between malignant and benign cases among the recalled cases, which may eventually help reduce the false-positive recall rate in screening mammography. PMID:25029964

  19. Can upstaging of ductal carcinoma in situ be predicted at biopsy by histologic and mammographic features?

    Science.gov (United States)

    Shi, Bibo; Grimm, Lars J.; Mazurowski, Maciej A.; Marks, Jeffrey R.; King, Lorraine M.; Maley, Carlo C.; Hwang, E. Shelley; Lo, Joseph Y.

    2017-03-01

    Reducing the overdiagnosis and overtreatment associated with ductal carcinoma in situ (DCIS) requires accurate prediction of the invasive potential at cancer screening. In this work, we investigated the utility of pre-operative histologic and mammographic features to predict upstaging of DCIS. The goal was to provide intentionally conservative baseline performance using readily available data from radiologists and pathologists and only linear models. We conducted a retrospective analysis on 99 patients with DCIS. Of those 25 were upstaged to invasive cancer at the time of definitive surgery. Pre-operative factors including both the histologic features extracted from stereotactic core needle biopsy (SCNB) reports and the mammographic features annotated by an expert breast radiologist were investigated with statistical analysis. Furthermore, we built classification models based on those features in an attempt to predict the presence of an occult invasive component in DCIS, with generalization performance assessed by receiver operating characteristic (ROC) curve analysis. Histologic features including nuclear grade and DCIS subtype did not show statistically significant differences between cases with pure DCIS and with DCIS plus invasive disease. However, three mammographic features, i.e., the major axis length of DCIS lesion, the BI-RADS level of suspicion, and radiologist's assessment did achieve the statistical significance. Using those three statistically significant features as input, a linear discriminant model was able to distinguish patients with DCIS plus invasive disease from those with pure DCIS, with AUC-ROC equal to 0.62. Overall, mammograms used for breast screening contain useful information that can be perceived by radiologists and help predict occult invasive components in DCIS.

  20. Reduction of false-positive recalls using a computerized mammographic image feature analysis scheme

    Science.gov (United States)

    Tan, Maxine; Pu, Jiantao; Zheng, Bin

    2014-08-01

    The high false-positive recall rate is one of the major dilemmas that significantly reduce the efficacy of screening mammography, which harms a large fraction of women and increases healthcare cost. This study aims to investigate the feasibility of helping reduce false-positive recalls by developing a new computer-aided diagnosis (CAD) scheme based on the analysis of global mammographic texture and density features computed from four-view images. Our database includes full-field digital mammography (FFDM) images acquired from 1052 recalled women (669 positive for cancer and 383 benign). Each case has four images: two craniocaudal (CC) and two mediolateral oblique (MLO) views. Our CAD scheme first computed global texture features related to the mammographic density distribution on the segmented breast regions of four images. Second, the computed features were given to two artificial neural network (ANN) classifiers that were separately trained and tested in a ten-fold cross-validation scheme on CC and MLO view images, respectively. Finally, two ANN classification scores were combined using a new adaptive scoring fusion method that automatically determined the optimal weights to assign to both views. CAD performance was tested using the area under a receiver operating characteristic curve (AUC). The AUC = 0.793  ±  0.026 was obtained for this four-view CAD scheme, which was significantly higher at the 5% significance level than the AUCs achieved when using only CC (p = 0.025) or MLO (p = 0.0004) view images, respectively. This study demonstrates that a quantitative assessment of global mammographic image texture and density features could provide useful and/or supplementary information to classify between malignant and benign cases among the recalled cases, which may eventually help reduce the false-positive recall rate in screening mammography.

  1. Mammographic Artifacts on Full-Field Digital Mammography

    National Research Council Canada - National Science Library

    Choi, Jae Jeong; Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Song, ByungJoo; Jung, Haijo

    2014-01-01

    This study investigates the incidence of full-field digital mammographic (FFDM) artifacts with three systems at two institutions and compares the artifacts between two detector types and two grid types...

  2. Characterizing mammographic images by using generic texture features

    National Research Council Canada - National Science Library

    Häberle, Lothar; Wagner, Florian; Fasching, Peter A; Jud, Sebastian M; Heusinger, Katharina; Loehberg, Christian R; Hein, Alexander; Bayer, Christian M; Hack, Carolin C; Lux, Michael P; Binder, Katja; Elter, Matthias; Münzenmayer, Christian; Schulz-Wendtland, Rüdiger; Meier-Meitinger, Martina; Adamietz, Boris R; Uder, Michael; Beckmann, Matthias W; Wittenberg, Thomas

    2012-01-01

    .... The aims of this study were to evaluate a variety of automated texture features in mammograms as risk factors for breast cancer and to compare them with the percentage mammographic density (PMD...

  3. A representation for mammographic image processing.

    Science.gov (United States)

    Highnam, R; Brady, M; Shepstone, B

    1996-03-01

    Mammographic image analysis is typically performed using standard, general-purpose algorithms. We note the dangers of this approach and show that an alternative physics-model-based approach can be developed to calibrate the mammographic imaging process. This enables us to obtain, at each pixel, a quantitative measure of the breast tissue. The measure we use is h(int) and this represents the thickness of 'interesting' (non-fat) tissue between the pixel and the X-ray source. The thicknesses over the image constitute what we term the h(int) representation, and it can most usefully be regarded as a surface that conveys information about the anatomy of the breast. The representation allows image enhancement through removing the effects of degrading factors, and also effective image normalization since all changes in the image due to variations in the imaging conditions have been removed. Furthermore, the h(int) representation gives us a basis upon which to build object models and to reason about breast anatomy. We use this ability to choose features that are robust to breast compression and variations in breast composition. In this paper we describe the h(int) representation, show how it can be computed, and then illustrate how it can be applied to a variety of mammographic image processing tasks. The breast thickness turns out to be a key parameter in the computation of h(int), but it is not normally recorded. We show how the breast thickness can be estimated from an image, and examine the sensitivity of h(int) to this estimate. We then show how we can simulate any projective X-ray examination and can simulate the appearance of anatomical structures within the breast. We follow this with a comparison between the h(int) representation and conventional representations with respect to invariance to imaging conditions and the surrounding tissue. Initial results indicate that image analysis is far more robust when specific consideration is taken of the imaging process and

  4. Biological and Computational Modeling of Mammographic Density and Stromal Patterning

    Science.gov (United States)

    2010-07-01

    mammographic images were stored on our private computer network and referenced in the dat abase. Mammographic density was assessed quantitatively using... Ibarra , C., W ilke, L., Yee, L., Kulkarni, S., Wood, M., Ga rber, J., Stouder, A., Grant, T., Broadwater, G., and Seewaldt, V .L. Random...Development 1. Nicholas D’Amato, PhD candidate. 2. Catherine Ibarra , Komen Career Catalyst, 2010. 2. Stacy Millon, PhD, 2010. 3. Molly Gregas, PhD, 2010

  5. Development of terminology for mammographic techniques for radiological technologists.

    Science.gov (United States)

    Yagahara, Ayako; Yokooka, Yuki; Tsuji, Shintaro; Nishimoto, Naoki; Uesugi, Masahito; Muto, Hiroshi; Ohba, Hisateru; Kurowarabi, Kunio; Ogasawara, Katsuhiko

    2011-07-01

    We are developing a mammographic ontology to share knowledge of the mammographic domain for radiologic technologists, with the aim of improving mammographic techniques. As a first step in constructing the ontology, we used mammography reference books to establish mammographic terminology for identifying currently available knowledge. This study proceeded in three steps: (1) determination of the domain and scope of the terminology, (2) lexical extraction, and (3) construction of hierarchical structures. We extracted terms mainly from three reference books and constructed the hierarchical structures manually. We compared features of the terms extracted from the three reference books. We constructed a terminology consisting of 440 subclasses grouped into 19 top-level classes: anatomic entity, image quality factor, findings, material, risk, breast, histological classification of breast tumors, role, foreign body, mammographic technique, physics, purpose of mammography examination, explanation of mammography examination, image development, abbreviation, quality control, equipment, interpretation, and evaluation of clinical imaging. The number of terms that occurred in the subclasses varied depending on which reference book was used. We developed a terminology of mammographic techniques for radiologic technologists consisting of 440 terms.

  6. Evaluation of ZnS:Cu phosphor as X-ray to light converter under mammographic conditions

    Energy Technology Data Exchange (ETDEWEB)

    Kandarakis, I. E-mail: kandarakis@teiath.gr; Cavouras, D.; Nikolopoulos, D.; Anastasiou, A.; Dimitropoulos, N.; Kalivas, N.; Ventouras, E.; Kalatzis, I.; Nomicos, C.; Panayiotakis, G

    2005-06-01

    The aim of the present study was to evaluate ZnS:Cu phosphor for use in X-ray mammographic detectors. This phosphor has never been used in medical imaging probably due to its moderate scintillation decay time. However, it may be suitable for non-dynamic medical imaging, due to its 'green' emission spectrum, which is compatible with the sensitivity of many currently used photodetectors, and its high X-ray to light intrinsic conversion efficiency. ZnS:Cu phosphor powder was used to prepare several test screens in laboratory. Parameters related to light emission and image quality properties were experimentally as well as theoretically evaluated and compared to those of other known ZnS-based phosphor materials. Results showed that ZnS:Cu performed adequately well in the mammographic energy range.

  7. Mammography screening and breast cancer mortality in Australia: an aggregate cohort study.

    Science.gov (United States)

    Morrell, Stephen; Taylor, Richard; Roder, David; Dobson, Annette

    2012-03-01

    Evidence that mammography screening reduces breast cancer mortality derives from trials, with observational studies broadly supporting trial findings. The purpose of this study was to evaluate the national mammographic screening programme, BreastScreen Australia, using aggregate screening and breast cancer mortality data. Breast cancer mortality from 1990 to 2004 in the whole Australian population was assessed in relation to screening exposure in the target of women aged 50-69 years. Population cohorts were defined by year of screening (and diagnosis), five-year age group at screening (and diagnosis), and local area of residence at screening (and diagnosis). Biennial screening data for BreastScreen Australia were related to cumulated mortality from breast cancer in an event analysis using Poisson regression, and in a time-to-event analysis using Cox proportional hazards regression. Results were adjusted for repeated measures and the potential effects of mammography outside BreastScreen Australia, regionality, and area socio-economic status. From the adjusted Poisson regression model, a 22% (95% CI:12-31%) reduction in six-year cumulated mortality from breast cancer was predicted for screening participation of approximately 60%, compared with no screening; 21% (95% CI:11-30%) for the most recently reported screening participation of 56%; and 25% (95% CI:15-35%) for the programme target of 70% biennial screening participation. Corresponding estimates from the Cox proportional hazard regression model were 30% (95% CI:17-41%), 28% (95% CI:16-38%) and 34% (95% CI:20-46%). Despite data limitations, the results of this nationwide study are consistent with the trial evidence, and with results of other service studies of mammography screening. With sufficient participation, mammography screening substantially reduces mortality from breast cancer.

  8. Mammographic CAD: Correlation of regions in ipsilateral views - a pilot study

    National Research Council Canada - National Science Library

    Padayachee, J; Alport, M J; Rae, W ID

    2009-01-01

    ...: The aim of this study was to develop image-processing algorithms that can be used to match a suspicious feature from one mammographic view to the same feature in another mammographic view of the same breast...

  9. Influence of lifestyle factors on mammographic density in postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Judith S Brand

    Full Text Available BACKGROUND: Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT, little is known about lifestyle factors that influence breast density. METHODS: We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI and HRT was studied. RESULTS: Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07. This association was modified by HRT use (P interaction  = 0.06: increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01 but not in non-current users (P trend  = 0.82. A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04. No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use. CONCLUSIONS: Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.

  10. Diabetes, diabetes treatment, and mammographic density in Danish Diet, Cancer, and Health cohort

    DEFF Research Database (Denmark)

    Buschard, Karsten; Thomassen, Katrin; Lynge, Elsebeth

    2017-01-01

    PURPOSE: We examined whether diabetes and diabetes treatment are associated with MD in a cohort study of Danish women above age of 50 years. METHODS: Study cohort consisted of 5,644 women (4,500 postmenopausal) who participated in the Danish Diet, Cancer, and Health cohort (1993......-1997) and subsequently attended mammographic screening in Copenhagen (1993-2001). We used MD assessed at the first screening after the cohort entry, defined as mixed/dense or fatty. Diabetes diagnoses and diabetes treatments (diet, insulin, or oral antidiabetic agents) were self-reported at the time of recruitment (1993.......61; 0.40-0.92). Similar inverse associations were observed for 44 women who controlled diabetes by diet only and did not receive any medication (0.56; 0.27-1.14), and 62 who took oral antidiabetic agents only for diabetes (0.59; 0.32-1.09), while women taking insulin had increased odds of mixed...

  11. Malignant Lesions as Mammographically Appearing Intramammary Ganglia; Lesiones malignas con apariencia mamografica de ganglios intramamarios

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Miraveta, P.; Pons, M. J.; Pina, L. J.; Zornoza, G. [Clinica Universitaria de Navarra. Pamplona (Spain)

    2004-07-01

    Intramammary ganglia are frequent mammographic findings of no pathological importance. We present two cases of malignant breast lesions whose mammographic appearance could resemble that of intramammary ganglia. Although the mammographic appearance of a lesion is similar to that of intramammary ganglia, it should be carefully studied, especially if it presents a poorly defined border or is palpable. (Author)

  12. Mammographic phenotypes of breast cancer risk driven by breast anatomy

    Science.gov (United States)

    Gastounioti, Aimilia; Oustimov, Andrew; Hsieh, Meng-Kang; Pantalone, Lauren; Conant, Emily F.; Kontos, Despina

    2017-03-01

    Image-derived features of breast parenchymal texture patterns have emerged as promising risk factors for breast cancer, paving the way towards personalized recommendations regarding women's cancer risk evaluation and screening. The main steps to extract texture features of the breast parenchyma are the selection of regions of interest (ROIs) where texture analysis is performed, the texture feature calculation and the texture feature summarization in case of multiple ROIs. In this study, we incorporate breast anatomy in these three key steps by (a) introducing breast anatomical sampling for the definition of ROIs, (b) texture feature calculation aligned with the structure of the breast and (c) weighted texture feature summarization considering the spatial position and the underlying tissue composition of each ROI. We systematically optimize this novel framework for parenchymal tissue characterization in a case-control study with digital mammograms from 424 women. We also compare the proposed approach with a conventional methodology, not considering breast anatomy, recently shown to enhance the case-control discriminatory capacity of parenchymal texture analysis. The case-control classification performance is assessed using elastic-net regression with 5-fold cross validation, where the evaluation measure is the area under the curve (AUC) of the receiver operating characteristic. Upon optimization, the proposed breast-anatomy-driven approach demonstrated a promising case-control classification performance (AUC=0.87). In the same dataset, the performance of conventional texture characterization was found to be significantly lower (AUC=0.80, DeLong's test p-valuebreast anatomy may further leverage the associations of parenchymal texture features with breast cancer, and may therefore be a valuable addition in pipelines aiming to elucidate quantitative mammographic phenotypes of breast cancer risk.

  13. Generation of CR mammographic image for evaluation quality parameters

    Energy Technology Data Exchange (ETDEWEB)

    Flores, Mabel B.; Mourao, Arnaldo P., E-mail: mbustos@ufmg.br, E-mail: apratabhz@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET-MG), Belo Horizonte, MG (Brazil). Centro de Engenharia Politecnica

    2017-11-01

    Currently, among the diseases most feared by women, breast cancer ranks first in the world with an incidence of more than 1.6 million cases and a mortality of more than 521.9 thousand cases by year, which makes this disease the type of cancer with higher incidence and mortality compared to the other types of cancer that mainly affect the female gender, without considering non-melanoma skin cancer. In Brazil, more than 14.4 thousand deaths were registered in 2013 and more than 57 thousand new cases were estimated for 2016. The use of computerized radiography (CR) for the generation of mammographic digital images is widely used in Brazil for the screening of breast cancer. The aim of this investigation is to study the variation of CR plate response to exposure to X-ray beams in a mammography unit. Two CR plates from different manufacturers and a compressed breast phantom containing calcium carbonate structures of different sizes simulating calcifications were used for this study. An X-ray beam generated by 30 kV was selected to realize successive exposures of each plate by performing a time variation of 0.5 to 3.5 s, obtaining the raw images. The acquired images were evaluated with the ImageJ software to determine the saturation time of the plates when exposed to X-ray beams and the qualitative resolution of each plate. The plates were found to saturate at different times when exposed under the same conditions to X-ray beams. By means of the images acquired with the breast phantom, it was possible to observe only structures of calcium carbonate with sizes greater than 177 μm. (author)

  14. Understanding Clinical Mammographic Breast Density Assessment: a Deep Learning Perspective.

    Science.gov (United States)

    Mohamed, Aly A; Luo, Yahong; Peng, Hong; Jankowitz, Rachel C; Wu, Shandong

    2017-09-20

    Mammographic breast density has been established as an independent risk marker for developing breast cancer. Breast density assessment is a routine clinical need in breast cancer screening and current standard is using the Breast Imaging and Reporting Data System (BI-RADS) criteria including four qualitative categories (i.e., fatty, scattered density, heterogeneously dense, or extremely dense). In each mammogram examination, a breast is typically imaged with two different views, i.e., the mediolateral oblique (MLO) view and cranial caudal (CC) view. The BI-RADS-based breast density assessment is a qualitative process made by visual observation of both the MLO and CC views by radiologists, where there is a notable inter- and intra-reader variability. In order to maintain consistency and accuracy in BI-RADS-based breast density assessment, gaining understanding on radiologists' reading behaviors will be educational. In this study, we proposed to leverage the newly emerged deep learning approach to investigate how the MLO and CC view images of a mammogram examination may have been clinically used by radiologists in coming up with a BI-RADS density category. We implemented a convolutional neural network (CNN)-based deep learning model, aimed at distinguishing the breast density categories using a large (15,415 images) set of real-world clinical mammogram images. Our results showed that the classification of density categories (in terms of area under the receiver operating characteristic curve) using MLO view images is significantly higher than that using the CC view. This indicates that most likely it is the MLO view that the radiologists have predominately used to determine the breast density BI-RADS categories. Our study holds a potential to further interpret radiologists' reading characteristics, enhance personalized clinical training to radiologists, and ultimately reduce reader variations in breast density assessment.

  15. Characterization of Mammographic Masses Based on Level Set Segmentation with New Image Features and Patient Information

    Science.gov (United States)

    Shi, Jiazheng; Sahiner, Berkman; Chan, Heang-Ping; Ge, Jun; Hadjiiski, Lubomir; Helvie, Mark A.; Nees, Alexis; Wu, Yi-Ta; Wei, Jun; Zhou, Chuan; Zhang, Yiheng; Cui, Jing

    2009-01-01

    Computer-aided diagnosis (CAD) for characterization of mammographic masses as malignant or benign has the potential to assist radiologists in reducing the biopsy rate without increasing false negatives. The purpose of this study was to develop an automated method for mammographic mass segmentation and explore new image based features in combination with patient information in order to improve the performance of mass characterization. Our previous CAD system, which used the active contour segmentation, and morphological, textural, and spiculation features, has achieved promising results in mass characterization. The new CAD system is based on the level set method, and includes two new types of image features related to the presence of microcalcifications with the mass and abruptness of the mass margin, and patient age. A linear discriminant analysis (LDA) classifier with stepwise feature selection was used to merge the extracted features into a classification score. The classification accuracy was evaluated using the area under the receiver operating characteristic curve. Our primary data set consisted of 427 biopsy-proven masses (200 malignant and 227 benign) in 909 regions of interest (ROIs) (451 malignant and 458 benign) from multiple mammographic views. Leave-one-case-out resampling was used for training and testing. The new CAD system based on the level set segmentation and the new mammographic feature space achieved a view-based Az value of 0.83±0.01. The improvement compared to the previous CAD system was statistically significant (p=0.02). When patient age was included in the new CAD system, view-based and case-based Az values were 0.85±0.01 and 0.87±0.02, respectively. The performance of the new CAD system was also compared to an experienced radiologist’s likelihood of malignancy rating. When patient age was used in classification, the accuracy of the new CAD system was comparable to that of the radiologist (p=0.34). The study also demonstrated the

  16. Characterization of difference of Gaussian filters in the detection of mammographic regions.

    Science.gov (United States)

    Catarious, David M; Baydush, Alan H; Floyd, Carey E

    2006-11-01

    In this article, we present a characterization of the effect of difference of Gaussians (DoG) filters in the detection of mammographic regions. DoG filters have been used previously in mammographic mass computer-aided detection (CAD) systems. As DoG filters are constructed from the subtraction of two bivariate Gaussian distributions, they require the specification of three parameters: the size of the filter template and the standard deviations of the constituent Gaussians. The influence of these three parameters in the detection of mammographic masses has not been characterized. In this work, we aim to determine how the parameters affect (1) the physical descriptors of the detected regions, (2) the true and false positive rates, and (3) the classification performance of the individual descriptors. To this end, 30 DoG filters are created from the combination of three template sizes and four values for each of the Gaussians' standard deviations. The filters are used to detect regions in a study database of 181 craniocaudal-view mammograms extracted from the Digital Database for Screening Mammography. To describe the physical characteristics of the identified regions, morphological and textural features are extracted from each of the detected regions. Differences in the mean values of the features caused by altering the DoG parameters are examined through statistical and empirical comparisons. The parameters' effects on the true and false positive rate are determined by examining the mean malignant sensitivities and false positives per image (FPpI). Finally, the effect on the classification performance is described by examining the variation in FPpI at the point where 81% of the malignant masses in the study database are detected. Overall, the findings of the study indicate that increasing the standard deviations of the Gaussians used to construct a DoG filter results in a dramatic decrease in the number of regions identified at the expense of missing a small number

  17. Tissue composition of mammographically dense and non-dense breast tissue.

    Science.gov (United States)

    Ghosh, Karthik; Brandt, Kathleen R; Reynolds, Carol; Scott, Christopher G; Pankratz, V S; Riehle, Darren L; Lingle, Wilma L; Odogwu, Tonye; Radisky, Derek C; Visscher, Daniel W; Ingle, James N; Hartmann, Lynn C; Vachon, Celine M

    2012-01-01

    Mammographic density is a strong risk factor for breast cancer but its underlying biology in healthy women is not well-defined. Using a novel collection of core biopsies from mammographically dense versus non-dense regions of the breasts of healthy women, we examined histologic and molecular differences between these two tissue types. Eligible participants were 40 + years, had a screening mammogram and no prior breast cancer or current endocrine therapy. Mammograms were used to identify dense and non-dense regions and ultrasound-guided core biopsies were performed to obtain tissue from these regions. Quantitative assessment of epithelium, stroma, and fat was performed on dense and non-dense cores. Molecular markers including Ki-67, estrogen receptor (ER) and progesterone receptor (PR) were also assessed for participants who had >0% epithelial area in both dense and non-dense tissue. Signed rank test was used to assess within woman differences in epithelium, stroma and fat between dense and non-dense tissue. Differences in molecular markers (Ki-67, ER, and PR) were analyzed using generalized linear models, adjusting for total epithelial area. Fifty-nine women, mean age 51 years (range: 40-82), were eligible for analyses. Dense tissue was comprised of greater mean areas of epithelium and stroma (1.1 and 9.2 mm(2) more, respectively) but less fat (6.0 mm(2) less) than non-dense tissue. There were no statistically significant differences in relative expression of Ki-67 (P = 0.82), ER (P = 0.09), or PR (P = 0.96) between dense and non-dense tissue. Consistent with prior reports, we found that mammographically dense areas of the breast differ histologically from non-dense areas, reflected in greater proportions of epithelium and stroma and lesser proportions of fat in the dense compared to non-dense breast tissue. Studies of both epithelial and stromal components are important in understanding the association between mammographic density and breast cancer risk.

  18. Circumscribed breast carcinoma: Mammographic and sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Soo Young; Lee, Yul; Park, Ki Soon; Lee, Ke Sook [College of Medicine, Hallym University, Seoul (Korea, Republic of)

    1992-03-15

    Circumscribe breast cancer is a well demarcated mass with or without a lobulated border simulating a benign tumor like fibroadenoma on mammography or breast US and is reported as approximate 10% of the incidence among primary breast carcinoma(1.2). Pathologically medullary, colloid, papillary, intraductal and rarely invasive ductal carcinomas are included in this group which show the less intense desmoplastic reaction than the scirrhous type cancer, resulting in the most favorable prognosis of all carcinoma of the breast. Among 214 primary breast carcinoma during the past 8 years, we experienced 6 case of pathologically proven circumscribed breast cancer(2 cases of medullary carcinoma, 1 of colloid carcinoma, 1 of intracystic papillary carcinoma, 2 of comedo type intraductal carcinoma). Clinically 2 cases showed bloody nipple discharge from one hole of a unilateral nipple orifice. Mammography showed a well circumscribed nodule with or without partial lobular contour and no pathologic calcification. Breast sonographic findings were a well defined heterogeneous hypoechoic nodule with weak posterior acoustic enhancement. Characteristically a thin dilated lactiferous duct between the mass and the nipple on US could be detected in 2 cases which clinically was accompanied by bloody nipple discharge. Although the mammographic criteria is promising as benign tumor, the possibility of circumscribed as benign tumor, the possibility of circumscribed breast carcinoma must be considered in heterogeneous hypoechoic nodule with weak posterior acoustic enhancement in US, especially in the presence of a dilated lactiferous duct between the mass and the nipple with bloody nipple discharge.

  19. 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.

  20. Mammographic density-a review on the current understanding of its association with breast cancer.

    Science.gov (United States)

    Huo, C W; Chew, G L; Britt, K L; Ingman, W V; Henderson, M A; Hopper, J L; Thompson, E W

    2014-04-01

    There has been considerable recent interest in the genetic, biological and epidemiological basis of mammographic density (MD), and the search for causative links between MD and breast cancer (BC) risk. This report will critically review the current literature on MD and summarize the current evidence for its association with BC. Keywords 'mammographic dens*', 'dense mammary tissue' or 'percent dens*' were used to search the existing literature in English on PubMed and Medline. All reports were critically analyzed. The data were assigned to one of the following aspects of MD: general association with BC, its relationship with the breast hormonal milieu, the cellular basis of MD, the generic variations of MD, and its significance in the clinical setting. MD adjusted for age, and BMI is associated with increased risk of BC diagnosis, advanced tumour stage at diagnosis and increased risk of both local recurrence and second primary cancers. The MD measures that predict BC risk have high heritability, and to date several genetic markers associated with BC risk have been found to also be associated with these MD risk predictors. Change in MD could be a predictor of the extent of chemoprevention with tamoxifen. Although the biological and genetic pathways that determine and perhaps modulate MD remain largely unresolved, significant inroads are being made into the understanding of MD, which may lead to benefits in clinical screening, assessment and treatment strategies. This review provides a timely update on the current understanding of MD's association with BC risk.

  1. Dense and nondense mammographic area and risk of breast cancer by age and tumor characteristics.

    Science.gov (United States)

    Bertrand, Kimberly A; Scott, Christopher G; Tamimi, Rulla M; Jensen, Matthew R; Pankratz, V Shane; Norman, Aaron D; Visscher, Daniel W; Couch, Fergus J; Shepherd, John; Chen, Yunn-Yi; Fan, Bo; Wu, Fang-Fang; Ma, Lin; Beck, Andrew H; Cummings, Steven R; Kerlikowske, Karla; Vachon, Celine M

    2015-05-01

    Mammographic density (MD) is a strong breast cancer risk factor. We previously reported associations of percent mammographic density (PMD) with larger and node-positive tumors across all ages, and estrogen receptor (ER)-negative status among women ages breast cancer subtypes. Data were pooled from six studies including 4,095 breast cancers and 8,558 controls. DA and NDA were assessed from digitized film-screen mammograms and standardized across studies. Breast cancer odds by density phenotypes and age according to histopathologic characteristics and receptor status were calculated using polytomous logistic regression. DA was associated with increased breast cancer risk [OR for quartiles: 0.65, 1.00 (Ref), 1.22, 1.55; P(trend) ages and invasive tumor characteristics. There were significant trends in the magnitude of associations of both DA and NDA with breast cancer by increasing tumor size (P(trend) age. DA and NDA are important to consider when developing age- and subtype-specific risk models. ©2015 American Association for Cancer Research.

  2. Computational growth model of breast microcalcification clusters in simulated mammographic environments.

    Science.gov (United States)

    Plourde, Shayne M; Marin, Zach; Smith, Zachary R; Toner, Brian C; Batchelder, Kendra A; Khalil, Andre

    2016-09-01

    When screening for breast cancer, the radiological interpretation of mammograms is a difficult task, particularly when classifying precancerous growth such as microcalcifications (MCs). Biophysical modeling of benign vs. malignant growth of MCs in simulated mammographic backgrounds may improve characterization of these structures A mathematical model based on crystal growth rules for calcium oxide (benign) and hydroxyapatite (malignant) was used in conjunction with simulated mammographic backgrounds, which were generated by fractional Brownian motion of varying roughness and quantified by the Hurst exponent to mimic tissue of varying density. Simulated MC clusters were compared by fractal dimension, average circularity of individual MCs, average number of MCs per cluster, and average cluster area. Benign and malignant clusters were distinguishable by average circularity, average number of MCs per cluster, and average cluster area with pbreast tissue density, which suggests tissue environment plays a role in regulating MC growth. Benign and malignant MCs are distinguishable in all types of tissue by shape, size, and area, which is consistent with findings in the literature. These results may help to better understand the effects of the tissue environment on tumor progression, and improve classification of MCs in mammograms via computer-aided diagnosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Affinity proteomic profiling of plasma for proteins associated to area-based mammographic breast density.

    Science.gov (United States)

    Byström, Sanna; Eklund, Martin; Hong, Mun-Gwan; Fredolini, Claudia; Eriksson, Mikael; Czene, Kamila; Hall, Per; Schwenk, Jochen M; Gabrielson, Marike

    2018-02-14

    Mammographic breast density is one of the strongest risk factors for breast cancer, but molecular understanding of how breast density relates to cancer risk is less complete. Studies of proteins in blood plasma, possibly associated with mammographic density, are well-suited as these allow large-scale analyses and might shed light on the association between breast cancer and breast density. Plasma samples from 1329 women in the Swedish KARMA project, without prior history of breast cancer, were profiled with antibody suspension bead array (SBA) assays. Two sample sets comprising 729 and 600 women were screened by two different SBAs targeting a total number of 357 proteins. Protein targets were selected through searching the literature, for either being related to breast cancer or for being linked to the extracellular matrix. Association between proteins and absolute area-based breast density (AD) was assessed by quantile regression, adjusting for age and body mass index (BMI). Plasma profiling revealed linear association between 20 proteins and AD, concordant in the two sets of samples (p density and processes of tissue homeostasis, DNA repair, cancer development and/or progression in breast cancer. Further validation and follow-up studies of the shortlisted protein candidates in independent cohorts will be needed to infer their role in breast density and its progression in premenopausal and postmenopausal women.

  4. Automated mammographic breast density estimation using a fully convolutional network.

    Science.gov (United States)

    Lee, Juhun; Nishikawa, Robert M

    2018-01-24

    The purpose of this study was to develop a fully automated algorithm for mammographic breast density estimation using deep learning. Our algorithm used a fully convolutional network, which is a deep learning framework for image segmentation, to segment both the breast and the dense fibroglandular areas on mammographic images. Using the segmented breast and dense areas, our algorithm computed the breast percent density (PD), which is the faction of dense area in a breast. Our dataset included full-field digital screening mammograms of 604 women, which included 1208 mediolateral oblique (MLO) and 1208 craniocaudal (CC) views. We allocated 455, 58, and 91 of 604 women and their exams into training, testing, and validation datasets, respectively. We established ground truth for the breast and the dense fibroglandular areas via manual segmentation and segmentation using a simple thresholding based on BI-RADS density assessments by radiologists, respectively. Using the mammograms and ground truth, we fine-tuned a pretrained deep learning network to train the network to segment both the breast and the fibroglandular areas. Using the validation dataset, we evaluated the performance of the proposed algorithm against radiologists' BI-RADS density assessments. Specifically, we conducted a correlation analysis between a BI-RADS density assessment of a given breast and its corresponding PD estimate by the proposed algorithm. In addition, we evaluated our algorithm in terms of its ability to classify the BI-RADS density using PD estimates, and its ability to provide consistent PD estimates for the left and the right breast and the MLO and CC views of the same women. To show the effectiveness of our algorithm, we compared the performance of our algorithm against a state of the art algorithm, laboratory for individualized breast radiodensity assessment (LIBRA). The PD estimated by our algorithm correlated well with BI-RADS density ratings by radiologists. Pearson's rho values of

  5. Smoking and high-risk mammographic parenchymal patterns: a case-control study

    Science.gov (United States)

    Sala, Evis; Warren, Ruth; McCann, Jenny; Duffy, Stephen; Luben , Robert; Day, Nicholas

    2000-01-01

    Introduction: Overall, epidemiological studies [1,2,3,4] have reported no substantial association between cigarette smoking and the risk of breast cancer. Some studies [5,6,7] reported a significant increase of breast cancer risk among smokers. In recent studies that addressed the association between breast cancer and cigarette smoking, however, there was some suggestion of a decreased risk [8,9,10], especially among current smokers, ranging from approximately 10 to 30% [9,10]. Brunet et al [11] reported that smoking might reduce the risk of breast cancer by 44% in carriers of BRCA1 or BRCA2 gene mutations. Wolfe [12] described four different mammographic patterns created by variations in the relative amounts of fat, epithelial and connective tissue in the breast, designated N1, P1, P2 and DY. Women with either P2 or DY pattern are considered at greater risk for breast cancer than those with N1 or P1 pattern [12,13,14,15]. There are no published studies that assessed the relationship between smoking and mammographic parenchymal patterns. Aims: To evaluate whether mammographic parenchymal patterns as classified by Wolfe, which have been positively associated with breast cancer risk, are affected by smoking. In this case-control study, nested within the European Prospective Investigation on Cancer in Norfolk (EPIC-Norfolk) cohort [16], the association between smoking habits and mammographic parenchymal patterns are examined. The full results will be published elsewhere. Methods: Study subjects were members of the EPIC cohort in Norwich who also attended the prevalence screening round at the Norwich Breast Screening Centre between November 1989 and December 1997, and were free of breast cancer at that screening. Cases were defined as women with a P2/DY Wolfe's mammographic parenchymal pattern on the prevalence screen mammograms. A total of 203 women with P2/DY patterns were identified as cases and were individually matched by date of birth (within 1 year) and date of

  6. A deep learning method for classifying mammographic breast density categories.

    Science.gov (United States)

    Mohamed, Aly A; Berg, Wendie A; Peng, Hong; Luo, Yahong; Jankowitz, Rachel C; Wu, Shandong

    2018-01-01

    Mammographic breast density is an established risk marker for breast cancer and is visually assessed by radiologists in routine mammogram image reading, using four qualitative Breast Imaging and Reporting Data System (BI-RADS) breast density categories. It is particularly difficult for radiologists to consistently distinguish the two most common and most variably assigned BI-RADS categories, i.e., "scattered density" and "heterogeneously dense". The aim of this work was to investigate a deep learning-based breast density classifier to consistently distinguish these two categories, aiming at providing a potential computerized tool to assist radiologists in assigning a BI-RADS category in current clinical workflow. In this study, we constructed a convolutional neural network (CNN)-based model coupled with a large (i.e., 22,000 images) digital mammogram imaging dataset to evaluate the classification performance between the two aforementioned breast density categories. All images were collected from a cohort of 1,427 women who underwent standard digital mammography screening from 2005 to 2016 at our institution. The truths of the density categories were based on standard clinical assessment made by board-certified breast imaging radiologists. Effects of direct training from scratch solely using digital mammogram images and transfer learning of a pretrained model on a large nonmedical imaging dataset were evaluated for the specific task of breast density classification. In order to measure the classification performance, the CNN classifier was also tested on a refined version of the mammogram image dataset by removing some potentially inaccurately labeled images. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to measure the accuracy of the classifier. The AUC was 0.9421 when the CNN-model was trained from scratch on our own mammogram images, and the accuracy increased gradually along with an increased size of training samples

  7. 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.

  8. Use of border information in the classification of mammographic masses.

    NARCIS (Netherlands)

    Varela, C.; Timp, S.; Karssemeijer, N.

    2006-01-01

    We are developing a new method to characterize the margin of a mammographic mass lesion to improve the classification of benign and malignant masses. Towards this goal, we designed features that measure the degree of sharpness and microlobulation of mass margins. We calculated these features in a

  9. Mammographic CAD: Correlation of regions in ipsilateral views – a ...

    African Journals Online (AJOL)

    Background. Radiologists analyse both standard mammographic views of a breast to confirm the presence of abnormalities and reduce false-positives. However, at present, no computer-aided diagnosis system uses ipsilateral mammograms to confirm the presence of suspicious features. Aim. The aim of this study was to ...

  10. Mammographic and sonographic spectrum of non-puerperal mastitis

    NARCIS (Netherlands)

    M.H. Lequin (Maarten); J. van Spengler (J.); R. van Pel; C.H.J. van Eijck (Casper); H. van Overhagen (H.)

    1995-01-01

    textabstractThe goal of this study was to explore possible specific mammographic and sonographic features in women with non-puerperal mastitis (NPM), in order to make an accurate diagnosis and prevent unnecessary surgical procedures. From a group of 93 patients with NPM diagnosed between 1987 and

  11. Metastatic intramammary lymph nodes: mammographic and ultrasonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil E-mail: isilbilgen@hotmail.com; Memis, Aysenur; Uestuen, EsinEmin

    2001-10-01

    Objective: To evaluate the mammographic and ultrasonographic findings in patients with intramammary lymph node (IMLN) involvement in breast cancer. Materials and methods: The mammograms of 1655 histopathologically proven breast cancer cases diagnosed during the last 10 years were retrospectively reviewed. There were 16 cases in which metastasis to intramammary lymph nodes was suspected mammographically and proven histopathologically. The clinical and radiological features of these 16 cases were evaluated. Results: On mammograms, the involved lymph nodes were all well circumscribed, homogeneous, oval or round opacities in the upper outer quadrant of the breast. They were all larger than 1 cm in size. On US, they were seen as well circumscribed, homogeneously hypoechoic masses with mild acoustic enhancement. In one case, besides enlargement, development of malignant microcalcifications was seen inside the node in the follow up period. In another case with IMLN metastasis, the primary focus of the breast cancer could not be detected either mammographically or histopathologically. So the case was accepted as occult breast carcinoma. All of the primary tumors detected were invasive histopathologically and their sizes varied between 1-6 cm (mean, 3 cm). Conclusion: The involvement of the IMLN can be suspected with mammographic and ultrasonographic features. Metastatic disease from breast cancer to IMLN may be the first clinical and/or radiological sign of breast cancer.

  12. Mammographer personality traits – elements of the optimal ...

    African Journals Online (AJOL)

    This article reports findings regarding patients' preferences and perceptions concerning mammographer personality traits. Method: Descriptive, exploratory research employed a non-probability, convenience sampling method to collect data by means of a questionnaire from 274 mammogram patients in four clinical training ...

  13. Mammographic classification of breast lesions amongst women in ...

    African Journals Online (AJOL)

    Cite as: Nwadike UI, Eze CU, Agwuna K, Mouka C. Mammographic classification of breast lesions amongst women in Enugu, South East. Nigeria. Afri Health ... It has the ability to detect micro-calcification which can- not be delineated by ... estimated 246,660 new cases of the invasive breast cancer are expected to be ...

  14. Mammographic detection and staging of invasive lobular carcinoma.

    NARCIS (Netherlands)

    Veltman, J.; Boetes, C.; Die, L. van; Bult, P.; Blickman, J.G.; Barentsz, J.O.

    2006-01-01

    The aim of the study was to evaluate mammography in detecting and staging of invasive lobular carcinoma (ILC) in order to assess the performance and impact of observer variability. Forty-two cases of ILC were retrospectively evaluated twice by two breast radiologists. Mammographic performance as

  15. Mammographic and sonographic findings of periductal mastitis : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Yang [Pochon CHA Univ. College of Medicine, Sungnam (Korea, Republic of); Oh, Ki Keun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-03-01

    Periductal mastitis arises from major ducts. Radiographic reports describing the phases of duct ectasia and secretory calcifications, have been published, but descriptions of the phases of periductal mastitis are rare. We report the mammographic and ultrasonographic findings of periductal mastitis in a 30-year-old woman who presented with a breast lump.

  16. Mammographic classification of breast lesions amongst women in ...

    African Journals Online (AJOL)

    Objectives: The study was to classify lesions identified on mammograms using Breast Imaging Reporting and Data System (BIRADS) grading method. This was in view of ascertaining the rate of occurrence of breast malignancy of the studied population. Methods: A retrospective cohort study of 416 mammographic reports of ...

  17. Mammographic Imaging Studies Using the Monte Carlo Image Simulation-Differential Sampling (MCMIS-DS) Code

    Energy Technology Data Exchange (ETDEWEB)

    Kuruvilla Verghese

    2002-04-05

    This report summarizes the highlights of the research performed under the 1-year NEER grant from the Department of Energy. The primary goal of this study was to investigate the effects of certain design changes in the Fisher Senoscan mammography system and in the degree of breast compression on the discernability of microcalcifications in calcification clusters often observed in mammograms with tumor lesions. The most important design change that one can contemplate in a digital mammography system to improve resolution of calcifications is the reduction of pixel dimensions of the digital detector. Breast compression is painful to the patient and is though to be a deterrent to women to get routine mammographic screening. Calcification clusters often serve as markers (indicators ) of breast cancer.

  18. Alcohol consumption and mammographic density in the Danish Diet, Cancer and Health cohort.

    Science.gov (United States)

    Jacobsen, Katja Kemp; Lynge, Elsebeth; Tjønneland, Anne; Vejborg, Ilse; von Euler-Chelpin, My; Andersen, Zorana J

    2017-12-01

    We examined the association between alcohol consumption and mammographic density (MD) considering in detail the time of exposure and the type of alcohol. Of 5,356 women (4,489 post-menopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening in Copenhagen (1993-2001), we used MD (mixed/dense or fatty) assessed at the first screening after cohort entry. Alcohol consumption was assessed at the time of recruitment. Logistic regression was used to estimate associations [odds ratios (OR), 95% confidence intervals (CI)] between alcohol consumption and MD. The mean age was 56.2 years, 56.5% of women had mixed/dense MD, and 91.8% were alcohol consumers. There was no association between current alcohol consumption and MD at baseline (age 50-65, on average 1 year before MD assessment) neither between age at drinking initiation and MD, in the fully adjusted model. There was a borderline statistically significantly increased OR of having mixed/dense MD in women who consumed > 7 drinks/week at age 20-29 (1.31, 95% CI 1.00-1.72) compared to non-drinkers in this age group, and no effect of drinking at age 30-39, 40-49 or after > 50 years, when adjusting for current drinking. However, when considering different types of alcohol, drinking spirits at age 20-29 was positively associated with mixed/dense breast (3-7 drinks/week: OR 1.74, 95% CI 1.12-2.72); >7 drinks/week: (OR 1.76, 95% CI 0.73-4.23). No consistent pattern was found with beer, wine, or fortified wine. We found higher MD among women with high alcohol consumption in early adulthood (ages 20-29), in those drinking spirits.

  19. The influence of mammogram acquisition on the mammographic density and breast cancer association in the Mayo Mammography Health Study cohort.

    Science.gov (United States)

    Olson, Janet E; Sellers, Thomas A; Scott, Christopher G; Schueler, Beth A; Brandt, Kathleen R; Serie, Daniel J; Jensen, Matthew R; Wu, Fang-Fang; Morton, Marilyn J; Heine, John J; Couch, Fergus J; Pankratz, V Shane; Vachon, Celine M

    2012-11-15

    Mammographic density is a strong risk factor for breast cancer. Image acquisition technique varies across mammograms to limit radiation and produce a clinically useful image. We examined whether acquisition technique parameters at the time of mammography were associated with mammographic density and whether the acquisition parameters confounded the density and breast cancer association. We examined this question within the Mayo Mammography Health Study (MMHS) cohort, comprised of 19,924 women (51.2% of eligible) seen in the Mayo Clinic mammography screening practice from 2003 to 2006. A case-cohort design, comprising 318 incident breast cancers diagnosed through December 2009 and a random subcohort of 2,259, was used to examine potential confounding of mammogram acquisition technique parameters (x-ray tube voltage peak (kVp), milliampere-seconds (mAs), thickness and compression force) on the density and breast cancer association. The Breast Imaging Reporting and Data System four-category tissue composition measure (BI-RADS) and percent density (PD) (Cumulus program) were estimated from screen-film mammograms at time of enrollment. Spearman correlation coefficients (r) and means (standard deviations) were used to examine the relationship of density measures with acquisition parameters. Hazard ratios (HR) and C-statistics were estimated using Cox proportional hazards regression, adjusting for age, menopausal status, body mass index and postmenopausal hormones. A change in the HR of at least 15% indicated confounding. Adjusted PD and BI-RADS density were associated with breast cancer (p-trends associations with breast cancer and their inclusion did not improve discriminatory accuracy. Results were similar for associations of dense and non-dense area with breast cancer. We confirmed a strong association between mammographic density and breast cancer risk that was not confounded by mammogram acquisition technique.

  20. Computing mammographic density from a multiple regression model constructed with image-acquisition parameters from a full-field digital mammographic unit

    Science.gov (United States)

    Lu, Lee-Jane W.; Nishino, Thomas K.; Khamapirad, Tuenchit; Grady, James J; Leonard, Morton H.; Brunder, Donald G.

    2009-01-01

    Breast density (the percentage of fibroglandular tissue in the breast) has been suggested to be a useful surrogate marker for breast cancer risk. It is conventionally measured using screen-film mammographic images by a labor intensive histogram segmentation method (HSM). We have adapted and modified the HSM for measuring breast density from raw digital mammograms acquired by full-field digital mammography. Multiple regression model analyses showed that many of the instrument parameters for acquiring the screening mammograms (e.g. breast compression thickness, radiological thickness, radiation dose, compression force, etc) and image pixel intensity statistics of the imaged breasts were strong predictors of the observed threshold values (model R2=0.93) and %density (R2=0.84). The intra-class correlation coefficient of the %-density for duplicate images was estimated to be 0.80, using the regression model-derived threshold values, and 0.94 if estimated directly from the parameter estimates of the %-density prediction regression model. Therefore, with additional research, these mathematical models could be used to compute breast density objectively, automatically bypassing the HSM step, and could greatly facilitate breast cancer research studies. PMID:17671343

  1. Computing mammographic density from a multiple regression model constructed with image-acquisition parameters from a full-field digital mammographic unit

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Lee-Jane W [Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1109 (United States); Nishino, Thomas K [Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555-0709 (United States); Khamapirad, Tuenchit [Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555-0709 (United States); Grady, James J [Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1109 (United States); Jr, Morton H Leonard [Department of Radiology, University of Texas Medical Branch, Galveston, TX 77555-0709 (United States); Brunder, Donald G [Department of Academic Computing/Academic Resources, University of Texas Medical Branch, Galveston, TX 77555-1035 (United States)

    2007-08-21

    Breast density (the percentage of fibroglandular tissue in the breast) has been suggested to be a useful surrogate marker for breast cancer risk. It is conventionally measured using screen-film mammographic images by a labor-intensive histogram segmentation method (HSM). We have adapted and modified the HSM for measuring breast density from raw digital mammograms acquired by full-field digital mammography. Multiple regression model analyses showed that many of the instrument parameters for acquiring the screening mammograms (e.g. breast compression thickness, radiological thickness, radiation dose, compression force, etc) and image pixel intensity statistics of the imaged breasts were strong predictors of the observed threshold values (model R{sup 2} = 0.93) and %-density (R{sup 2} = 0.84). The intra-class correlation coefficient of the %-density for duplicate images was estimated to be 0.80, using the regression model-derived threshold values, and 0.94 if estimated directly from the parameter estimates of the %-density prediction regression model. Therefore, with additional research, these mathematical models could be used to compute breast density objectively, automatically bypassing the HSM step, and could greatly facilitate breast cancer research studies.

  2. No evidence for association of inherited variation in genes involved in mitosis and percent mammographic density

    OpenAIRE

    Vachon, Celine M.; Li, Jingmei; Scott, Christopher G.; Hall, Per; Czene, Kamila; Wang, Xianshu; LIU, Jianjun; Fredericksen, Zachary S.; Rider, David N.; Wu, Fang-Fang; Olson, Janet E.; Cunningham, Julie M.; Stevens, Kristen N; Sellers, Thomas A.; Pankratz, Shane V

    2012-01-01

    Introduction Increased mammographic breast density is one of the strongest risk factors for breast cancer. While two-thirds of the variation in mammographic density appears to be genetically influenced, few variants have been identified. We examined the association of inherited variation in genes from pathways that mediate cell division with percent mammographic density (PMD) adjusted for age, body mass index (BMI) and postmenopausal hormones, in two studies of healthy postmenopausal women. M...

  3. Mammographic detection of breast arterial calcification as an independent predictor of coronary atherosclerotic disease in a single ethnic cohort of African American women.

    Science.gov (United States)

    Newallo, Domnique; Meinel, Felix G; Schoepf, U Joseph; Baumann, Stefan; De Cecco, Carlo N; Leddy, Rebecca J; Vliegenthart, Rozemarijn; Möllmann, Helge; Hamm, Christian W; Morris, Pamela B; Renker, Matthias

    2015-09-01

    Accumulating data on predominantly Caucasian women suggests an association between breast arterial calcification (BAC) and coronary artery disease (CAD). We sought to comprehensively examine the correlation between mammographic BAC and CAD endpoints detected by cardiac computed tomography (CCT) in African American (AA) women. Consecutive AA women who underwent digital screening mammography and CCT were identified. In blinded fashion, mammographic and CCT studies were reviewed. Patient-related pertinent covariates were assessed. Two-hundred-four AA women (median age, 52.5 years) were included. BAC was present in 42 women (20.6%). BAC was significantly associated with coronary artery calcium score >100 (odds ratio [OR], 7.66; 95% confidence interval [CI], 2.75-21.29; P women, BAC is associated with increased probability of coronary calcification, atherosclerosis, and CAD on CCT. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Sonographic and Mammographic Features of Breast Apocrine Metaplasia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Do Youn; Kang, Seok Seon; Ji, Eun Kyung; Kwon, Tae Hee; Park, Hae Lin; Shim, Jeong Yun [CHA Hospital, Pochon CHA University College of Medicine, Pocheon (Korea, Republic of)

    2008-03-15

    To evaluate the sonographic and mammographic features of apocrine metaplasia of the breast. We retrospectively evaluated the sonographic and mammographic findings of 16 lesions that were diagnosed with only apocrine metaplasia after mammotome excision. The age ranged from 27 years old to 57 years old (mean age: 40 years old). The sonographic features were interpreted by the ACR BI-RADS(American College of Radiology Breast Imaging Reporting and Data System) for shape, orientation, margin, boundary, echo pattern, posterior acoustic feature, calcification and special cases. The mammographic features were interpreted by the ACR BI-RADS (American College of Radiology Breast Imaging Reporting and Data System) for breast composition, shape, margin, density and calcification. Sonographic features were that the shapes were oval (n = 16) in 100%. The orientation was parallel (n =15) in 94%. The margins were circumscribed (n = 8) in 50% and microlobulated (n = 8) in 50%. The echo patterns were hypoechoic (n = 8) in 50%, complex (n = 5) in 31% and anechoic (n = 3) in 19%. Posterior acoustic enhancement was seen in 69% (n = 11). There was internal microcyst (n = 4) in 25%. There was no calcification. Mammography performed for 12 cases demonstrated negative findings (n = 10) for 83%, obscured hypodense mass (n = 1) for 8% in 11 cases of breast composition 3 and 4, and circumscribed isodense mass (n = 1)for 8% in one case of breast composition 2. There was no calcification. The final assessment was category 4a (n= 7) in 44%, category 3 (n = 6) in 38% and category 2 (n = 3) in 19%. Although sonographic and mammographic features of apocrine metaplasia are occasionally suspicious malignancy such as microlobulation and complex echo. We consider the possibility of apocrine metaplasia if masses show internal microcyst and abrupt boundary

  5. Alcohol intake from early adulthood to midlife and mammographic density.

    Science.gov (United States)

    McDonald, Jasmine A; Michels, Karin B; Cohn, Barbara A; Flom, Julie D; Tehranifar, Parisa; Terry, Mary Beth

    2016-04-01

    Moderate alcohol consumption (15 g/day) has been consistently associated with increased breast cancer risk; however, the association between alcohol and mammographic density, a strong marker of breast cancer risk, has been less consistent. Less is known about the effect of patterns of alcohol intake across the lifecourse. Using the Early Determinants of Mammographic Density study, an adult follow-up of women born in two US birth cohorts (n = 697; Collaborative Perinatal Project in Boston and Providence sites and the Childhood Health and Development Studies in California), we examined the association between alcohol intake in early adulthood (ages 20-29 years) and at time of interview and mammographic density (percent density and total dense area). We report the difference between nondrinkers and three levels of alcohol intake. We considered confounding by age at mammogram, body mass index, geographic site, race/ethnicity, and reproductive characteristics. Seventy-nine percent of women reported ever consuming alcohol. Compared to nondrinkers in early adulthood, we observed an inverse association between >7 servings/week and percent density in fully adjusted models (β = -5.1, 95% CI -8.7, -1.5; p for trend = 7 servings/week and percent density was also inverse (β = -3.1, 95% CI -7.0, 0.8; p for trend = 0.01). In contrast, moderate alcohol intake (>0-≤7 servings/week) in either time period was positively associated with dense area; but associations were not statistically significant in fully adjusted models. Our study does not lend support to the hypothesis that the positive association between alcohol intake and breast cancer risk is through increasing mammographic density.

  6. Mammographic image quality and exposure in South East Asia.

    Science.gov (United States)

    Ng, K H; DeWerd, L A; Schmidt, R C

    2000-12-01

    Generally there is a significant delay before optimized performance of mammography is fully realized in the developing countries. To evaluate the status of mammographic performance, a survey of mammographic image quality and exposure was performed in nine hospitals from four selected South East Asian countries. The entrance exposure on the surface of the American College of Radiology (ACR) mammographic phantom (ACR-RMI model 156) was made using both thermoluminescent dosimeters (TLDs) and an ionization chamber. The TLDs were mailed from the University of Wisconsin Radiation Calibration Laboratory (UWRCL) to the cooperating hospitals. The surveyed hospitals processed the images and returned them to the UWRCL for subsequent evaluation of the image quality of the mammographic phantom. Machine-specific data, technique factors and sensitometric data were also obtained. At 28 kVp, the mean entrance exposure is 0.91 R (0.46 to 2.6 R), mean glandular dose is 1.61 mGy (0.90 to 4.15 mGy), mean optical density is 1.37 (0.66 to 2.30), mean total phantom image score is 9.1(4-12). Only three of the nine hospitals tested achieved an acceptable score above the minimum 10. Results for 25 and 30 kVp showed similar trend. The variation between the ion chamber measurements and TLD measurements ranged from 4 to 24%. There is a wide variation in the image quality and entrance exposure among hospitals in South East Asia. There is a need for a quality assurance program. The factors that cause low score in the phantom images must be corrected. Calibration and the use of appropriate ionization chambers for mammography is important.

  7. Tubulolobular carcinoma of the breast: Clinical, mammographic and sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil [Ege University Hospital, Department of Radiology, Bornova, Izmir (Turkey)]. E-mail: isilbilgen@hotmail.com; Oktay, Aysenur [Ege University Hospital, Department of Radiology, Bornova, Izmir (Turkey)

    2006-12-15

    Purpose: To determine and quantitate radiologic characteristics of tubulolobular carcinoma of the breast and to report clinical and pathologic findings. Materials and methods: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 26 histopathologically proven tubulolobular carcinoma of the breast. Analysis included history; findings at physical examination, mammography, and sonography (US) at the time of diagnosis and in postoperative follow-up, and histopathological results. Results: At physical examination, palpable mass was present in 85% (n = 22) of the patients. The mammographic findings were mass in 17 (65%), asymmetric focal density in 2 (8%), architectural distortion in 2 (8%) and negative mammograms in 5 (19%) of the 26 patients. US depicted 25 masses in 24 patients, all of which were hypoechoic, with spiculated (n = 13) or microlobulated (n = 12) margins. The cancer was clinically occult in 12% (n = 3), mammographically occult in 19% (n = 5), and radiologically occult in 4% (n = 1) of the patients. Histologically, the mean size of the tumor was 1.7 cm and 18 (69%) patients were node negative. Conclusion: Tubulolobular carcinoma of the breast usually manifests clinically as a firm, immobile mass and mammographically as a spiculated or ill-defined, irregular, isodense mass without microcalcifications. Common findings on sonography include a homogeneously hypoechoic, spiculated or microlobulated mass with posterior acoustic shadowing or normal acoustic transmission. Tubulolobular carcinoma should be included in the differential diagnosis for breast masses with these imaging features.

  8. Invasive ductal carcinoma vs. invasive lobular carcinoma; mammographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Chun; Do, Young Soo; Oh, Hoon Il; Han, Yoon Hee; Kim, Ki Soo; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1996-01-01

    The purpose of this study is to evaluate mammographic findings of invasive ductal carcinoma (IDC) and invasive lobular carcinoma(ILC) and to find differential points between the two. 239 patients, who underwent mammography prior to surgery and were proved to have IDC(patients) or ILC(15 patients) pathologically, were analized retrospectively. On mammogram, presence of mass and microcalcification were analized. When there was a mass on mammogram, lesion opacity was classified into high, equal, or low opacity and border of the mass was classified into spiculated, poorly marginated, and well-marginated. When there was no definite mass, mammographic findings were classifie into asymmetric opacity and no mass. Masses were observed in 168 patients(75%) of IDC and 12 patients(80%) of ILC. Border of the masses were spiculated(n=50, 22.3%), poorly marginated(n=112, 50%), or well-marginated(n=6, 2.7%) in patients with IDC. Spiculated and poorly marginated borders were observed in 8 patients(53.3%) and 4 patients(26.7%) respectively, in patients with ILC. Microcalcifications were seen in 88 patients(17.3%) of IDC and patients(33.3%) of ILC. Although equal or low opacities were observed more frequently in ILC and microcalcifications were noted more frequently in IDC, it was difficult to differentiate the two diseases based on mammographic findings.

  9. Progestogen levels, Progesterone Receptor Gene polymorphisms, and mammographic density changes: results from the Postmenopausal Estrogen/Progestin Interventions Mammographic Density Study (PEPI-MDS)

    Science.gov (United States)

    Lee, Eunjung; Ingles, Sue A.; Van Den Berg, David; Wang, Wei; LaVallee, Chris; Huang, Mei-Hua; Crandall, Carolyn J.; Stanczyk, Frank Z.; Greendale, Gail A.; Ursin, Giske

    2015-01-01

    Objective Estrogen plus progestin therapy (EPT) in postmenopausal women increases breast cancer risk and mammographic density to a higher extent than does estrogen therapy (ET) alone. Data from the randomized placebo-controlled Postmenopausal Estrogen/Progestin Interventions (PEPI) trial showed that EPT-induced increases in serum estrone and estrone sulfate levels were positively correlated with increases in mammographic density. Here, after adjusting for serum estrone and estrone sulfate levels, we investigated the roles of post-treatment serum progestogen increase and of progesterone receptor gene (PGR) genetic variations on changes in mammographic density. Methods We measured percent mammographic density and serum progestogen levels in 280 PEPI participants randomized to EPT treatment. Analyses of genetic variations in PGR were limited to 260 white women for whom we successfully obtained PGR genotypes. We used linear regression analyses to determine how increase in progestogen levels and PGR genetic variations influenced mammographic density change following EPT. Results The increase in post-treatment serum progestogen level was positively associated with greater increases in mammographic density after adjustment for covariates (P-trend=0.044). Compared to women in the lowest quartile of serum progestogen, women in the highest quartile experienced a 3.5% greater increase in mammographic density (P=0.046). We did not find a strong indication that genetic variations in PGR were associated with mammographic density increase, or modified the association with serum progestogen, however confidence in these null findings is constrained by our small sample size. Conclusions Our results suggest that higher serum progestogen levels resulting from EPT treatment lead to greater increases in mammographic density. PMID:22105149

  10. Paget's disease of the breast: Clinical, mammographic, sonographic and pathologic findings in 52 cases

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil [Ege University Hospital, Department of Radiology, Bornova 35100, Izmir (Turkey)]. E-mail: isilbilgen@hotmail.com; Oktay, Aysenur [Ege University Hospital, Department of Radiology, Bornova 35100, Izmir (Turkey)

    2006-11-15

    Purpose: To determine and quantitate radiologic characteristics of Paget's disease of the breast and to report clinical and pathologic findings. Materials and methods: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 52 histologicallly proved Paget's disease of the breast. Analysis included history, findings at physical examination, mammography and sonography (US) and histologic type of Paget's disease. Results: At physical examination, palpable mass (n = 33, 63%), nipple erythema-eczema-ulceration (n = 17, 33%) and blood-stained nipple discharge (n = 5, 10%) were noted. Among 17 patients who had clinically evident Paget's disease, the mammographic findings were isolated microcalcifications in 3 (18%), mass associated with microcalcifications in 5 (29%), mass in 2 (12%) and negative in 7 (41%) patients. In the 35 patients with clinically inevident Paget's disease, these mammographic findings were 43% (n = 15), 34% (n = 12), 20% (n = 7) and 3% (n = 1), respectively. US depicted 43 masses in 35 patients, all of which were lobulated or irregularly contoured, mostly (n = 41, 95%) without posterior acoustic shadowing. The cancer was clinically occult in 10% (n = 5), mammographically occult in 15% (n = 8) and radiologically occult in 13% (n = 7) of the 52 patients. Histologically, the tumor was multifocal and/or multicentric in 11 (21%) patients. Conclusion: The clinical features of Paget's disease are characteristic and should alert the clinician to the likelihood of an underlying carcinoma, which should be evaluated radiologically. However, as Paget's disease is primarily a clinical diagnosis and mammograms may be negative, screening programs without clinical examination may result with delay in diagnosis. As a result, both clinical and imaging findings are complementary and should be correlated to confirm or exclude a diagnosis of Paget

  11. Fat necrosis of the breast: clinical, mammographic and sonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Bilgen, Isil Guenhan; Ustun, Esin Emin; Memis, Aysenur

    2001-08-01

    Objective: the purpose of this study was to describe and quantitate the clinical, mammographic and sonographic (US) features and to evaluate the evolution of fat necrosis in the breast. Materials and methods: a retrospective review of the clinical, mammographic and US findings of 126 fat necrosis lesions in 94 patients, diagnosed between 1989 and 1999, was done. All the cases included in the study had at least 3 years follow-up mammograms. In addition, 48 patients with a total of 62 fat necrosis lesions, also had an US follow-up. Fat necrosis was diagnosed on the basis of histologic (n=25) and initial or follow-up imaging (n=69) findings. Results: the predominant mammographic features of the 114 lesions apparent on mammograms were radiolucent oil cyst (n=34, 26.9%), round opacity (n=16, 12.6%), asymmetrical opacity or heterogenicity of the subcutaneous tissues (n=20, 15.8%), dystrophic calcifications (n=34, 26.9%), clustered pleomorphic microcalcifications (n=5, 3.9%), and suspicious speculated mass (n=5, 3.9%). In five patients with 12 (9.5%) palpable masses, mammograms were normal. The predominant US features of the 112 lesions apparent on sonograms were solid (n=18, 14.2%), anechoic with posterior acoustic enhancement (n=21, 16.6%), anechoic with posterior acoustic shadowing (n=20, 15.8%), cystic with internal echoes (n=14, 11.1%), cystic with mural nodule (n=5, 3.9%) and increased echogenicity of the subcutaneous tissues (n=34, 26.9%). In five patients with 14 (11.1%) lesions, sonographic examination was normal. Mammographic follow-up showed that five of the radiolucent oil cysts developed curvilinear calcifications, six of the round opacities decreased in size and density, and another two disappeared. Eleven of the dystrophic calcifications became even more coarse. Six of the asymmetrical opacities became vague and one developed an oil cyst and coarse calcifications. The only nonoperated speculated mass developed a typical small radiolucent oil cyst in the

  12. Positive predictive value of abnormal mammographic findings and role of assessment procedures; Valore predittivo positivo dei segni radiologici in mammografia e apporto degli esami di approfondimento

    Energy Technology Data Exchange (ETDEWEB)

    Menna, S.; Marra, V.; Di Virgilio, M.R.; Macchia, G.; Frigerio, A. [Turin Ospedale San Giovanni Antica Sede, Turin (Italy). Dipt. oncologico

    1999-05-01

    To investigate the positive predictive value for cancer of abnormal mammographic findings and the role of assessment, the authors reviewed a series of 962 patients recalled and examined in the first breast screening center of Turin (Italy), out of 18996 women aged 50-59 from 1991 to 1995, within a population-based mammography program. The results of this study confirm the accuracy of mammography in the early detection of breast cancer and the different role of assessment procedures in the various abnormal mammographic findings. The improvement in positive predictive value for screening demonstrates the importance of the learning curve within the screening team. Most of this improvement could be referred to refined diagnostic criteria for calcifications. [Italian] Per determinare il valore predittivo positivo per carcinoma dei singoli segni mammografici e valutare il ruolo degli esami di approfondimento, sono stati revisionati 962 casi richiamati per approfondimento nel Centro di screening mammografico di Torino, su 18996 donne 50-59enni negli anni 1991-1995. I risultati confermano l'accuratezza della mammografia nella diagnosi precoce del carcinoma mammario e mostrano come, nel caso di richiamo per controllo, l'affidabilita' degli esami di approfondimento sia variabile per i diversi segni radiologici responsabili del richiamo. Il miglioramento del valore predittivo positivo del richiamo dimostra l'importanza della curva di apprendimento tra i radiologici del Centro di screening. Esso puo' essere attribuito all'affinamento dei criteri di valutazione delle microcalcificazioni.

  13. Improved mammographic CAD performance using multi-view information: a Bayesian network framework.

    NARCIS (Netherlands)

    Velikova, M.V.; Samulski, M.R.M.; Lucas, P.J.; Karssemeijer, N.

    2009-01-01

    Mammographic reading by radiologists requires the comparison of at least two breast projections (views) for the detection and the diagnosis of breast abnormalities. Despite their reported potential to support radiologists, most mammographic computer-aided detection (CAD) systems have a major

  14. Unbiased screen for interactors of leucine-rich repeat kinase 2 supports a common pathway for sporadic and familial Parkinson disease

    NARCIS (Netherlands)

    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.; 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.; 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, Omar; 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; 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.; Ferrucci, Luigi; Johnson, Robert; Longo, Dan L.; Majounie, Elisa; Nalls, Michael A.; O'Brien, Richard; 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

  15. Genome-wide screen identifies pathways that govern GAA/TTC repeat fragility and expansions in dividing and nondividing yeast cells.

    Science.gov (United States)

    Zhang, Yu; Shishkin, Alexander A; Nishida, Yuri; Marcinkowski-Desmond, Dana; Saini, Natalie; Volkov, Kirill V; Mirkin, Sergei M; Lobachev, Kirill S

    2012-10-26

    Triplex structure-forming GAA/TTC repeats pose a dual threat to the eukaryotic genome integrity. Their potential to expand can lead to gene inactivation, the cause of Friedreich's ataxia disease in humans. In model systems, long GAA/TTC tracts also act as chromosomal fragile sites that can trigger gross chromosomal rearrangements. The mechanisms that regulate the metabolism of GAA/TTC repeats are poorly understood. We have developed an experimental system in the yeast Saccharomyces cerevisiae that allows us to systematically identify genes crucial for maintaining the repeat stability. Two major groups of mutants defective in DNA replication or transcription initiation are found to be prone to fragility and large-scale expansions. We demonstrate that problems imposed by the repeats during DNA replication in actively dividing cells and during transcription initiation in nondividing cells can culminate in genome instability. We propose that similar mechanisms can mediate detrimental metabolism of GAA/TTC tracts in human cells. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Task-Specific Optimization of Mammographic Systems

    Science.gov (United States)

    2007-03-01

    16 Appendices………………………………………………………………………….…17 4 Introduction The primary screening tool for breast cancer is x-ray...mammography. While mammography reduces breast cancer mortality, it has areas for improvement as it misses many early-stage cancers . This research...seeks to improve the efficacy of mammography by optimizing the entire image chain for the detection of breast masses and microcalcifications . This

  17. 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.

  18. Versican but not decorin accumulation is related to malignancy in mammographically detected high density and malignant-appearing microcalcifications in non-palpable breast carcinomas

    Directory of Open Access Journals (Sweden)

    Kalofonos Haralabos P

    2011-07-01

    Full Text Available Abstract Background Mammographic density (MD and malignant-appearing microcalcifications (MAMCs represent the earliest mammographic findings of non-palpable breast carcinomas. Matrix proteoglycans versican and decorin are frequently over-expressed in various malignancies and are differently involved in the progression of cancer. In the present study, we have evaluated the expression of versican and decorin in non-palpable breast carcinomas and their association with high risk mammographic findings and tumor characteristics. Methods Three hundred and ten patients with non-palpable suspicious breast lesions, detected during screening mammography, were studied. Histological examination was carried out and the expression of decorin, versican, estrogen receptor α (ERα, progesterone receptor (PR and c-erbB2 (HER-2/neu was assessed by immunohistochemistry. Results Histological examination showed 83 out of 310 (26.8% carcinomas of various subtypes. Immunohistochemistry was carried out in 62/83 carcinomas. Decorin was accumulated in breast tissues with MD and MAMCs independently of the presence of malignancy. In contrast, versican was significantly increased only in carcinomas with MAMCs (median ± SE: 42.0 ± 9.1 and MD (22.5 ± 10.1 as compared to normal breast tissue with MAMCs (14.0 ± 5.8, MD (11.0 ± 4.4 and normal breast tissue without mammographic findings (10.0 ± 2.0. Elevated levels of versican were correlated with higher tumor grade and invasiveness in carcinomas with MD and MAMCs, whereas increased amounts of decorin were associated with in situ carcinomas in MAMCs. Stromal deposition of both proteoglycans was related to higher expression of ERα and PR in tumor cells only in MAMCs. Conclusions The specific accumulation of versican in breast tissue with high MD and MAMCs only in the presence of malignant transformation and its association with the aggressiveness of the tumor suggests its possible use as molecular marker in non

  19. Mammographic density and risk of breast cancer by age and tumor characteristics.

    Science.gov (United States)

    Bertrand, Kimberly A; Tamimi, Rulla M; Scott, Christopher G; Jensen, Matthew R; Pankratz, V; Visscher, Daniel; Norman, Aaron; Couch, Fergus; Shepherd, John; Fan, Bo; Chen, Yunn-Yi; Ma, Lin; Beck, Andrew H; Cummings, Steven R; Kerlikowske, Karla; Vachon, Celine M

    2013-11-04

    Understanding whether mammographic density (MD) is associated with all breast tumor subtypes and whether the strength of association varies by age is important for utilizing MD in risk models. Data were pooled from six studies including 3414 women with breast cancer and 7199 without who underwent screening mammography. Percent MD was assessed from digitized film-screen mammograms using a computer-assisted threshold technique. We used polytomous logistic regression to calculate breast cancer odds according to tumor type, histopathological characteristics, and receptor (estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER2)) status by age (ages, with a two-fold increased risk for high (>51%) versus average density (11-25%). Women ages ages 55-64 and ≥ 65 years (P(age-interaction) = 0.02). Among all ages, MD had a stronger association with large (>2.1 cm) versus small tumors and positive versus negative lymph node status (P's ages breast cancer than ER-positive tumors compared to women ages 55-64 and ≥ 65 years (P(age-interaction) = 0.04). MD was positively associated with both HER2-negative and HER2-positive tumors within each age group. MD is strongly associated with all breast cancer subtypes, but particularly tumors of large size and positive lymph nodes across all ages, and ER-negative status among women ages <55 years, suggesting high MD may play an important role in tumor aggressiveness, especially in younger women.

  20. Pseudoangiomatous stromal hyperplasia: a study of the mammographic and sonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Celliers, L., E-mail: liesl.celliers@health.wa.gov.a [Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); Wong, D.D. [PathWest Laboratory Medicine, Department of Anatomical Pathology, Nedlands, Western Australia (Australia); Bourke, A. [Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia)

    2010-02-15

    Aim: To review the imaging features on mammogram and ultrasound of pseudoangiomatous stromal hyperplasia (PASH) of the breast. Materials and methods: A systematic search of the breast cancer screening centre and pathology department database at a teaching hospital was performed to identify cases reported as PASH between 2000 and 2007. The findings on mammogram and ultrasound were reviewed. Information on demographics and clinical outcome were obtained from the patient's medical records. Results: Seventy-three cases of PASH were identified, which occurred in women with a mean age of 51.1 +- 10.5 years. The mean size of the lesion was 18 mm. Up to 70.8% of cases were radiologically detected and 29.2% presented as palpable masses. The most common appearance on mammography was of a solitary, non-calcified mass (30.4%) or localized increased stroma (30.4%). The distribution of mammographic findings differed in screen-detected patients compared with those presenting clinically (p = 0.015, Fisher's exact test). The most frequent sonographic appearance was of a well-defined hypoechoic mass (36.7%). Conclusion: Although there are emerging patterns associated with PASH on imaging, the features are not sufficiently specific to allow for a prospective diagnosis. Histological confirmation, preferably with core biopsy, should always be considered.

  1. Mammographic Density Change With Estrogen and Progestin Therapy and Breast Cancer Risk.

    Science.gov (United States)

    Byrne, Celia; Ursin, Giske; Martin, Christopher F; Peck, Jennifer D; Cole, Elodia B; Zeng, Donglin; Kim, Eunhee; Yaffe, Martin D; Boyd, Norman F; Heiss, Gerardo; McTiernan, Anne; Chlebowski, Rowan T; Lane, Dorothy S; Manson, JoAnn E; Wactawski-Wende, Jean; Pisano, Etta D

    2017-09-01

    Estrogen plus progestin therapy increases both mammographic density and breast cancer incidence. Whether mammographic density change associated with estrogen plus progestin initiation predicts breast cancer risk is unknown. We conducted an ancillary nested case-control study within the Women's Health Initiative trial that randomly assigned postmenopausal women to daily conjugated equine estrogen 0.625 mg plus medroxyprogesterone acetate 2.5 mg or placebo. Mammographic density was assessed from mammograms taken prior to and one year after random assignment for 174 women who later developed breast cancer (cases) and 733 healthy women (controls). Logistic regression analyses included adjustment for confounders and baseline mammographic density when appropriate. Among women in the estrogen plus progestin arm (97 cases/378 controls), each 1% positive change in percent mammographic density increased breast cancer risk 3% (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01 to 1.06). For women in the highest quintile of mammographic density change (>19.3% increase), breast cancer risk increased 3.6-fold (95% CI = 1.52 to 8.56). The effect of estrogen plus progestin use on breast cancer risk (OR = 1.28, 95% CI = 0.90 to 1.82) was eliminated in this study, after adjusting for change in mammographic density (OR = 1.00, 95% CI = 0.66 to 1.51). We found the one-year change in mammographic density after estrogen plus progestin initiation predicted subsequent increase in breast cancer risk. All of the increased risk from estrogen plus progestin use was mediated through mammographic density change. Doctors should evaluate changes in mammographic density with women who initiate estrogen plus progestin therapy and discuss the breast cancer risk implications.

  2. Characterizing mammographic images by using generic texture features.

    Science.gov (United States)

    Häberle, Lothar; Wagner, Florian; Fasching, Peter A; Jud, Sebastian M; Heusinger, Katharina; Loehberg, Christian R; Hein, Alexander; Bayer, Christian M; Hack, Carolin C; Lux, Michael P; Binder, Katja; Elter, Matthias; Münzenmayer, Christian; Schulz-Wendtland, Rüdiger; Meier-Meitinger, Martina; Adamietz, Boris R; Uder, Michael; Beckmann, Matthias W; Wittenberg, Thomas

    2012-04-10

    Although mammographic density is an established risk factor for breast cancer, its use is limited in clinical practice because of a lack of automated and standardized measurement methods. The aims of this study were to evaluate a variety of automated texture features in mammograms as risk factors for breast cancer and to compare them with the percentage mammographic density (PMD) by using a case-control study design. A case-control study including 864 cases and 418 controls was analyzed automatically. Four hundred seventy features were explored as possible risk factors for breast cancer. These included statistical features, moment-based features, spectral-energy features, and form-based features. An elaborate variable selection process using logistic regression analyses was performed to identify those features that were associated with case-control status. In addition, PMD was assessed and included in the regression model. Of the 470 image-analysis features explored, 46 remained in the final logistic regression model. An area under the curve of 0.79, with an odds ratio per standard deviation change of 2.88 (95% CI, 2.28 to 3.65), was obtained with validation data. Adding the PMD did not improve the final model. Using texture features to predict the risk of breast cancer appears feasible. PMD did not show any additional value in this study. With regard to the features assessed, most of the analysis tools appeared to reflect mammographic density, although some features did not correlate with PMD. It remains to be investigated in larger case-control studies whether these features can contribute to increased prediction accuracy.

  3. Comparison of subjective and fully automated methods for measuring mammographic density.

    Science.gov (United States)

    Moshina, Nataliia; Roman, Marta; Sebuødegård, Sofie; Waade, Gunvor G; Ursin, Giske; Hofvind, Solveig

    2018-02-01

    Background Breast radiologists of the Norwegian Breast Cancer Screening Program subjectively classified mammographic density using a three-point scale between 1996 and 2012 and changed into the fourth edition of the BI-RADS classification since 2013. In 2015, an automated volumetric breast density assessment software was installed at two screening units. Purpose To compare volumetric breast density measurements from the automated method with two subjective methods: the three-point scale and the BI-RADS density classification. Material and Methods Information on subjective and automated density assessment was obtained from screening examinations of 3635 women recalled for further assessment due to positive screening mammography between 2007 and 2015. The score of the three-point scale (I = fatty; II = medium dense; III = dense) was available for 2310 women. The BI-RADS density score was provided for 1325 women. Mean volumetric breast density was estimated for each category of the subjective classifications. The automated software assigned volumetric breast density to four categories. The agreement between BI-RADS and volumetric breast density categories was assessed using weighted kappa (k w ). Results Mean volumetric breast density was 4.5%, 7.5%, and 13.4% for categories I, II, and III of the three-point scale, respectively, and 4.4%, 7.5%, 9.9%, and 13.9% for the BI-RADS density categories, respectively ( P for trend density categories was k w  = 0.5 (95% CI = 0.47-0.53; P density increased with increasing density category of the subjective classifications. The agreement between BI-RADS and volumetric breast density categories was moderate.

  4. Towards an automatic tool for resolution evaluation of mammographic images

    Energy Technology Data Exchange (ETDEWEB)

    De Oliveira, J. E. E. [FUMEC, Av. Alfonso Pena 3880, CEP 30130-009 Belo Horizonte - MG (Brazil); Nogueira, M. S., E-mail: juliae@fumec.br [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Pte. Antonio Carlos 6627, 31270-901, Belo Horizonte - MG (Brazil)

    2014-08-15

    Medical images are important for diagnosis purposes as they are related to patients medical history and pathology. Breast cancer represents a leading cause of death among women worldwide, and its early detection is the most effective method of reducing mortality. In a way to identify small structures with low density differences, a high image quality is required with the use of low doses of radiation. The analysis of the quality of the obtained image from a mammogram is performed from an image of a simulated breast and this is a fundamental key point for a program of quality control of mammography equipment s. In a control program of mammographic equipment s, besides the analysis of the quality of mammographic images, each element of the chain which composes the formation of the image is also analyzed: X-rays equipment s, radiographic films, and operating conditions. This control allows that an effective and efficient exam can be provided to the population and is within the standards of quality required for the early detection of breast cancer. However, according to the State Program of Quality Control in Mammography of Minas Gerais, Brazil, only 40% of the mammographies have provided a simulated image with a minimum level of quality, thus reinforcing the need for monitoring the images. The reduction of the morbidity and mortality indexes, with optimization and assurance of access to diagnosis and breast cancer treatment in the state of Minas Gerais, Brazil, may be the result of a mammographic exam which has a final image with good quality and which automatic evaluation is not subjective. The reason is that one has to consider the hypothesis that humans are subjective when performing the image analysis and that the evaluation of the image can be executed by a computer with objectivity. In 2007, in order to maintain the standard quality needed to mammography, the State Health Secretariat of Minas Gerais, Brazil, established a Program of Monthly Monitoring the

  5. 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%.

  6. [Complex evaluation of film mammographic imaging systems. 2. Comparison of 18 systems using a signal-noise matrix].

    Science.gov (United States)

    Friedrich, M; Weskamp, P

    1984-06-01

    The concept of the signal-noise matrix with physiological optical noise measurements for defining visibility thresholds provides a quantitative means for comparing film mammographic systems (9). Eighteen such systems were compared. A graded list can be produced relating the integrated signal-noise ratio to area and detail contrast (image quality) and to the required radiation dose (dose efficiency). For this, maximal dose (industrial film) and minimal image quality can be taken into consideration. In this list, in agreement with other publications (12) high resolution film-screen combinations, using industrial film (eg. Cronex 70/screen) come top. In combination with a grid technique, this system achieves a greatly superior image quality. Amongst commercial film-screen systems, only the Trimax mammography system with high resolution screens is comparable. All other commercial systems (single or double coated films) are unsatisfactory with respect to their dose efficiency and image quality. Some industrial films without screens (Mamoray M4) are intermediate between high definition and other commercial systems. Ninety-second, screenless films offered for mammography appear unsuitable for this purpose, both in view of their dose efficiency and image quality.

  7. Computerized quantitative evaluation of mammographic accreditation phantom images

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yongbum; Tsai, Du-Yih; Shinohara, Norimitsu [Department of Radiological Technology, School of Health Sciences, Niigata University, 2-746 Asahimachidori, Chuouku, Niigata 951-8518 (Japan); Department of Radiological Technology, Gifu Univesity of Medical Science, 1-795 Hiraga-aza-nagamine, Seki, Gifu 501-3892 (Japan)

    2010-12-15

    Purpose: The objective was to develop and investigate an automated scoring scheme of the American College of Radiology (ACR) mammographic accreditation phantom (RMI 156, Middleton, WI) images. Methods: The developed method consisted of background subtraction, determination of region of interest, classification of fiber and mass objects by Mahalanobis distance, detection of specks by template matching, and rule-based scoring. Fifty-one phantom images were collected from 51 facilities for this study (one facility provided one image). A medical physicist and two radiologic technologists also scored the images. The human and computerized scores were compared. Results: In terms of meeting the ACR's criteria, the accuracies of the developed method for computerized evaluation of fiber, mass, and speck were 90%, 80%, and 98%, respectively. Contingency table analysis revealed significant association between observer and computer scores for microcalcifications (p<5%) but not for masses and fibers. Conclusions: The developed method may achieve a stable assessment of visibility for test objects in mammographic accreditation phantom image in whether the phantom image meets the ACR's criteria in the evaluation test, although there is room left for improvement in the approach for fiber and mass objects.

  8. CADx of mammographic masses and clustered microcalcifications: A review

    Energy Technology Data Exchange (ETDEWEB)

    Elter, Matthias; Horsch, Alexander [Fraunhofer Institute for Integrated Circuits (IIS), Am Wolfsmantel 33, 91058 Erlangen (Germany); Institute for Medical Statistics and Epidemiology, TU Muenchen, Ismaninger Strasse 22, 81675 Muenchen (Germany) and Department of Computer Science, University of Tromsoe Breivika, N-9037 Tromsoe (Norway)

    2009-06-15

    Breast cancer is the most common type of cancer among women in the western world. While mammography is regarded as the most effective tool for the detection and diagnosis of breast cancer, the interpretation of mammograms is a difficult and error-prone task. Hence, computer aids have been developed that assist the radiologist in the interpretation of mammograms. Computer-aided detection (CADe) systems address the problem that radiologists often miss signs of cancers that are retrospectively visible in mammograms. Furthermore, computer-aided diagnosis (CADx) systems have been proposed that assist the radiologist in the classification of mammographic lesions as benign or malignant. While a broad variety of approaches to both CADe and CADx systems have been published in the past two decades, an extensive survey of the state of the art is only available for CADe approaches. Therefore, a comprehensive review of the state of the art of CADx approaches is presented in this work. Besides providing a summary, the goals for this article are to identify relations, contradictions, and gaps in literature, and to suggest directions for future research. Because of the vast amount of publications on the topic, this survey is restricted to the two most important types of mammographic lesions: masses and clustered microcalcifications. Furthermore, it focuses on articles published in international journals.

  9. Unobtrusively tracking mammographers' eye gaze direction and pupil diameter

    Science.gov (United States)

    Barrett, James R.; deParedes, Ellen S.; Dwyer, Samuel J., III; Merickel, Michael B.; Hutchinson, Thomas E.

    1994-04-01

    We developed techniques to unobtrusively track direction and pupil diameter of radiologists reading a wide variety of films. This study concentrated on mammography since the use of mammograms is important for successful treatment of breast cancer, and we wished to determine how previous studies of eye gaze with lung films relate to the specialized field of mammography. Our objective was to identify eye gaze patterns in mammographic experts as they observe features, such as masses and microcalcification clusters: identification of these patterns could lead to improving the rate of early detection of breast cancer. Our near IR light system successfully tracked eye gaze direction and pupil diameter of mammographic experts evaluating films. The association of long eye gaze dwells with diagnostic accuracy varied with the type of object being viewed. In films with masses, false positive diagnoses were associated with long dwells: this is similar to published results of observing lung nodule diagnosis. In mammograms with microcalcifications, true positive diagnoses were associated with long dwells. The association of prolonged dwells with true positive diagnoses of microcalcifications is a new observation.

  10. Intramammary metastases: Comparison of mammographic and ultrasound features

    Energy Technology Data Exchange (ETDEWEB)

    Abbas, Jasmin, E-mail: Jasmin_Abbas@web.de [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Wienke, Andreas, E-mail: andreas.wienke@medizin.uni-halle.de [Department of Epidemiology, Biometry and Informatics, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Spielmann, Rolf Peter, E-mail: rolf.spielmann@medizin.uni-halle.de [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Bach, Andreas Gunter [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany); Surov, Alexey, E-mail: alex.surow@medizin.uni-halle.de [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 Halle (Saale) (Germany)

    2013-09-15

    Purpose: To describe the mammographical and ultrasound features of IM, and to compare radiological patterns of IM arising from different malignancies. Materials and methods: A retrospective search in the statistical database of our institution from January 2000 to December 2009 revealed 51 cases of intramammary metastases from solid malignancies. Additionally, a retrospective search in the Pubmed database was performed. Publications in the time interval from 1980 to 2010 were considered. After thorough analysis, 119 articles with 229 patients were involved in the study. Therefore, together with our cases our analysis comprises 280 patients. Mammographic and ultrasound findings of different IM were analyzed. Results: The detected metastases showed two main radiological patterns: intramammary masses (81.5%) and architectural distortion (18.5%). Carcinomas of the stomach caused more frequently an architectural distortion, whereas other malignancies tended to present as intramammary masses. The size of the masses ranged from 2 to 104 mm. The largest lesions occurred in rhabdomyosarcoma, followed by hepatocellular carcinoma and squamous cell carcinomas of the head and neck region. The smallest lesions arose from malignancies of the thyroid gland carcinoma. Most IM showed circumscribed margins, while breast lesions in rhabdomyosarcoma were rather microlobulated. On ultrasound, IM from lung cancer were usually inhomogenously hypoechoic with circumscribed margins and showed posterior shadowing in almost 50% of the cases. Breast metastases from ovarian carcinoma had typically microlobulated margins and posterior enhancement. Conclusion: IM can present with a broad spectrum of radiological features. Their imaging findings vary depending on the primary tumor.

  11. A Genome-wide CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) Screen Identifies NEK7 as an Essential Component of NLRP3 Inflammasome Activation.

    Science.gov (United States)

    Schmid-Burgk, Jonathan L; Chauhan, Dhruv; Schmidt, Tobias; Ebert, Thomas S; Reinhardt, Julia; Endl, Elmar; Hornung, Veit

    2016-01-01

    Inflammasomes are high molecular weight protein complexes that assemble in the cytosol upon pathogen encounter. This results in caspase-1-dependent pro-inflammatory cytokine maturation, as well as a special type of cell death, known as pyroptosis. The Nlrp3 inflammasome plays a pivotal role in pathogen defense, but at the same time, its activity has also been implicated in many common sterile inflammatory conditions. To this effect, several studies have identified Nlrp3 inflammasome engagement in a number of common human diseases such as atherosclerosis, type 2 diabetes, Alzheimer disease, or gout. Although it has been shown that known Nlrp3 stimuli converge on potassium ion efflux upstream of Nlrp3 activation, the exact molecular mechanism of Nlrp3 activation remains elusive. Here, we describe a genome-wide CRISPR/Cas9 screen in immortalized mouse macrophages aiming at the unbiased identification of gene products involved in Nlrp3 inflammasome activation. We employed a FACS-based screen for Nlrp3-dependent cell death, using the ionophoric compound nigericin as a potassium efflux-inducing stimulus. Using a genome-wide guide RNA (gRNA) library, we found that targeting Nek7 rescued macrophages from nigericin-induced lethality. Subsequent studies revealed that murine macrophages deficient in Nek7 displayed a largely blunted Nlrp3 inflammasome response, whereas Aim2-mediated inflammasome activation proved to be fully intact. Although the mechanism of Nek7 functioning upstream of Nlrp3 yet remains elusive, these studies provide a first genetic handle of a component that specifically functions upstream of Nlrp3. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  12. The significance of repeat testing in Turkish blood donors screened with HBV, HCV and HIV immunoassays and the importance of S/CO ratios in the interpretation of HCV/HIV screening test results and as a determinant for further confirmatory testing.

    Science.gov (United States)

    Acar, Ali; Kemahli, Sabri; Altunay, Husnu; Kosan, Erdogan; Oncul, Oral; Gorenek, Levent; Cavuslu, Saban

    2010-06-01

    The purpose of this study was to investigate the intra-assay correlations amongst initial reactive and repeat screening results used in enzyme immunoassays (EIAs) for hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV in blood donors. This study evaluated the value of using the power of the signal to cut-off (S/CO) ratio index for confirming anti-HCV/HIV reactive screening results, thereby touching upon the utility of S/CO indices in determining whether further confirmatory testing was necessary. Screening test results of the 72,695 blood donors were evaluated over a 1-year period. Correlation analysis among each initial test and retests was done by Pearson r test. Appropriate S/CO values to determine the need of the confirmation testing was investigated by ROC analyses. EIA intra-assay correlations were of statistical significance and were determined as follows: 0.948 for anti-HCV, 0.827 for anti-HIV and 0.948 for HBsAg. The threshold S/CO ratio values which predicted more than 95% of the confirmation test result were 3.8 for HCV and 5.6 for HIV. We were able to demonstrate a strong level of intra-assay correlation amongst EIAs, thereby eliminating the need for repetition of the screening test. Hence, we suggest that repeat screening should only be limited to HBV and HIV tests with low EIA S/CO ratios. Thus, using the power of the S/CO ratio in determining the need for HCV confirmation testing can be a cost-effective measure, especially if the S/CO value is >or=3.8.

  13. Are Qualitative Assessments of Background Parenchymal Enhancement, Amount of Fibroglandular Tissue on MR Images, and Mammographic Density Associated with Breast Cancer Risk?

    Science.gov (United States)

    Dontchos, Brian N; Rahbar, Habib; Partridge, Savannah C; Korde, Larissa A; Lam, Diana L; Scheel, John R; Peacock, Sue; Lehman, Constance D

    2015-08-01

    To investigate whether qualitative magnetic resonance (MR) imaging assessments of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT), and mammographic density are associated with risk of developing breast cancer in women who are at high risk. In this institutional review board-approved HIPAA-compliant retrospective study, all screening breast MR images obtained from January 2006 to December 2011 in women aged 18 years or older and at high risk for but without a history of breast cancer were identified. Women in whom breast cancer was diagnosed after index MR imaging comprised the cancer cohort, and one-to-one matching (age and BRCA status) of each woman with breast cancer to a control subject was performed by using MR images obtained in women who did not develop breast cancer with follow-up time maximized. Amount of BPE, BPE pattern (peripheral vs central), amount of FGT at MR imaging, and mammographic density were assessed on index images. Imaging features were compared between cancer and control cohorts by using conditional logistic regression. Twenty-three women at high risk (mean age, 47 years ± 10 [standard deviation]; six women had BRCA mutations) with no history of breast cancer underwent screening breast MR imaging; in these women, a diagnosis of breast cancer (invasive, n = 12; in situ, n = 11) was made during the follow-up interval. Women with mild, moderate, or marked BPE were nine times more likely to receive a diagnosis of breast cancer during the follow-up interval than were those with minimal BPE (P = .007; odds ratio = 9.0; 95% confidence interval: 1.1, 71.0). BPE pattern, MR imaging amount of FGT, and mammographic density were not significantly different between the cohorts (P = .5, P = .5, and P = .4, respectively). Greater BPE was associated with a higher probability of developing breast cancer in women at high risk for cancer and warrants further study. (©) RSNA, 2015 Online supplemental material is available for

  14. Rapid and Accurate Approach for Screening of Microsatellite Unstable Tumours Using Quasimonomorphic Mononucleotide Repeats and Denaturating High Performance Liquid Chromatography (DHPLC

    Directory of Open Access Journals (Sweden)

    Gašper Berginc

    2009-01-01

    Full Text Available MSI analysis is becoming increasingly important for the detection of both hereditary non-polyposis colorectal cancer and sporadic primary colorectal tumours with MSI high phenotype. The Bethesda panel of five microsatellite markers has been proposed to provide uniform criteria for MSI analysis. Here we report on an MSI analysis approach using quasimonomorphic mononucleotide repeats and denaturating high performance liquid chromatography (DHPLC. We analysed 595 newly diagnosed colorectal tumours and 145 normal samples. Microsatellite markers BAT-25, BAT-26, NR-21, NR-22, and NR-27 were amplified in multiplex reaction and analysed using DHPLC and capillary electrophoresis (CE. DHPLC conditions for analysis of MSI multiplex assay were evaluated and tested. Analysis and cross-examination of the results obtained from 96 samples using DHPLC and capillary electrophoresis showed the same sensitivity and specificity of the two approaches for detecting MSI-H tumours. Using our new approach we showed that the tested markers are quasimonomorphic in a Slovenian population, with frequencies of polymorphisms 0.07%, 1.4%, 2.1%, 1.4%, and 1.4% for BAT-25, BAT-26, NR-21, NR-22, and NR-27, respectively. Forty-three (7.2% new MSI-H tumours were identified, of which 84% showed instability in all 5 tested markers. Overall, we developed a high-throughput, robust, accurate and cost-effective approach for the detection of MSI-H tumours.

  15. Evolution of mammographic image quality in the state of Rio de Janeiro

    National Research Council Canada - National Science Library

    Villar, Vanessa Cristina Felippe Lopes; Seta, Marismary Horsth De; de Andrade, Carla Lourenço Tavares; Delamarque, Elizabete Vianna; de Azevedo, Ana Cecília Pedrosa

    2015-01-01

    To evaluate the evolution of mammographic image quality in the state of Rio de Janeiro on the basis of parameters measured and analyzed during health surveillance inspections in the period from 2006 to 2011...

  16. Demonstration Project on Mammographic Computer-Aided Diagnosis for Breast Cancer Detection

    National Research Council Canada - National Science Library

    Doi, Kunio

    1999-01-01

    ...) in mammographic detection of breast cancer. Our plan is to develop advanced CAD schemes for detection and characterization of clustered microcalcifications and masses by incorporating artificial neural networks and various image processing techniques...

  17. Demonstration Project on Mammographic Computer-Aided Diagnosis for Breast Cancer Detection

    National Research Council Canada - National Science Library

    Doi, Kunio

    2002-01-01

    ...) in mammographic detection of breast cancer. Our plan is to develop advanced CAD schemes for detection and characterization of clustered microcalcifications and masses by incorporating artificial neural networks and various image processing techniques...

  18. Demonstration Project on Mammographic Computer-Aided Diagnosis for Breast Cancer Detection

    National Research Council Canada - National Science Library

    Doi, Kunio

    2000-01-01

    ...) in mammographic detection of breast cancer. Our plan is to develop advanced CAD schemes for detection and characterization of clustered microcalcifications and masses by incorporating artificial neural networks and various image processing techniques...

  19. Demonstration Project on Mammographic Computer-Aided Diagnosis for Breast Cancer Detection

    National Research Council Canada - National Science Library

    Doi, Kunio

    2001-01-01

    ...) in mammographic detection of breast cancer. Our plan is to develop advanced CAD schemes for detection and characterization of clustered microcalcifications and masses by incorporating artificial neural networks and various image processing techniques...

  20. Demonstration Project on Mammographic Computer-Aided Diagnosis for Breast Cancer Detection

    National Research Council Canada - National Science Library

    Doi, Kunio

    1998-01-01

    ...) in mammographic detection of breast cancer. Our plan is to develop advanced CAD schemes for detection and characterization of clustered microcalcifications and masses by incorporating artificial neural networks and various image processing techniques...

  1. Demonstration Project on Mammographic Computer-Aided Diagnosis for Breast Cancer Detection

    National Research Council Canada - National Science Library

    Doi, Kunio

    1997-01-01

    ...) in mammographic detection of breast cancer. Our plan is to develop advanced CAD schemes for detection and characterization of clustered microcalcifications and masses by incorporating artificial neural networks and various image processing techniques...

  2. Mammographic evidence of microenvironment changes in tumorous breasts.

    Science.gov (United States)

    Marin, Zach; Batchelder, Kendra A; Toner, Brian C; Guimond, Lyne; Gerasimova-Chechkina, Evgeniya; Harrow, Amy R; Arneodo, Alain; Khalil, Andre

    2017-04-01

    The microenvironment of breast tumors plays a critical role in tumorigenesis. As long as the structural integrity of the microenvironment is upheld, the tumor is suppressed. If tissue structure is lost through disruptions in the normal cell cycle, the microenvironment may act as a tumor promoter. Therefore, the properties that distinguish between healthy and tumorous tissues may not be solely in the tumor characteristics but rather in surrounding non-tumor tissue. The goal of this paper was to show preliminary evidence that tissue disruption and loss of homeostasis in breast tissue microenvironment and breast bilateral asymmetry can be quantitatively and objectively assessed from mammography via a localized, wavelet-based analysis of the whole breast. A wavelet-based multifractal formalism called the 2D Wavelet Transform Modulus Maxima (WTMM) method was used to quantitate density fluctuations from mammographic breast tissue via the Hurst exponent (H). Each entire mammogram was cut in hundreds of 360 × 360 pixel subregions in a gridding scheme of overlapping sliding windows, with each window boundary separated by 32 pixels. The 2D WTMM method was applied to each subregion individually. A data mining approach was set up to determine which metrics best discriminated between normal vs. cancer cases. These same metrics were then used, without modification, to discriminate between normal vs. benign and benign vs. cancer cases. The density fluctuations in healthy mammographic breast tissue are either monofractal anti-correlated (H 1/2) for dense tissue. However, tissue regions with H~1/2, as well as left vs. right breast asymetries, were found preferably in tumorous (benign or cancer) breasts vs. normal breasts, as quantified via a combination metric yielding a P-value ~ 0.0006. No metric considered showed significant differences between cancer vs. benign breasts. Since mammographic tissue regions associated with uncorrelated (H~1/2) density fluctuations were

  3. Optimal screening schedules for prevention of metastatic cancer.

    Science.gov (United States)

    Hanin, Leonid; Pavlova, Lyudmila

    2013-01-30

    We develop methodological, mathematical, statistical, and computational approaches to constructing schedules of cancer screening that maximize the probability that by the time of primary tumor detection it has not yet metastasized. Solving this problem is based on a comprehensive mechanistic model of cancer progression. We apply the model with realistic parameters and the screening optimization methodology to mammographic screening for breast cancer within the American female population. We uncover some general patterns of optimal screening schedules. We show that optimization of screening regimens leads to a significant reduction in the probability of detecting breast cancer that has already disseminated. Copyright © 2012 John Wiley & Sons, Ltd.

  4. Quality assurance applied to mammographic equipments using phantoms and software for its evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Mayo, Patricia, E-mail: p.mayo@titaniast.co [Titania Servicios Tecnologicos S.L., Grupo Dominguis, Apartado 46015, Valencia (Spain); Rodenas, Francisco [Departamento de Matematica Aplicada, Universidad Politecnica de Valencia, Apartado 46022, Valencia (Spain); Manuel Campayo, Juan [Hospital Clinico Universitario de Valencia, Avda. Blasco Ibanez, Apartado 46017, Valencia (Spain); Verdu, Gumersido [Departamento de Ingenieria Quimica y Nuclear, Universidad Politecnica de Valencia, Apartado 46022, Valencia (Spain)

    2010-07-21

    The image quality assessment in radiographic equipments is a very important item for a complete quality control of the radiographic image chain. The periodic evaluation of the radiographic image quality must guarantee the constancy of this quality to carry out a suitable diagnosis. Mammographic phantom images are usually used to study the quality of images obtained by determined mammographic equipment. The digital image treatment techniques allow to carry out an automatic analysis of the phantom image. In this work we apply some techniques of digital image processing to analyze in an automatic way the image quality of mammographic phantoms, namely CIRS SP01 and RACON for different varying conditions of the mammographic equipment. The CIRS SP01 phantom is usually used in analogic mammographic equipments and the RACON phantom has been specifically developed by authors to be applied to acceptance and constancy tests of the image quality in digital radiographic equipments following recommendations of international associations. The purpose of this work consists in analyzing the image quality for both phantoms by means of an automatic software utility. This analysis allows us to study the functioning of the image chain of the mammographic system in an objective way, so an abnormal functioning of the radiographic equipment might be detected.

  5. Quality assurance applied to mammographic equipments using phantoms and software for its evaluation

    Science.gov (United States)

    Mayo, Patricia; Rodenas, Francisco; Manuel Campayo, Juan; Verdú, Gumersido

    2010-07-01

    The image quality assessment in radiographic equipments is a very important item for a complete quality control of the radiographic image chain. The periodic evaluation of the radiographic image quality must guarantee the constancy of this quality to carry out a suitable diagnosis. Mammographic phantom images are usually used to study the quality of images obtained by determined mammographic equipment. The digital image treatment techniques allow to carry out an automatic analysis of the phantom image. In this work we apply some techniques of digital image processing to analyze in an automatic way the image quality of mammographic phantoms, namely CIRS SP01 and RACON for different varying conditions of the mammographic equipment. The CIRS SP01 phantom is usually used in analogic mammographic equipments and the RACON phantom has been specifically developed by authors to be applied to acceptance and constancy tests of the image quality in digital radiographic equipments following recommendations of international associations. The purpose of this work consists in analyzing the image quality for both phantoms by means of an automatic software utility. This analysis allows us to study the functioning of the image chain of the mammographic system in an objective way, so an abnormal functioning of the radiographic equipment might be detected.

  6. Statistical Segmentation of Regions of Interest on a Mammographic Image

    Directory of Open Access Journals (Sweden)

    Juhan Valerie

    2007-01-01

    Full Text Available This paper deals with segmentation of breast anatomical regions, pectoral muscle, fatty and fibroglandular regions, using a Bayesian approach. This work is a part of a computer aided diagnosis project aiming at evaluating breast cancer risk and its association with characteristics (density, texture, etc. of regions of interest on digitized mammograms. Novelty in this paper consists in applying and adapting Markov random field for detecting breast anatomical regions on digitized mammograms whereas most of previous works were focused on masses and microcalcifications. The developed method was tested on 50 digitized mammograms of the mini-MIAS database. Computer segmentation is compared to manual one made by a radiologist. A good agreement is obtained on 68% of the mini-MIAS mammographic image database used in this study. Given obtained segmentation results, the proposed method could be considered as a satisfying first approach for segmenting regions of interest in a breast.

  7. Statistical Segmentation of Regions of Interest on a Mammographic Image

    Directory of Open Access Journals (Sweden)

    Valerie Juhan

    2007-01-01

    Full Text Available This paper deals with segmentation of breast anatomical regions, pectoral muscle, fatty and fibroglandular regions, using a Bayesian approach. This work is a part of a computer aided diagnosis project aiming at evaluating breast cancer risk and its association with characteristics (density, texture, etc. of regions of interest on digitized mammograms. Novelty in this paper consists in applying and adapting Markov random field for detecting breast anatomical regions on digitizedmammograms whereas most of previous works were focused on masses and microcalcifications. The developed method was tested on 50 digitized mammograms of the mini-MIAS database. Computer segmentation is compared to manual one made by a radiologist. A good agreement is obtained on 68% of the mini-MIAS mammographic image database used in this study. Given obtained segmentation results, the proposed method could be considered as a satisfying first approach for segmenting regions of interest in a breast.

  8. Computerized evaluation of mammographic image quality using phantom images.

    Science.gov (United States)

    Dougherty, G

    1998-01-01

    A simple, quick and computerized method for quantitatively evaluating the image quality of mammography phantom images has been developed. Images of the American College of Radiology (ACR) mammographic accreditation phantoms were acquired under different X-ray techniques, scored and ranked subjectively by five expert readers, and digitized for quantitative analysis. The contrast and signal-to-noise (contrast-to-noise) ratios of the main nodule and microcalcification group were obtained accurately and reproducibly using an image processing protocol. The contrast values were successful at discriminating differences in image quality due to variations in scatter conditions (as a result of different kVp's, and the presence or absence of an acrylic scatterer and/or a moving Bucky grid). They were more precise, reproducible and sensitive than the ACR score. In particular, the contrast of the main nodule was highly correlated (r(s) = 0.988: pimage quality by our panel of expert readers.

  9. Diffusion equations with negentropy applied to denoise mammographic images.

    Science.gov (United States)

    Mayo, P; Rodenas, F; Ginestar, D; Verdú, G; Miró, R

    2006-01-01

    Mammography is a radiographic technique used for the detection of breast lesions. The analysis of the digital image normally requires a previous application of filters as a preprocessing step to reduce the noise level of the image, while preserving important details to carry out a suitable diagnostic. In the literature, there are a large amount of denoising techniques applied to different medical images. In this work we have studied the performance of a diffusive filter with a stopping condition based on the statistical concept of negentropy, applied to denoise mammographic images. The negentropy has been succesfully prove with other denoising methods as independent component analysis by the authors in [1]. We have evaluated the final image quality obtained, measuring a root mean squared error between the noise-free initial image and the final restored image and compared the results obtained by this diffusive filter with those obtained by an adaptative non-linear Wiener filter.

  10. Breast cancer screening and cost-effectiveness; policy alternatives, quality of life considerations and the possible impact of uncertain factors

    NARCIS (Netherlands)

    de Koning, H. J.; van Ineveld, B. M.; van Oortmarssen, G. J.; de Haes, J. C.; Collette, H. J.; Hendriks, J. H.; van der Maas, P. J.

    1991-01-01

    Mammographic screening for women aged 50-70 is effective in reducing breast cancer mortality, but the impact on quality of life and the attainable mortality reduction remain to be discussed. The consequences of expanding screening programmes to include women in other age groups are uncertain. We

  11. Green tea, soy, and mammographic density in Singapore Chinese women.

    Science.gov (United States)

    Wu, Anna H; Ursin, Giske; Koh, Woon-Puay; Wang, Renwei; Yuan, Jian-Min; Khoo, Kei-Siong; Yu, Mimi C

    2008-12-01

    There is increasing evidence from observational studies that breast cancer risk is inversely associated with soy and green tea consumption. We investigated the effects of these two dietary agents on mammographic density, a well-established biomarker for breast cancer risk, in a cross-sectional analysis of mammograms and validated food frequency questionnaires from 3,315 Chinese women in Singapore. Percent mammographic density (PMD) was assessed using a reproducible computer-assisted method. We used generalized linear models to estimate PMD by intake of soy, green tea, and black tea while adjusting for potential confounders. Daily green tea drinkers showed statistically significantly lower PMD (19.5%) than non-tea drinkers (21.7%; P = 0.002) after adjusting for relevant covariates. This difference in PMD between daily green tea drinkers and non-tea drinkers remained statistically significant after adjustment for soy (P = 0.002); the effect was more apparent among lower soy consumers (Q1-Q3; 21.9% versus 19.4%; P = 0.002) than in higher (Q4) consumers (20.9% versus 19.5%; P = 0.32). Black tea intake was unrelated to PMD. Only among postmenopausal women who reported very high soy intake (Q4) compared with those with less soy intake was there any association noted between PMD and soy intake (18.9% versus 20.5%; P = 0.035). Following adjustment for green tea intake, the association between soy and PMD was no longer statistically significant (P = 0.52). Our findings suggest that both regular green tea and high soy intake may have beneficial effects on the breast; the effect of green tea on PMD may be stronger than the effect of soy.

  12. Development of breast phantom for quality assessment of mammographic images

    Energy Technology Data Exchange (ETDEWEB)

    Arvelos, Jeniffer Miranda; Flores, Mabel Bustos; Amaral, Fernando; Rio, Margarita Chevalier del; Mourao, Arnaldo Prata, E-mail: jenifferarvelos00@gmail.com [Centro Federal de Educação Tecnológica de Minas Gerais (CEFET-MG), Belo Horizonte, MG (Brazil). Centro de Engenharia Biomedica; Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Universidad Complutense de Madrid (UCM), Madrid (Spain). Faculdad de Medicina. Departmento de Radiologia

    2017-11-01

    Diagnosis of breast cancer in young women may be impaired by the tissue composition of breast in this age group, as fibroglandular tissue is present in greater amount in young women and it has higher density than fibrous and fatty tissues which predominate in women older than 40 years old. The higher density of breast tissue makes it difficult to identify nodules in two-dimensional techniques, due to the overlapping of dense layers. Breast phantoms are used in evaluation and quality control of clinical images, and therefore, it is important to develop non-homogeneous phantoms that may better simulate a real breast. Grouped microcalcifications are often the earliest changes associated with malignant neoplasm of breast. In this work, a phantom was developed in the form of a compressed breast using acrylic resin blend. The resin blend used to fulfill the interior of the phantom has similar mammographic density to the one in fibroglandular tissue, representing a dense breast. The lesions were made of acrylic resin blend and calcium compounds that might simulate breast abnormalities, representing nodules, macrocalcifications and microcalcifications of different dimensions and densities. They were distributed into the ma-terial representing fibroglandular tissue. The developed phantom has a thickness of 1 cm, and it may be matched with other plates to represent a dense breast of thickness between 5 and 6 cm. The main goal of the project is to evaluate the sensitivity of detection of these calcifications in relation to their density and location in the breast in two-dimensional images generated in mammography equipment. Mammographic images allow the visualization of the changes implemented in the phantom. The developed phantom may be used in evaluation of diagnostic images generated through two-dimensional and three-dimensional images. (author)

  13. Male breast disease: clinical, mammographic, and ultrasonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil E-mail: isilbilgen@hotmail.com; Bozkaya, Halil; Uestuen, Esin Emin; Memis, Aysenur

    2002-09-01

    Purpose: To describe and quantitate the radiological (mammographic and ultrasonographic) characteristics of male breast disease and to report the clinical and pathological findings. Materials and methods: Two-hundred-thirty-six male patients with different male breast diseases, diagnosed at our institution between January 1990 and July 2001, were retrospectively evaluated. The history, physical examination, mammographic and ultrasonographic findings were analyzed. Results: The spectrum of the disease in 236 male patients were gynecomastia (n=206), primary breast carcinoma (n=14), fat necrosis (n=5), lipoma (n=3), subareolar abscess (n=2), epidermal inclusion cyst (n=1), sebaceous cyst (n=1), hematoma (n=1), myeloma (n=1), and metastatic carcinoma (n=2). The distribution of patterns of gynecomastia were; 34% (n=71) nodular, 35% (n=73) dendritic and 31% (n=62) diffuse glandular. Gynecomastia was unilateral in 55% (n=113) and bilateral in 45% (n=93) of the patients. Male breast cancer presented as a mass without microcalcifications in 86% (n=12) and with microcalcifications in 7% (n=1) of patients. The mass was obscured by gynecomastia, partially in two, totally in one patient. The location of the mass was retroareolar in 46% (n=6) and eccentric to the nipple in 54% (n=7) of patients. On ultrasonography (US), the contours were well-circumscribed in 20% (n=3) and irregular in 80% (n=12) of the masses. Conclusion: Male breast has a wide spectrum of diseases, some of which have characteristic radiological appearances that can be correlated with their pathologic diagnosis. In the evaluation of the male breast, mammography and US are essential and should be performed along with physical examination.

  14. Fibrocystic disease of breast: variable mammographic and sonography appearance

    Energy Technology Data Exchange (ETDEWEB)

    Han, Heon; Cha, Yoo Mi; Yang, Joo Hyun; Song, Ek Hyun; Hwang, Hee Yong; Chung, Hyo Sun; Park, Sung Hye [Chung Ang Gil Hospital, Incheon (Korea, Republic of)

    1993-12-15

    Fibrocystic disease of the breast is a frequent cause of abnormal mammogram and ultrasonogram in patients with breast pain. The differentiation of fibrocystic disease form fibroadenoma or carcinoma is often difficult. The present study was performed to evaluate the mammographic and sonographic features of fibrocystic disease of the breast Mammograms and sonogram s of 45 patients with pathologically proven fibrocystic disease of breast were analyzed and correlated retrospectively with the pathologic specimens. Clinically the patients had palpable breast lumps or focal skin thickening. The patients were aged 19 to 64 years(average, 37 years) Histologic examination of 29 patients with abnormal findings in mammograms and/or sonograms revealed stromal fibrosis in 28(97%), cyst formation in 24(83%), epithelial hyperplasia in 29(90%), apocrine metaplasia in 7 (24%), chronic inflammation in 15 (52%), fibroadenomatous change in 2 (7%), large pseudocyst formation in 2 (7%), calcification in 1 (3%), and/or chondroid maseptol in 1 (3%). Of 43 patients with mammograms, 23 showed no detectable lesion, even in retrospect, because of dense mammograms there were well marginated mass in 7, poorly marginated mass in 4, multiple small nodules in 2, mixed density radio opaque mass in 3, radiolucent mass in one, and asymmetrical dense breast in 3. One case had calcification within the mass, and another one had very high density nodules that showed chondroid metaplasia. In 14 patients with sonograms, the echogenicity was variable; anechoic in 2, hypoechoic in 8, isoechoic in 3, or mixed echoic in one. The shape of the lesion was round in 2, ovoid in 8, tubular in 2, and irregular in 2. The margin was well marginated in 11 and poorly marginated in 3. Fibrocystic breast disease, which is a frequent cause of breast lumps, has variable findings in mammograms and sonograms. Therefore, fibrocystic disease should be included in the differential diagnosis of breast mass when the typical

  15. Evaluation of mammographic image quality: pilot study comparing five methods.

    Science.gov (United States)

    Caldwell, C B; Fishell, E K; Jong, R A; Weiser, W J; Yaffe, M J

    1992-08-01

    A radiograph is considered of high quality when it allows a radiologist to identify abnormalities with high sensitivity and specificity. Although many methods for assessing image quality have been devised, it is not clear which is most meaningful or how well these methods correlate with one another. A pilot study was undertaken to compare five methods of evaluating mammographic image quality. Each of the methods was used to form separate rankings of 11 mammographic system configurations. In two of the methods, observers (three radiologists and three physicists) subjectively ranked the "image quality" of radiographs of phantoms obtained with each configuration. The third method ranked the systems according to contrast as measured densitometrically with an aluminum step wedge, and the fourth, in terms of lowest to highest mean glandular radiation doses to the breast. In the final method, observers based their rankings on mammograms of patients. The intra- and interobserver variabilities of each ranking method were assessed, as well as the correlations between methods, by using standard nonparametric statistical tests. Intraobserver consistency was high with any of the image quality ranking methods; however, image quality rankings based on either of the two phantoms provided better agreement among observers than did rankings based on images of patients. Surprisingly, no significant degree of correlation was found between any two image quality evaluation methods. Our work may have two implications for the American College of Radiology Mammography Accreditation Program: (1) small variations in phantom scores do not necessarily correlate with subjective variation in image quality in radiographs of patients, and (2) when small numbers of radiographs are used, the assessment of the quality of mammograms of patients may vary considerably among radiologists.

  16. Vision 20/20: Mammographic breast density and its clinical applications.

    Science.gov (United States)

    Ng, Kwan-Hoong; Lau, Susie

    2015-12-01

    Breast density is a strong predictor of the failure of mammography screening to detect breast cancer and is a strong predictor of the risk of developing breast cancer. The many imaging options that are now available for imaging dense breasts show great promise, but there is still the question of determining which women are "dense" and what imaging modality is suitable for individual women. To date, mammographic breast density has been classified according to the Breast Imaging-Reporting and Data System (BI-RADS) categories from visual assessment, but this is known to be very subjective. Despite many research reports, the authors believe there has been a lack of physics-led and evidence-based arguments about what breast density actually is, how it should be measured, and how it should be used. In this paper, the authors attempt to start correcting this situation by reviewing the history of breast density research and the debates generated by the advocacy movement. The authors review the development of breast density estimation from pattern analysis to area-based analysis, and the current automated volumetric breast density (VBD) analysis. This is followed by a discussion on seeking the ground truth of VBD and mapping volumetric methods to BI-RADS density categories. The authors expect great improvement in VBD measurements that will satisfy the needs of radiologists, epidemiologists, surgeons, and physicists. The authors believe that they are now witnessing a paradigm shift toward personalized breast screening, which is going to see many more cancers being detected early, with the use of automated density measurement tools as an important component.

  17. Diabetes, diabetes treatment, and mammographic density in Danish Diet, Cancer, and Health cohort.

    Science.gov (United States)

    Buschard, Karsten; Thomassen, Katrin; Lynge, Elsebeth; Vejborg, Ilse; Tjønneland, Anne; von Euler-Chelpin, My; Andersen, Zorana Jovanovic

    2017-01-01

    We examined whether diabetes and diabetes treatment are associated with MD in a cohort study of Danish women above age of 50 years. Study cohort consisted of 5,644 women (4,500 postmenopausal) who participated in the Danish Diet, Cancer, and Health cohort (1993-1997) and subsequently attended mammographic screening in Copenhagen (1993-2001). We used MD assessed at the first screening after the cohort entry, defined as mixed/dense or fatty. Diabetes diagnoses and diabetes treatments (diet, insulin, or oral antidiabetic agents) were self-reported at the time of recruitment (1993-1997). The association between MD and diabetes was analyzed by logistic regression adjusted for potential confounders. Effect modification by menopausal status and body mass index (BMI) was performed by introducing an interaction term into the model and tested by Wald test. Of 5,644 women with mean age of 56 years, 137 (2.4%) had diabetes and 3,180 (56.3%) had mixed/dense breasts. Having diabetes was significantly inversely associated with having mixed/dense breasts, in both, the crude model (odds ratio; 95% confidence interval: 0.33; 0.23-0.48), and after adjustment for adiposity and other risk factors (0.61; 0.40-0.92). Similar inverse associations were observed for 44 women who controlled diabetes by diet only and did not receive any medication (0.56; 0.27-1.14), and 62 who took oral antidiabetic agents only for diabetes (0.59; 0.32-1.09), while women taking insulin had increased odds of mixed/dense breasts (2.08; 0.68-6.35). There was no effect modification of these associations by menopausal status or BMI. Having diabetes controlled by diet or oral antidiabetic agents is associated with a decrease in MD, whereas taking insulin is associated with an increase in MD.

  18. Vision 20/20: Mammographic breast density and its clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Kwan-Hoong, E-mail: ngkh@ummc.edu.my; Lau, Susie [Department of Biomedical Imaging and University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2015-12-15

    Breast density is a strong predictor of the failure of mammography screening to detect breast cancer and is a strong predictor of the risk of developing breast cancer. The many imaging options that are now available for imaging dense breasts show great promise, but there is still the question of determining which women are “dense” and what imaging modality is suitable for individual women. To date, mammographic breast density has been classified according to the Breast Imaging-Reporting and Data System (BI-RADS) categories from visual assessment, but this is known to be very subjective. Despite many research reports, the authors believe there has been a lack of physics-led and evidence-based arguments about what breast density actually is, how it should be measured, and how it should be used. In this paper, the authors attempt to start correcting this situation by reviewing the history of breast density research and the debates generated by the advocacy movement. The authors review the development of breast density estimation from pattern analysis to area-based analysis, and the current automated volumetric breast density (VBD) analysis. This is followed by a discussion on seeking the ground truth of VBD and mapping volumetric methods to BI-RADS density categories. The authors expect great improvement in VBD measurements that will satisfy the needs of radiologists, epidemiologists, surgeons, and physicists. The authors believe that they are now witnessing a paradigm shift toward personalized breast screening, which is going to see many more cancers being detected early, with the use of automated density measurement tools as an important component.

  19. Performance of hand-held whole-breast ultrasound based on BI-RADS in women with mammographically negative dense breast

    Energy Technology Data Exchange (ETDEWEB)

    Youk, Ji Hyun; Kim, Eun-Kyung; Kim, Min Jung; Kwak, Jin Young; Son, Eun Ju [Yonsei University, College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seoul (Korea, Republic of)

    2011-04-15

    To assess the performance of breast ultrasound based on BI-RADS final assessment categories in women with mammographically negative dense breast. Of 3,820 cases with mammographically negative dense breast and subsequent hand-held bilateral whole-breast ultrasound, a total of 1,507 cases in 1,046 women who had biopsy or at least 2-year follow-up ultrasound constituted the basis of this retrospective study. Cancer rate of each sonographic BI-RADS category was determined and medical audit was performed separately in screening-general, screening-treated, and diagnostic group. A total of 43 cases (2.9%) were confirmed as malignancy. Cancer rate among BI-RADS categories was significantly different (p < 0.0001). Among three groups, the cancer rate was significantly different (p < 0.0001) and the highest in diagnostic group (15.8%, 22 of 139). Abnormal interpretation rate, PPV of biopsy performed, cancer detection rate, and rate of early stage cancer, and the size of invasive cancer were significantly different among three groups and the highest in diagnostic group. Regarding cancer characteristics, the proportion of advanced cancer was the highest in diagnostic group. Breast ultrasound based on BI-RADS as an adjunctive to negative mammography can be useful for predicting malignancy in women with dense breast. (orig.)

  20. Image quality of mammography in Croatian nationwide screening program: comparison between various types of facilities.

    Science.gov (United States)

    Brnić, Zoran; Blašković, Darko; Klasić, Branimir; Ramač, Jelena Popić; Flegarić-Bradić, Mirjana; Stimac, Damir; Lubina, Ivan Zvonimir; Brnić, Vedran; Faj, Dario

    2012-04-01

    The study was aimed to provide objective evidence about the mammographic image quality in Croatia, to compare it between different types of MG facilities and to identify the most common deficiencies and possible reasons as well as the steps needed to improve image quality. A total of 420 mammographic examinations collected from 84 mammographic units participating in the Croatian nationwide breast cancer screening program were reviewed in terms of four image quality categories: identification of patient and examination, breast positioning and compression, exposure and contrast, and artifacts. Those were rated using image evaluating system based on American College of Radiology and European Commission proposals. The results were compared among different types of mammographic units, and common image quality deficiencies were identified. Total image quality scores of 12.8, 16.1, 13.0 and 13.7 were found for general hospitals, university hospitals, private clinics and public healthcare centres, respectively. Average score for all mammographic units was 13.5 (out of 25 points). University hospitals were significantly better than all other mammography units in overall image quality, which was mostly contributed by better breast positioning practices. Private clinics showed the worst results in identification, exposure, contrast and artifacts. Serious deficiencies in identification and breast positioning, which might compromise breast cancer screening outcome, were detected in our material. They occur mainly due to subjective reasons and could be corrected through additional staff training and improvement of working discipline. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Does the prediction of breast cancer improve using a combination of mammographic density measures compared to individual measures alone?

    Science.gov (United States)

    Wong Sik Hee, Joseph Ryan; Harkness, Elaine F.; Gadde, Soujanya; Lim, Yit Y.; Maxwell, Anthony J.; Evans, D. Gareth; Howell, Anthony; Astley, Susan M.

    2017-03-01

    High mammographic density is associated with an increased risk of breast cancer, however whether the association is stronger when there is agreement across measures is unclear. This study investigates whether a combination of density measures is a better predictor of breast cancer risk than individual methods alone. Women recruited to the Predicting Risk of Cancer At Screening (PROCAS) study and with mammographic density assessed using three different methods were included (n=33,304). Density was assessed visually using Visual Analogue Scales (VAS) and by two fully automated methods, Quantra and Volpara. Percentage breast density was divided into (high, medium and low) and combinations of measures were used to further categorise individuals (e.g. `all high'). A total of 667 breast cancers were identified and logistic regression was used to determine the relationship between breast density and breast cancer risk. In total, 44% of individuals were in the same tertile for all three measures, 8.6% were in non-adjacent (high and low) or mixed categories (high, medium and low). For individual methods the strongest association with breast cancer risk was for medium and high tertiles of VAS with odds ratios (OR) adjusted for age and BMI of 1.63 (95% CI 1.31-2.03) and 2.33 (1.87-2.90) respectively. For the combination of density methods the strongest association was for `all high' (OR 2.42, 1.77-3.31) followed by "two high" (OR 1.90, 1.35-3.31) and "two medium" (OR 1.88, 1.40-2.52). Combining density measures did not affect the magnitude of risk compared to using individual methods.

  2. A Comparison of DWI Repeaters and Non-repeaters Who Attended a Level I Rehabilitation Program.

    Science.gov (United States)

    Landrum, James W.; Windham, Gerald O.

    1981-01-01

    Compares behavioral and demographic characteristics of drunk drivers with repeated arrests and drivers not having repeated arrests, after attending an alcohol education program. Previous public drunkeness and previous drunk driving arrests were strong predictors of repeat arrests and were judged useful in screening offenders for rehabilitation…

  3. Variants in 6q25.1 Are Associated with Mammographic Density in Malaysian Chinese Women.

    Science.gov (United States)

    Mariapun, Shivaani; Ho, Weang Kee; Kang, Peter Choon Eng; Li, Jingmei; Lindström, Sara; Yip, Cheng Har; Teo, Soo Hwang

    2016-02-01

    Mammographic density is an established risk factor for breast cancer and has a strong heritable component. Genome-wide association studies (GWAS) for mammographic density conducted in women of European descent have identified several genetic associations, but none of the studies have been tested in Asians. We sought to investigate whether these genetic loci, and loci associated with breast cancer risk and breast size, are associated with mammographic density in an Asian cohort. We conducted genotyping by mass spectrometry in 1,189 women (865 Chinese, 187 Indian, and 137 Malay). Quantitative measurements of mammographic density were performed using ImageJ, a fully automated thresholding technique. The associations of SNPs to densities were analyzed using linear regression models. We successfully evaluated the associations of 36 SNPs with mammographic densities. After adjusting for age, body mass index, parity, and menopausal status, we found that in our cohort of 865 Malaysian Chinese, three SNPs in the 6q25.1 region near ESR1 (rs2046210, rs12173570, and rs10484919) that were associated with mammographic density, breast cancer risk, or breast size in previous GWAS were significantly associated with both percentage density and absolute dense area. We could not replicate the most significant association found previously in European women (rs10995190, ZNF365 gene) because the minor allele was absent for Asian women. We found that the directions of genetic associations were similar to those reported in Caucasian women. Our results show that even in Asian women with lower population risk to breast cancer, there is shared heritability between mammographic density and breast cancer risk. ©2015 American Association for Cancer Research.

  4. Prediction of occult invasive disease in ductal carcinoma in situ using computer-extracted mammographic features

    Science.gov (United States)

    Shi, Bibo; Grimm, Lars J.; Mazurowski, Maciej A.; Marks, Jeffrey R.; King, Lorraine M.; Maley, Carlo C.; Hwang, E. Shelley; Lo, Joseph Y.

    2017-03-01

    Predicting the risk of occult invasive disease in ductal carcinoma in situ (DCIS) is an important task to help address the overdiagnosis and overtreatment problems associated with breast cancer. In this work, we investigated the feasibility of using computer-extracted mammographic features to predict occult invasive disease in patients with biopsy proven DCIS. We proposed a computer-vision algorithm based approach to extract mammographic features from magnification views of full field digital mammography (FFDM) for patients with DCIS. After an expert breast radiologist provided a region of interest (ROI) mask for the DCIS lesion, the proposed approach is able to segment individual microcalcifications (MCs), detect the boundary of the MC cluster (MCC), and extract 113 mammographic features from MCs and MCC within the ROI. In this study, we extracted mammographic features from 99 patients with DCIS (74 pure DCIS; 25 DCIS plus invasive disease). The predictive power of the mammographic features was demonstrated through binary classifications between pure DCIS and DCIS with invasive disease using linear discriminant analysis (LDA). Before classification, the minimum redundancy Maximum Relevance (mRMR) feature selection method was first applied to choose subsets of useful features. The generalization performance was assessed using Leave-One-Out Cross-Validation and Receiver Operating Characteristic (ROC) curve analysis. Using the computer-extracted mammographic features, the proposed model was able to distinguish DCIS with invasive disease from pure DCIS, with an average classification performance of AUC = 0.61 +/- 0.05. Overall, the proposed computer-extracted mammographic features are promising for predicting occult invasive disease in DCIS.

  5. Developing a new case based computer-aided detection scheme and an adaptive cueing method to improve performance in detecting mammographic lesions

    Science.gov (United States)

    Tan, Maxine; Aghaei, Faranak; Wang, Yunzhi; Zheng, Bin

    2017-01-01

    The purpose of this study is to evaluate a new method to improve performance of computer-aided detection (CAD) schemes of screening mammograms with two approaches. In the first approach, we developed a new case based CAD scheme using a set of optimally selected global mammographic density, texture, spiculation, and structural similarity features computed from all four full-field digital mammography images of the craniocaudal (CC) and mediolateral oblique (MLO) views by using a modified fast and accurate sequential floating forward selection feature selection algorithm. Selected features were then applied to a ‘scoring fusion’ artificial neural network classification scheme to produce a final case based risk score. In the second approach, we combined the case based risk score with the conventional lesion based scores of a conventional lesion based CAD scheme using a new adaptive cueing method that is integrated with the case based risk scores. We evaluated our methods using a ten-fold cross-validation scheme on 924 cases (476 cancer and 448 recalled or negative), whereby each case had all four images from the CC and MLO views. The area under the receiver operating characteristic curve was AUC  =  0.793  ±  0.015 and the odds ratio monotonically increased from 1 to 37.21 as CAD-generated case based detection scores increased. Using the new adaptive cueing method, the region based and case based sensitivities of the conventional CAD scheme at a false positive rate of 0.71 per image increased by 2.4% and 0.8%, respectively. The study demonstrated that supplementary information can be derived by computing global mammographic density image features to improve CAD-cueing performance on the suspicious mammographic lesions.

  6. Breast cancer screening in Korean woman with dense breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hee Jung [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ko, Eun Sook [Dept. of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Yi, Ann [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-11-15

    Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results.

  7. Novel Associations between Common Breast Cancer Susceptibility Variants and Risk-Predicting Mammographic Density Measures

    Science.gov (United States)

    Stone, Jennifer; Thompson, Deborah J.; dos-Santos-Silva, Isabel; Scott, Christopher; Tamimi, Rulla M.; Lindstrom, Sara; Kraft, Peter; Hazra, Aditi; Li, Jingmei; Eriksson, Louise; Czene, Kamila; Hall, Per; Jensen, Matt; Cunningham, Julie; Olson, Janet E.; Purrington, Kristen; Couch, Fergus J.; Brown, Judith; Leyland, Jean; Warren, Ruth M. L.; Luben, Robert N.; Khaw, Kay-Tee; Smith, Paula; Wareham, Nicholas J.; Jud, Sebastian M.; Heusinger, Katharina; Beckmann, Matthias W.; Douglas, Julie A.; Shah, Kaanan P.; Chan, Heang-Ping; Helvie, Mark A.; Le Marchand, Loic; Kolonel, Laurence N.; Woolcott, Christy; Maskarinec, Gertraud; Haiman, Christopher; Giles, Graham G.; Baglietto, Laura; Krishnan, Kavitha; Southey, Melissa C.; Apicella, Carmel; Andrulis, Irene L.; Knight, Julia A.; Ursin, Giske; Grenaker Alnaes, Grethe I.; Kristensen, Vessela N.; Borresen-Dale, Anne-Lise; Gram, Inger Torhild; Bolla, Manjeet K.; Wang, Qin; Michailidou, Kyriaki; Dennis, Joe; Simard, Jacques; Paroah, Paul; Dunning, Alison M.; Easton, Douglas F.; Fasching, Peter A.; Pankratz, V. Shane; Hopper, John; Vachon, Celine M.

    2015-01-01

    Mammographic density measures adjusted for age and body mass index (BMI) are heritable predictors of breast cancer risk but few mammographic density-associated genetic variants have been identified. Using data for 10,727 women from two international consortia, we estimated associations between 77 common breast cancer susceptibility variants and absolute dense area, percent dense area and absolute non-dense area adjusted for study, age and BMI using mixed linear modeling. We found strong support for established associations between rs10995190 (in the region of ZNF365), rs2046210 (ESR1) and rs3817198 (LSP1) and adjusted absolute and percent dense areas (all p breast cancer susceptibility variants, associations were found between rs1432679 (EBF1), rs17817449 (MIR1972-2: FTO), rs12710696 (2p24.1), and rs3757318 (ESR1) and adjusted absolute and percent dense areas, respectively. There were associations between rs6001930 (MKL1) and both adjusted absolute dense and non-dense areas, and between rs17356907 (NTN4) and adjusted absolute non-dense area. Trends in all but two associations were consistent with those for breast cancer risk. Results suggested that 18% of breast cancer susceptibility variants were associated with at least one mammographic density measure. Genetic variants at multiple loci were associated with both breast cancer risk and the mammographic density measures. Further understanding of the underlying mechanisms at these loci could help identify etiological pathways implicated in how mammographic density predicts breast cancer risk. PMID:25862352

  8. The mammographic correlations of a new immunohistochemical classification of invasive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Taneja, S. [Nottingham Breast Institute, City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom)], E-mail: sheeba_taneja@yahoo.co.uk; Evans, A.J. [Nottingham Breast Institute, City Hospital, Hucknall Road, Nottingham NG5 1PB (United Kingdom); Rakha, E.A.; Green, A.R. [Division of Pathology, School of Molecular Medical Sciences, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham (United Kingdom); Ball, G. [Nottingham Trent University, School of Biomedical and Natural Sciences, Nottingham (United Kingdom); Ellis, I.O. [Division of Pathology, School of Molecular Medical Sciences, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham (United Kingdom)

    2008-11-15

    Aim: Recent protein expression profiling of breast cancer has identified specific subtypes with clinical, biological, and therapeutic implications. The aim of this study was to identify the mammographic correlates of these novel molecular classes of invasive breast cancer. Materials and methods: The mammographic findings of 415 patients with operable breast cancer were correlated with the previously described protein expression classes identified by our group using immunohistochemical (IHC) assessment of a large series of breast cancer cases prepared as tissue microarrays (TMAs). Twenty-five proteins of known relevance in breast cancer were assessed, including hormone receptors, HER-2 status, basal and luminal markers, p53 expression, and E-cadherin. Results: The mammographic background pattern and proportion of lesions that were mammographically occult were similar in all groups. Groups characterized by luminal and hormone receptor positivity had significantly more spiculate lesions at mammography. Groups characterized by HER-2 overexpression, basal characteristics, and E-cadherin positivity had a significantly higher proportion of ill-defined masses. These findings were independent of histological grade. Conclusion: The mammographic features of breast cancer show significant correlation with molecular classes of invasive breast cancer identified by protein expression IHC analysis. The biological reasons for the findings and implications of these regarding imaging protocols require further study and may provide mechanisms for improvement of detection of these lesions.

  9. Validation of DM-Scan, a computer-assisted tool to assess mammographic density in full-field digital mammograms.

    Science.gov (United States)

    Pollán, Marina; Llobet, Rafael; Miranda-García, Josefa; Antón, Joaquín; Casals, María; Martínez, Inmaculada; Palop, Carmen; Ruiz-Perales, Francisco; Sánchez-Contador, Carmen; Vidal, Carmen; Pérez-Gómez, Beatriz; Salas-Trejo, Dolores

    2013-12-01

    We developed a semi-automated tool to assess mammographic density (MD), a phenotype risk marker for breast cancer (BC), in full-field digital images and evaluated its performance testing its reproducibility, comparing our MD estimates with those obtained by visual inspection and using Cumulus, verifying their association with factors that influence MD, and studying the association between MD measures and subsequent BC risk. Three radiologists assessed MD using DM-Scan, the new tool, on 655 processed images (craniocaudal view) obtained in two screening centers. Reproducibility was explored computing pair-wise concordance correlation coefficients (CCC). The agreement between DM-Scan estimates and visual assessment (semi-quantitative scale, 6 categories) was quantified computing weighted kappa statistics (quadratic weights). DM-Scan and Cumulus readings were compared using CCC. Variation of DM-Scan measures by age, body mass index (BMI) and other MD modifiers was tested in regression mixed models with mammographic device as a random-effect term. The association between DM-Scan measures and subsequent BC was estimated in a case-control study. All BC cases in screening attendants (2007-2010) at a center with full-field digital mammography were matched by age and screening year with healthy controls (127 pairs). DM-Scan was used to blindly assess MD in available mammograms (112 cases/119 controls). Unconditional logistic models were fitted, including age, menopausal status and BMI as confounders. DM-Scan estimates were very reliable (pairwise CCC: 0.921, 0.928 and 0.916). They showed a reasonable agreement with visual MD assessment (weighted kappa ranging 0.79-0.81). DM-Scan and Cumulus measures were highly concordant (CCC ranging 0.80-0.84), but ours tended to be higher (4%-5% on average). As expected, DM-Scan estimates varied with age, BMI, parity and family history of BC. Finally, DM-Scan measures were significantly associated with BC (p-trend=0.005). Taking MD=29

  10. European breast cancer service screening outcomes: a first balance sheet of the benefits and harms

    NARCIS (Netherlands)

    Paci, E.; Broeders, M.J.M.; Hofvind, S.; Puliti, D.; Duffy, S.W.

    2014-01-01

    A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast

  11. Breast Tissue Composition and Immunophenotype and Its Relationship with Mammographic Density in Women at High Risk of Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Jia-Min B Pang

    Full Text Available To investigate the cellular and immunophenotypic basis of mammographic density in women at high risk of breast cancer.Mammograms and targeted breast biopsies were accrued from 24 women at high risk of breast cancer. Mammographic density was classified into Wolfe categories and ranked by increasing density. The histological composition and immunophenotypic profile were quantified from digitized haematoxylin and eosin-stained and immunohistochemically-stained (ERα, ERβ, PgR, HER2, Ki-67, and CD31 slides and correlated to mammographic density.Increasing mammographic density was significantly correlated with increased fibrous stroma proportion (rs (22 = 0.5226, p = 0.0088 and significantly inversely associated with adipose tissue proportion (rs (22 = -0.5409, p = 0.0064. Contrary to previous reports, stromal expression of ERα was common (19/20 cases, 95%. There was significantly higher stromal PgR expression in mammographically-dense breasts (p=0.026.The proportion of stroma and fat underlies mammographic density in women at high risk of breast cancer. Increased expression of PgR in the stroma of mammographically dense breasts and frequent and unexpected presence of stromal ERα expression raises the possibility that hormone receptor expression in breast stroma may have a role in mediating the effects of exogenous hormonal therapy on mammographic density.

  12. Computer-aided classification of mammographic masses using the deep learning technology: a preliminary study

    Science.gov (United States)

    Qiu, Yuchen; Yan, Shiju; Tan, Maxine; Cheng, Samuel; Liu, Hong; Zheng, Bin

    2016-03-01

    Although mammography is the only clinically acceptable imaging modality used in the population-based breast cancer screening, its efficacy is quite controversy. One of the major challenges is how to help radiologists more accurately classify between benign and malignant lesions. The purpose of this study is to investigate a new mammographic mass classification scheme based on a deep learning method. In this study, we used an image dataset involving 560 regions of interest (ROIs) extracted from digital mammograms, which includes 280 malignant and 280 benign mass ROIs, respectively. An eight layer deep learning network was applied, which employs three pairs of convolution-max-pooling layers for automatic feature extraction and a multiple layer perception (MLP) classifier for feature categorization. In order to improve robustness of selected features, each convolution layer is connected with a max-pooling layer. A number of 20, 10, and 5 feature maps were utilized for the 1st, 2nd and 3rd convolution layer, respectively. The convolution networks are followed by a MLP classifier, which generates a classification score to predict likelihood of a ROI depicting a malignant mass. Among 560 ROIs, 420 ROIs were used as a training dataset and the remaining 140 ROIs were used as a validation dataset. The result shows that the new deep learning based classifier yielded an area under the receiver operation characteristic curve (AUC) of 0.810+/-0.036. This study demonstrated the potential superiority of using a deep learning based classifier to distinguish malignant and benign breast masses without segmenting the lesions and extracting the pre-defined image features.

  13. Feature extraction using convolutional neural network for classifying breast density in mammographic images

    Science.gov (United States)

    Thomaz, Ricardo L.; Carneiro, Pedro C.; Patrocinio, Ana C.

    2017-03-01

    Breast cancer is the leading cause of death for women in most countries. The high levels of mortality relate mostly to late diagnosis and to the direct proportionally relationship between breast density and breast cancer development. Therefore, the correct assessment of breast density is important to provide better screening for higher risk patients. However, in modern digital mammography the discrimination among breast densities is highly complex due to increased contrast and visual information for all densities. Thus, a computational system for classifying breast density might be a useful tool for aiding medical staff. Several machine-learning algorithms are already capable of classifying small number of classes with good accuracy. However, machinelearning algorithms main constraint relates to the set of features extracted and used for classification. Although well-known feature extraction techniques might provide a good set of features, it is a complex task to select an initial set during design of a classifier. Thus, we propose feature extraction using a Convolutional Neural Network (CNN) for classifying breast density by a usual machine-learning classifier. We used 307 mammographic images downsampled to 260x200 pixels to train a CNN and extract features from a deep layer. After training, the activation of 8 neurons from a deep fully connected layer are extracted and used as features. Then, these features are feedforward to a single hidden layer neural network that is cross-validated using 10-folds to classify among four classes of breast density. The global accuracy of this method is 98.4%, presenting only 1.6% of misclassification. However, the small set of samples and memory constraints required the reuse of data in both CNN and MLP-NN, therefore overfitting might have influenced the results even though we cross-validated the network. Thus, although we presented a promising method for extracting features and classifying breast density, a greater database is

  14. Beyond breast cancer: mammographic features and mortality risk in a population of healthy women.

    Directory of Open Access Journals (Sweden)

    Rachel A Murphy

    Full Text Available Breast fibroglandular (dense tissue is a risk factor for breast cancer. Beyond breast cancer, little is known regarding the prognostic significance of mammographic features.We evaluated relationships between nondense (fatty breast area and dense area with all-cause mortality in 4,245 initially healthy women from the Breast Cancer Detection Demonstration Project; 1,361 died during a mean follow-up of 28.2 years. Dense area and total breast area were assessed using planimeter measurements from screening mammograms. Percent density reflects dense area relative to breast area and nondense area was calculated as the difference between total breast area and dense area. Hazard ratios (HRs and 95% confidence intervals (CIs were estimated by Cox proportional hazards regression.In age-adjusted models, greater nondense and total breast area were associated with increased risk of death (HR 1.17, 95% CI 1.10-1.24 and HR 1.13, 95% CI 1.06-1.19, per SD difference while greater dense area and percent density were associated with lower risk of death (HR 0.91, 95% CI 0.86-0.95 and HR 0.87, 95% CI 0.83-0.92, per SD difference. Associations were not attenuated with adjustment for race, education, mammogram type (x-ray or xerogram, smoking status, diabetes and heart disease. With additional adjustment for body mass index, associations were diminished for all features but remained statistically significant for dense area (HR 0.94, 95% CI 0.89-0.99, per SD difference and percent density (HR 0.93, 95% CI 0.87-0.98, per SD difference.These data indicate that dense area and percent density may relate to survival in healthy women and suggest the potential utility of mammograms beyond prediction of breast cancer risk.

  15. Predictors of invasive breast cancer in mammographically detected microcalcification in patients with a core biopsy diagnosis of flat epithelial atypia, atypical ductal hyperplasia or ductal carcinoma in situ and recommendations for a selective approach to sentinel lymph node biopsy.

    Science.gov (United States)

    Catteau, Xavier; Simon, Philippe; Noël, Jean-Christophe

    2012-04-15

    15±30% of malignancies detected through screening programs are ductal carcinoma in situ (DCIS), and the majority of DCIS cases present in the form of mammographic microcalcification. This study was performed in order to determine the value of features in predicting invasive disease in patients with mammographic calcification and to help determine which patients (with, Core Needle Biopsy-diagnosed DCIS) are the most appropriate candidates for Sentinel Lymph Node (SLN) biopsy. The original aspect of this study was to select patients with mammographic microcalcification but without an associated mass. The factor that we identified to be associated with invasive disease at final surgical excision was the presence of necrosis at core histology. SLN biopsy or complete axillary lymph node dissection was performed in 22 (40%) patients of whom only one (4.5%) had a micrometastasis. Further larger studies are needed to see if it would be interesting to propose a SLN biopsy in case of necrosis on CNB-diagnosed DCIS with microcalcifications but not associated with a mass. Copyright © 2012 Elsevier GmbH. All rights reserved.

  16. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Sanabria-Mondragón, Mónica; Hernández-Beltrán, Lourdes; López-Amador, Noé; Cerda-Flores, Ricardo M.

    2012-01-01

    Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ 2) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns. PMID:23346398

  17. Mammographic thickness compensation for image analysis and display enhancement

    Science.gov (United States)

    Rico, Dan; Yaffe, Martin J.; Augustine, Bindu J.; Mawdsley, Gordon E.

    2003-05-01

    This paper proposes a novel algorithm for mammographic image enhancenment, based on identifying the peripheral region of the breast and suppressing the large change in signal caused by reduction of thickness there, while maintaining the local contrast information related to tissue composition. The thickness compensation algorithm consists of three processing steps. The first step is to generate a thickness map using two phantoms, one which simulates the shape of the breast in the cranio-caudal projection and a second one as a triangular attenuator. The second step is to warp the phantom thickness map in the peripheral region to that of the breast image. The third step is to equalize the signal values in the peripheral region relative to the signal in the uniform thickness area using the warped thickness map data. Examples are presented to show the effectiveness of the proposed method in effectively suppressing the large range of signal caused by thickness changes in the peripheral region, thereby facilitating image presentation and analysis. The performance of the proposed algorithm was also evaluated on clinical mammograms by computing volumetric breast density.

  18. Statistical Evaluation of a Fully Automated Mammographic Breast Density Algorithm

    Directory of Open Access Journals (Sweden)

    Mohamed Abdolell

    2013-01-01

    estimated density in 5% increments for 138 “For Presentation” single MLO views; the median of the radiologists’ estimates was used as the reference standard. Agreement amongst radiologists was excellent, ICC = 0.884, 95% CI (0.854, 0.910. Similarly, the agreement between the algorithm and the reference standard was excellent, ICC = 0.862, falling within the 95% CI of the radiologists’ estimates. The Bland-Altman plot showed that the reference standard was slightly positively biased (+1.86% compared to the algorithm-generated densities. A scatter plot showed that the algorithm moderately overestimated low densities and underestimated high densities. A box plot showed that 95% of the algorithm-generated assessments fell within one BI-RADS category of the reference standard. This study demonstrates the effective use of several statistical techniques that collectively produce a comprehensive evaluation of the algorithm and its potential to provide mammographic density measures that can be used to inform clinical practice.

  19. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    Directory of Open Access Journals (Sweden)

    Ana Laura Calderón-Garcidueñas

    2012-01-01

    Full Text Available Breast density (BD is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate ( and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170, fibroglandular 29% (87, heterogeneously dense 5.7% (17, and dense pattern 8.6% (26. Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117 and older than 50 (68.8%, 126/183. Patterns of high breast density (BD (dense + heterogeneously dense were observed in 25.6% (30/117 of women ≤50 years and 7.1% (13/183 of women >50. Asymmetry in BD was observed in 22% (66/300. Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300 of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300 of cases, vascular calcification in 150 cases (78.9%, and fat necrosis in 38 cases (20%. Conclusions. Mexican women have a low percentage of high-density patterns.

  20. Accuracy and reading time for six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts.

    Science.gov (United States)

    Tagliafico, Alberto Stefano; Calabrese, Massimo; Bignotti, Bianca; Signori, Alessio; Fisci, Erica; Rossi, Federica; Valdora, Francesca; Houssami, Nehmat

    2017-12-01

    To compare six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts. This is a substudy of the 'ASTOUND' trial. 163 women who underwent tomosynthesis with synthetically reconstructed projection images (S-2D) inclusive of 13 (7.9%) cases diagnosed with breast cancer at histopathology after surgery were evaluated. Accuracy measures and screen-reading time of six reading strategies were assessed: (A) Single reading of S-2D alone, (B) single reading of tomosynthesis alone, (C) single reading of joint interpretation of tomosynthesis + S-2D, (D) double-reading of S-2D alone, (E) double reading of tomosynthesis alone, (F) double reading of joint interpretation of tomosynthesis + S-2D. The median age of the patients was 53 years (range, 36-88 years). The highest global accuracy was obtained with double reading of tomosynthesis + S2D (F) with an AUC of 0.979 (preading time of 154 s versus 34 s for the fastest strategy (single reading of S-2D alone). The AUCs for the other five strategies did not differ from each other. Double reading of tomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time. • Tomosynthesis acquisitions are progressively implemented with reconstructed synthesized 2D images • Double reading using S-2D plus tomosynthesis had the highest global accuracy (preading of S-2D plus tomosynthesis increased reading time.

  1. Background risk of breast cancer and the association between physical activity and mammographic density.

    Science.gov (United States)

    Trinh, Thang; Eriksson, Mikael; Darabi, Hatef; Bonn, Stephanie E; Brand, Judith S; Cuzick, Jack; Czene, Kamila; Sjölander, Arvid; Bälter, Katarina; Hall, Per

    2015-04-02

    High physical activity has been shown to decrease the risk of breast cancer, potentially by a mechanism that also reduces mammographic density. We tested the hypothesis that the risk of developing breast cancer in the next 10 years according to the Tyrer-Cuzick prediction model influences the association between physical activity and mammographic density. We conducted a population-based cross-sectional study of 38,913 Swedish women aged 40-74 years. Physical activity was assessed using the validated web-questionnaire Active-Q and mammographic density was measured by the fully automated volumetric Volpara method. The 10-year risk of breast cancer was estimated using the Tyrer-Cuzick (TC) prediction model. Linear regression analyses were performed to assess the association between physical activity and volumetric mammographic density and the potential interaction with the TC breast cancer risk. Overall, high physical activity was associated with lower absolute dense volume. As compared to women with the lowest total activity level (association was seen for any type of physical activity among women with association between total activity and absolute dense volume was modified by the TC breast cancer risk (P interaction = 0.05). As anticipated, high physical activity was also associated with lower non-dense volume. No consistent association was found between physical activity and percent dense volume. Our results suggest that physical activity may decrease breast cancer risk through reducing mammographic density, and that the physical activity needed to reduce mammographic density may depend on background risk of breast cancer.

  2. Mammographic changes in postmenopausal women : comparative effects between continuous combined hormone and single estrogen replacement therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Sug; Choi, Jong Tae; Jung, Kyoon Soon; Jung, Seung Hye [Jeil Women' s Hospital, Seoul (Korea, Republic of)

    1997-06-01

    As the use of hormone replacement therapy for the menopausal women increases, some caution is advised, since there is an increased risk of breast cancer. Accordingly, the importance of regular mammography has been addressed. This cross-setional study analyzed the effects of different hormone therapies on mammographic density. Sixty-seven postemenopausal women who had completed one year of hormone therapy and had undergone follow-up mammography, were divided into two groups : Group I : continuous conjugated equine estrogen, 0.625mg, plus continuous medroxyprogesterone acetate, 2.5mg (n=48), Group II : continuous conjugated equine estrogen 0.625mg (n=19). The mammograms were read by two radiologists. With regard to the radiologists involved, interobserver reliabillity (kappa) was 0.70 and intraobserver reliability (kappa) was 0.51 and 0.67. Before hormone therapy, factors related to decreased mammographic density were age and number of full term pregnancies (p<0.05). After one year of hormone therapy, body fat showed a significant increase (p<0.05), but in spite of this, increased mammographic density induced by hormone therapy remained significantly high (p<0.05). Compared with Group II, Group I showed a significant increase in mammographic density (p<0.05). In Group I, mammographic density increased from P2 to DY pattern in two cases, but there was no such change in Group II. The increase of mammographic density seen in Group II was much more significant statistically than that seen in Group I. The mammograms of women who have undergone continuous combined hormone therapy should therefore be interpreted very cautiously.

  3. The relationship of obesity, mammographic breast density, and magnetic resonance imaging in patients with breast cancer.

    Science.gov (United States)

    Gillman, Jennifer; Chun, Jennifer; Schwartz, Shira; Schnabel, Freya; Moy, Linda

    The purpose was to evaluate the relationship between body mass index (BMI), mammographic breast density, magnetic resonance (MR) background parenchymal enhancement (BPE), and MR fibroglandular tissue (FGT) in women with breast cancer. Our institutional database was queried for patients with preoperative mammography and breast MR imaging. There were 573 women eligible for analysis. Elevated BMI was associated with advanced stage of disease (P=.01), lower mammographic density (Pbreast density and FGT. Higher BMI was also associated with advanced stage disease and nonpalpable tumors on clinical exam. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Mammographic findings predicting an extensive intraductal component in early stage invasive breast cancer : analysis on microcalcification

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ah; Kim, Mi Hye; Lee, Mi Kyung; Oh, Ki Keun [College of Medicine, Yonsei University, Seoul (Korea, Republic of); Kim, Eun Kyung [Pundang CHA General Hospital, College of Medicine, Pochon CHA University, Seoul (Korea, Republic of)

    2000-05-01

    To analyze the mammographic findings of extensive intraductal component (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in an invasive carcinoma. The mammographic and pathologic findings in 71 patients aged 34-79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were retrospectively analysed. The mammographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalcification only. The shape and distribution of a calcification were classified according to the BI-RADS lexicon, and its extent was classified as either more or less than 3 cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were re-examined by means of slide mappings. Twenty-eight of 71 patients (39%) showed ECI positivity. The mammographic findings of EIC-positive invasive cancer (n=3D28) were mass with microcalcification (n=3D14), microcalcification only (n=3D7) and mass only (n=3D7). The mammographic finding which predicted EIC positivity was mass with microcalcification (PPV:0.67, NPV:0.33, p=3D0.02). A mammographic of mass only (n=3D39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, P less than 0.01). A comparison of cases with or without calcification showed that those with microcalcifications (n=3D32) showed a significantly high PPV of 0.66 (NPV:0.34, p less than 0.01) while those without calcification (n=3D39) showed a significantly high NPV of 0.82 (PPV:0.18, p less than 0.01). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Whenever microcalcification with or without mass is seen on mammographs obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS lexicon. (author)

  5. Online mammographic images database for development and comparison of CAD schemes.

    Science.gov (United States)

    Matheus, Bruno Roberto Nepomuceno; Schiabel, Homero

    2011-06-01

    Considering the difficulties in finding good-quality images for the development and test of computer-aided diagnosis (CAD), this paper presents a public online mammographic images database free for all interested viewers and aimed to help develop and evaluate CAD schemes. The digitalization of the mammographic images is made with suitable contrast and spatial resolution for processing purposes. The broad recuperation system allows the user to search for different images, exams, or patient characteristics. Comparison with other databases currently available has shown that the presented database has a sufficient number of images, is of high quality, and is the only one to include a functional search system.

  6. Increasingly strong reduction in breast cancer mortality due to screening

    Science.gov (United States)

    van Schoor, G; Moss, S M; Otten, J D M; Donders, R; Paap, E; den Heeten, G J; Holland, R; Broeders, M J M; Verbeek, A L M

    2011-01-01

    Background: Favourable outcomes of breast cancer screening trials in the 1970s and 1980s resulted in the launch of population-based service screening programmes in many Western countries. We investigated whether improvements in mammography and treatment modalities have had an influence on the effectiveness of breast cancer screening from 1975 to 2008. Methods: In Nijmegen, the Netherlands, 55 529 women received an invitation for screening between 1975 and 2008. We designed a case–referent study to evaluate the impact of mammographic screening on breast cancer mortality over time from 1975 to 2008. A total number of 282 breast cancer deaths were identified, and 1410 referents aged 50–69 were sampled from the population invited for screening. We estimated the effectiveness by calculating the odds ratio (OR) indicating the breast cancer death rate for screened vs unscreened women. Results: The breast cancer death rate in the screened group over the complete period was 35% lower than in the unscreened group (OR=0.65; 95% CI=0.49–0.87). Analysis by calendar year showed an increasing effectiveness from a 28% reduction in breast cancer mortality in the period 1975–1991 (OR=0.72; 95% CI=0.47–1.09) to 65% in the period 1992–2008 (OR=0.35; 95% CI=0.19–0.64). Conclusion: Our results show an increasingly strong reduction in breast cancer mortality over time because of mammographic screening. PMID:21343930

  7. Mammographic density, MRI background parenchymal enhancement and breast cancer risk

    Science.gov (United States)

    Pike, M. C.; Pearce, C. L.

    2013-01-01

    Mammographic density (MD), representing connective and epithelial tissue (fibroglandular tissue, FGT) is a major risk factor for breast cancer. In an analysis of an autopsy series (Bartow SA, Pathak DR, Mettler FA. Radiographic microcalcification and parenchymal patterns as indicators of histologic “high-risk” benign breast disease. Cancer 1990; 66: 1721–1725, Bartow SA, Pathak DR, Mettler FA et al. Breast mammographic pattern: a concatenation of confounding and breast cancer risk factors. Am J Epidemiol 1995; 142: 813–819), MD was found to be strongly correlated with the collagen and epithelial content of the breast (Li T, Sun L, Miller N et al. The association of measured breast tissue characteristics with MD and other risk factors for breast cancer. Cancer Epidemiol Biomarkers Prev 2005; 14: 343–349), and another report showed that breast epithelium was highly concentrated in the areas of collagen concentration (Hawes D, Downey S, Pearce CL et al. Dense breast stromal tissue shows greatly increased concentration of breast epithelium but no increase in its proliferative activity. Breast Cancer Res 2006; 8: R24). Collagen comprises the overwhelming majority of the FGT, occupying an area on the slides obtained from the autopsy series some 15 times the area of glandular tissue. The relationship of MD with breast cancer risk appears likely to be due to a major extent to increasing epithelial cell numbers with increasing MD. FGT is also seen in breast magnetic resonance imaging (breast MRI) and, as expected, it has been shown that this measure of FGT (MRI-FGT) is highly correlated with MD. A contrast-enhanced breast MRI shows that normal FGT ‘enhances’ (background parenchymal enhancement, BPE) after contrast agent is administered(Morris EA. Diagnostic breast MR imaging: current status and future directions. Radiol Clin North Am 2007; 45: 863–880, vii., Kuhl C. The current status of breast MR imaging. Part I. Choice of technique, image interpretation

  8. Mammographic density, MRI background parenchymal enhancement and breast cancer risk.

    Science.gov (United States)

    Pike, M C; Pearce, C L

    2013-11-01

    Mammographic density (MD), representing connective and epithelial tissue (fibroglandular tissue, FGT) is a major risk factor for breast cancer. In an analysis of an autopsy series (Bartow SA, Pathak DR, Mettler FA. Radiographic microcalcification and parenchymal patterns as indicators of histologic "high-risk" benign breast disease. Cancer 1990; 66: 1721-1725, Bartow SA, Pathak DR, Mettler FA et al. Breast mammographic pattern: a concatenation of confounding and breast cancer risk factors. Am J Epidemiol 1995; 142: 813-819), MD was found to be strongly correlated with the collagen and epithelial content of the breast (Li T, Sun L, Miller N et al. The association of measured breast tissue characteristics with MD and other risk factors for breast cancer. Cancer Epidemiol Biomarkers Prev 2005; 14: 343-349), and another report showed that breast epithelium was highly concentrated in the areas of collagen concentration (Hawes D, Downey S, Pearce CL et al. Dense breast stromal tissue shows greatly increased concentration of breast epithelium but no increase in its proliferative activity. Breast Cancer Res 2006; 8: R24). Collagen comprises the overwhelming majority of the FGT, occupying an area on the slides obtained from the autopsy series some 15 times the area of glandular tissue. The relationship of MD with breast cancer risk appears likely to be due to a major extent to increasing epithelial cell numbers with increasing MD. FGT is also seen in breast magnetic resonance imaging (breast MRI) and, as expected, it has been shown that this measure of FGT (MRI-FGT) is highly correlated with MD. A contrast-enhanced breast MRI shows that normal FGT 'enhances' (background parenchymal enhancement, BPE) after contrast agent is administered(Morris EA. Diagnostic breast MR imaging: current status and future directions. Radiol Clin North Am 2007; 45: 863-880, vii., Kuhl C. The current status of breast MR imaging. Part I. Choice of technique, image interpretation, diagnostic

  9. Association between the Adherence to the International Guidelines for Cancer Prevention and Mammographic Density.

    Directory of Open Access Journals (Sweden)

    Adela Castelló

    Full Text Available Mammographic density (MD is considered a strong predictor of Breast Cancer (BC. The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR recommendations for cancer prevention.Data of 3584 women attending screening from a population-based multicenter cross-sectional study (DDM-Spain collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF/AICR recommendations: R1Maintain adequate body weight; R2Be physically active; 3RLimit the intake of high density foods; R4Eat mostly plant foods; R5Limit the intake of animal foods; R6Limit alcohol intake; R7Limit salt and salt preserved food intake; R8Meet nutritional needs through diet. The association between the score and MD (assessed by a single radiologist using a semi-quantitative scale was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out.A higher compliance with the WCRF/AICR recommendations was associated with lower MD (OR1-unit increase = 0.93 95%CI:0.86;0.99. The association was stronger in postmenopausal women (OR = 0.91 95%CI:0.84;0.99 and nonsmokers (OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042. Among nonsmokers, maintaining adequate body weight (OR = 0.81 95%CI:0.65;1.01, practicing physical activity (OR = 0.68 95%CI:0.48;0.96 and moderating the intake of high-density foods (OR = 0.58 95%CI:0.40;0.86 and alcoholic beverages (OR = 0.76 95%CI:0.55;1.05 were the recommendations showing the strongest associations with MD.postmenopausal women and non-smokers with greater compliance with the WCRF/AICR guidelines have lower MD. These results may provide guidance to design specific

  10. Spectral analysis of mammographic images using a multitaper method

    Energy Technology Data Exchange (ETDEWEB)

    Wu Gang; Mainprize, James G.; Yaffe, Martin J. [Department of Medical Biophysics, University of Toronto (Canada); Imaging Research, Sunnybrook Health Sciences Centre, S636, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada)

    2012-02-15

    Purpose: Power spectral analysis in radiographic images is conventionally performed using a windowed overlapping averaging periodogram. This study describes an alternative approach using a multitaper technique and compares its performance with that of the standard method. This tool will be valuable in power spectrum estimation of images, whose content deviates significantly from uniform white noise. The performance of the multitaper approach will be evaluated in terms of spectral stability, variance reduction, bias, and frequency precision. The ultimate goal is the development of a useful tool for image quality assurance. Methods: A multitaper approach uses successive data windows of increasing order. This mitigates spectral leakage allowing one to calculate a reduced-variance power spectrum. The multitaper approach will be compared with the conventional power spectrum method in several typical situations, including the noise power spectra (NPS) measurements of simulated projection images of a uniform phantom, NPS measurement of real detector images of a uniform phantom for two clinical digital mammography systems, and the estimation of the anatomic noise in mammographic images (simulated images and clinical mammograms). Results: Examination of spectrum variance versus frequency resolution and bias indicates that the multitaper approach is superior to the conventional single taper methods in the prevention of spectrum leakage and variance reduction. More than four times finer frequency precision can be achieved with equivalent or less variance and bias. Conclusions: Without any shortening of the image data length, the bias is smaller and the frequency resolution is higher with the multitaper method, and the need to compromise in the choice of regions of interest size to balance between the reduction of variance and the loss of frequency resolution is largely eliminated.

  11. Mammographic density and breast cancer risk: a mediation analysis.

    Science.gov (United States)

    Rice, Megan S; Bertrand, Kimberly A; VanderWeele, Tyler J; Rosner, Bernard A; Liao, Xiaomei; Adami, Hans-Olov; Tamimi, Rulla M

    2016-09-21

    High mammographic density (MD) is a strong risk factor for breast cancer. However, it is unclear whether high MD is an intermediate phenotype or whether breast cancer risk factors influence breast cancer risk and MD independently. Our study population included 1290 invasive breast cancer cases and 3422 controls from the Nurses' Health Studies. We estimated the percent of the total association between the risk factor and breast cancer that was mediated by MD. In both pre- and postmenopausal women, the association between history of biopsy-confirmed benign breast disease and risk was partially mediated by percent MD (percent mediated (PM) = 17 %, p age 18) and breast cancer risk were substantially mediated by percent MD (PM = 73 %, p = 0.05 and PM = 82 %, p = 0.04, respectively). In postmenopausal women, the proportion of the associations of childhood somatotype and adolescent somatotype that were mediated by percent MD were lower (PM = 26 %, p = 0.01 for both measures). Hormone therapy use at mammogram was significantly mediated by percent MD in postmenopausal women (PM = 22 %, p risk factors, such as age at menarche or family history of breast cancer, were not mediated by percent MD. Percent MD partially mediated some of the associations between risk factors and breast cancer, though the magnitude varied by risk factor and menopausal status. These findings suggest that high MD may be an intermediate in some biological pathways for breast cancer development.

  12. Mammographically detected breast arterial calcifications: Indicators for arteriosclerotic diseases?

    Energy Technology Data Exchange (ETDEWEB)

    Taskin, Fuesun [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey)]. E-mail: fusuntaskin@yahoo.com; Akdilli, Alev [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Karaman, Can [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Unsal, Alparslan [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Koeseoglu, Kutsi [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Ergin, Filiz [Adnan Menderes University, Faculty of Medicine, Department of Public Health, Aydin (Turkey)

    2006-11-15

    Purpose: To determine the prevalence of breast arterial calcifications (BAC) detected on mammography and search for conditions that may influence their existence. Materials and methods: The mammograms of 6156 consecutive patients were reevaluated for the presence of BAC. Four hundred eighty-five women having BAC were enrolled in the patient group. Additionally, randomly selected 500 women, without BAC constituted the control group. Hospital records of the participants were reviewed for parity, menopausal status, oral contraceptive agent (OCA) usage, hormone replacement therapy (HRT) usage, presence of diabetes, hypertension, hyperlipidemia, albuminuria and history of myocardial infarction (MI). Results: Prevalence of BAC was 7.9% on mammograms. Ninety-four women were aged between 40 and 49 years, 165 were aged between 50 and 59 years and 226 were over 60 years among BAC positive 485 women. A significant relationship was found for the frequency of BAC versus age and HRT usage in all age groups (p < 0.05). Similarly, significant relationships were also found for the frequency of BAC versus OCA usage, HRT usage, hyperlipidemia and diabetes in age group of 40-49 and in age group of 50-59, and for the frequency of BAC versus albuminuria in age group of 40-49, BAC versus history of myocardial infarction in age group of 59-59 and over 60 years (p < 0.05). The correlations were not significant for the relationships of BAC with OCA usage, hyperlipidemia, diabetes and albuminuria in women over 60 years (p > 0.05). Conclusion: Most benign findings like BAC are not routinely reported during mammographic evaluation. Our study showed that, presence of BAC on mammography was strongly related to advancing age. However, these findings may signify a systemic risk and can be used as precautious indicators for undocumented systemic diseases, especially in premenopausal women.

  13. A study of mammographic appearance of the breast disease

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kil Ho; Jung, Kyung Hee; Hwang, Mi Soo; Chang, Jae Chun; Kim, Myung Se; Shim, Min Chul; Min, Hyun Sik [College of Medicine, Yeung Nam University, Gyeongsan (Korea, Republic of)

    1985-08-15

    The history of the radiological examination of the breast has been long, and recently the methods for examining the breast are variable: mammography, thermography, xeroradiography, ultrasonography, water-path sonography, transillumination, mammary C.T., M.R imaging, infra-red scanning, nuclear medicine, and galactography. Most of these methods were not proven or have not been satisfied on their clinical testing but conventional mammography has been the gold standard for diagnosis of the breast cancer and no other method has reached its effectiveness. The authors performed mammography in 488 patients with breast abnormalities who had visited to Yeung Nam University hospital from May, 1983 to December, 1984. And we analyzed the mammographic findings and diagnostic accuracy in pathologically confirmed 53 cases by operations or biopsies. The results are as follows: 1. Among 16 cases of breast malignancies (1) the most prevalent age group is 6th decade (37.5%), followed by 5th decade (31.3%), (2) the most common pathologic type is ductal carcinoma (93.75%), (3) the masses are larger than 2cm in 8 cases, smaller than 2cm in 5 cases, and no visible mass is observed in 3 cases. 2. Among 37 cases of benign breast diseases, (1) the most prevalent age group is 4th and 5th decades (each 11 cases), and followed by 3rd decade (8 cases), (2) the most common disease is benign tumor (17 cases), followed by fibrocystic dysplasia (13 cases), and inflammating disease (7 cases), (3) radiologically visible masses are observed in 16 cases and the masses are smaller than 2cm in 11 cases. 3. The diagnostic accuracy of mammography compared with that of pathology, (1) in malignancy, the accuracy rate is 75% (12/16 cases), and 87% (32/37 cases) in benign diseases, (2) average accuracy rate is 81% (44/53 cases)

  14. Spectral analysis of mammographic images using a multitaper method.

    Science.gov (United States)

    Wu, Gang; Mainprize, James G; Yaffe, Martin J

    2012-02-01

    Power spectral analysis in radiographic images is conventionally performed using a windowed overlapping averaging periodogram. This study describes an alternative approach using a multitaper technique and compares its performance with that of the standard method. This tool will be valuable in power spectrum estimation of images, whose content deviates significantly from uniform white noise. The performance of the multitaper approach will be evaluated in terms of spectral stability, variance reduction, bias, and frequency precision. The ultimate goal is the development of a useful tool for image quality assurance. A multitaper approach uses successive data windows of increasing order. This mitigates spectral leakage allowing one to calculate a reduced-variance power spectrum. The multitaper approach will be compared with the conventional power spectrum method in several typical situations, including the noise power spectra (NPS) measurements of simulated projection images of a uniform phantom, NPS measurement of real detector images of a uniform phantom for two clinical digital mammography systems, and the estimation of the anatomic noise in mammographic images (simulated images and clinical mammograms). Examination of spectrum variance versus frequency resolution and bias indicates that the multitaper approach is superior to the conventional single taper methods in the prevention of spectrum leakage and variance reduction. More than four times finer frequency precision can be achieved with equivalent or less variance and bias. Without any shortening of the image data length, the bias is smaller and the frequency resolution is higher with the multitaper method, and the need to compromise in the choice of regions of interest size to balance between the reduction of variance and the loss of frequency resolution is largely eliminated.

  15. 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.

  16. Birth weight, childhood body mass index, and height in relation to mammographic density and breast cancer

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Baker, Jennifer Lyn; Bihrmann, Kristine

    2014-01-01

    High breast density, a strong predictor of breast cancer may be determined early in life. Childhood anthropometric factors have been related to breast cancer and breast density, but rarely simultaneously. We examined whether mammographic density (MD) mediates an association of birth weight...

  17. Probabilistic Computer Model Developed from Clinical Data in National Mammography Database Format to Classify Mammographic Findings

    OpenAIRE

    Burnside, Elizabeth S.; Davis, Jesse; Chhatwal, Jagpreet; Alagoz, Oguzhan; Mary J Lindstrom; Geller, Berta M; Littenberg, Benjamin; Shaffer, Katherine A.; Charles E Kahn; Page, C David

    2009-01-01

    Purpose: To determine whether a Bayesian network trained on a large database of patient demographic risk factors and radiologist-observed findings from consecutive clinical mammography examinations can exceed radiologist performance in the classification of mammographic findings as benign or malignant.

  18. Incremental clinical value of ultrasound in men with mammographically confirmed gynecomastia

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Po-Hao, E-mail: howard_chen@post.harvard.edu [Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 (United States); Department of Radiology, Hospital of University of Pennsylvania, 3400 Spruce Street, Philadlephia, PA 19104 (United States); Slanetz, Priscilla J., E-mail: pslanetz@bidmc.harvard.edu [Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 (United States); Beth Israel Deaconess Medical Center, Department of Radiology, 330 Brookline Avenue, Boston, MA 02215 (United States)

    2014-01-15

    Purpose: To determine whether ultrasound is of any value in male patients presenting with focal symptoms who have classic features of gynecomastia but no concerning findings on mammography. Materials and Methods: Over a 3-year period, all male patients who underwent mammographic evaluation were identified in this retrospective study. Patients with a mammographic diagnosis of gynecomastia and subsequent breast ultrasound at a large tertiary academic medical center comprised the study cohort. Men whose ultrasound diagnosis differed from the initial mammographic evaluation were analyzed for both additional benign findings as well as findings that warranted biopsy. Results: A total of 353 mammograms were obtained from 327 unique patients (ages 18–95, mean 51 years). Of all mammographic examinations, gynecomastia was the sole finding in 73% (259). In those 259 studies, 85% were further evaluated with ultrasound, in which 6 (2.7%) showed additional benign findings, and 4 (1.8%) showed suspicious findings for which biopsy was recommended. No malignancies were detected in those patients. Furthermore, no malignancies were detected in patients whose mammogram revealed only normal fatty parenchyma or only gynecomastia. In all cases of cancer, mammography revealed visible masses. Conclusion: Judicious use of breast ultrasound in men improves outcome. Our data suggest that targeted ultrasound is of limited value in symptomatic male patients where mammography is negative or reveals only gynecomastia and leads to unnecessary benign biopsies in these patients. When mammography reveals concerning findings, ultrasound adds positively to clinical management.

  19. Comparison of mammographic image quality in various methods of reconstructive breast surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lindbichler, F. [University Hospital, Graz (Austria). Dept. of Radiology; Hoflehner, H. [University Hospital, Graz (Austria). Dept. of Plastic and Reconstructive Surgery; Schmidt, F. [University Hospital, Graz (Austria). Dept. of Radiology; Pierer, G.R. [University Hospital, Graz (Austria). Dept. of Plastic and Reconstructive Surgery; Raith, J. [University Hospital, Graz (Austria). Dept. of Radiology; Umschaden, J. [University Hospital, Graz (Austria). Dept. of Plastic and Reconstructive Surgery; Preidler, K.W. [University Hospital, Graz (Austria). Dept. of Radiology

    1996-12-01

    The purpose of our study was to evaluate mammographic image quality of various methods of reconstructive breast surgery with specific reference to the possibility of diagnosis of recurrent tumors. A total of 39 patients who underwent breast reconstruction following modified radical mastectomy were subject to clinical and mammographic examination. Three groups were formed: (a) autonomous tissue reconstruction (TRAM-flap; n=9), (b) submuscular silicon gel prostheses (n=21), and (c) supramuscular silicon gel prostheses (n=9). Mammographic images quality of the groups was compared by two radiologists working together using a point system where five specific criteria were valued and scored. The result was tabulated into three quality levels: good, acceptable, and limited. Mammograms were assessed as good, acceptable, or limited, respectively, as follows: group I: 7 (77.8%), 1 (11.1%), 1 (11.1%); group II; 4 (19%), 11 (52.4%), 6 (28.6%); group III: 3 (33.3%), 4 (44.5%), 2 (22.2%). The TRAM-flap method of reconstruction displays a high degree of mammographic image quality and therefore is preferable with respect to early diagnosis of recurrent tumors. (orig.)

  20. Comparison of mammographic image quality in various methods of reconstructive breast surgery.

    Science.gov (United States)

    Lindbichler, F; Hoflehner, H; Schmidt, F; Pierer, G R; Raith, J; Umschaden, J; Preidler, K W

    1996-01-01

    The purpose of our study was to evaluate mammographic image quality of various methods of reconstructive breast surgery with specific reference to the possibility of diagnosis of recurrent tumors. A total of 39 patients who underwent breast reconstruction following modified radical mastectomy were subject to clinical and mammographic examination. Three groups were formed: (a) autonomous tissue reconstruction (TRAM-flap; n = 9), (b) submuscular silicon gel prostheses (n = 21), and (c) supramuscular silicon gel prostheses (n = 9). Mammographic image quality of the groups was compared by two radiologists working together using a point system where five specific criteria were valued and scored. The result was tabulated into three quality levels: good, acceptable, and limited. Mammograms were assessed as good, acceptable, or limited, respectively, as follows: group I: 7 (77.8%), 1 (11.1%), 1 (11.1%); group II: 4 (19%), 11 (52.4%), 6 (28.6%); group III: 3 (33.3%), 4 (44.5%), 2 (22.2%). The TRAM-flap method of reconstruction displays a high degree of mammographic image quality and therefore is preferable with respect to early diagnosis of recurrent tumors.

  1. Automated Method for Analysis of Mammographic Breast Density - A Technique for Breast Cancer Risk Estimation

    Science.gov (United States)

    2006-07-01

    tion. The data set comprised the four- view craniocaudal (CC) and medio - lateral oblique (MLO) mammograms obtained in 65 patients who were ran- domly... Mexico . Radiology 1998;209:511–518. 4. Boyd NF, Byng RA, Jong EK, et al. Quantita- tive classification of mammographic densi- ties and breast cancer risk

  2. Anthropometric parameters: weight height, body mass index and mammary volume in relationship with the mammographic pattern; Parametros antropmetricos: peso, talla, indice de masa corporal y volumen mamario, en relacion con el patron mamografico

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Candela, V.; Busto, C.; Avila, R.; Marrero, M. G.; Liminana, J. M.; Orengo, J. C. [Hospital Universitario Maternoinfantil de Canarias. Las Palmas de Gran Canaria (Spain)

    2001-07-01

    A prospective study to attempt to relate the anthropometric parameters of height, weight, body mass index as well as age with the mammographic patterns obtained for the patients and obtain an anthropometric profile was carried out. The study was performed in 1.000 women who underwent a mammography in cranial-caudal and medial lateral oblique projection of both breasts, independently of whether they were screened or diagnosed. Prior to the performance of the mammography, weight and height were obtained, and this was also performed by the same technicians, and the patient were asked their bra size to deduce breast volume. With the weight, the body mass index of Quetelet was calculated (weight [kg]/height''2 (ml)). After reading the mammography, the patient was assigned to one of the four mammographic patterns considered in the BIRADS (Breast Imaging Reporting and Data System) established by the ACR (American College of Radiology): type I (fat). type II (disperse fibroglandular densities), type III (fibroglandular densities distributed heterogeneously), type 4 (dense). The results were introduced into a computer database and the SPSS 8.0 statistical program was applied, using the statistical model of multivariant logistic regression. In women under 40 years, with normal weight, the dense breast pattern accounted for 67.8% and as the body mass index (BMI) increased, this pattern decreased to 25.1%. The fat pattern is 20% and as the BMI increases, this increased to 80%. In 40-60 year old women with normal weight, the dense pattern accounts for 44% and decreases to 20.9% in the grades II, III and IV obese. The fat pattern is 11.1% and increases to 53.7% in the grade II, III and IV obese. In women over 60 with normal, the dense pattern accounts for 19.3% and and decreases to 13% in the grade III obese. The fat pattern is 5.3% and increases to 20.2% in the grade iii of obesity. As age increases, the probability of presenting a mammographic pattern with a fat

  3. Robust estimation of mammographic breast density: a patient-based approach

    Science.gov (United States)

    Heese, Harald S.; Erhard, Klaus; Gooßen, Andre; Bulow, Thomas

    2012-02-01

    Breast density has become an established risk indicator for developing breast cancer. Current clinical practice reflects this by grading mammograms patient-wise as entirely fat, scattered fibroglandular, heterogeneously dense, or extremely dense based on visual perception. Existing (semi-) automated methods work on a per-image basis and mimic clinical practice by calculating an area fraction of fibroglandular tissue (mammographic percent density). We suggest a method that follows clinical practice more strictly by segmenting the fibroglandular tissue portion directly from the joint data of all four available mammographic views (cranio-caudal and medio-lateral oblique, left and right), and by subsequently calculating a consistently patient-based mammographic percent density estimate. In particular, each mammographic view is first processed separately to determine a region of interest (ROI) for segmentation into fibroglandular and adipose tissue. ROI determination includes breast outline detection via edge-based methods, peripheral tissue suppression via geometric breast height modeling, and - for medio-lateral oblique views only - pectoral muscle outline detection based on optimizing a three-parameter analytic curve with respect to local appearance. Intensity harmonization based on separately acquired calibration data is performed with respect to compression height and tube voltage to facilitate joint segmentation of available mammographic views. A Gaussian mixture model (GMM) on the joint histogram data with a posteriori calibration guided plausibility correction is finally employed for tissue separation. The proposed method was tested on patient data from 82 subjects. Results show excellent correlation (r = 0.86) to radiologist's grading with deviations ranging between -28%, (q = 0.025) and +16%, (q = 0.975).

  4. Computerized prediction of breast cancer risk: comparison between the global and local bilateral mammographic tissue asymmetry

    Science.gov (United States)

    Wang, Xingwei; Lederman, Dror; Tan, Jun; Wang, Xiao Hui; Zheng, Bin

    2011-03-01

    We have developed and preliminarily tested a new breast cancer risk prediction model based on computerized bilateral mammographic tissue asymmetry. In this study, we investigated and compared the performance difference of our risk prediction model when the bilateral mammographic tissue asymmetrical features were extracted in two different methods namely (1) the entire breast area and (2) the mirror-matched local strips between the left and right breast. A testing dataset including bilateral craniocaudal (CC) view images of 100 negative and 100 positive cases for developing breast abnormalities or cancer was selected from a large and diverse full-field digital mammography (FFDM) image database. To detect bilateral mammographic tissue asymmetry, a set of 20 initial "global" features were extracted from the entire breast areas of two bilateral mammograms in CC view and their differences were computed. Meanwhile, a pool of 16 local histogram-based statistic features was computed from eight mirror-matched strips between the left and right breast. Using a genetic algorithm (GA) to select optimal features, two artificial neural networks (ANN) were built to predict the risk of a test case developing cancer. Using the leave-one-case-out training and testing method, two GAoptimized ANNs yielded the areas under receiver operating characteristic (ROC) curves of 0.754+/-0.024 (using feature differences extracted from the entire breast area) and 0.726+/-0.026 (using the feature differences extracted from 8 pairs of local strips), respectively. The risk prediction model using either ANN is able to detect 58.3% (35/60) of cancer cases 6 to 18 months earlier at 80% specificity level. This study compared two methods to compute bilateral mammographic tissue asymmetry and demonstrated that bilateral mammographic tissue asymmetry was a useful breast cancer risk indicator with high discriminatory power.

  5. Mammographic bi-dimensional product: a powerful predictor of successful excision of ductal carcinoma in situ

    Energy Technology Data Exchange (ETDEWEB)

    Evans, A. [Breast Institute, Nottingham City Hospital, Nottingham (United Kingdom)]. E-mail: andrew.evans@nuh.nhs.uk; Clements, K. [West Midlands Cancer Intelligence Unit, Birmingham (United Kingdom); Maxwell, A. [Bolton Breast Unit, Bolton (United Kingdom); Dobson, H. [West of Scotland Breast Screening Unit, Glasgow (United Kingdom); Wallis, M. [Warwickshire, Solihull and Coventry Breast Screening Service, Coventry (United Kingdom); Lawrence, G. [West Midlands Cancer Intelligence Unit, Birmingham (United Kingdom); Bishop, H. [Bolton Breast Unit, Bolton (United Kingdom)

    2007-08-15

    Background: The aim of this analysis was to ascertain whether uni-dimensional measurement of mammographic microcalcification, the product of bi-dimensional measurement, calcification morphology, and pathological grade are helpful in predicting successful single therapeutic wide local excision (WLE) of ductal carcinoma in situ (DCIS). Methods: The study group comprised 505 patients whose mammograms showed the DCIS as calcification, and in whom a non-operative diagnosis had been obtained and WLE attempted. The extents of mammographic calcifications was measured in two planes at 90{sup o} on the oblique view, the appearances classified as comedo, granular, or punctate. DCIS was graded using cyto-nuclear characteristics. Results: Three hundred and forty-two patients had a successful first WLE and 163 patients had further surgery. A uni-dimensional measurement of <35 mm and a bi-dimensional product of <800 mm{sup 2} were associated with successful excision (69 versus 54%, p = 0.02 and 70 versus 27%, p = 0.0001, respectively). Mammographic calcification morphology and histological grade did not influence the likelihood of a successful first WLE. For high-grade DCIS, the upper limit of the bi-dimensional product associated with successful WLE was 800 mm{sup 2} (69 versus 24%, p = 0.0003). In contrast, for non-high-grade DCIS, the cut-off was 400 mm{sup 2} (73 versus 33%, p = 0.01). Analyses based on mammographic calcification morphology gave similar findings. Conclusion: The mammographic bi-dimensional product is a powerful predictor of successful WLE of DCIS when combined with histological grade and/or calcification morphology.

  6. Optimizing Digital Mammographic Image Quality for Full-Field Digital Detectors: Artifacts Encountered during the QC Process.

    Science.gov (United States)

    Jayadevan, Rashmi; Armada, M Julie; Shaheen, Rola; Mulcahy, Constance; Slanetz, Priscilla J

    2015-01-01

    Early detection of breast cancer through routine mammographic screening has been shown to reduce mortality from breast cancer by up to 30% in multiple studies. However, this reduction of mortality is possible only with careful attention to image quality by the medical physicist, radiologic technologist, and interpreting radiologist. The accepted quality control (QC) processes for analog mammography are well established. However, now that use of digital units is widespread in both the United States and internationally, information regarding the necessary steps and the inherent challenges that might be encountered at each step needs to be elucidated. In this review, the essential steps of the QC process for digital mammography are reviewed, with special attention to the possible problems that can occur during the QC process, many of which can lead to image artifacts. For each of the daily, weekly, monthly, and semiannual QC tests, we review the steps and expected performance and provide examples of some of the common artifacts that may be encountered. Understanding the components of the QC process and recognizing problems that may result in a suboptimal image is critical to ensure optimal image quality in an effort to maximize early detection of breast cancer. (©)RSNA, 2015.

  7. Remote Patient Management in a Mammographic Screening Environment in Underserved Areas

    National Research Council Canada - National Science Library

    Gur, David

    2002-01-01

    .... The purpose of this project is to evaluate in a multi-phase project the possible impact of a unique telemammography system that utilizes common carriers with wavelet-based data compression for image...

  8. Remote Patient Management in a Mammographic Screening Environment in Underserved Areas

    National Research Council Canada - National Science Library

    Gur, David

    2004-01-01

    .... The purpose of this project is to evaluate in a multi-phase project the possible impact of a unique tele-mammography system that utilizes common carriers with wavelet-based data compression for image...

  9. Regional trends in breast cancer incidence and mortality in Denmark prior to mammographic screening

    DEFF Research Database (Denmark)

    Andreasen, A H; Andersen, K W; Madsen, Mette

    1994-01-01

    and the mortality varied between the regions, with maximum differences of 22%. The analysis showed no variation in the time trends in the different regions, and thus indicates that the use of a regional comparison group would be a valid basis for evaluation of the Copenhagen programme. Our study, however, underlies...

  10. [The diffusion of screening programmes in Italy, year 2010].

    Science.gov (United States)

    Zappa, Marco; Dardanoni, Gabriella; Giorgi Rossi, Paolo; Grazzini, Grazia; Naldoni, Carlo; Paci, Eugenio; Pirola, Maria Elena; Pizzuti, Renato; Segnan, Nereo; Zorzi, Manuel; Federici, Antonio

    2012-01-01

    The national meeting of the National Centre for Screening Monitoring (ONS) was given the title "The screening during the crisis" as we realize that the severe economical crisis of our country influences all the health policies and, as a consequence, screening programs. Within this global scenario, the results of 2010 concerning screening programs can be considered as still positive even if the gap between the North and the Central Regions as compared to the South remains. In short, in 2010 almost 9.5 millions people were invited to undergo a screening examination (3,450,000; 2,496,000 and 3,464,000 for cervical, mammographic and colorectal cancer respectively). As compared to the previous year, a large increase was observed for colorectal screening.Whereas a slight decrease was observed both for cervical and for mammographic screening. The latter trend was partially due to the overload consequent to the extension of the programme to women younger than fifty in a couple of regions (Emilia-Romagna and Piemonte). More than 4.3 millions of subjects actually complied to the invitation (1,375,000; 1,382,000 and 1,582,000 for cervical, mammographic and colorectal cancer, respectively). As a consequence of these activities were identified 6,015 breast cancers (31% of annual occurring breast cancers in Italy in the age group 50-69 years according to the most update estimates of breast cancer occurrence), 4,597 CIN2 or more severe cervical lesions, 2,916 colorectal cancers (15% of annual occurring CRC cancer in Italy in the age group 50-69 years) and 15,049 advanced adenomas.

  11. External validation of a publicly available computer assisted diagnostic tool for mammographic mass lesions with two high prevalence research datasets.

    Science.gov (United States)

    Benndorf, Matthias; Burnside, Elizabeth S; Herda, Christoph; Langer, Mathias; Kotter, Elmar

    2015-08-01

    Lesions detected at mammography are described with a highly standardized terminology: the breast imaging-reporting and data system (BI-RADS) lexicon. Up to now, no validated semantic computer assisted classification algorithm exists to interactively link combinations of morphological descriptors from the lexicon to a probabilistic risk estimate of malignancy. The authors therefore aim at the external validation of the mammographic mass diagnosis (MMassDx) algorithm. A classification algorithm like MMassDx must perform well in a variety of clinical circumstances and in datasets that were not used to generate the algorithm in order to ultimately become accepted in clinical routine. The MMassDx algorithm uses a naïve Bayes network and calculates post-test probabilities of malignancy based on two distinct sets of variables, (a) BI-RADS descriptors and age ("descriptor model") and (b) BI-RADS descriptors, age, and BI-RADS assessment categories ("inclusive model"). The authors evaluate both the MMassDx (descriptor) and MMassDx (inclusive) models using two large publicly available datasets of mammographic mass lesions: the digital database for screening mammography (DDSM) dataset, which contains two subsets from the same examinations-a medio-lateral oblique (MLO) view and cranio-caudal (CC) view dataset-and the mammographic mass (MM) dataset. The DDSM contains 1220 mass lesions and the MM dataset contains 961 mass lesions. The authors evaluate discriminative performance using area under the receiver-operating-characteristic curve (AUC) and compare this to the BI-RADS assessment categories alone (i.e., the clinical performance) using the DeLong method. The authors also evaluate whether assigned probabilistic risk estimates reflect the lesions' true risk of malignancy using calibration curves. The authors demonstrate that the MMassDx algorithms show good discriminatory performance. AUC for the MMassDx (descriptor) model in the DDSM data is 0.876/0.895 (MLO/CC view) and AUC

  12. An investigation into why two-view mammography is better than one-view in breast cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Hackshaw, A.K.; Wald, N.J.; Michell, M.J.; Field, S.; Wilson, A.R.M

    2000-06-01

    AIM: To determine why two-view mammography in screening for breast cancer is more effective than using a single medio-lateral oblique view. MATERIALS AND METHODS: In the United Kingdom Coordinating Committee on Cancer Research randomized trial of one- vs two-view mammography in breast cancer screening the oblique view was assessed by one radiologist and two views (oblique and cranio-caudal) assessed by another. For the present study the mammographic films were retrieved from the screening centres and assessed by three consultant radiologists. Mammographic films were available from 110 women; 87 had their breast cancer detected by both one and two views and in 23 it was missed by one view but detected using two views. Outcome measures were breast size, location and size of the cancer, mammographic features, presence of microcalcification and overall radiological assessment. RESULTS: Although 23 cancers were missed in the original trial when one view was used, only two were not visible on the oblique view. Cancers missed using a single oblique view (and only detected if the cranio-caudal view was available with the oblique) tended to be smaller by about 4 mm (P = 0.05), centrally located in the breast (P = 0.16), not spiculated or round, (P {<=} 0.001) and lacked microcalcification (P = 0.15). Breast size and breast radiographic density were not significantly associated with breast cancer detection. CONCLUSIONS: The results provide the basis for the observation that two-view mammographic screening is more effective than one-view mammographic screening. Hackshaw, A. (2000). Clinical Radiology 55, 454-458.

  13. Densidade mamográfica em mulheres climatéricas em uso de terapia de reposição hormonal Mammographic parenchymal pattern in climacteric women receiving hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Herberth Régis de Araújo

    2004-01-01

    denser mammographic pattern. CONCLUSIONS: an increase in mammographic density was shown in women undergoing HRT, and was most pronounced in women with androgenic fat distribution. Additional studies must be carried out in order to evaluate if this increment in mammographic density could impair the mammographic screening of breast cancer.

  14. Mammographic Breast Density in Chinese Women: Spatial Distribution and Autocorrelation Patterns.

    Science.gov (United States)

    Lai, Christopher W K; Law, Helen K W

    2015-01-01

    Mammographic breast density (MBD) is a strong risk factor for breast cancer. The spatial distribution of MBD in the breast is variable and dependent on physiological, genetic, environmental and pathological factors. This pilot study aims to define the spatial distribution and autocorrelation patterns of MBD in Chinese women aged 40-60. By analyzing their digital mammographic images using a public domain Java image processing program for segmentation and quantification of MBD, we found their left and right breasts were symmetric to each other in regard to their breast size (Total Breast Area), the amount of BMD (overall PD) and Moran's I values. Their MBD was also spatially autocorrelated together in the anterior part of the breast in those with a smaller breast size, while those with a larger breast size tend to have their MBD clustered near the posterior part of the breast. Finally, we observed that the autocorrelation pattern of MBD was dispersed after a 3-year observation period.

  15. Alcohol consumption and mammographic density in the Danish Diet, Cancer and Health cohort

    DEFF Research Database (Denmark)

    Jacobsen, Katja Kemp; Lynge, Elsebeth; Tjønneland, Anne

    2017-01-01

    consumption and MD. RESULTS: The mean age was 56.2 years, 56.5% of women had mixed/dense MD, and 91.8% were alcohol consumers. There was no association between current alcohol consumption and MD at baseline (age 50-65, on average 1 year before MD assessment) neither between age at drinking initiation and MD......, or fortified wine. CONCLUSIONS: We found higher MD among women with high alcohol consumption in early adulthood (ages 20-29), in those drinking spirits.......PURPOSE: We examined the association between alcohol consumption and mammographic density (MD) considering in detail the time of exposure and the type of alcohol. METHODS: Of 5,356 women (4,489 post-menopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic...

  16. Changes in mammographic features of breast cancer; Comparison with previous films

    Energy Technology Data Exchange (ETDEWEB)

    Matsunaga, Tadaharu; Hagiwara, Kei (Tokyo Metropolitan Cancer Detection Center (Japan)); Kimura, Kohzaburo; Kusama, Mikihiro

    1992-11-01

    Mammographic features of 87 breast cancer patients were studied in comparison with their previous survey films. Changes in the mammographic features included microcalcification (28 cases), tumor shadow (35 cases) and intratumorous microcalcifications (6 cases). Seven cases had several extremely high calcifications on the previous films, and three of six cases with clustered and scattered microcalcifications that extended over an entire breast quadrant had increased in number, density and extent. Eight cases in which clustered microcalcifications had increased in number, density and extent suggested a relationship between the increase in the extent of microcalcifications and length of time between visits. In most cases with tumor shadow, a slight localized increase in mammary gland density, irregular margins and strainghtened trabeculae were overlooked because of breast density. (author).

  17. Unsupervised deep learning applied to breast density segmentation and mammographic risk scoring

    DEFF Research Database (Denmark)

    Kallenberg, Michiel Gijsbertus J.; Petersen, Peter Kersten; Nielsen, Mads

    2016-01-01

    Mammographic risk scoring has commonly been automated by extracting a set of handcrafted features from mammograms, and relating the responses directly or indirectly to breast cancer risk. We present a method that learns a feature hierarchy from unlabeled data. When the learned features are used...... as the input to a simple classifier, two different tasks can be addressed: i) breast density segmentation, and ii) scoring of mammographic texture. The proposed model learns features at multiple scales. To control the models capacity a novel sparsity regularizer is introduced that incorporates both lifetime...... and population sparsity. We evaluated our method on three different clinical datasets. Our state-of-the-art results show that the learned breast density scores have a very strong positive relationship with manual ones, and that the learned texture scores are predictive of breast cancer. The model is easy...

  18. Mammographic quantitative image analysis and biologic image composition for breast lesion characterization and classification

    Energy Technology Data Exchange (ETDEWEB)

    Drukker, Karen, E-mail: kdrukker@uchicago.edu; Giger, Maryellen L.; Li, Hui [Department of Radiology, University of Chicago, Chicago, Illinois 60637 (United States); Duewer, Fred; Malkov, Serghei; Joe, Bonnie; Kerlikowske, Karla; Shepherd, John A. [Radiology Department, University of California, San Francisco, California 94143 (United States); Flowers, Chris I. [Department of Radiology, University of South Florida, Tampa, Florida 33612 (United States); Drukteinis, Jennifer S. [Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612 (United States)

    2014-03-15

    Purpose: To investigate whether biologic image composition of mammographic lesions can improve upon existing mammographic quantitative image analysis (QIA) in estimating the probability of malignancy. Methods: The study population consisted of 45 breast lesions imaged with dual-energy mammography prior to breast biopsy with final diagnosis resulting in 10 invasive ductal carcinomas, 5 ductal carcinomain situ, 11 fibroadenomas, and 19 other benign diagnoses. Analysis was threefold: (1) The raw low-energy mammographic images were analyzed with an established in-house QIA method, “QIA alone,” (2) the three-compartment breast (3CB) composition measure—derived from the dual-energy mammography—of water, lipid, and protein thickness were assessed, “3CB alone”, and (3) information from QIA and 3CB was combined, “QIA + 3CB.” Analysis was initiated from radiologist-indicated lesion centers and was otherwise fully automated. Steps of the QIA and 3CB methods were lesion segmentation, characterization, and subsequent classification for malignancy in leave-one-case-out cross-validation. Performance assessment included box plots, Bland–Altman plots, and Receiver Operating Characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) for distinguishing between benign and malignant lesions (invasive and DCIS) was 0.81 (standard error 0.07) for the “QIA alone” method, 0.72 (0.07) for “3CB alone” method, and 0.86 (0.04) for “QIA+3CB” combined. The difference in AUC was 0.043 between “QIA + 3CB” and “QIA alone” but failed to reach statistical significance (95% confidence interval [–0.17 to + 0.26]). Conclusions: In this pilot study analyzing the new 3CB imaging modality, knowledge of the composition of breast lesions and their periphery appeared additive in combination with existing mammographic QIA methods for the distinction between different benign and malignant lesion types.

  19. Incorporation of clinical data into a computerized method for the assessment of mammographic breast lesions

    Science.gov (United States)

    Huo, Zhimin; Giger, Maryellen L.

    2000-06-01

    We previously developed a computerized method to classify mammographic masses as benign or malignant. In this method, mammographic features that are similar to the ones used by radiologists are automatically extracted to characterize a mass lesion. These features are then merged by an artificial neural network (ANN), which yields an estimated likelihood of malignancy for each mass. The performance of the method was evaluated on an independent database consisting of 110 cases (60 benign and 50 malignant cases). The method achieved an Az of 0.91 from round-robin analysis in the task of differentiating between benign and malignant masses using the computer-extracted features only. As the most important clinical risk factor for breast cancer, age achieved a performance level (Az equals 0.79) similar to that (Az equals 0.77 and 0.80) of the computer-extracted spiculation features, which are the most important indicators for malignancy of a mass, in differentiating between the malignant and benign cases. In this study, age is included as an additional input feature to the ANN. The performance of the scheme (Az equals 0.93) is improved when age is included. However, the improvement is not found to be statistically significant. Our results indicated that age may be a strong feature in predicting malignancy of a mass. For this database, however, the inclusion of age may not have a strong impact on the determination of the likelihood for a mammographic mass lesion when the major mammographic characteristics (e.g., spiculation) of a mass are accurately extracted and analyzed along with other features using an artificial neural network.

  20. Contrast-enhanced dedicated breast CT detection of invasive breast cancer preceding mammographic diagnosis

    OpenAIRE

    Prionas, Nicolas D.; Aminololama-Shakeri, Shadi; Yang, Kai; Martinez, Steve R.; Lindfors, Karen K.; Boone, John M.

    2015-01-01

    Dedicated breast computed tomography (bCT) generates high-resolution, three-dimensional images of the pendent uncompressed breast. Intravenous iodinated contrast during bCT provides additional physiologic information. In this case, a 10.0-mm invasive ductal carcinoma was visualized using contrast-enhanced breast CT one year before mammographic detection. Mammography four months before bCT was negative. The bCT contrast enhancement pattern closely matched the dynamic contrast-enhanced MRI obta...

  1. Direct measurement of mammographic x-ray spectra using a CdZnTe detector.

    Science.gov (United States)

    Matsumoto, M; Yamamoto, A; Honda, I; Taniguchi, A; Kanamori, H

    2000-07-01

    Our purpose is to directly measure mammographic x-ray spectra with collimators and a low-efficiency CdZnTe detector developed recently and to find out the best fit response function of CdZnTe detector to correct the measured spectra. Photon spectra (target Mo or Rh) produced by a mammographic x-ray unit at 25-32 kV and 240 mAs (= 3 times of 80 mAs) and transmitted through 0.03 mm Mo or 0.025 mm Rh filter and object (0.1 mm Al to 0.8 mm Al phantoms) have been analyzed. Since detected spectra were distorted by the response of CdZnTe detector and did not present the true photon spectra, the correction was applied by the stripping procedure. The response function of detector used in this procedure has been determined by the evaluation of interactions (K-escape, coherent scattering, and Compton scattering processes) and incomplete charge collection calculated using the Monte Carlo method. We have used Kalpha1, Kalpha2, Kbeta1, Kbeta2 radiations of Cd, Zn, and Te, respectively and have used the weight function for the incomplete charge collection and have considered Compton scattering. The Monte Carlo simulations were continued by changing the important factors (mean path length of hole lambda(h), dead layer of the CZT crystal and weight factor Wq) of incomplete charge collection until the best fit response function was found out. Corrected photon spectra were compared with the mammographic x-ray spectral data of Bureau of Radiological Health (BRH) measured using a Ge detector. Attenuation curves of aluminum for 25-32 kV were calculated from the corrected photon spectra and compared with the attenuation curves measured using an ionization chamber. These results obtained using the CdZnTe detector agreed with the mammographic x-ray spectral data of BRH and attenuation curves obtained by the ionization chamber.

  2. Mammographic classification of breast lesions amongst women in ...

    African Journals Online (AJOL)

    BA, Teresa LF and Sonia IS. Screening of Breast Lesions: a Comparative Study between Mammography, B-mode. Ultrasonography, Sonoelastography and histological re- sults. Radiologia Brasileira 2013; 46(4): 78-99. 21. Frank NG Jnr, Akwasi A, Sebastian E, Saanid MA,. Samuel D. Pattern of Breast Cancer Distribution in ...

  3. International Consortium on Mammographic Density: Methodology and Population Diversity captured across 22 Countries

    Science.gov (United States)

    McCormack, Valerie A.; Burton, Anya; dos-Santos-Silva, Isabel; Hipwell, John H.; Dickens, Caroline; Salem, Dorria; Kamal, Rasha; Hartman, Mikael; Ling Lee, Charmaine Pei; Chia, Kee-Seng; Ozmen, Vahit; Aribal, Mustafa Erkin; Flugelman, Anath Arzee; Lajous, Martín; Lopez-Riduara, Ruy; Rice, Megan; Romieu, Isabelle; Ursin, Giske; Qureshi, Samera; Ma, Huiyan; Lee, Eunjung; van Gils, Carla H.; Wanders, Johanna O.P.; Vinayak, Sudhir; Ndumia, Rose; Allen, Steve; Vinnicombe, Sarah; Moss, Sue; Lee, Jong Won; Kim, Jisun; Pereira, Ana; Garmendia, Maria Luisa; Sirous, Reza; Sirous, Mehri; Peplonska, Beata; Bukowska, Agnieszka; Tamimi, Rulla M.; Bertrand, Kimberly; Nagata, Chisato; Kwong, Ava; Vachon, Celine; Scott, Christopher; Perez-Gomez, Beatriz; Pollan, Marina; Maskarinec, Gertraud; Giles, Graham; Hopper, John; Stone, Jennifer; Rajaram, Nadia; Teo, Soo-Hwang; Mariapun, Shivaani; Yaffe, Martin J.; Schüz, Joachim; Chiarelli, Anna; Linton, Linda; Boyd, Norman F.

    2015-01-01

    Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether they are consistent across populations worldwide. We included 11755 women, from 27 studies in 22 countries, on whom individual-level risk factor data were pooled and original mammographic images were re-read for ICMD by a core team to obtain standardized comparable MD data. In the present article, we present (i) the rationale for this consortium; (ii) characteristics of the studies and women included; and (iii) study methodology to obtain comparable MD data from original re-read films. We also highlight the risk factor heterogeneity captured by such an effort and, thus, the unique insight the pooled study promises to offer through wider exposure ranges, different confounding structures and enhanced power for sub-group analyses. PMID:26724463

  4. CdZnTe detector in mammographic x-ray spectroscopy.

    Science.gov (United States)

    Miyajima, Satoshi; Imagawa, Kotaro

    2002-11-21

    A CdZnTe (CZT) detector was utilized in mammographic x-ray spectroscopy under clinical conditions. First, the detector response was investigated using y-rays from 241Am. The escape of secondary (Compton scattered and K fluorescent) x-rays and tailing due to carrier trapping were minor in the mammographic energy range. In addition, the transmission of primary x-rays was minimal from the results calculated using the mass attenuation coefficients of CZT. Therefore, spectral distortion in this energy range was expected to be negligible. Secondly, x-ray spectroscopy was carried out with the CZT detector. The measured spectra were in good agreement with the spectra obtained with the Compton-scatter method with a high-purity germanium detector. Moreover, the half-value layers (HVLs) calculated from the CZT spectra were consistent with the HVLs measured with an ionization chamber. The results indicate that a CZT detector can be utilized in mammographic x-ray spectroscopy without any corrections.

  5. Mammographic density in asymptomatic menopausal women: correlation with clinical and sonographic findings

    Directory of Open Access Journals (Sweden)

    Beatriz Regina Alvares

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate mammographic breast density in asymptomatic menopausal women in correlation with clinical and sonographic findings. MATERIALS AND METHODS: Mammograms and clinical and sonographic findings of 238 asymptomatic patients were retrospectively reviewed in the period from February/2022 to June/2006. The following variables were analyzed: mammographic density patterns, sonographic findings, patients' age, parity, body mass index and use of hormone replacement therapy. RESULTS: Age, parity and body mass index showed a negative correlation with breast density pattern, while use of hormone replacement therapy showed a positive correlation. Supplementary breast ultrasonography was performed in 103 (43.2% patients. Alterations which could not be visualized at mammography were found in 34 (33% of them, most frequently in women with breast density patterns 3 and 4. CONCLUSION: The authors concluded that breast density patterns were influenced by age, parity, body mass index and time of hormone replacement therapy. Despite not having found any malignant abnormality in the studied cases, the authors have observed a predominance of benign sonographic abnormalities in women with high breast density patterns and without mammographic abnormalities, proving the relevance of supplementary ultrasonography to identify breast lesions in such patients.

  6. A GaAs pixel detectors-based digital mammographic system: Performances and imaging tests results

    Science.gov (United States)

    Annovazzi, A.; Amendolia, S. R.; Bigongiari, A.; Bisogni, M. G.; Catarsi, F.; Cesqui, F.; Cetronio, A.; Colombo, F.; Delogu, P.; Fantacci, M. E.; Gilberti, A.; Lanzieri, C.; Lavagna, S.; Novelli, M.; Passuello, G.; Paternoster, G.; Pieracci, M.; Poletti, M.; Quattrocchi, M.; Rosso, V.; Stefanini, A.; Testa, A.; Venturelli, L.

    2007-06-01

    The prototype presented in this paper is based on GaAs pixel detectors read-out by the PCC/MEDIPIX I circuit. The active area of a sensor is about 1 cm 2 therefore to cover the typical irradiation field used in mammography (18×24 cm 2), 18 GaAs detection units have been organized in two staggered rows of nine chips each and moved by a stepper motor in the orthogonal direction. The system is integrated in a mammographic equipment which comprehends the X-ray tube, the bias and data acquisition systems and the PC-based control system. The prototype has been developed in the framework of the Integrated Mammographic Imaging (IMI) project, an industrial research activity aiming to develop innovative instrumentation for morphologic and functional imaging. The project has been supported by the Italian Ministry of Education, University and Research (MIUR) and by five Italian High Tech companies, Alenia Marconi Systems (AMS), CAEN, Gilardoni, LABEN and Poli.Hi.Tech., in collaboration with the universities of Ferrara, Roma "La Sapienza", Pisa and the Istituto Nazionale di Fisica Nucleare (INFN). In this paper, we report on the electrical characterization and the first imaging test results of the digital mammographic system. To assess the imaging capability of such a detector we have built a phantom, which simulates the breast tissue with malignancies. The radiographs of the phantom, obtained by delivering an entrance dose of 4.8 mGy, have shown particulars with a measured contrast below 1%.

  7. Sclerosing adenosis: mammographic and ultrasonographic findings with clinical and histopathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil E-mail: isilbilgen@hotmail.com; Memis, Aysenur; Uestuen, Esin Emin; Oezdemir, Necmettin; Erhan, Yildiz

    2002-12-01

    Objective: To evaluate the mammographic and ultrasonographic findings of sclerosing adenosis, a relatively uncommon entity which may sometimes mimic carcinoma. Materials and methods: A retrospective review of the records of 33700 women, who have undergone mammographic examination at our institution between January 1985 and July 2001 revealed 43 histopathologically proven sclerosing adenosis. The history, physical examination, mammographic and ultrasonographic findings were analyzed in all patients. In 30 patients, the nonpalpable lesions were preoperatively localized by the needle-hookwire system under the guidance of mammography (n=22) or ultrasonography (US) (n=8). Radiological features were correlated with histopathological findings. Results: The age of the patients varied between 32 and 55 years (mean, 43.7 years). Only two patients had a family history of breast cancer. In six patients, the presenting complaint was mastalgia. A palpable mass was present in 13 cases. The mammographic findings were; microcalcifications in 24 (55.8%) (clustered in 22, diffuse in two), mass in five (11.6%), asymmetric focal density in three (6.9%), and focal architectural distortion in three (6.9%) patients. Four of the masses were irregularly contoured, while one was well-circumscribed. On US, focal acoustic shadowing without a mass configuration was noted in the three patients who showed asymmetrical focal density on mammography. In eight patients, who showed normal mammograms, a solid mass was detected on US. Two masses had discrete well-circumscribed oval or lobulated contours, while six showed microlobulation and irregularity. In one case, the irregularly contoured mass had marked posterior acoustic shadowing. Two of the three patients, who had focal architectural distortion on mammograms, had an irregularly contoured solid mass, while the third presented as focal acoustic shadowing without a mass configuration. Conclusion: Sclerosing adenosis mostly presents as a nonpalpable

  8. Effect of Text Message, Phone Call, and In-Person Appointment Reminders on Uptake of Repeat HIV Testing among Outpatients Screened for Acute HIV Infection in Kenya: A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Peter M Mugo

    Full Text Available Following HIV-1 acquisition, many individuals develop an acute retroviral syndrome and a majority seek care. Available antibody testing cannot detect an acute HIV infection, but repeat testing after 2-4 weeks may detect seroconversion. We assessed the effect of appointment reminders on attendance for repeat HIV testing.We enrolled, in a randomized controlled trial, 18-29 year old patients evaluated for acute HIV infection at five sites in Coastal Kenya (ClinicalTrials.gov NCT01876199. Participants were allocated 1:1 to either standard appointment (a dated appointment card or enhanced appointment (a dated appointment card plus SMS and phone call reminders, or in-person reminders for participants without a phone. The primary outcome was visit attendance, i.e., the proportion of participants attending the repeat test visit. Factors associated with attendance were examined by bivariable and multivariable logistic regression.Between April and July 2013, 410 participants were randomized. Attendance was 41% (85/207 for the standard group and 59% (117/199 for the enhanced group, for a relative risk of 1.4 [95% Confidence Interval, CI, 1.2-1.7].Higher attendance was independently associated with older age, study site, and report of transactional sex in past month. Lower attendance was associated with reporting multiple partners in the past two months.Appointment reminders through SMS, phone calls and in-person reminders increased the uptake of repeat HIV test by forty percent. This low-cost intervention could facilitate detection of acute HIV infections and uptake of recommended repeat testing.Clinicaltrials.gov NCT01876199.

  9. The implementation of an AR (augmented reality) approach to support mammographic interpretation training: an initial feasibility study

    Science.gov (United States)

    Tang, Qiang; Chen, Yan; Gale, Alastair G.

    2017-03-01

    Appropriate feedback plays an important role in optimising mammographic interpretation training whilst also ensuring good interpretation performance. The traditional keyboard, mouse and workstation technical approach has a critical limitation in providing supplementary image-related information and providing complex feedback in real time. Augmented Reality (AR) provides a possible superior approach in this situation, as feedback can be provided directly overlaying the displayed mammographic images so making a generic approach which can also be vendor neutral. In this study, radiological feedback was dynamically remapped virtually into the real world, using perspective transformation, in order to provide a richer user experience in mammographic interpretation training. This is an initial attempt of an AR approach to dynamically superimpose pre-defined feedback information of a DICOM image on top of a radiologist's view, whilst the radiologist is examining images on a clinical workstation. The study demonstrates the feasibility of the approach, although there are limitations on interactive operations which are due to the hardware used. The results of this fully functional approach provide appropriate feedback/image correspondence in a simulated mammographic interpretation environment. Thus, it is argued that employing AR is a feasible way to provide rich feedback in the delivery of mammographic interpretation training.

  10. Mammographic surveillance in the follow up of early primary breast cancer in England: A cross-sectional survey

    Energy Technology Data Exchange (ETDEWEB)

    Greenwood-Haigh, Lesley [Mid Yorkshire Hospitals NHS Trust, X-Ray Department, Clayton Hospital, Northgate, Wakefield, West Yorkshire, WF1 3JS (United Kingdom)], E-mail: lesley.greenwood-haigh@midyorks.nhs.uk

    2009-08-15

    Purpose: The aim of this study was to determine current practice in the clinical setting at national and regional level of the use of mammographic surveillance in the follow up of patients surgically treated for early breast cancer. Method: A cross-sectional survey method was employed. Self-administered questionnaires were sent to a random selection of symptomatic breast imaging units representing all the cancer networks in England nationally, and all symptomatic breast imaging units in one cancer network regionally. Questions were designed to determine frequency and duration of mammographic surveillance for patients aged < 50 years and {>=}50 years surgically treated by mastectomy or breast conserving surgery and the number of units with protocols based on the risk of local recurrence or development of a new primary breast cancer. Results: The protocols demonstrated a striking diversity in both the frequency and duration of mammographic surveillance; however the variation was less marked regionally. The duration of mammography for patient's aged {>=}70 years surgically treated by mastectomy, demonstrated the greatest diversity (range: 0-15 years). Four protocols had regimes tailored to risk. Conclusion: The introduction of protocols based on risk of development of a local recurrence or new primary could prove cost effective by targeting mammographic surveillance to those who would benefit the most. The survey has demonstrated that a 'post-code lottery' exists for both the frequency and duration of mammographic surveillance in this patient group indicating an urgent need for evidence based national guidance.

  11. A method to determine the mammographic regions that show early changes due to the development of breast cancer

    Science.gov (United States)

    Karemore, Gopal; Nielsen, Mads; Karssemeijer, Nico; Brandt, Sami S.

    2014-11-01

    It is well understood nowadays that changes in the mammographic parenchymal pattern are an indicator of a risk of breast cancer and we have developed a statistical method that estimates the mammogram regions where the parenchymal changes, due to breast cancer, occur. This region of interest is computed from a score map by utilising the anatomical breast coordinate system developed in our previous work. The method also makes an automatic scale selection to avoid overfitting while the region estimates are computed by a nested cross-validation scheme. In this way, it is possible to recover those mammogram regions that show a significant difference in classification scores between the cancer and the control group. Our experiments suggested that the most significant mammogram region is the region behind the nipple and that can be justified by previous findings from other research groups. This result was conducted on the basis of the cross-validation experiments on independent training, validation and testing sets from the case-control study of 490 women, of which 245 women were diagnosed with breast cancer within a period of 2-4 years after the baseline mammograms. We additionally generalised the estimated region to another, mini-MIAS study and showed that the transferred region estimate gives at least a similar classification result when compared to the case where the whole breast region is used. In all, by following our method, one most likely improves both preclinical and follow-up breast cancer screening, but a larger study population will be required to test this hypothesis.

  12. Distribution of dense breasts using screening mammography in Korean women: a retrospective observational study

    OpenAIRE

    Bae, Jong-Myon; Shin, Sang Yop; Kim, Eun Hee; Kim, Yoon-Nam; Nam, Chung Mo

    2014-01-01

    OBJECTIVES: This retrospective observational study evaluated the distribution of dense breasts by age group among healthy Korean women. METHODS: Participants were women aged 30 years and older who voluntarily underwent screening mammography between January 2007 and December 2011. Women who received the Breast Imaging Reporting and Data System for mammographic density of 3 or 4 were defined as having dense breasts. The proportion of women with dense breasts (PDB, %) was calculated by dividing ...

  13. Local breast density assessment using reacquired mammographic images.

    Science.gov (United States)

    García, Eloy; Diaz, Oliver; Martí, Robert; Diez, Yago; Gubern-Mérida, Albert; Sentís, Melcior; Martí, Joan; Oliver, Arnau

    2017-08-01

    The aim of this paper is to evaluate the spatial glandular volumetric tissue distribution as well as the density measures provided by Volpara™ using a dataset composed of repeated pairs of mammograms, where each pair was acquired in a short time frame and in a slightly changed position of the breast. We conducted a retrospective analysis of 99 pairs of repeatedly acquired full-field digital mammograms from 99 different patients. The commercial software Volpara™ Density Maps (Volpara Solutions, Wellington, New Zealand) is used to estimate both the global and the local glandular tissue distribution in each image. The global measures provided by Volpara™, such as breast volume, volume of glandular tissue, and volumetric breast density are compared between the two acquisitions. The evaluation of the local glandular information is performed using histogram similarity metrics, such as intersection and correlation, and local measures, such as statistics from the difference image and local gradient correlation measures. Global measures showed a high correlation (breast volume R=0.99, volume of glandular tissue R=0.94, and volumetric breast density R=0.96) regardless the anode/filter material. Similarly, histogram intersection and correlation metric showed that, for each pair, the images share a high degree of information. Regarding the local distribution of glandular tissue, small changes in the angle of view do not yield significant differences in the glandular pattern, whilst changes in the breast thickness between both acquisition affect the spatial parenchymal distribution. This study indicates that Volpara™ Density Maps is reliable in estimating the local glandular tissue distribution and can be used for its assessment and follow-up. Volpara™ Density Maps is robust to small variations of the acquisition angle and to the beam energy, although divergences arise due to different breast compression conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Prospective study evaluating performance of first-trimester combined screening for trisomy 21 using repeat sampling of maternal serum markers PAPP-A and free β-hCG

    DEFF Research Database (Denmark)

    Ekelund, C; Wright, D; Ball, S

    2012-01-01

    To prospectively evaluate the performance of first-trimester combined screening for trisomy 21 using the biochemical markers pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (free β-hCG) obtained before and at the time of the nuchal translucency (NT) scan....

  15. European Breast Cancer Service Screening Outcomes

    DEFF Research Database (Denmark)

    Paci, Eugenio; Broeders, Mireille; Hofvind, Solveig

    2014-01-01

    A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast...... seven to nine breast cancer deaths are avoided, four cases are overdiagnosed, 170 women have at least one recall followed by noninvasive assessment with a negative result, and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of a breast cancer...... cancer overdiagnosis, and false-positive results. On the basis of the studies reviewed, the authors present a first estimate of the benefit and harm balance sheet. For every 1,000 women screened biennially from ages 50 to 51 years until ages 68 to 69 years and followed up until age 79 years, an estimated...

  16. Trends in television and computer/videogame use and total screen time in high school students from Caruaru city, Pernambuco, Brazil: A repeated panel study between 2007 and 2012

    Directory of Open Access Journals (Sweden)

    Luis José Lagos Aros

    2018-01-01

    Full Text Available Abstract Aim: to analyze the pattern and trends of use of screen-based devices and associated factors from two surveys conducted on public high school students in Caruaru-PE. Methods: two representative school-based cross-sectional surveys conducted in 2007 (n=600 and 2012 (n=715 on high school students (15-20 years old. The time of exposure to television (TV and computer/videogames PC/VG was obtained through a validated questionnaire, and ≥3 hours/day was considered as being excessive exposure. The independent variables were socioeconomic status, school related, and physical activity. Crude and adjusted binary logistic regression were employed to examine the factors associated with screen time. The statistical significance was set at p<0.05. Results: There was a significant reduction in TV time on weekdays and total weekly, but no change in the prevalence of excessive exposure. The proportion of exposure to PC/VG of ≥3 hours/day increased 182.5% on weekdays and 69.5% on weekends (p <0.05. In 2007, being physically active was the only protection factor for excessive exposure to total screen time. In 2012, girls presented less chance of excessive exposure to all screen-based devices and total screen time. Other protective factors were studying at night and being physically active (PC/VG time, while residing in an urban area [OR 5.03(2.77-7.41] and having higher family income [OR 1.55(1.04-2.30] were risk factors. Conclusion: Significant and important changes in the time trends and pattern of use PC/VG were observed during the interval of 5 years. This rapid increase could be associated with increased family income and improved access to these devices, driven by technological developments.

  17. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  18. Impact of contra-lateral breast reshaping on mammographic surveillance in women undergoing breast reconstruction following mastectomy for breast cancer.

    Science.gov (United States)

    Nava, Maurizio B; Rocco, Nicola; Catanuto, Giuseppe; Falco, Giuseppe; Capalbo, Emanuela; Marano, Luigi; Bordoni, Daniele; Spano, Andrea; Scaperrotta, Gianfranco

    2015-08-01

    The ultimate goal of breast reconstruction is to achieve symmetry with the contra-lateral breast. Contra-lateral procedures with wide parenchymal rearrangements are suspected to impair mammographic surveillance. This study aims to evaluate the impact on mammographic detection of mastopexies and breast reductions for contralateral adjustment in breast reconstruction. We retrospectively evaluated 105 women affected by uni-lateral breast cancer who underwent mastectomy and immediate two-stage reconstruction between 2002 and 2007. We considered three groups according to the contra-lateral reshaping technique: mastopexy or breast reduction with inferior dermoglandular flap (group 1); mastopexy or breast reduction without inferior dermoglandular flap (group 2); no contra-lateral reshaping (group 3). We assessed qualitative mammographic variations and breast density in the three groups. Statistically significant differences have been found when comparing reshaped groups with non reshaped groups regarding parenchymal distortions, skin thickening and stromal edema, but these differences did not affect cancer surveillance. The surveillance mammography diagnostic accuracy in contra-lateral cancer detection was not significantly different between the three groups (p = 0.56), such as the need for MRI for equivocal findings at mammographic contra-lateral breast (p = 0.77) and the need for core-biopsies to confirm mammographic suspect of contra-lateral breast cancer (p = 0.90). This study confirms previous reports regarding the safety of mastopexies and breast reductions when performed in the setting of contra-lateral breast reshaping after breast reconstruction. Mammographic accuracy, sensitivity and specificity are not affected by the glandular re-arrangement. These results provide a further validation of the safety of current reconstructive paradigms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Association of Catechol-O-methyltransferase polymorphism Val158Met and mammographic density: A meta-analysis.

    Science.gov (United States)

    Kallionpää, Roope A; Uusitalo, Elina; Peltonen, Juha

    2017-08-15

    The Val158Met polymorphism in catechol-O-methyltransferase (COMT) enzyme reduces the methylation of catechol estrogens, which may affect mammographic density. High mammographic density is a known risk factor of breast cancer. Our aim was to perform meta-analysis of the effect of COMT Val158Met polymorphism on mammographic density. Original studies reporting data on mammographic density, stratified by the presence of COMT Val158Met polymorphism, were identified and combined using genetic models Met/Val vs. Val/Val, Met/Met vs. Val/Val, Val/Met+Met/Met vs. Val/Val (dominant model) and Met/Met vs. Val/Met+Val/Val (recessive model). Subgroup analyses by breast cancer status, menopausal status and use of hormone replacement therapy (HRT) were also performed. Eight studies were included in the meta-analysis. The overall effect in percent mammographic density was -1.41 (CI -2.86 to 0.05; P=0.06) in the recessive model. Exclusion of breast cancer patients increased the effect size to -1.93 (CI -3.49 to -0.37; P=0.02). The results suggested opposite effect of COMT Val158Met for postmenopausal users of HRT versus premenopausal women or postmenopausal non-users of HRT. COMT Val158Met polymorphism may be associated with mammographic density at least in healthy women. Menopausal status and HRT should be taken into account in future studies to avoid masking of the underlying effects. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Computerized Prediction of Risk for Developing Breast Cancer Based on Bilateral Mammographic Breast Tissue Asymmetry

    Science.gov (United States)

    Wang, Xingwei; Lederman, Dror; Tan, Jun; Wang, Xiao Hui; Zheng, Bin

    2011-01-01

    This study developed and assessed a computerized scheme to detect breast abnormalities and predict the risk of developing cancer based on bilateral mammographic tissue asymmetry. A digital mammography database of 100 randomly selected negative cases and 100 positive cases for having high-risk of developing breast cancer was established. Each case includes four images of craniocaudal (CC) and mediolateral oblique (MLO) views of the left and right breast. To detect bilateral mammographic tissue asymmetry, a pool of 20 computed features was assembled. A genetic algorithm was applied to select optimal features and build an artificial neural network based classifier to predict the likelihood of a test case being positive. The leave-one-case-out validation method was used to evaluate the classifier performance. Several approaches were investigated to improve the classification performance including extracting asymmetrical tissue features from either selected regions of interests or the entire segmented breast area depicted on bilateral images in one view, and the fusion of classification results from two views. The results showed that (1) using the features computed from the entire breast area, the classifier yielded the higher performance than using ROIs, and (2) using a weighted average fusion method, the classifier achieved the highest performance with the area under ROC curve of 0.781±0.023. At 90% specificity, the scheme detected 58.3% of high-risk cases in which cancers developed and verified 6 to 18 months later. The study demonstrated the feasibility of applying a computerized scheme to detect cases with high risk of developing breast cancer based on computer-detected bilateral mammographic tissue asymmetry. PMID:21482168

  1. Visibility of simulated microcalcifications--a hardcopy-based comparison of three mammographic systems.

    Science.gov (United States)

    Lai, Chao-Jen; Shaw, Chris C; Whitman, Gary J; Johnston, Dennis A; Yang, Wei T; Selinko, Veronica; Arribas, Elsa; Dogan, Basak; Kappadath, S Cheenu

    2005-01-01

    Full-field digital mammography systems are currently available for clinical use. These digital systems offer improved image quality, flexible image processing, display, storage, retrieval, and transmission. These systems employ a variety of different x-ray detectors based on storage phosphors (in computed radiography), charge-coupled devices (CCDs), or amorphous silicon flat panels (FPs). The objective of this study is to compare three different types of mammographic detectors: screenfilm (SF) combination, a CsI-based FP detector, a CCD and x-ray phosphor-based detector for their performance in detection of simulated microcalcifications. Microcalcifications (MCs) were simulated with calcium carbonate grains of various sizes (90-355 microm). They were overlapped with a slab of simulated 50% adipose/50% glandular breast tissue for a uniform background or an anthropomorphic breast phantom for a tissue structure background. Images of the phantoms, acquired with and without magnification, were reviewed by mammographers, physicists, and students. A five-point confidence level rating was given for each MC reviewed. Average ratings from the mammographers were used to compare the performances of the three imaging systems, various MC size groups, and two magnification modes. The results indicate that with uniform background and no magnification, the FP system performed the best while the SF system did slightly better than the CCD system. With magnification added, all detection tasks were improved except for the smallest and largest one or two size groups. In particular, detection in the SF and CCD images was significantly improved over that in the FP images. With tissue structure background and no magnification, the FP system was outperformed by the SF and the CCD systems. With magnification added, the performance of the FP and the CCD systems was improved significantly. With this improvement, the SF and FP systems were outperformed by the CCD system.

  2. Mammographic CAD: Correlation of regions in ipsilateral views - a pilot study

    Directory of Open Access Journals (Sweden)

    J Padayachee

    2009-08-01

    Full Text Available Background: Radiologists analyse both standard mammographic views of a breast to confirm the presence of abnormalities and reduce false-positives. However, at present no computer-aided diagnosis system uses ipsilateral mammograms to confirm the presence of suspicious features. Aim: The aim of this study was to develop image-processing algorithms that can be used to match a suspicious feature from one mammographic view to the same feature in another mammographic view of the same breast. This algorithm can be incorporated into a computer-aided diagnosis package to confirm the presence of suspicious features. Method: The algorithms were applied to 68 matched pairs of cranio-caudal and mediolateral-oblique mammograms. The results of this pilot study take the form of maps of similarity. A novel method of evaluating the similarity maps is presented, using the area under the receiver operating characteristic curve (AUC and the contrast (C between the area of the matched region and the background of the similarity map. Results and Conclusions: The first matching algorithm (using texture measures extracted from a grey-level co-occurrence matrix (GLCM and a Euclidean distance similarity metric achieved an average AUC=0.80±0.17 with an average C=0.46±0.26. The second algorithm (using GLCMs and a mutual information similarity metric achieved an average AUC=0.77±0.25 with an average C=0.50±0.42. The latter algorithm also performed remarkably well with the matching of malignant masses and achieved an average AUC=0.96±0.05 with an average C=0.90±0.21.

  3. Mammographic density and breast cancer risk by family history in women of white and Asian ancestry.

    Science.gov (United States)

    Maskarinec, Gertraud; Nakamura, Kaylae L; Woolcott, Christy G; Conroy, Shannon M; Byrne, Celia; Nagata, Chisato; Ursin, Giske; Vachon, Celine M

    2015-04-01

    Mammographic density, i.e., the radiographic appearance of the breast, is a strong predictor of breast cancer risk. To determine whether the association of breast density with breast cancer is modified by a first-degree family history of breast cancer (FHBC) in women of white and Asian ancestry, we analyzed data from four case-control studies conducted in the USA and Japan. The study population included 1,699 breast cancer cases and 2,422 controls, of whom 45% reported white (N = 1,849) and 40% Asian (N = 1,633) ancestry. To standardize mammographic density assessment, a single observer re-read all mammograms using one type of interactive thresholding software. Logistic regression was applied to estimate odds ratios (OR) while adjusting for confounders. Overall, 496 (12%) of participants reported a FHBC, which was significantly associated with breast cancer risk in the adjusted model (OR 1.51; 95% CI 1.23-1.84). There was a statistically significant interaction on a multiplicative scale between FHBC and continuous percent density (per 10 % density: p = 0.03). The OR per 10% increase in percent density was higher among women with a FHBC (OR 1.30; 95% CI 1.13-1.49) than among those without a FHBC (OR 1.14; 1.09-1.20). This pattern was apparent in whites and Asians. The respective ORs were 1.45 (95% CI 1.17-1.80) versus 1.22 (95% CI 1.14-1.32) in whites, whereas the values in Asians were only 1.24 (95% CI 0.97-1.58) versus 1.09 (95% CI 1.00-1.19). These findings support the hypothesis that women with a FHBC appear to have a higher risk of breast cancer associated with percent mammographic density than women without a FHBC.

  4. Tubular carcinoma of the breast: Mammographic, sonographic, clinical and pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil [Ege University Hospital, Department of Radiology, Bornova, Izmir 35100 (Turkey)]. E-mail: isilbilgen@hotmail.com; Oktay, Aysenur [Ege University Hospital, Department of Radiology, Bornova, Izmir 35100 (Turkey)

    2007-01-15

    Purpose: To determine and quantitate the radiological characteristics of tubular carcinoma of the breast, to report clinical and pathologic findings and to define findings at follow-up. Materials and methods: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 32 histopathologically proven pure tubular carcinoma of the breast. Analysis included history; findings at physical examination, mammography, and sonography (US) at the time of diagnosis and in postoperative follow-up and histopathological results. Results: Fifty-nine percent of the patients (n = 19) presented with a palpable mass. The mammographic findings were a mass in 23 (72%), a mass with microcalcifications in 2 (6%), asymmetric focal density in 1 (3%), architectural distortion in 1 (3%) and negative in 5 (16%) of the 32 patients. Most (96%) masses had spiculated margins. US depicted 30 masses in 29 patients, all of which were hypoechoic, mostly (n = 27, 90%) with posterior acoustic shadowing. The cancer was clinically occult in 41% (n = 13), mammographically occult in 16% (n = 5), and sonographically occult in 6% (n = 2) of the patients. Histologically, the tumor was multifocal in 3% (n = 1) of the patients. Four (13%) patients developed contralateral breast carcinoma at follow-up. Conclusion: Tubular carcinoma has a variety of presentations, but it is mostly seen on mammography as a small spiculated mass, and on sonography as an irregular mass with posterior acoustic shadowing. Although tubular carcinoma is known as a well-differentiated tumor with excellent prognosis, the mammographic follow-up of the contralateral breast is important.

  5. Mammographic findings of infiltrating ductal carcinoma: correlation with histologic grading and age

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kue Hee; Lee, Ki Yeol; Kang, Eun Young [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    To investigate the correlation between mammographic findings of infiltrating ductal carcinoma (IDC), patient age and pathologic grading. The study included 103 cases of infiltrating ductal carcinoma in 102 women who during the preceding three years had undergone mammography and surgery. The mammograms were retrospectively reviewed by two radiologists. The mean age of the patients was 45.2 (range 26 - 74) years and the age distribution was seven in the 3rd decade, 37 in the 4th, 29 in the 5th, 24 in the 6th, and six in the 7th or above. Thirty-three lesions were histologic. Grade 1, 59 were Grade 2 and 11 were Grade 3. Ten (9.7%) of 103 cases, all of whom were younger than 50, were missed during mammographic diagnosis. On mammograms, primary findings of breast malignancy were found in 54 (74%) of 73 patients younger than 50 and 27 (90%) of 30 patients older than 51. Mass with or without microcalcification was found in 45 patients (62%) younger than 50 and in 26 (87%) older than 51. Nine (12%) and 3 (10%) in each age group showed secondary findings. There was no correlation between age distribution and histologic grading. Seventy-three percent of Grade 1 lesions and 78% of those of Grade 3 showed primary findings. Five lesions in each of Grade 1 and 2 were missed at mammographic interpretation, but this was not statistically significant (p=0.250). In all 11 Grade 3 cases, breast cancer were manifested as primary findings, but this was not statistically significant (p=0.203). The majority of IDC were detected by mammography, but 9.7% of IDC patients, all younger than 50, were misdiagnosed. Most IDC was manifested as primary findings, particularly in patients aged over 51. There were no differences in pathologic grading according to age distribution. All histologic Grade 3 lesions were detected by mammography.

  6. Ductal Carcinoma in situ Detected during Prospective MR Imaging Screening of a Woman with a BRCA2 Mutation: The First Case Report in Japan.

    Science.gov (United States)

    Tozaki, Mitsuhiro; Nakamura, Seigo; Kitagawa, Dai; Iwase, Takuji; Horii, Rie; Akiyama, Futoshi; Arai, Masami

    2017-07-10

    The present case is the first report in Japan in which a breast cancer was discovered as a result of prospective magnetic resonance imaging (MRI) screening study for BRCA1/2 mutation carriers who were free of breast or ovarian cancer. This case is significant and it verifies the importance of MRI screening in breast or ovarian cancer-free BRCA1/2 mutation carriers who do not exhibit positive mammographic or ultrasonographic findings.

  7. MR Imaging as an Additional Screening Modality for the Detection of Breast Cancer in Women Aged 50-75 Years with Extremely Dense Breasts: The DENSE Trial Study Design

    NARCIS (Netherlands)

    Emaus, M.J.; Bakker, M.F.; Peeters, P.H.M.; Loo, C.E.; Mann, R.M.; Jong, M.D.E.; Bisschops, R.H.; Veltman, J.; Duvivier, K.M.; Lobbes, M.B.; Pijnappel, R.M.; Karssemeijer, N.; Koning, H.J. de; Bosch, M.A. van den; Monninkhof, E.M.; Mali, W.P.; Veldhuis, W.B.; Gils, C.H. van

    2015-01-01

    Women with extremely dense breasts have an increased risk of breast cancer and lower mammographic tumor detectability. Nevertheless, in most countries, these women are currently screened with mammography only. Magnetic resonance (MR) imaging has the potential to improve breast cancer detection at an

  8. MR imaging as an additional screening modality for the detection of breast cancer in women aged 50-75 years with extremely dense breasts : The DENSE trial study design

    NARCIS (Netherlands)

    Emaus, Marleen J.; Bakker, Marije F.; Peeters, Petra H M; Loo, Claudette E.; Mann, Ritse M.; De Jong, Mathijn D F; Bisschops, Robertus H C; Veltman, Jeroen; Duvivier, Katya M.; Lobbes, Marc B I; Pijnappel, Ruud M.; Karssemeijer, Nico; De Koning, Harry J.; Van Den Bosch, Maurice A A J; Monninkhof, Evelyn M.; Mali, W.P.T.M.; Veldhuis, WB; Van Gils, Carla H.

    2015-01-01

    Women with extremely dense breasts have an increased risk of breast cancer and lower mammographic tumor detectability. Nevertheless, in most countries, these women are currently screened with mammography only. Magnetic resonance (MR) imaging has the potential to improve breast cancer detection at an

  9. A curved crystal spectrometer for energy calibration and spectral characterization of mammographic x-ray sources.

    Science.gov (United States)

    Hudson, L T; Deslattes, R D; Henins, A; Chantler, C T; Kessler, E G; Schweppe, J E

    1996-10-01

    Clinical efficacy of diagnostic radiology for mammographic examinations is critically dependent on source characteristics, detection efficiency, image resolution and applied high voltage. In this report we focus on means for evaluation of source-dependent issues including noninvasive determination of the applied high voltage, and characterization of intrinsic spectral distributions which in turn reflect the effects of added filtration and target and window contamination. It is shown that a particular form of x-ray curved crystal spectrometry with electronic imaging can serve to determine all relevant parameters within the confines of a standard clinical exposure.

  10. Intraductal papilloma in a reconstructed breast: mammographic and sonographic appearance with pathologic correlation.

    Science.gov (United States)

    Mesurolle, Benoît; Kethani, Karim; El-Khoury, Mona; Meterissian, Sarkis

    2006-10-01

    The usual abnormal mammographic and sonographic findings encountered after reconstruction with autologous myocutaneous flaps for breast carcinoma, include fat necrosis, calcifications, lymphedema, and locally recurrent carcinoma. This case report describes a case of an intraductal papilloma occurring in a reconstructed breast in a 48-year-old woman who underwent a left-sided mastectomy for recurrent ductal carcinoma in situ followed by immediate reconstruction with a supercharged transverse rectus abdominal muscle flap. The role of imaging in the detection and management of occult or clinically palpable abnormalities in reconstructed breasts is discussed.

  11. Comparison of Mammographic Changes Across Three Different Fractionation Schedules for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Sibo [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, Rutgers, New Jersey (United States); Paster, Lina F. [Department of Radiology, Rutgers Robert Wood Johnson Medical School, Rutgers, New Jersey (United States); Kim, Sinae [Biometrics Division, Rutgers Cancer Institute of New Jersey, and Department of Biostatistics, Rutgers School of Public Health, Rutgers, New Jersey (United States); Kirstein, Laurie [Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, Rutgers, New Jersey (United States); Haffty, Bruce G.; Ferro, Adam [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, Rutgers, New Jersey (United States); Amorosa, Judith [Department of Radiology, Rutgers Robert Wood Johnson Medical School, Rutgers, New Jersey (United States); Goyal, Sharad, E-mail: goyalsh@rutgers.edu [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, Rutgers, New Jersey (United States)

    2016-06-01

    Purpose: As the use of hypofractionated breast radiation therapy (RT) increases, so will the need for long-term data on post-RT mammographic changes. The purpose of the present study was to longitudinally compare the incidence of common mammographic sequelae seen after breast conserving surgery and RT in patients treated with accelerated partial breast irradiation (APBI), hypofractionated whole breast irradiation (HWBI), and conventionally fractionated whole breast irradiation (WBI). Methods and Materials: Patients treated with either APBI or HWBI after breast conserving therapy and with ≥3 mammograms of the treated breast were identified. They were matched 1:1 by age ±5 years to patients treated with WBI. The mammograms were evaluated for common post-RT breast findings by a mammographer who was unaware of the treatment. The outcomes were analyzed using a cumulative logistic regression model; P<.05 indicated statistically significance. Results: Of 89 patients treated with RT from 2006 to 2011, 29 had received APBI, 30 had received HWBI, and 30 had received WBI. Their median age was 60 years (range 33-83). A total of 605 mammograms were evaluated, with a median follow-up of 48 months. The treatment technique did not affect the severity of architectural distortion when the groups were evaluated longitudinally. The likelihood of finding skin thickening decreased with increasing follow-up duration (odds ratio 0.6; P<.001) adjusted for fractionation schemes. No differences were seen with respect to changes in skin thickening, fluid collections, or calcifications among the treatment groups, after adjustment for the follow-up time. The clinical characteristics, including age, race, T stage, and chemotherapy use, were not linked to the likelihood of finding several mammographic phenomena over time. Conclusions: Although specific post-treatment imaging findings evolved over time, RT fractionation did not alter the relative incidence or severity of architectural

  12. Mammographic characterization of breast cancer associated with axillary lymph node metastasis

    Directory of Open Access Journals (Sweden)

    Patcharee Hongsmatip

    2012-08-01

    Full Text Available Objective: To describe mammographic characterization of breast cancer associated with axillary lymph node metastasis at King Chulalongkorn Memorial Hospital. Methods: The data were collected retrospectively from female patients with breast cancers who underwent breast surgery and axillary node dissection at King Chulalongkorn Memorial Hospital during January 1, 2004 and July 31, 2011. One hundred and ninety histopathologically proven cases of invasive ductal carcinoma (IDC were randomly recruited; consisted of ninety-five patients with axillary lymph node metastasis and the rest of patients without axillary lymph node metastasis. All patients were reviewed their mammograms with additional ultrasounds and correlation between each mammographic characteristic and ipsilateral node involvement was analyzed, using P-value (P, Odd ratio (OR and 95% confidence interval (CI. Results: Mammographic characterization associated with the highest risk of axillary node metastasis was malignant pattern of ipsilateral axillary node (P < 0.001; OR = 44.53; 95% CI = 13.10 - 151.37 with following by intermediate pattern of ipsilateral axillary node (P = 0.002; OR=5.18; 95% CI = 1.79 - 15.04. The other characteristics in descending orders for associated with axillary node involvement are upper outer quadrant tumors associated risk of ipsilateral axillary node involvement (P = 0.02; OR = 3.36; 95% CI = 1.23 - 9.14 and size of breast cancer by additional ultrasound (P = 0.04; OR = 1.48; 95% CI = 1.02-2.17. There was no association between risk of axillary node involvement and the rest of mammographic findings, including microcalcification of the tumor, vascularity of the tumor and size of axillary node. Conclusions: The highest predictive risk of axillary node metastasis in breast cancer was malignant axillary node pattern. The moderate risk was intermediate axillary node pattern and the lower risks were the tumor located in upper outer quadrant and increased tumor

  13. A novel and automatic mammographic texture resemblance marker is an independent risk factor for breast cancer

    DEFF Research Database (Denmark)

    Nielsen, Mads; Karemore, Gopal; Loog, Marco

    2011-01-01

    Objective: We investigated whether breast cancer is predicted by a breast cancer risk mammographic texture resemblance (MTR) marker. Methods: A previously published case-control study included 495 women of which 245 were diagnosed with breast cancer. In baseline mammograms, 2-4 years prior......) surpasses others significantly except H. HRT-MTR (E) did not significantly identify future cancers or correlate with any other marker. Conclusions: Breast cancer risk MTR marker was independent of density scores and more predictive of risk. The hormone replacement treatment MTR marker did not identify...

  14. Observer study to evaluate the simulation of mammographic calcification clusters

    Science.gov (United States)

    Sousa, Maria A. Z.; Marcomini, Karem D.; Bakic, Predrag R.; Maidment, Andrew D. A.; Schiabel, Homero

    2016-03-01

    Numerous breast phantoms have been developed to be as realistic as possible to ensure the accuracy of image quality analysis, covering a greater range of applications. In this study, we simulated three different densities of the breast parenchyma using paraffin gel, acrylic plates and PVC films. Hydroxyapatite was used to simulate calcification clusters. From the images acquired with a GE Senographe DR 2000D mammography system, we selected 68 regions of interest (ROIs) with and 68 without a simulated calcification cluster. To validate the phantom simulation, we selected 136 ROIs from the University of South Florida's Digital Database for Screening Mammography (DDSM). Seven trained observers performed two observer experiments by using a high-resolution monitor Barco mod. E-3620. In the first experiment, the observers had to distinguish between real or phantom ROIs (with and without calcification). In the second one, the observers had to indicate the ROI with calcifications between a pair of ROIs. Results from our study show that the hydroxyapatite calcifications had poor contrast in the simulated breast parenchyma, thus observers had more difficulty in identifying the presence of calcification clusters in phantom images. Preliminary analysis of the power spectrum was conducted to investigate the radiographic density and the contrast thresholds for calcification detection. The values obtained for the power spectrum exponent (β) were comparable with those found in the literature.

  15. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

    2014-09-15

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  16. Stereoscopic representation of the breast from two mammographic view with external markers

    Science.gov (United States)

    Kallergi, Maria; Manohar, Anand

    2003-05-01

    A new breast imaging technique has been develoepd and tested for the stereoscopic representation of the breast. The method uses markers at specific locations on the breast surface and standard mammographic projections and was tested with an anthropomorphic phantom containing five mass-like objects at locations determined by a CT scan. The phantom was imaged with a GE Senographe 2000D digital system with and without the markers. The algorithm's modules included: 1) Breast area segmentation; 2) Pectoral muscle segmentation; 3) Registration and alignment of the mammographic projections based on selected reference points; 4) Breast volume estimation basdd on volume conservation principle during compression and shape definition using surface points; 5) 3D lesion(s) localization and representation. An interactive, ILD-based, graphical interface was also developed for the stereoscopic display of the breast. The reconstruction algorithm assumed that the breast shrinks and stretches uniformly when compression is applied and removed. The relative movement of the markers after compression allowed more accurate estimation of the shrinking and stretching of the surface offering a relatively simple and practical way to improve volume estimation and surface reconstruction. Such stereoscopic representation of the breast and associated findings may improve radiological interpretation and physical examinations for breast cancer diagnosis.

  17. Differentiation between Phyllodes Tumors and Fibroadenomas Based on Mammographic Sonographic and MRI Features

    Science.gov (United States)

    Duman, Lale; Gezer, Naciye S.; Balcı, Pınar; Altay, Canan; Başara, Işıl; Durak, Merih G.; Sevinç, Ali İ.

    2016-01-01

    Summary Background This study was performed to compare the mammographic, sonographic, and magnetic resonance imaging (MRI) characteristics of phyllodes tumors and fibroadenomas, which may resemble each other. Methods Preoperative mammograms, B-mode and Doppler sonograms, and dynamic breast MRIs of 72 patients with pathologically proven fibroadenomas and 70 patients with pathologically proven phyllodes tumor were evaluated in this retrospective study. Statistical significance was evaluated using chi-square and Fisher's exact tests. Correlations in lesion size among radiological methods were examined by Pearson's correlation analysis. Results The features that differed on mammogram were size, shape, and margin of the mass. Sonograms showed significant differences in size, shape, margin, echo pattern, and vascularization of the mass. Pearson's correlation analysis showed strong agreement among radiological methods in terms of assessment of size. Tumor size ≥ 3 cm, irregular shape, microlobulated margins, complex internal echo pattern, and hypervascularity were significant findings of phyllodes tumors. Internal cystic areas on MRI were frequently associated with phyllodes tumors. Conclusion Mammographic, sonographic, and MRI findings of fibroadenomas and phyllodes tumors could help radiologists to ascertain imaging-histological concordance and guide clinicians in their decision making regarding adequate follow-up or the necessity of biopsy. PMID:27239174

  18. Identification of a novel percent mammographic density locus at 12q24.

    Science.gov (United States)

    Stevens, Kristen N; Lindstrom, Sara; Scott, Christopher G; Thompson, Deborah; Sellers, Thomas A; Wang, Xianshu; Wang, Alice; Atkinson, Elizabeth; Rider, David N; Eckel-Passow, Jeanette E; Varghese, Jajini S; Audley, Tina; Brown, Judith; Leyland, Jean; Luben, Robert N; Warren, Ruth M L; Loos, Ruth J F; Wareham, Nicholas J; Li, Jingmei; Hall, Per; Liu, Jianjun; Eriksson, Louise; Czene, Kamila; Olson, Janet E; Pankratz, V Shane; Fredericksen, Zachary; Diasio, Robert B; Lee, Adam M; Heit, John A; DeAndrade, Mariza; Goode, Ellen L; Vierkant, Robert A; Cunningham, Julie M; Armasu, Sebastian M; Weinshilboum, Richard; Fridley, Brooke L; Batzler, Anthony; Ingle, James N; Boyd, Norman F; Paterson, Andrew D; Rommens, Johanna; Martin, Lisa J; Hopper, John L; Southey, Melissa C; Stone, Jennifer; Apicella, Carmel; Kraft, Peter; Hankinson, Susan E; Hazra, Aditi; Hunter, David J; Easton, Douglas F; Couch, Fergus J; Tamimi, Rulla M; Vachon, Celine M

    2012-07-15

    Percent mammographic density adjusted for age and body mass index (BMI) is one of the strongest risk factors for breast cancer and has a heritable component that remains largely unidentified. We performed a three-stage genome-wide association study (GWAS) of percent mammographic density to identify novel genetic loci associated with this trait. In stage 1, we combined three GWASs of percent density comprised of 1241 women from studies at the Mayo Clinic and identified the top 48 loci (99 single nucleotide polymorphisms). We attempted replication of these loci in 7018 women from seven additional studies (stage 2). The meta-analysis of stage 1 and 2 data identified a novel locus, rs1265507 on 12q24, associated with percent density, adjusting for age and BMI (P = 4.43 × 10(-8)). We refined the 12q24 locus with 459 additional variants (stage 3) in a combined analysis of all three stages (n = 10 377) and confirmed that rs1265507 has the strongest association in the 12q24 region (P = 1.03 × 10(-8)). Rs1265507 is located between the genes TBX5 and TBX3, which are members of the phylogenetically conserved T-box gene family and encode transcription factors involved in developmental regulation. Understanding the mechanism underlying this association will provide insight into the genetics of breast tissue composition.

  19. Computer-aided diagnosis of mammographic masses using geometric verification-based image retrieval

    Science.gov (United States)

    Li, Qingliang; Shi, Weili; Yang, Huamin; Zhang, Huimao; Li, Guoxin; Chen, Tao; Mori, Kensaku; Jiang, Zhengang

    2017-03-01

    Computer-Aided Diagnosis of masses in mammograms is an important indicator of breast cancer. The use of retrieval systems in breast examination is increasing gradually. In this respect, the method of exploiting the vocabulary tree framework and the inverted file in the mammographic masse retrieval have been proved high accuracy and excellent scalability. However it just considered the features in each image as a visual word and had ignored the spatial configurations of features. It greatly affect the retrieval performance. To overcome this drawback, we introduce the geometric verification method to retrieval in mammographic masses. First of all, we obtain corresponding match features based on the vocabulary tree framework and the inverted file. After that, we grasps the main point of local similarity characteristic of deformations in the local regions by constructing the circle regions of corresponding pairs. Meanwhile we segment the circle to express the geometric relationship of local matches in the area and generate the spatial encoding strictly. Finally we judge whether the matched features are correct or not, based on verifying the all spatial encoding are whether satisfied the geometric consistency. Experiments show the promising results of our approach.

  20. Determination of the tube voltage from clinic mammographic system using two types of detectors

    Energy Technology Data Exchange (ETDEWEB)

    Barreira, Jacqueline S.; Vivolo, Vitor, E-mail: jacsales@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2014-07-01

    The use of X rays for diagnostic radiology is very common and important to Medicine, including mammographic diagnosis focusing decreasing of the doses applied to the patients and preserving high quality of the diagnostic image. A quality control program of the irradiation systems it is necessary to control periodically the performance of the X-ray systems applied in that diagnosis in order to obtain the best results in that diagnosis. The verification of the beam characteristics is made by using standard dosimetric procedures which include the determination of the kilovoltage and the kerma rates for the different radiation qualities applied in the diagnosis. The Instruments Calibration Laboratory (LCI) of IPEN perform calibration in dosemeters used in radiation dosimetry (in diagnostic radiology) for many years and are improving their methodology to attend the actual demand of that equipment used in quality control of that X-radiation systems. The objective of that paper were the measurements of kVp and air kerma produced for one mammographic system of LCI, Model VMI - Graphmammo AF (Philips) using two different measurements systems from PTW (Diavolt) and Radcal (kVp meter) that procedure is just to determine the stability of that system that is used to perform diagnosis in mammography level. The results obtained with the two systems utilized shows good agreement. That measurement can be applied at a routine quality control program of that X-ray system. (author)

  1. A novel approach to computer-aided diagnosis of mammographic images

    Energy Technology Data Exchange (ETDEWEB)

    Sari-Sarraf, H.; Gleason, S.S. [Oak Ridge National Lab., TN (United States); Hudson, K.T.; Hubner, K.F. [Univ. of Tennessee Medical Center, Knoxville, TN (United States)

    1996-08-01

    This is a work-in-progress report of a research endeavor that deals with the design and development of a novel approach to computer-aided diagnosis (CAD) of mammographic images. With the initial emphasis being on the analysis of microcalcifications, the proposed approach defines a synergistic paradigm that utilizes new methodologies together with previously developed techniques. The new paradigm is intended to promote a higher degree of accuracy in CAD of mammograms with an increased overall throughput. The process of accomplishing these goals is initiated by the fractal encoding of the input image, which gives rise to the generation of focus-of-attention regions (FARs), that is, regions that contain anomalies. The primary thrust of this work is to demonstrate that by considering FARs, rather than the entire input image, the performances of the ensuing processes (i.e., segmentation, feature extraction, and classification) are enhanced in terms of accuracy and speed. After presenting the proposed approach to CAD of mammographic images, the paper describes the generation of FARs. Furthermore, an experimental study is included that demonstrates the impact of this front-end procedure on the process of microcalcification segmentation. Specifically, the experimentation reveals a dramatic decrease (increase) in the amount of input data (throughput), as well as a reduction in the number of false detections.

  2. The significance of circumscribed malignant mammographic masses in the surveillance of BRCA 1/2 gene mutation carriers

    Energy Technology Data Exchange (ETDEWEB)

    Kaas, R. [Department of Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek ziekenhuis Plesmanlaan 121, 1066 CX, Amsterdam (Netherlands); Kroger, R.; Besnard, A.P.E.; Koops, W.; Pameijer, F.A.; Prevoo, W.; Loo, C.E.; Muller, S.H. [Department of Radiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek ziekenhuis Plesmanlaan 121, 1066 CX, Amsterdam (Netherlands); Hendriks, J.H.C.L. [Dutch Reference Center for Breast Cancer Screening, Nijmegen (Netherlands)

    2004-09-01

    Breast cancers in gene mutation carriers may escape mammographic detection because of rapid growth and tumor expansion. Therefore, they may mimic benign lesions on the mammogram. Twenty-nine BRCA 1/2 mutation carriers under surveillance developed 31 breast cancers between 1994 and 2001 at a mean age of 44.2 years. Controls were 63 women with 67 breast cancers in the same period at a mean age of 53.8 years, also under surveillance because of a life time risk of at least 15%. In 26% of the carriers vs. 48% of the controls, mammography was the method that first suspected a malignancy. Seven radiologists performed a retrospective review of the original mammograms to establish technical assessment, with special attention for circumscribed lesions and estimated probability of malignancy. In the mutation carriers seven (23%) circumscribed non-calcified mammographic masses were found and three in the controls (4.5%) P=0.01. These masses were proven to be malignant. In both groups around 70% of these fast-growing circumscribed lesions were detected by the patients. The masses were situated in breasts with a good interpretable breast pattern. BRCA 1/2 mutation carriers had a significantly higher percentage of circumscribed non-calcified mammographic masses that proved to be malignant. These mammographic lesions in women at high risk should be described as at least Birads 0 and worked-up with ultrasound and needle biopsy. (orig.)

  3. Mammographic features of calcifications in DCIS: correlation with oestrogen receptor and human epidermal growth factor receptor 2 status

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Min Sun; Moon, Woo Kyung; Chang, Jung Min; Cho, Nariya [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, So Yeon; Won, Jae-Kyung; Jeon, Yoon-Kyung; Park, In Ae [Seoul National University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Moon, Hyeong-Gon; Han, Wonshik [Seoul National University College of Medicine, Department of Surgery, Seoul (Korea, Republic of)

    2013-08-15

    This study investigated the correlation of oestrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) status with the probability of malignancy (POM) of mammographic calcifications in ductal carcinoma in situ (DCIS). A total of 101 women (age range, 27-83 years) with pure DCIS that presented as mammographic calcifications were included. Three radiologists independently reviewed mammograms according to the BI-RADS lexicon and provided 100-point POM scores and a BI-RADS category. ER, HER2 and breast cancer subtypes were determined using immunohistochemistry (IHC) and fluorescence in situ hybridisation. Pairwise correlations between POM and IHC biomarker scores were calculated, and mammographic features were compared between breast cancer subtypes. HER2 level positively correlated with the POM score (P < 0.0001) and BI-RADS category (P < 0.0001), and ER level inversely correlated with the POM score (P < 0.013) and BI-RADS category (P < 0.010). Fine linear branching (P = 0.004) and segmental (P = 0.014) calcifications were significantly associated with HER2-positive cancers, and clustered calcifications were more frequently observed in ER-positive cancers (P = 0.014). HER2 status in DCIS correlated positively with the POM of mammographic calcifications, as determined by radiologists on the basis of the BI-RADS lexicon. (orig.)

  4. A novel approach to mammographic breast compression: Improved standardization and reduced discomfort by controlling pressure instead of force

    NARCIS (Netherlands)

    de Groot, J. E.; Broeders, M. J. M.; Branderhorst, W.; den Heeten, G. J.; Grimbergen, C. A.

    2013-01-01

    In x-ray mammography, flattening of the breast improves image quality and reduces absorbed dose. Current mammographic compression guidelines are based on applying a standardized force to each breast. Because breast size is not taken into consideration, this approach leads to large variations in

  5. 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.

  6. Screen-detected mucinous breast carcinoma: Potential for delayed diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Dhillon, R. [Department of Diagnostic and Interventional Imaging, Royal Perth Hospital, Perth, WA (Australia)]. E-mail: ravinder.dhillon@health.wa.gov.au; Depree, P. [Department of Diagnostic and Interventional Imaging, Royal Perth Hospital, Perth, WA (Australia); Metcalf, C. [Department of Anatomical Pathology, Royal Perth Hospital, Perth, WA (Australia); Wylie, E. [Department of Diagnostic and Interventional Imaging, Royal Perth Hospital, Perth, WA (Australia)

    2006-05-15

    AIM: To describe the imaging features of 34 screen-detected mucinous carcinomas lesions. MATERIALS AND METHODS: The BreastScreen Western Australia (WA) database between January 1991 and December 2003 was searched. During this period, 214,507 women were screened and 2745 cases of invasive carcinoma and 45 cases of mucinous carcinoma were recorded. Case notes, radiology films and pathology reports of patients with mucinous carcinoma were reviewed. Thirty-four radiologically detected pure mucinous carcinomas are described. RESULTS: Of the pure mucinous carcinomas, the average age at diagnosis was 65 years (range 48-82 years), which was higher than that of other women with breast cancer (average age 60 years) screened at BreastScreen WA. Characteristic mammographic features of mucinous carcinoma are well-circumscribed masses with lobulated margins (26/34). Only 39% (11/28) of tumours were detected at ultrasound, as the smaller lesions less than 15 mm in diameter were often isoechoic with normal fat. Where histological grade was reported at excision, most (25/26) were low to medium-grade tumours (Bloom, Richardson and Elston grade I and II). A significant number of lesions (13/34) were evident on the previous screening examination where they were misinterpreted as benign lesions. However, none of these cases had positive axillary lymph nodes at final diagnosis. CONCLUSION: Although mammographically benign appearances of mucinous carcinoma caused a delay in diagnosis in 38% of the present cases, mucinous breast carcinomas have a favourable prognosis, as they are often low-grade tumours and rarely metastasize. Delay in diagnosis for these tumours in a screening programme may not lead to a significant adverse outcome for most women.

  7. Comparison of image quality between mammography dedicated monitor and UHD 4K monitor, using standard mammographic phantom: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Young; Cha, Soon Joo; Hong, Sung Hwan; Kim, Su Young; Kim, Yong Hoon; Kim, You Sung; Kim, Jeong A [Dept. of Radiology, Inje Unveristy Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2017-03-15

    Using standard mammographic phantom images, we compared the image quality obtained between a mammography dedicated 5 megapixel monitor (5M) and a UHD 4K (4K) monitor with digital imaging and communications in medicine display, to investigate the possibility of clinical application of 4K monitors. Three different exposures (autoexposure, overexposure and underexposure) images of mammographic phantom were obtained, and six radiologists independently evaluated the images in 5M and 4K without image modulation, by scoring of fibers, groups of specks and masses within the phantom image. The mean score of each object on both monitors was independently analyzed, using t-test and interobserver reliability by intraclass correlation coefficient (ICC) of SPSS. The overall mean scores of fiber, group of specks, and mass in 5M were 4.25, 3.92, and 3.28 respectively, and scores obtained in 4K monitor were 3.81, 3.58, and 3.14, respectively. No statistical difference was seen in scores of fiber and mass between the two monitors at all exposure conditions, but the score of group of specks in 4K was statistically lower in the overall (p = 0.0492) and in underexposure conditions (p = 0.012). The ICC for interobserver reliability was excellent (0.874). Our study suggests that since the mammographic phantom images are appropriate with no significant difference in image quality observed between the two monitors, the 4K monitor could be used for clinical studies. Since this is a small preliminary study using phantom images, the result may differ in actual mammographic images, and subsequent investigation with clinical mammographic images is required.

  8. Comparison of Unmonochromatized Synchrotron Radiation and Conventional X-rays in the Imaging of Mammographic Phantom and Human Breast Specimens: A Preliminary Result

    Science.gov (United States)

    Jung, Haijo; Kim, Eun-Kyung; Hong, Jin-O; Je, Jung Ho; Hwu, Yeukuang; Tsai, Wen-Li; Magaritondo, Giorgio; Yoo, Hyung-Sik

    2005-01-01

    A simple imaging setup based on the principle of coherence-based contrast X-ray imaging with unmonochromatized synchrotron radiation was used for studying mammographic phantom and human breast specimens. The use of unmonochromatized synchrotron radiation simplifies the instrumentation, decreases the cost and makes the procedure simpler and potentially more suitable for clinical applications. The imaging systems consisted of changeable silicon wafer attenuators, a tungsten slit system, a CdWO4 scintillator screen, a CCD (Charge Coupled Device) camera coupled to optical magnification lenses, and a personal computer. In preliminary studies, a spatial resolution test pattern and glass capillary filled with air bubbles were imaged to evaluate the resOolution characteristics and coherence-based contrast enhancement. Both the spatial resolution and image quality of the proposed system were compared with those of a conventional mammography system in order to establish the characteristic advantages of this approach. The images obtained with the proposed system showed a resolution of at least 25 µm on the test pattern with much better contrast, while the images of the capillary filled with air bubbles revealed coherence-based edge enhancement. This result shows that the coherence-based contrast imaging system, which emphasizes the refraction effect from the edge of materials of different refractive indexes, is applicable to imaging studies in fundamental medicine and biology, although further research works will be required before it can be used for clinical applications. PMID:15744811

  9. Comparison of unmonochromatized synchrotron radiation and conventional X-rays in the imaging of mammographic phantom and human breast specimens: a preliminary result.

    Science.gov (United States)

    Jung, Haijo; Kim, Hee-Joung; Kim, Eun-Kyung; Hong, Jin-O; Je, Jung Ho; Hwu, Yeukuang; Tsai, Wen-Li; Magaritondo, Giorgio; Yoo, Hyung-Sik

    2005-02-28

    A simple imaging setup based on the principle of coherence-based contrast X-ray imaging with unmonochromatized synchrotron radiation was used for studying mammographic phantom and human breast specimens. The use of unmonochromatized synchrotron radiation simplifies the instrumentation, decreases the cost and makes the procedure simpler and potentially more suitable for clinical applications. The imaging systems consisted of changeable silicon wafer attenuators, a tungsten slit system, a CdWO4 scintillator screen, a CCD (Charge Coupled Device) camera coupled to optical magnification lenses, and a personal computer. In preliminary studies, a spatial resolution test pattern and glass capillary filled with air bubbles were imaged to evaluate the resOolution characteristics and coherence-based contrast enhancement. Both the spatial resolution and image quality of the proposed system were compared with those of a conventional mammography system in order to establish the characteristic advantages of this approach. The images obtained with the proposed system showed a resolution of at least 25 microm on the test pattern with much better contrast, while the images of the capillary filled with air bubbles revealed coherence-based edge enhancement. This result shows that the coherence-based contrast imaging system, which emphasizes the refraction effect from the edge of materials of different refractive indexes, is applicable to imaging studies in fundamental medicine and biology, although further research works will be required before it can be used for clinical applications.

  10. Impact of type of full-field digital image on mammographic density assessment and breast cancer risk estimation: a case-control study.

    Science.gov (United States)

    Busana, Marta Cecilia; Eng, Amanda; Denholm, Rachel; Dowsett, Mitch; Vinnicombe, Sarah; Allen, Steve; Dos-Santos-Silva, Isabel

    2016-09-26

    Full-field digital mammography, which is gradually being introduced in most clinical and screening settings, produces two types of images: raw and processed. However, the extent to which mammographic density measurements, and their ability to predict breast cancer risk, vary according to type of image is not fully known. We compared the performance of the semi-automated Cumulus method on digital raw, "analogue-like" raw and processed images, and the performance of a recently developed method - Laboratory for Breast Radiodensity Assessment (LIBRA) - on digital raw and processed images, in a case-control study (414 patients (cases) and 684 controls) by evaluating the extent to which their measurements were associated with breast cancer risk factors, and by comparing their ability to predict breast cancer risk. Valid Cumulus and LIBRA measurements were obtained from all available images, but the resulting distributions differed according to the method and type of image used. Both Cumulus and LIBRA percent density were inversely associated with age, body mass index (BMI), parity and postmenopausal status, regardless of type of image used. Cumulus percent density was strongly associated with breast cancer risk, but with the magnitude of the association slightly stronger for processed (risk increase per one SD increase in percent density (95 % CI): 1.55 (1.29, 1.85)) and "analogue-like" raw (1.52 (1.28, 1.80)) than for raw (1.35 (1.14, 1.60)) images. LIBRA percent density produced weaker associations with risk, albeit stronger for processed (1.32 (1.08, 1.61)) than raw images (1.17 (0.99, 1.37)). The percent density values yielded by the various density assessment/type of image combinations had similar ability to discriminate between patients and controls (area under the receiving operating curve values for percent density, age, BMI, parity and menopausal status combined ranged from 0.61 and 0.64). The findings showed that Cumulus can be used to measure density on all

  11. Honesty through repeated interactions.

    Science.gov (United States)

    Rich, Patricia; Zollman, Kevin J S

    2016-04-21

    In the study of signaling, it is well known that the cost of deception is an essential element for stable honest signaling in nature. In this paper, we show how costs for deception can arise endogenously from repeated interactions between individuals. Utilizing the Sir Philip Sidney game as an illustrative case, we show that repeated interactions can sustain honesty with no observable signal costs, even when deception cannot be directly observed. We provide a number of potential experimental tests for this theory which distinguish it from the available alternatives. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Mammographic detection of breast arterial calcification as an independent predictor of coronary atherosclerotic disease in a single ethnic cohort of African American women

    NARCIS (Netherlands)

    Newallo, Domnique; Meinel, Felix G.; Schoepf, U. Joseph; Baumann, Stefan; De Cecco, Carlo N.; Leddy, Rebecca J.; Vliegenthart, Rozemarijn; Moellmann, Helge; Hamm, Christian W.; Morris, Pamela B.; Renker, Matthias

    Objective: Accumulating data on predominantly Caucasian women suggests an association between breast arterial calcification (BAC) and coronary artery disease (CAD). We sought to comprehensively examine the correlation between mammographic BAC and CAD endpoints detected by cardiac computed tomography

  13. Differential impact of conventional and low-dose oral hormone therapy, tibolone and raloxifene on mammographic breast density, assessed by an automated quantitative method.

    NARCIS (Netherlands)

    Eilertsen, A.L.; Karssemeijer, N.; Skaane, P.; Qvigstad, E.; Sandset, P.M.

    2008-01-01

    OBJECTIVE: To evaluate impact of different postmenopausal hormone therapy (HT) regimens and raloxifene on mammographic breast density. DESIGN: Open, randomised, comparative clinical trial. SETTING: Women were recruited through local newspapers and posters. They were examined at the Departments of

  14. Ultrasonography in Paget's disease of the breast: Comparison with Mammographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sang Hee; Chung, Soo Young; Lee, Kyung Won; Yang, Ik; Kim, Hong Dae; Shin, Sang June; Chung, Bong Wha; Shin, Jung Weon [Hallym University College of Medicine, Chuncheon (Korea, Republic of); Kim, Hak Hee; Kim, Hyeon Sook [Catholic University College of Medicine, Seoul (Korea, Republic of)

    2001-06-15

    To evaluate sonographic and mammographic findings in Paget's disease of the breast and to assess the usefulness of sonography. Sonographic (n=13) and mammographic findings (n=12) of thirteen patients (age ranged from 25 and 86 years with the mean age of 56) with pathologically proven Paget's disease of the breast were retrospectively reviewed and compared. Clinical manifestations of the subjects were reviewed using patients' medical records. On sonography, any change in subareolar, the presence of mass, the configuration of the mass if present, the changes of the main lactiferous ducts and the presence of calcification were analyzed. On mammography, the subareolar density, parenchymal distortion, the presence of mass and the presence and type of calcifications were analyzed. The frequent clinical manifestations of Paget's disease were nipple retraction (7/13), bloody nipple discharge (7/13), nipple eczema (4/13) and subareolar mass (4/13). On sonography, mass was the most common (12/13) feature, and the mass was seen as an irregular hypoechoic mass. The irregularly dilated major lactiferous duct associated with a mass (3/13), calcification (2/13), subareolar low echogenicity (1/13) and parenchymal distortion (1/13) were also observed. The most frequent mammographic findings was increased subareolar density(9/12), followed by parenchymal distortion (8/12), microcalcification (6/12) and the presence of mass (3/12). The types of microcalcification seen on mammography were branching (4/6) and granular (2/6) shapes. Mass in the breast was more frequent detected on sonography (12/13) than on mammography (4/12). The irregularly dilated major lactiferous duct (3/12) associated with the mass could not be demonstrated on mammography. On the other hand, breast sonography was inferior to mammography in the detection rate of microcalcification. In diagnosis of Paget's disease in the breast, sonography was more useful than mammography in the detection of

  15. The association of alcohol consumption with mammographic density in a multiethnic urban population.

    Science.gov (United States)

    Quandt, Zoe; Flom, Julie D; Tehranifar, Parisa; Reynolds, Diane; Terry, Mary Beth; McDonald, Jasmine A

    2015-01-01

    Alcohol consumption is associated with higher breast cancer risk. While studies suggest a modest association between alcohol intake and mammographic density, few studies have examined the association in racial/ethnic minority populations. We assessed dense breast area and total breast area from digitized film mammograms in an urban cohort of African American (42%), African Caribbean (22%), white (22%), and Hispanic Caribbean (9%) women (n = 189, ages 40-61). We examined the association between alcohol intake and mammographic density (percent density and dense area). We used linear regression to examine mean differences in mammographic density across alcohol intake categories. We considered confounding by age, body mass index (BMI), hormone contraceptive use, family history of breast cancer, menopausal status, smoking status, nativity, race/ethnicity, age at first birth, and parity. Fifty percent currently consumed alcohol. Women who consumed >7 servings/week of alcohol, but not those consuming ≤7 servings/week, had higher percent density compared to nondrinkers after full adjustments (servings/week >7 β = 8.2, 95% Confidence Interval (CI) 1.8, 14.6; ≤7 β = -0.5, 95% CI -3.7, 2.8). There was a positive association between high alcohol intake and dense area after full adjustments (servings/week >7 β = 5.8, 95% CI -2.7, 14.2; ≤7 β = -0.1, 95% CI -4.4, 4.2). We did not observe race/ethnicity modification of the association between alcohol intake and percent density. In women with a BMI of 7 servings/week of alcohol had a = 17% increase in percent density compared to nondrinkers (95% CI 5.4, 29.0) and there was no association in women with a BMI ≥ 25 kg/m(2) (BMI ≥ 25-30 kg/m(2) > 7 β = 5.1, 95% CI -8.5, 18.7 and BMI > 30 kg/m(2) > 7 β = 0.5, 95% CI -6.5, 7.5) after adjusting for age and BMI (continuous). In a racially/ethnically diverse cohort, women who consumed >7 servings/week of alcohol, especially those with

  16. Repeated Infections in Children

    Science.gov (United States)

    ... he/she have ear tubes?What are the dangers of my child’s repeated infections?Should my child ... affect you or your baby through your breast milk.December 2017December 2017familydoctor.org editorial staffHip Problems in ...

  17. Increased COX-2 expression in epithelial and stromal cells of high mammographic density tissues and in a xenograft model of mammographic density.

    Science.gov (United States)

    Chew, G L; Huo, C W; Huang, D; Hill, P; Cawson, J; Frazer, H; Hopper, J L; Haviv, I; Henderson, M A; Britt, K; Thompson, E W

    2015-08-01

    Mammographic density (MD) adjusted for age and body mass index is one of the strongest known risk factors for breast cancer. Given the high attributable risk of MD for breast cancer, chemoprevention with a safe and available agent that reduces MD and breast cancer risk would be beneficial. Cox-2 has been implicated in MD-related breast cancer risk, and was increased in stromal cells in high MD tissues in one study. Our study assessed differential Cox-2 expression in epithelial and stromal cells in paired samples of high and low MD human breast tissue, and in a validated xenograft biochamber model of MD. We also examined the effects of endocrine treatment upon Cox-2 expression in high and low MD tissues in the MD xenograft model. Paired high and low MD human breast tissue samples were immunostained for Cox-2, then assessed for differential expression and staining intensity in epithelial and stromal cells. High and low MD human breast tissues were separately maintained in biochambers in mice treated with Tamoxifen, oestrogen or placebo implants, then assessed for percentage Cox-2 staining in epithelial and stromal cells. Percentage Cox-2 staining was greater for both epithelial (p = 0.01) and stromal cells (p tissues. In high MD biochamber tissues, percentage Cox-2 staining was greater in stromal cells of oestrogen-treated versus placebo-treated tissues (p = 0.05).

  18. Screening mammography: the results for four years

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyo Kyeong; Park, Jeong Mi; Lee, Jun Hyung; Son, Byung Ho; Ahn, Sei Hyun [Asan Medical Center, College of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    2000-06-01

    To perform a medical audit of screening mammography for breast cancer and to determine the benefit of this procedure for the early detection of this condition. We reviewed the results of 43,329 instances of mammography in 36,802 women (18-86 (mean,46) years old) who underwent the procedure at our health promotion center between January 1995 and December 1998. After reviewing the mammographic reports, we selected ACR BI-RADS assessment categories 0, 4, 5, and then reviewed the follow-up studies and the pathologic results thus obtained. By comparison with the total number of patients diagnosed with breast cancer during the same period, false negative cases were confirmed, and from these data a medical audit was performed. The percentage of women undergoing mammographic examination has increased in recent years (from 64.5% in 1995 to 97.4 % in 1998), and cases of breast cancer among those aged 30 to 69 has tended to increase. A total of 1.879 cases were assessed as Bi-Rads categories 0, 4, 5, and of these, 155 were recommended for biopsy or surgery. A confirmatory pathologic diagnosis was obtained in 106 cases, and in 43 of these, breast cancer was pathologically proven. The recall rate was 5.1%, and the cancer detection rate was 1.2/1000 population. Positive predictive value 1 (PPV1) was found in 2.3% of cases, PPV2 in 27.7%, and PPV3 in 40.6%. The most common mammographic finding was microcalcification (40.5%), and a pathological finding of invasive ductal carcinoma was found in 66.7% of cases. Patients diagnosed with breast cancer totalled 47 (four cases were false negative); the estimated sensitivity was 91.5%, with a specificity of 95.0%. The percentage of minimal cancers found was 48.8, while that of axillary node-positive invasive cancers was 33.3. The total rate of axillary nodal metastasis was 22.0%, and the rate of stages 0 and I was 73.2%. When appropriate interpretation and follow-up monitoring of screening mammography is performed, the procedure is

  19. Mammographic density, parity and age at first birth, and risk of breast cancer: an analysis of four case-control studies.

    Science.gov (United States)

    Woolcott, Christy G; Koga, Karin; Conroy, Shannon M; Byrne, Celia; Nagata, Chisato; Ursin, Giske; Vachon, Celine M; Yaffe, Martin J; Pagano, Ian; Maskarinec, Gertraud

    2012-04-01

    Mammographic density is strongly and consistently associated with breast cancer risk. To determine if this association was modified by reproductive factors (parity and age at first birth), data were combined from four case-control studies conducted in the United States and Japan. To overcome the issue of variation in mammographic density assessment among the studies, a single observer re-read all the mammograms using one type of interactive thresholding software. Logistic regression was used to estimate odds ratios (OR) while adjusting for other known breast cancer risk factors. Included were 1,699 breast cancer cases and 2,422 controls, 74% of whom were postmenopausal. A positive association between mammographic density and breast cancer risk was evident in every group defined by parity and age at first birth (OR per doubling of percent mammographic density ranged between 1.20 and 1.39). Nonetheless, the association appeared to be stronger among nulliparous than parous women (OR per doubling of percent mammographic density = 1.39 vs. 1.24; P interaction = 0.054). However, when examined by study location, the effect modification by parity was apparent only in women from Hawaii and when examined by menopausal status, it was apparent in postmenopausal, but not premenopausal, women. Effect modification by parity was not significant in subgroups defined by body mass index or ethnicity. Adjusting for mammographic density did not attenuate the OR for the association between parity and breast cancer risk by more than 16.4%, suggesting that mammographic density explains only a small proportion of the reduction in breast cancer risk associated with parity. In conclusion, this study did not support the hypothesis that parity modifies the breast cancer risk attributed to mammographic density. Even though an effect modification was found in Hawaiian women, no such thing was found in women from the other three locations.

  20. Common Breast Cancer Susceptibility Variants in LSP1 and RAD51L1 Are Associated with Mammographic Density Measures that Predict Breast Cancer Risk

    Science.gov (United States)

    Vachon, Celine M.; Scott, Christopher G.; Fasching, Peter A.; Hall, Per; Tamimi, Rulla M.; Li, Jingmei; Stone, Jennifer; Apicella, Carmel; Odefrey, Fabrice; Gierach, Gretchen L.; Jud, Sebastian M.; Heusinger, Katharina; Beckmann, Matthias W.; Pollan, Marina; Fernández-Navarro, Pablo; González-Neira, Anna; Benítez, Javier; van Gils, Carla H.; Lokate, Mariëtte; Onland-Moret, N. Charlotte; Peeters, Petra H.M.; Brown, Judith; Leyland, Jean; Varghese, Jajini S.; Easton, Douglas F.; Thompson, Deborah J.; Luben, Robert N.; Warren, Ruth ML; Wareham, Nicholas J.; Loos, Ruth JF; Khaw, Kay-Tee; Ursin, Giske; Lee, Eunjung; Gayther, Simon A.; Ramus, Susan J.; Eeles, Rosalind A.; Leach, Martin O.; Kwan-Lim, Gek; Couch, Fergus J.; Giles, Graham G.; Baglietto, Laura; Krishnan, Kavitha; Southey, Melissa C.; Le Marchand, Loic; Kolonel, Laurence N.; Woolcott, Christy; Maskarinec, Gertraud; Haiman, Christopher A; Walker, Kate; Johnson, Nichola; McCormack, Valerie A.; Biong, Margarethe; Alnæs, Grethe I.G.; Gram, Inger Torhild; Kristensen, Vessela N.; Børresen-Dale, Anne-Lise; Lindström, Sara; Hankinson, Susan E.; Hunter, David J.; Andrulis, Irene L.; Knight, Julia A.; Boyd, Norman F.; Figueroa, Jonine D.; Lissowska, Jolanta; Wesolowska, Ewa; Peplonska, Beata; Bukowska, Agnieszka; Reszka, Edyta; Liu, JianJun; Eriksson, Louise; Czene, Kamila; Audley, Tina; Wu, Anna H.; Pankratz, V. Shane; Hopper, John L.; dos-Santos-Silva, Isabel

    2013-01-01

    Background Mammographic density adjusted for age and body mass index (BMI) is a heritable marker of breast cancer susceptibility. Little is known about the biological mechanisms underlying the association between mammographic density and breast cancer risk. We examined whether common low-penetrance breast cancer susceptibility variants contribute to inter-individual differences in mammographic density measures. Methods We established an international consortium (DENSNP) of 19 studies from 10 countries, comprising 16,895 Caucasian women, to conduct a pooled cross-sectional analysis of common breast cancer susceptibility variants in 14 independent loci and mammographic density measures. Dense and non-dense areas, and percent density, were measured using interactive-thresholding techniques. Mixed linear models were used to assess the association between genetic variants and the square roots of mammographic density measures adjusted for study, age, case status, body mass index (BMI) and menopausal status. Results Consistent with their breast cancer associations, the C-allele of rs3817198 in LSP1 was positively associated with both adjusted dense area (p=0.00005) and adjusted percent density (p=0.001) whereas the A-allele of rs10483813 in RAD51L1 was inversely associated with adjusted percent density (p=0.003), but not with adjusted dense area (p=0.07). Conclusion We identified two common breast cancer susceptibility variants associated with mammographic measures of radio-dense tissue in the breast gland. Impact We examined the association of 14 established breast cancer susceptibility loci with mammographic density phenotypes within a large genetic consortium and identified two breast cancer susceptibility variants, LSP1-rs3817198 and RAD51L1-rs10483813, associated with mammographic measures and in the same direction as the breast cancer association. PMID:22454379

  1. Mammographic texture resemblance generalizes as an independent risk factor for breast cancer

    DEFF Research Database (Denmark)

    Nielsen, Mads; Vachon, Celine M.; Scott, Christopher G.

    2014-01-01

    INTRODUCTION:Breast density has been established as a major risk factor for breast cancer. We have previously demonstrated that mammographic texture resemblance (MTR), recognizing the local texture patterns of the mammogram, is also a risk factor for breast cancer, independent of percent breast....... The patterns were recognized in the same study using cross-validation to form resemblance scores associated with breast cancer. Texture patterns from S1 were examined in an independent nested case-control study within the Mayo Mammography Health Study cohort (S2) of 226 cases and 442 matched controls...... and continuously for association with breast cancer using odds ratios (OR) and adjusting for known risk factors including age, body mass index (BMI), and hormone usage.RESULTS:The mean ages of S1 and S2 were 58.0+/-5.7years and 55.2+/-10.5years, respectively. The MTR scores on S1 showed significant capability...

  2. Combining different views of mammographic texture resemblance (MTR) marker of breast cancer risk

    DEFF Research Database (Denmark)

    Sun, S.; Karemore, Gopal; Chernoff, Konstantin

    PURPOSE Mammographic density is a well established breast cancer risk factor. Texture analysis in terms of the Mammographoc Texture Resemblance (MTR) marker has recently shown to add to risk segregation. Hitherto only single view MTR analysis has been performed. Standard mammography examinations...... the subsequent 4 years whereas 245 cases had a diagnosis 2-4 years post mammography. We employed the MTR supervised texture learning framework to perform risk evaluation from a single mammography view. In the framework 20,000 pixels were sampled and classified by a kNN pixel classifier. A feature selection step...... is included to reduce input space dimensionality. Weak local decision scores for pixels were fused into an overall risk score. The dataset was randomly separated into a training data set (60%) and a test data set (40%). Risk scores for combinations of views were obtained by linear and quadratic discriminant...

  3. Development of a 2D silicon strip detector system for mammographic imaging using particle physics technology

    CERN Document Server

    Royle, G J; Speller, R D; Hall, G; Iles, G; Raymond, M; Corrin, E; Stelt, P F; Manthos, N; Triantis, F A

    2002-01-01

    2D silicon strip sensors using particle physics readout technology have been evaluated as mammographic detectors. Two different versions of the APV series of front-end electronics were used that provided different noise levels. The sensors were evaluated using a typical mammography X-ray spectrum. The spatial resolution was evaluated using line pair test patterns and the modulation transfer function (MTF) was measured using the Edge Response Function. Low contrast performance was measured using the TOR(MAX) test object. Limiting spatial resolution of 52 mu m was obtained and an MTF value of 0.1 at 16 lp/mm. The low contrast performance was estimated from 250, 500 mu m and 6 mm diameter objects and was found to be 11.5%, 7% and better than 3.8%, respectively.

  4. Feature and Contrast Enhancement of Mammographic Image Based on Multiscale Analysis and Morphology

    Directory of Open Access Journals (Sweden)

    Shibin Wu

    2013-01-01

    Full Text Available A new algorithm for feature and contrast enhancement of mammographic images is proposed in this paper. The approach bases on multiscale transform and mathematical morphology. First of all, the Laplacian Gaussian pyramid operator is applied to transform the mammography into different scale subband images. In addition, the detail or high frequency subimages are equalized by contrast limited adaptive histogram equalization (CLAHE and low-pass subimages are processed by mathematical morphology. Finally, the enhanced image of feature and contrast is reconstructed from the Laplacian Gaussian pyramid coefficients modified at one or more levels by contrast limited adaptive histogram equalization and mathematical morphology, respectively. The enhanced image is processed by global nonlinear operator. The experimental results show that the presented algorithm is effective for feature and contrast enhancement of mammogram. The performance evaluation of the proposed algorithm is measured by contrast evaluation criterion for image, signal-noise-ratio (SNR, and contrast improvement index (CII.

  5. Feature and Contrast Enhancement of Mammographic Image Based on Multiscale Analysis and Morphology

    Science.gov (United States)

    Wu, Shibin; Xie, Yaoqin

    2013-01-01

    A new algorithm for feature and contrast enhancement of mammographic images is proposed in this paper. The approach bases on multiscale transform and mathematical morphology. First of all, the Laplacian Gaussian pyramid operator is applied to transform the mammography into different scale subband images. In addition, the detail or high frequency subimages are equalized by contrast limited adaptive histogram equalization (CLAHE) and low-pass subimages are processed by mathematical morphology. Finally, the enhanced image of feature and contrast is reconstructed from the Laplacian Gaussian pyramid coefficients modified at one or more levels by contrast limited adaptive histogram equalization and mathematical morphology, respectively. The enhanced image is processed by global nonlinear operator. The experimental results show that the presented algorithm is effective for feature and contrast enhancement of mammogram. The performance evaluation of the proposed algorithm is measured by contrast evaluation criterion for image, signal-noise-ratio (SNR), and contrast improvement index (CII). PMID:24416072

  6. Contrast-enhanced dedicated breast CT detection of invasive breast cancer preceding mammographic diagnosis

    Directory of Open Access Journals (Sweden)

    Nicolas D. Prionas, MD, PhD

    2015-01-01

    Full Text Available Dedicated breast computed tomography (bCT generates high-resolution, three-dimensional images of the pendent uncompressed breast. Intravenous iodinated contrast during bCT provides additional physiologic information. In this case, a 10.0-mm invasive ductal carcinoma was visualized using contrast-enhanced breast CT one year before mammographic detection. Mammography four months before bCT was negative. The bCT contrast enhancement pattern closely matched the dynamic contrast-enhanced MRI obtained after diagnosis. Lesion enhancement at contrast-enhanced breast CT matched previously published enhancement values of breast cancer. Contrast-enhanced dedicated bCT provided high-resolution tomographic images and physiologic contrast enhancement data that facilitated the detection of an early breast cancer.

  7. The Shrinking Breast: An Unusual Mammographic Finding of Invasive Lobular Carcinoma.

    Science.gov (United States)

    Jafri, Nazia F; Slanetz, Priscilla J

    2007-01-01

    We report two cases of invasive lobular carcinoma of the breast that were initially missed on first mammographic interpretation because of an uncommon, easily overlooked, and unreported imaging presentation. The abnormality in the cases manifested as an apparent decrease in breast glandular tissue volume when compared with the patients' previous mammograms, observed as "shrinking" of the breast on mammography. Invasive lobular carcinoma is considered one of the most difficult subtypes of breast cancer to identify on mammography because the changes that occur are often nonspecific and subtle. Microcalcifications that are usually associated with breast masses on imaging are rarely seen in this subtype of breast cancer. Although magnetic resonance imaging and computer-aided detection have somewhat improved the detection of invasive lobular carcinoma, radiologic and clinical detection remains a challenge.

  8. Breast density in screening mammography in Indian population - Is it different from western population?

    Science.gov (United States)

    Singh, Tulika; Khandelwal, Niranjan; Singla, Veenu; Kumar, Dileep; Gupta, Madhu; Singh, Gurpreet; Bal, Amanjit

    2017-11-15

    Mammography is the only method presently considered appropriate for mass screening of breast cancer. However, higher breast density was strongly associated with lower mammographic sensitivity. Breast density is also identified as independent and strongest risk factors for breast cancer. Studies have shown women with high breast density have four to six times increased risk of breast cancer as compare to women with fatty breast. It varies between different age group it generally decreases with increasing age in postmenopausal women and it can be different in different ethnic groups and people from different geographical areas. This study evaluates the breast density in Indian population and its relationship with the age. We reviewed of all screening mammography examinations performed from May 2012 to January 2015 at our institute PGIMER, Chandigarh, INDIA. Descriptive analyses were used to examine the association between age and breast density. A total of 6132 screening mammograms were performed. Each subgroup categorized by decade of age. There was a significant inverse relationship between age and breast density (P density in Indian and Western population with more Indians having ACR Grade 1 and 2 and Western population having 2 and 3. We found an inverse relationship between patient age and mammographic breast density. However, there were a large proportion of young women who had lower grades of mammographic density which could potentially benefit from the use of routine screening mammography in this subgroup of patients. Moreover, the breast density of Indian population is less when compared to the Western population. This might suggest that mammography is a good modality of choice for screening Indian population. © 2017 Wiley Periodicals, Inc.

  9. Association between air pollution and mammographic breast density in the Breast Cancer Surveilance Consortium.

    Science.gov (United States)

    Yaghjyan, Lusine; Arao, Robert; Brokamp, Cole; O'Meara, Ellen S; Sprague, Brian L; Ghita, Gabriela; Ryan, Patrick

    2017-04-06

    Mammographic breast density is a well-established strong risk factor for breast cancer. The environmental contributors to geographic variation in breast density in urban and rural areas are poorly understood. We examined the association between breast density and exposure to ambient air pollutants (particulate matter Breast Cancer Surveillance Consortium (2001-2009). We included women aged ≥40 years with known residential zip codes before the index mammogram (n = 279,967). Breast density was assessed using the American College of Radiology's Breast Imaging-Reporting and Data System (BI-RADS) four-category breast density classification. PM2.5 and O3 estimates for grids across the USA (2001-2008) were obtained from the US Environmental Protection Agency Hierarchical Bayesian Model (HBM). For the majority of women (94%), these estimates were available for the year preceding the mammogram date. Association between exposure to air pollutants and density was estimated using polytomous logistic regression, adjusting for potential confounders. Women with extremely dense breasts had higher mean PM2.5 and lower O3 exposures than women with fatty breasts (8.97 vs. 8.66 ug/m3 and 33.70 vs. 35.82 parts per billion (ppb), respectively). In regression analysis, women with heterogeneously dense vs. scattered fibroglandular breasts were more likely to have higher exposure to PM2.5 (fourth vs. first quartile odds ratio (OR) = 1.19, 95% confidence interval (CI) 1.16 - 1.23). Women with extremely dense vs. scattered fibroglandular breasts were less likely to have higher levels of ozone exposure (fourth vs. first quartile OR = 0.80, 95% CI 0.73-0.87). Exposure to PM2.5 and O3 may in part explain geographical variation in mammographic density. Further studies are warranted to determine the causal nature of these associations.

  10. Comparison of mammographic and sonographic findings in typical and atypical medullary carcinomas of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, E.; Lebe, B.; Balci, P.; Sal, S.; Canda, T

    2002-07-01

    AIM: The aim of this study was to describe the contribution of mammographic and sonographic findings to the discrimination of typical and atypical histopathologic groups of medullary carcinomas of the breast. MATERIALS AND METHODS: Imaging findings were retrospectively assessed in 33 women with medullary carcinomas (15 typical medullary carcinomas and 18 atypical medullary carcinomas) identified during pre-operative mammography. Twenty-nine of these women also had ultrasound and these findings were reviewed. RESULTS: Mammography showed a well circumscribed mass in 10 of the 15 (67%) typical medullary carcinomas and in four of the 17 (24%) atypical medullary carcinomas (P < 0.02). One small tumour in a woman with atypical medullary carcinoma was missed on mammography and was shown only on sonography. Sonographically, an irregular margin surrounding the whole mass or part of it was seen in three out of 14 (21%) patients with typical medullary carcinoma and in nine out of 15 (60%) patients with atypical medullary carcinomas (P < 0.05). Posterior acoustic shadowing was more often observed in the typical medullary carcinoma group than in atypical medullary carcinoma and the difference was found to be statistically significant (P < 0.05). None of the other mammographic and sonographic findings were sufficiently characteristic to allow for a differentiation between two groups. CONCLUSION: When typical medullary carcinomas were compared with atypical medullary carcinomas according to imaging features, they tended to be well circumscribed masses on both mammography and sonography, and a posterior acoustic shadow was not found on sonography. However, the imaging findings in these two subgroups often resembled each other and histopathology will always be required to confirm the diagnosis. Yilmaz, E. et al. (2002)

  11. RELATIONSHIP OF MAMMOGRAPHIC DENSITY AND GENE EXPRESSION: ANALYSIS OF NORMAL BREAST TISSUE SURROUNDING BREAST CANCER

    Science.gov (United States)

    Sandhu, Rupninder; Williams, Tyisha; Midkiff, Bentley R.; Lissowska, Jolanta; Wesolowska, Ewa; Boyd, Norman F.; Johnson, Nicole B.; Figueroa, Jonine D.; Sherman, Mark E.; Troester, Melissa A.

    2014-01-01

    Purpose Previous studies of breast tissue gene expression have demonstrated that the extratumoral microenvironment has substantial variability across individuals, some of which can be attributed to epidemiologic factors. To evaluate how mammographic density (MD) and breast tissue composition relate to extratumoral microenvironment gene expression, we used data on 121 breast cancer patients from the population-based Polish Women's Breast Cancer Study. Design Breast cancer cases were classified based on a previously reported, biologically-defined extratumoral gene expression signature with two subtypes: an Active subtype, which is associated with high expression of genes related to fibrosis and wound response, and an Inactive subtype, which has high expression of cellular adhesion genes. MD of the contralateral breast was assessed using pre-treatment mammograms and a quantitative, reliable computer-assisted thresholding method. Breast tissue composition was evaluated based on digital image analysis of tissue sections. Results The Inactive extratumoral subtype was associated with significantly higher percentage mammographic density (PD) and dense area (DA) in univariate analysis (PD: p=0.001; DA: p=0.049) and in multivariable analyses adjusted for age and body mass index (PD: p=0.004; DA: p=0.049). Inactive/higher MD tissue was characterized by a significantly higher percentage of stroma and a significantly lower percentage of adipose tissue, with no significant change in epithelial content. Analysis of published gene expression signatures suggested that Inactive/higher MD tissue expressed increased estrogen response and decreased TGF-β signaling. Conclusions By linking novel molecular phenotypes with MD, our results indicate that MD reflects broad transcriptional changes, including changes in both epithelia- and stroma-derived signaling. PMID:23918601

  12. Glycemic index, glycemic load and mammographic breast density: the EPIC Florence longitudinal study.

    Science.gov (United States)

    Masala, Giovanna; Assedi, Melania; Bendinelli, Benedetta; Ermini, Ilaria; Occhini, Daniela; Sieri, Sabina; Brighenti, Furio; Del Turco, Marco Rosselli; Ambrogetti, Daniela; Palli, Domenico

    2013-01-01

    A few studies have evaluated the association between diet and mammographic breast density (MBD) and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI) or glycemic load (GL) may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83%) and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories) with those with low MBD (N1+P1) through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048) while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further investigations.

  13. Construction of mammographic examination process ontology using bottom-up hierarchical task analysis.

    Science.gov (United States)

    Yagahara, Ayako; Yokooka, Yuki; Jiang, Guoqian; Tsuji, Shintarou; Fukuda, Akihisa; Nishimoto, Naoki; Kurowarabi, Kunio; Ogasawara, Katsuhiko

    2018-01-10

    Describing complex mammography examination processes is important for improving the quality of mammograms. It is often difficult for experienced radiologic technologists to explain the process because their techniques depend on their experience and intuition. In our previous study, we analyzed the process using a new bottom-up hierarchical task analysis and identified key components of the process. Leveraging the results of the previous study, the purpose of this study was to construct a mammographic examination process ontology to formally describe the relationships between the process and image evaluation criteria to improve the quality of mammograms. First, we identified and created root classes: task, plan, and clinical image evaluation (CIE). Second, we described an "is-a" relation referring to the result of the previous study and the structure of the CIE. Third, the procedural steps in the ontology were described using the new properties: "isPerformedBefore," "isPerformedAfter," and "isPerformedAfterIfNecessary." Finally, the relationships between tasks and CIEs were described using the "isAffectedBy" property to represent the influence of the process on image quality. In total, there were 219 classes in the ontology. By introducing new properties related to the process flow, a sophisticated mammography examination process could be visualized. In relationships between tasks and CIEs, it became clear that the tasks affecting the evaluation criteria related to positioning were greater in number than those for image quality. We developed a mammographic examination process ontology that makes knowledge explicit for a comprehensive mammography process. Our research will support education and help promote knowledge sharing about mammography examination expertise.

  14. Glycemic index, glycemic load and mammographic breast density: the EPIC Florence longitudinal study.

    Directory of Open Access Journals (Sweden)

    Giovanna Masala

    Full Text Available A few studies have evaluated the association between diet and mammographic breast density (MBD and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI or glycemic load (GL may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83% and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories with those with low MBD (N1+P1 through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048 while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further

  15. Clinical and mammographic profile of patients with breast cancer surgically treated

    Directory of Open Access Journals (Sweden)

    Raquel Rodrigues Muradas

    2015-06-01

    Full Text Available Summary Objective: to analyze the epidemiological, clinical and mammographic profile of women with breast cancer who were treated at the mastology clinic of the University Hospital of Santa Maria and who underwent breast surgery between January 2007 and December 2012. Methods: this was a cross-sectional study, approved by the Ethics in Research Committee. A review of the patients' medical records was performed. The data were then exported to a software program for statistical analysis, namely Minitab 14.1. Results: the patients' profile indicated that they were mostly born and raised in Santa Maria (respectively 11.1%, n=16, and 26.3%, n=68. They were about 55.6 years old (SD±12.3, white (90.2%, n=213, had already given birth and breastfed their children, were nonsmokers, but also overweight (average BMI of 27kg/m2. On physical examination of the first medical consultation, these patients, as described in the records: had a palpable mass (81.1%, n=184 measuring over three centimeters, located in the left breast, precisely in the upper outer quadrant (41.4%, n=81. Mammography (39%, n=109 showed that this lump was classified as BIRADS ® 5 (40%, n=81. On histopathological examination, the lump was diagnosed as an invasive ductal cancer (71.1%, n=191. Surgery was generally a radical mastectomy (84.7%, n=236 with axillary dissection (92.5%, n=222. Conclusion: some of the epidemiological, clinical and mammographic features mentioned above resembled those found in the literature reviewed. However, these patients had advanced disease and underwent non conservative surgical procedures.

  16. Developing a visual sensitive image features based CAD scheme to assist classification of mammographic masses

    Science.gov (United States)

    Wang, Yunzhi; Aghaei, Faranak; Tan, Maxine; Qiu, Yuchen; Liu, Hong; Zheng, Bin

    2017-03-01

    Computer-aided diagnosis (CAD) schemes of mammograms have been previously developed and tested. However, due to using "black-box" approaches with a large number of complicated features, radiologists have lower confidence to accept or consider CAD-cued results. In order to help solve this issue, this study aims to develop and evaluate a new CAD scheme that uses visual sensitive image features to classify between malignant and benign mammographic masses. A dataset of 301 masses detected on both craniocaudal (CC) and mediolateraloblique (MLO) view images was retrospectively assembled. Among them, 152 were malignant and 149 were benign. An iterative region-growing algorithm was applied to the special Gaussian-kernel filtered images to segment mass regions. Total 13 Image features were computed to mimic 5 categories of visually sensitive features that are commonly used by radiologists in classifying suspicious mammographic masses namely, mass size, shape factor, contrast, homogeneity and spiculation. We then selected one optimal feature in each of 5 feature categories by using a student t-test, and applied two logistic regression classifiers using either CC or MLO view images to distinguish between malignant and benign masses. Last, a fusion method of combining two classification scores was applied and tested. By applying a 10-fold cross-validation method, the area under receiver operating characteristic curves was 0.806+/-0.025. This study demonstrated a new approach to develop CAD scheme based on 5 visually sensitive image features. Combining with a "visual-aid" interface, CAD results are much more easily explainable to the observers and may increase their confidence to consider CAD-cued results.

  17. 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.

  18. Fractal analysis of radiologists' visual scanning pattern in screening mammography

    Science.gov (United States)

    Alamudun, Folami T.; Yoon, Hong-Jun; Hudson, Kathy; Morin-Ducote, Garnetta; Tourassi, Georgia

    2015-03-01

    Several researchers 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 composite 4- view scanpaths. For each case, the complexity of each radiologist's scanpath was measured using fractal dimension estimated with the box counting method. The association between the fractal dimension of the radiologists' visual scanpath, case pathology, case density, and radiologist experience was evaluated using fixed effects ANOVA. ANOVA showed that the complexity of the radiologists' visual search pattern in screening mammography is dependent on case specific attributes (breast parenchyma density and case pathology) as well as on reader attributes, namely experience level. Visual scanning patterns are significantly different for benign and malignant cases than for normal cases. There is also substantial inter-observer variability which cannot be explained only by experience level.

  19. Allowing repeat winners

    OpenAIRE

    Marco D. Huesch; Richard Brady

    2010-01-01

    Unbiased lotteries seem the least unfair and simplest procedures to allocate scarce indivisible resources to those with equal claims. But, when lotteries are repeated, it is not immediately obvious whether prior winners should be included or excluded. As in design questions surrounding single-shot lotteries, considerations of self-interest and distributive social preferences may interact. We investigate preferences for allowing participation of earlier winners in sequential lotteries. We foun...

  20. Duct Leakage Repeatability Testing

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-01-01

    Duct leakage often needs to be measured to demonstrate compliance with requirements or to determine energy or Indoor Air Quality (IAQ) impacts. Testing is often done using standards such as ASTM E1554 (ASTM 2013) or California Title 24 (California Energy Commission 2013 & 2013b), but there are several choices of methods available within the accepted standards. Determining which method to use or not use requires an evaluation of those methods in the context of the particular needs. Three factors that are important considerations are the cost of the measurement, the accuracy of the measurement and the repeatability of the measurement. The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards.

  1. Genome-wide association study identifies multiple loci associated with both mammographic density and breast cancer risk.

    Science.gov (United States)

    Lindström, Sara; Thompson, Deborah J; Paterson, Andrew D; Li, Jingmei; Gierach, Gretchen L; Scott, Christopher; Stone, Jennifer; Douglas, Julie A; dos-Santos-Silva, Isabel; Fernandez-Navarro, Pablo; Verghase, Jajini; Smith, Paula; Brown, Judith; Luben, Robert; Wareham, Nicholas J; Loos, Ruth J F; Heit, John A; Pankratz, V Shane; Norman, Aaron; Goode, Ellen L; Cunningham, Julie M; deAndrade, Mariza; Vierkant, Robert A; Czene, Kamila; Fasching, Peter A; Baglietto, Laura; Southey, Melissa C; Giles, Graham G; Shah, Kaanan P; Chan, Heang-Ping; Helvie, Mark A; Beck, Andrew H; Knoblauch, Nicholas W; Hazra, Aditi; Hunter, David J; Kraft, Peter; Pollan, Marina; Figueroa, Jonine D; Couch, Fergus J; Hopper, John L; Hall, Per; Easton, Douglas F; Boyd, Norman F; Vachon, Celine M; Tamimi, Rulla M

    2014-10-24

    Mammographic density reflects the amount of stromal and epithelial tissues in relation to adipose tissue in the breast and is a strong risk factor for breast cancer. Here we report the results from meta-analysis of genome-wide association studies (GWAS) of three mammographic density phenotypes: dense area, non-dense area and percent density in up to 7,916 women in stage 1 and an additional 10,379 women in stage 2. We identify genome-wide significant (Pbreast cancer susceptibility loci, and four additional regions were found to be associated with breast cancer (Pbreast cancer and illustrate the power of studying intermediate quantitative phenotypes to identify putative disease-susceptibility loci.

  2. Risk-benefit analysis for mass screening of breast cancer utilizing mammography as a screening test

    Energy Technology Data Exchange (ETDEWEB)

    Iinuma, T.A.; Tateno, Yukio (National Inst. of Radiological Sciences, Chiba (Japan))

    1989-09-01

    Incidence of breast cancers in Japanese women is increasing steadily. Mass screening of breast cancer was started in Japan under auspices of Adult Health Promotion Act of the Japanese Government from 1987. As the first screening method, the palpation of breasts is employed at present, but it is expected to be replaced by the mammography. In this report, the risk-benefit analysis is presented between risk of breast carcinogenesis due to radiation and benefit of mass screening of breast cancer. The benefit of mass screening is taken as the net elongation of average life expectancy of women due to survival from breast cancers. The risk of mammography is taken as the net loss of average life expectancy of women due to breast carcinogenesis. In the latter, the latency time and plateau period of radiation carcinogenesis were taken into consideration in the calculation. The results show that the ages at which the benefit and risk become equal are between 30 and 35 years old when dose equivalent of mammography is between 10 and 20 mSv, that are conventionally used. However, the critical age will be reduced to 20 years old if the dose equivalent becomes 1 mSv. Therefore, it is strongly recommended that a low dose mammographic system should be developed in order to achieve 1 mSv for the mass screening of breast cancer of Japanese women. In author's opinion, this is quite feasible by employing a new digital radiography with imaging plate. (author).

  3. Improvement of Breast Cancer Detection Using Non-subsampled Contourlet Transform and Super-Resolution Technique in Mammographic Images

    OpenAIRE

    Fatemeh Pak; Hamidreza Rashidy Kanan

    2015-01-01

    Introduction Breast cancer is one of the most life-threatening conditions among women. Early detection of this disease is the only way to reduce the associated mortality rate. Mammography is a standard method for the early detection of breast cancer. Today, considering the importance of breast cancer detection, computer-aided detection techniques have been employed to increase the quality of mammographic images and help physicians reduce false positive rate (FPR). Materials and Methods In thi...

  4. Association between mammographic density and pregnancies relative to age and BMI: a breast cancer case-only analysis.

    Science.gov (United States)

    Hack, Carolin C; Emons, Julius; Jud, Sebastian M; Heusinger, Katharina; Adler, Werner; Gass, Paul; Haeberle, Lothar; Heindl, Felix; Hein, Alexander; Schulz-Wendtland, Rüdiger; Uder, Michael; Hartmann, Arndt; Beckmann, Matthias W; Fasching, Peter A; Pöhls, Uwe G

    2017-12-01

    Percentage mammographic density (PMD) is a major risk factor for breast cancer (BC). It is strongly associated with body mass index (BMI) and age, which are themselves risk factors for breast cancer. This analysis investigated the association between the number of full-term pregnancies and PMD in different subgroups relative to age and BMI. Patients were identified in the breast cancer database of the University Breast Center for Franconia. A total of 2410 patients were identified, for whom information on parity, age, and BMI, and a mammogram from the time of first diagnosis were available for assessing PMD. Linear regression analyses were conducted to investigate the influence on PMD of the number of full-term pregnancies (FTPs), age, BMI, and interaction terms between them. As in previous studies, age, number of FTPs, and BMI were found to be associated with PMD in the expected direction. However, including the respective interaction terms improved the prediction of PMD even further. Specifically, the association between PMD and the number of FTPs differed in young patients under the age of 45 (mean decrease of 0.37 PMD units per pregnancy) from the association in older age groups (mean decrease between 2.29 and 2.39 PMD units). BMI did not alter the association between PMD and the number of FTPs. The effect of pregnancies on mammographic density does not appear to become apparent before the age of menopause. The mechanism that drives the effect of pregnancies on mammographic density appears to be counter-regulated by other influences on mammographic density in younger patients.

  5. Age at Menarche and Late Adolescent Adiposity Associated with Mammographic Density on Processed Digital Mammograms in 24,840 Women.

    Science.gov (United States)

    Alexeeff, Stacey E; Odo, Nnaemeka U; Lipson, Jafi A; Achacoso, Ninah; Rothstein, Joseph H; Yaffe, Martin J; Liang, Rhea Y; Acton, Luana; McGuire, Valerie; Whittemore, Alice S; Rubin, Daniel L; Sieh, Weiva; Habel, Laurel A

    2017-09-01

    Background: High mammographic density is strongly associated with increased breast cancer risk. Some, but not all, risk factors for breast cancer are also associated with higher mammographic density.Methods: The study cohort (N = 24,840) was drawn from the Research Program in Genes, Environment and Health of Kaiser Permanente Northern California and included non-Hispanic white females ages 40 to 74 years with a full-field digital mammogram (FFDM). Percent density (PD) and dense area (DA) were measured by a radiological technologist using Cumulus. The association of age at menarche and late adolescent body mass index (BMI) with PD and DA were modeled using linear regression adjusted for confounders.Results: Age at menarche and late adolescent BMI were negatively correlated. Age at menarche was positively associated with PD (P value for trend 16 years was associated with an increase in PD of 1.47% (95% CI, 0.69-2.25) and an increase in DA of 1.59 cm(2) (95% CI, 0.48-2.70). Late adolescent BMI was inversely associated with PD (P < 0.0001) and DA (P < 0.0001) in fully adjusted models.Conclusions: Age at menarche and late adolescent BMI are both associated with Cumulus measures of mammographic density on processed FFDM images.Impact: Age at menarche and late adolescent BMI may act through different pathways. The long-term effects of age at menarche on cancer risk may be mediated through factors besides mammographic density. Cancer Epidemiol Biomarkers Prev; 26(9); 1450-8. ©2017 AACR. ©2017 American Association for Cancer Research.

  6. Tumor characteristics and family history in relation to mammographic density and breast cancer: The French E3N cohort.

    Science.gov (United States)

    Maskarinec, Gertraud; Dartois, Laureen; Delaloge, Suzette; Hopper, John; Clavel-Chapelon, Françoise; Baglietto, Laura

    2017-08-01

    Mammographic density is a known heritable risk factor for breast cancer, but reports how tumor characteristics and family history may modify this association are inconsistent. Dense and total breast areas were assessed using Cumulus™ from pre-diagnostic mammograms for 820 invasive breast cancer cases and 820 matched controls nested within the French E3N cohort study. To allow comparisons across models, percent mammographic density (PMD) was standardized to the distribution of the controls. Odds ratios (OR) and 95% confidence intervals (CI) of breast cancer risk for mammographic density were estimated by conditional logistic regression while adjusting for age and body mass index. Heterogeneity according to tumor characteristic and family history was assessed using stratified analyses. Overall, the OR per 1 SD for PMD was 1.50 (95% CI, 1.33-1.69). No evidence for significant heterogeneity by tumor size, lymph node status, grade, and hormone receptor status (estrogen, progesterone, and HER2) was detected. However, the association of PMD was stronger for women reporting a family history of breast cancer (OR 1SD =2.25; 95% CI, 1.67-3.04) than in women reporting none (OR 1SD =1.41; 95% CI, 1.24-1.60; p heterogeneity =0.002). Similarly, effect modification by FHBC was observed using categories of PMD (p heterogeneity =0.02) with respective ORs of 15.16 (95% CI, 4.23-54.28) vs. 3.14 (95% CI, 1.89-5.22) for ≥50% vs. breast cancer risk with a family history supports the hypothesis of shared genetic factors responsible for familial aggregation of breast cancer and the heritable component of mammographic density. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Mammographic parenchymal texture as an imaging marker of hormonal activity: a comparative study between pre- and post-menopausal women

    Science.gov (United States)

    Daye, Dania; Bobo, Ezra; Baumann, Bethany; Ioannou, Antonios; Conant, Emily F.; Maidment, Andrew D. A.; Kontos, Despina

    2011-03-01

    Mammographic parenchymal texture patterns have been shown to be related to breast cancer risk. Yet, little is known about the biological basis underlying this association. Here, we investigate the potential of mammographic parenchymal texture patterns as an inherent phenotypic imaging marker of endogenous hormonal exposure of the breast tissue. Digital mammographic (DM) images in the cranio-caudal (CC) view of the unaffected breast from 138 women diagnosed with unilateral breast cancer were retrospectively analyzed. Menopause status was used as a surrogate marker of endogenous hormonal activity. Retroareolar 2.5cm2 ROIs were segmented from the post-processed DM images using an automated algorithm. Parenchymal texture features of skewness, coarseness, contrast, energy, homogeneity, grey-level spatial correlation, and fractal dimension were computed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate feature classification performance in distinguishing between 72 pre- and 66 post-menopausal women. Logistic regression was performed to assess the independent effect of each texture feature in predicting menopause status. ROC analysis showed that texture features have inherent capacity to distinguish between pre- and post-menopausal statuses (AUC>0.5, pLogistic regression including all texture features yielded an ROC curve with an AUC of 0.76. Addition of age at menarche, ethnicity, contraception use and hormonal replacement therapy (HRT) use lead to a modest model improvement (AUC=0.78) while texture features maintained significant contribution (p<0.05). The observed differences in parenchymal texture features between pre- and post- menopausal women suggest that mammographic texture can potentially serve as a surrogate imaging marker of endogenous hormonal activity.

  8. 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.

  9. Mammographic Density Reduction as a Prognostic Marker for Postmenopausal Breast Cancer: Results Using a Joint Longitudinal-Survival Modeling Approach.

    Science.gov (United States)

    Andersson, Therese M-L; Crowther, Michael J; Czene, Kamila; Hall, Per; Humphreys, Keith

    2017-11-01

    Previous studies have linked reductions in mammographic density after a breast cancer diagnosis to an improved prognosis. These studies focused on short-term change, using a 2-stage process, treating estimated change as a fixed covariate in a survival model. We propose the use of a joint longitudinal-survival model. This enables us to model long-term trends in density while accounting for dropout as well as for measurement error. We studied the change in mammographic density after a breast cancer diagnosis and its association with prognosis (measured by cause-specific mortality), overall and with respect to hormone replacement therapy and tamoxifen treatment. We included 1,740 women aged 50-74 years, diagnosed with breast cancer in Sweden during 1993-1995, with follow-up until 2008. They had a total of 6,317 mammographic density measures available from the first 5 years of follow-up, including baseline measures. We found that the impact of the withdrawal of hormone replacement therapy on density reduction was larger than that of tamoxifen treatment. Unlike previous studies, we found that there was an association between density reduction and survival, both for tamoxifen-treated women and women who were not treated with tamoxifen. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  10. Predicted image quality of a CMOS APS X-ray detector across a range of mammographic beam qualities

    Science.gov (United States)

    Konstantinidis, A.

    2015-09-01

    Digital X-ray detectors based on Complementary Metal-Oxide- Semiconductor (CMOS) Active Pixel Sensor (APS) technology have been introduced in the early 2000s in medical imaging applications. In a previous study the X-ray performance (i.e. presampling Modulation Transfer Function (pMTF), Normalized Noise Power Spectrum (NNPS), Signal-to-Noise Ratio (SNR) and Detective Quantum Efficiency (DQE)) of the Dexela 2923MAM CMOS APS X-ray detector was evaluated within the mammographic energy range using monochromatic synchrotron radiation (i.e. 17-35 keV). In this study image simulation was used to predict how the mammographic beam quality affects image quality. In particular, the experimentally measured monochromatic pMTF, NNPS and SNR parameters were combined with various mammographic spectral shapes (i.e. Molybdenum/Molybdenum (Mo/Mo), Rhodium/Rhodium (Rh/Rh), Tungsten/Aluminium (W/Al) and Tungsten/Rhodium (W/Rh) anode/filtration combinations at 28 kV). The image quality was measured in terms of Contrast-to-Noise Ratio (CNR) using a synthetic breast phantom (4 cm thick with 50% glandularity). The results can be used to optimize the imaging conditions in order to minimize patient's Mean Glandular Dose (MGD).

  11. Simplified method for quality evaluation of the mammographic system; Metodo simplificado para avaliar a qualidade do sistema mamografico

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, Claudio Domingues de; Coutinho, Celia Maria Campos [Instituto de Radioprotecao e Dosimetria (IRD), Rio de Janeiro, RJ (Brazil); Oliveira, Larissa Conceicao Gomes [Fundacao Tecnico Eduacional Souza Marques, Rio de Janeiro, RJ (Brazil)

    2002-07-01

    In order to produce mammograms at the lowest doses consistent with high diagnostic sensitivity and specificity, it is necessary that careful consideration be given to the selection of equipment, patient positioning and imaging techniques, besides the establishment of an effective quality control program. So, in this work is proposed a comprehensive method to evaluate the consistence of quality mammographic systems by analyzing results from automatic exposure control, image contrast index, optical densities and image quality from a mammographic phantom. Results point out that from a total of 12 installed units analyzed, classified as good equipment, 8% overexposure the patients above from those necessary to register adequate optical densities when 58% of phantom images presented values below from those acceptable index. Yet, 33% of equipment had shown failures on AEC and 50% of images presented poor quality. Finally, on this statistic, only one installation executed procedures of quality control. Conclusion shows the necessity of simple and objective methods which should be part of routines in mammographic installations. (author)

  12. Reliability and validity of the Repeatable Battery for the Assessment of Neuropsychological Status in community-dwelling elderly

    National Research Council Canada - National Science Library

    Cheng, Yan; Wu, Wenyuan; Wang, Jiaqi; Feng, Wei; Wu, Xiangwei; Li, Chunbo

    2011-01-01

    The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used screening instrument in neuropsychological assessment and is a brief, individually administered measure...

  13. Repeatability of Cryogenic Multilayer Insulation

    Science.gov (United States)

    Johnson, W. L.; Vanderlaan, M.; Wood, J. J.; Rhys, N. O.; Guo, W.; Van Sciver, S.; Chato, D. J.

    2017-01-01

    Due to the variety of requirements across aerospace platforms, and one off projects, the repeatability of cryogenic multilayer insulation has never been fully established. The objective of this test program is to provide a more basic understanding of the thermal performance repeatability of MLI systems that are applicable to large scale tanks. There are several different types of repeatability that can be accounted for: these include repeatability between multiple identical blankets, repeatability of installation of the same blanket, and repeatability of a test apparatus. The focus of the work in this report is on the first two types of repeatability. Statistically, repeatability can mean many different things. In simplest form, it refers to the range of performance that a population exhibits and the average of the population. However, as more and more identical components are made (i.e. the population of concern grows), the simple range morphs into a standard deviation from an average performance. Initial repeatability testing on MLI blankets has been completed at Florida State University. Repeatability of five GRC provided coupons with 25 layers was shown to be +/- 8.4 whereas repeatability of repeatedly installing a single coupon was shown to be +/- 8.0. A second group of 10 coupons have been fabricated by Yetispace and tested by Florida State University, through the first 4 tests, the repeatability has been shown to be +/- 16. Based on detailed statistical analysis, the data has been shown to be statistically significant.

  14. Repeatability of Cryogenic Multilayer Insulation

    Science.gov (United States)

    Johnson, W. L.; Vanderlaan, M.; Wood, J. J.; Rhys, N. O.; Guo, W.; Van Sciver, S.; Chato, D. J.

    2017-12-01

    Due to the variety of requirements across aerospace platforms, and one off projects, the repeatability of cryogenic multilayer insulation (MLI) has never been fully established. The objective of this test program is to provide a more basic understanding of the thermal performance repeatability of MLI systems that are applicable to large scale tanks. There are several different types of repeatability that can be accounted for: these include repeatability between identical blankets, repeatability of installation of the same blanket, and repeatability of a test apparatus. The focus of the work in this report is on the first two types of repeatability. Statistically, repeatability can mean many different things. In simplest form, it refers to the range of performance that a population exhibits and the average of the population. However, as more and more identical components are made (i.e. the population of concern grows), the simple range morphs into a standard deviation from an average performance. Initial repeatability testing on MLI blankets has been completed at Florida State University. Repeatability of five Glenn Research Center (GRC) provided coupons with 25 layers was shown to be +/- 8.4% whereas repeatability of repeatedly installing a single coupon was shown to be +/- 8.0%. A second group of 10 coupons has been fabricated by Yetispace and tested by Florida State University, the repeatability between coupons has been shown to be +/- 15-25%. Based on detailed statistical analysis, the data has been shown to be statistically significant.

  15. Duct Leakage Repeatability Testing

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-08-01

    The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques for duct leakage using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards. The three duct leak measurement methods assessed in this report are the two duct pressurization methods that are commonly used by many practitioners and the DeltaQ technique. These are methods B, C and A, respectively of the ASTM E1554 standard. Although it would be useful to evaluate other duct leak test methods, this study focused on those test methods that are commonly used and are required in various test standards, such as BPI (2010), RESNET (2014), ASHRAE 62.2 (2013), California Title 24 (CEC 2012), DOE Weatherization and many other energy efficiency programs.

  16. Evaluation of the knowledge of women and registered nurses in Japan regarding the benefits and risks of breast cancer screening.

    Science.gov (United States)

    Shimada, Tomoyuki; Takahashi, Masayuki; Shimizu, Yuki; Hashimoto, Masaji

    2017-11-01

    Objective: Routine, population-based mammographic screening for breast cancer has been implemented nationally in Japan for the past decade. The objective of this study was to evaluate the knowledge of the general public and of nurses concerning breast screening practices in Japan, especially with regards to the benefits and risks of breast cancer screening. Methods: In 2014, a questionnaire regarding the benefits and risks of breast cancer screening was administered to women who underwent breast cancer screening and to registered nurses. The questionnaire was distributed to 1,649 women and 1,905 registered nurses. Results: Completed questionnaires were returned by 1,552 (94.1%) of the screened participants and 1,710 (89.8%) nurses. The majority of the screened participants and registered nurses believed that screening prevented or reduced the risk of developing breast cancer (86% and 62%, respectively); that screening reduced the mortality risk of breast cancer by more than 50% (69% and 60%, respectively); and that 10 years of regular screening for 50-year-old women could prevent ≥ 10 breast cancer deaths per 1,000 women (62% and 61%, respectively). Conclusions: Women in the target population and registered nurses were aware that earlier diagnosis led to better prognosis, but demonstrated misconceptions regarding other aspects of the benefits and risks of breast cancer screening. In Japan, all women should be educated on both the benefits and risks of breast cancer screening to enable them to make an informed decision on whether to participate in the mammographic breast cancer screening program.

  17. Measurement of the radiation dose and assessment of the risk in mammography screening for early detection of cancer of the breast, in Israel.

    Science.gov (United States)

    Broisman, A; Schlesinger, T; Alfassi, Z B

    2011-01-01

    The mean glandular doses to samples of women attending for mammographic screening are measured routinely at screening centres in Israel. As at present, no detailed and systematic data have been collected regarding the average glandular dose in mammography screening procedures carried out in Israel for the last 20 y. Especially data are lacking related to the glandular dose (GD) involved in mammography with the new digital mammography systems. In this work, partial results of the measurements are presented to asses the radiation dose to the breast and to the glandular tissue within the Israeli national mammography programme updated to year 2009.

  18. Repeat Customer Success in Extension

    Science.gov (United States)

    Bess, Melissa M.; Traub, Sarah M.

    2013-01-01

    Four multi-session research-based programs were offered by two Extension specialist in one rural Missouri county. Eleven participants who came to multiple Extension programs could be called "repeat customers." Based on the total number of participants for all four programs, 25% could be deemed as repeat customers. Repeat customers had…

  19. Retail venue based screening mammography: assessment of women's preferences.

    Science.gov (United States)

    Gupta, Supriya; Vij, Abhinav; Cafiero, Elizabeth; Bloom, David; Agarwal, Sheela; Donelan, Karen; Kopans, Daniel; Saini, Sanjay

    2012-10-01

    The aim of this study was to explore women's interest and preferences in undergoing screening mammography in a retail health care setting. Self-administered surveys were distributed to 400 mammography patients in May to June 2009. All of the women who were asked were eligible for screening (age >40 years, no abnormal mammographic findings in the recent past). Three hundred eighty-six screening-eligible women filled out and returned the self-administered survey. The average respondent age was 57 years. Three hundred ten of the patients (80.3%) had college or postgraduate educations. Two hundred three (52.6%) reported annual incomes >$60,000. Two hundred forty-one respondents (62.4%) had been undergoing screening mammography for >10 years, while this was the first examination for eight patients (2%). More than half of the patients (n = 215 [55.7%]) affirmed their interest in undergoing annual screening mammography in a private area within a retail shopping facility. Most preferred a pharmacy (77%) over Wal-Mart or a grocery store. Appealing factors about a retail setting were proximity to home (90%), free parking (62%), and operating hours (48.8%). There is interest among women in undergoing screening mammography at retail health care clinics, preferably pharmacies. The provision of services at a convenient location can increase adherence to guidelines for screening mammography. Published by Elsevier Inc.

  20. Thermography is not a feasible method for breast cancer screening.

    Science.gov (United States)

    Brkljacić, Boris; Miletić, Damir; Sardanelli, Francesco

    2013-06-01

    Breast cancer is a common malignancy causing high mortality in women especially in developed countries. Due to the contribution of mammographic screening and improvements in therapy, the mortality rate from breast cancer has decreased considerably. An imaging-based early detection of breast cancer improves the treatment outcome. Mammography is generally established not only as diagnostic but also as screening tool, while breast ultrasound plays a major role in the diagnostic setting in distinguishing solid lesions from cysts and in guiding tissue sampling. Several indications are established for contrast-enhanced magnetic resonance imaging. Thermography was not validated as a screening tool and the only study performed long ago for evaluating this technology in the screening setting demonstrated very poor results. The conclusion that thermography might be feasible for screening cannot be derived from studies with small sample size, unclear selection of patients, and in which mammography and thermography were not blindly compared as screening modalities. Thermography can not be used to aspirate, biopsy or localize lesions preoperatively since no method so far was described to accurately transpose the thermographic location of the lesion to the mammogram or ultrasound and to surgical specimen. Thermography cannot be proclaimed as a screening method, without any evidence whatsoever.

  1. Repeated judgment sampling: Boundaries

    Directory of Open Access Journals (Sweden)

    Johannes Muller-Trede

    2011-06-01

    Full Text Available This paper investigates the boundaries of the recent result that eliciting more than one estimate from the same person and averaging these can lead to accuracy gains in judgment tasks. It first examines its generality, analysing whether the kind of question being asked has an effect on the size of potential gains. Experimental results show that the question type matters. Previous results reporting potential accuracy gains are reproduced for year-estimation questions, and extended to questions about percentage shares. On the other hand, no gains are found for general numerical questions. The second part of the paper tests repeated judgment sampling's practical applicability by asking judges to provide a third and final answer on the basis of their first two estimates. In an experiment, the majority of judges do not consistently average their first two answers. As a result, they do not realise the potential accuracy gains from averaging.

  2. Allowing repeat winners

    Directory of Open Access Journals (Sweden)

    Marco D. Huesch

    2010-08-01

    Full Text Available Unbiased lotteries seem the least unfair and simplest procedures to allocate scarce indivisible resources to those with equal claims. But, when lotteries are repeated, it is not immediately obvious whether prior winners should be included or excluded. As in design questions surrounding single-shot lotteries, considerations of self-interest and distributive social preferences may interact. We investigate preferences for allowing participation of earlier winners in sequential lotteries. We found a strong preference for exclusion, both in settings where subjects were involved, and those where they were not. Subjects who answered questions about both settings did not differ in their tendency to prefer exclusion. Stated rationales significantly predicted choice but did not predict switching of choices between the two settings.

  3. Mammographic breast density: Predictive value for pathological response to neoadjuvant chemotherapy in breast cancer patients.

    Science.gov (United States)

    Elsamany, S; Alzahrani, A; Abozeed, W N; Rasmy, A; Farooq, M U; Elbiomy, M A; Rawah, E; Alsaleh, K; Abdel-Aziz, N M

    2015-10-01

    This study aims to evaluate the relation between mammographic breast density (BD) and pathological response to neoadjuvant chemotherapy. In this retrospective study, 241 breast cancer patients who received neoadjuvant chemotherapy were included. BD was assessed in mammograms already performed at diagnosis. Pathological complete response (pCR) and pathological stage were correlated with BD, tumour phenotype and other clinico-pathological factors. Patients with low BD had better pCR compared to those with high density (30.5% vs 19.5% respectively, OR = 1.8, 95% CI = 0.98-3.3, p = 0.056) which was more pronounced after adjustment with body mass index (BMI) (OR = 2.4, 95% CI = 1.2-4.8, p = 0.011). HER2-positive disease (32.5% vs. 18.4%, OR = 2.2, 95% = 1.2-4.0, p = 0.01), lower BMI (OR = 1.1, 95% CI = 1.03-1.15, p = 0.004) and lower clinical stage (p = 0.002) were significant predictors of pCR in univariate analysis. In multivariate analysis, low BD (OR = 2.7, 95% CI = 1.3-5.5, p = 0.006) and lower BMI (OR = 1.1, 95% CI = 1.03-1.17, p = 0.003) were independent predictors of better pCR, while early clinical stage (I, II) was of borderline significance (OR = 2.6, 95% CI = 0.99-6.7, p = 0.052). High BD (OR = 1.8, 95% CI = 1.1-3.2, p = 0.03), advanced clinical stage (III) (OR = 1.5, 95% CI = 1.03-2.1, p = 0.03) and higher BMI (OR = 1.06, 95% CI = 1.02-1.11, p = 0.006) were significant predictors of advanced pathological stage. Low mammographic BD, low BMI and early clinical stage were associated with improved pCR rate and lower pathological stage after neoadjuvant chemotherapy. BD had more pronounced association with response to chemotherapy after adjustment with BMI. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Polymorphisms in genes involved in the estrogen pathway and mammographic density

    Directory of Open Access Journals (Sweden)

    Dumas Isabelle

    2010-11-01

    Full Text Available Abstract Background Single nucleotide polymorphisms (SNPs in genes involved in the estrogen pathway appear to be associated with breast cancer risk and possibly with mammographic density (MD, but little is known of these associations among premenopausal women. This study examines the association of 11 polymorphisms in five estrogen-related genes (estrogen receptors alpha and beta (ERα, ERβ, 17β-hydroxysteroid dehydrogenase 1 (HSD17B1, catechol-O-methyltransferase (COMT, cytochrome P450 1B1 (CYP1B1 with premenopausal MD. Effect modification of four estrogen-related factors (parity, age at menarche, hormonal derivatives use and body mass index (BMI on this relation is also assessed. Methods Polymorphisms were genotyped in 741 premenopausal Caucasian women whose MD was measured in absolute density (AD, cm2 and percent density using a computer-assisted method. Multivariate linear models were used to examine the associations (Ptrend and interactions (Pi. Results None of the SNPs showed a statistically significant association with AD. However, each additional rare allele of rs1056836 CYP1B1 was associated with a reduction in AD among nulliparous women (Ptrend = 0.004, while no association was observed among parous women (Ptrend = 0.62; Pi = 0.02. An increase in the number of rare alleles of the HSD17B1 SNP (rs598126 and rs2010750 was associated with an increase in AD among women who never used hormonal derivatives (Ptrend = 0.06 and Ptrend = 0.04, respectively, but with a decrease in AD among past hormonal derivatives users (Ptrend = 0.04; Pi = 0.02 and Ptrend = 0.08; Pi = 0.01, respectively. Moreover, a negative association of rs598126 HSD17B1 SNP with AD was observed among women with higher BMI (>median (Ptrend = 0.01; Pi = 0.02. A negative association between an increased number of rare alleles of COMT rs4680 SNP and AD was limited to women who never used hormonal derivatives (Ptrend = 0.02; Pi = 0.03 or with late age at menarche (>median

  5. Image quality and breast dose of 24 screen-film combinations for mammography.

    Science.gov (United States)

    Dimakopoulou, A D; Tsalafoutas, I A; Georgiou, E K; Yakoumakis, E N

    2006-02-01

    In this study the effect of different mammographic screen-film combinations on image quality and breast dose, and the correlation between the various image quality parameters, breast dose and the sensitometric parameters of a film were investigated. Three Agfa (MR5-II, HDR, HT), two Kodak (Min-R M, Min-R 2000), one Fuji (AD-M), one Konica (CM-H) and one Ferrania (HM plus) single emulsion mammographic films were combined with three intensifying screens (Agfa HDS, Kodak Min-R 2190 and Fuji AD-MA). The film characteristics were det