The Impact of Breast Density Notification Laws on Supplemental Breast Imaging and Breast Biopsy

We sought to evaluate the impact of needle core size and number of core samples on diagnostic accuracy and upgrade rates for image-guided core needle biopsies of the breast. A total of 234 patients underwent image-guided percutaneous needle biopsies and subsequent surgical excision. Large-core needles (9 gauge or less) were used in 14.5 per cent of cases and the remainder were performed with smaller core needles. More than four core samples were taken in 78.9 per cent of patients. In 71.8 per cent of cases, needle biopsy pathology matched surgical excision pathology. After surgical excision, upgraded pathology was revealed in 10.7 per cent of cases. Of 11 patients (52.4%) with benign needle core pathology who had upgraded final pathology on surgical excision, 10 had a Breast Imaging Recording and Data System score 4 or 5 imaging study. Lesions smaller than 10 mm were more likely to be misdiagnosed ( P = 0.01) or have upgraded pathology ( P = 0.009). Other predictors of upgraded pathology were patient age 50 years or older ( P = 0.03) and taking four or fewer core samples ( P = 0.003). Needle core size did not impact accuracy or upgrade rates. Surgeons should exercise caution when interpreting needle biopsy results with older patients, smaller lesions, and limited sampling. Discordant pathology and imaging still mandate surgical confirmation.

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Validation of Wavelia Microwave Breast Imaging System Using Mammography Breast Density

2021 15th European Conference on Antennas and Propagation (EuCAP) ◽

10.23919/eucap51087.2021.9410918 ◽

2021 ◽

Author(s):

Yazan Abdoush ◽

Angie Fasoula ◽

Luc Duchesne ◽

Julio D. Gil Cano ◽

Brian M. Moloney ◽

...

Keyword(s):

Breast Density ◽

Breast Imaging ◽

Imaging System ◽

Microwave Breast Imaging

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Breast Density Notification: A Systematic Review of the Impact on Primary Care Practitioners

Journal of Women s Health ◽

10.1089/jwh.2020.8898 ◽

2021 ◽

Author(s):

Brooke Nickel ◽

Tessa Copp ◽

Meagan Brennan ◽

Rachel Farber ◽

Kirsten McCaffery ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Breast Density ◽

Primary Care Practitioners ◽

The Impact

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The Impact of Breast Density on Breast Cancer Detection

Jurnal Sains Kesihatan Malaysia ◽

10.17576/jskm-2021-1901-12 ◽

2021 ◽

Vol 19 (01) ◽

pp. 109-116

Author(s):

NORHASHIMAH MOHD NORSUDDIN ◽

NURFADHILAH IDRIS

Keyword(s):

Breast Cancer ◽

Breast Density ◽

Cancer Detection ◽

Breast Cancer Detection ◽

The Impact

OBJEKTIF: Kajian ini dilakukan untuk mengenalpasti kategori densiti payudara yang mempunyai kebarangkalian tinggi untuk menyebabkan kanser payudara tidak dikesan atau disalah diagnosis. METODOLOGI: Kelulusan etika menjalankan penyelidikan telah diperolehi daripada Jawatankuasa Etika Penyelidikan Universiti Kebangsaan Malaysia. Sebanyak 495 kes mamografi telah dipilih dari Jabatan Radiologi, Pusat Perubatan Universiti Kebangsaan Malaysia. Semua kes mamografi telah diasingkan kepada 4 kumpulan diagnosis iaitu negative benar, positif benar, positif palsu dan negatif palsu. Kemudian, setiap kes mamografi dibahagikan mengikut empat kategori densiti payudara BI-RADS (I, II, III, IV). Analisis kebarangkalian risiko (odd ratio) setiap kategori densiti payudara dengan keputusan positif palsu dan negatif palsu dilakukan dengan menggunakan ujian regresi logistik. HASIL KAJIAN: Kebarangkalian imej mamografi dalam kategori densiti BI-RAD IV didiagnosis sebagai positif palsu adalah emapt kali ganda berbanding imej mamografi dalam kategori densiti BI-RAD I (odd ratio [OR], 4.27; 95% CI,0.88- 20.67). Manakala, imej mamografi yang mempunyai densiti BI-RAD II dan BI-RAD III mempunyai hampir dua kali ganda kemungkinan didiagnosis sebagai negatif palsu berbanding wanita berdensiti BI-RAD I (odd ratio [OR], 1.59, 1.32; 95% CI, 0.29-8.77, 0.25-7.01). KESIMPULAN: Densiti payudara dalam mamografi mempengaruhi keputusan diagnosis pakar radiologi dalam pengesanan kanser payudara. Kes mamografi yang mempunyai densiti BI-RAD IV lebih cenderung disalah diagnosis. Manakala pengesanan kanser dalam payudara berdensiti BI-RAD II dan BI-RAD III lebih berisiko untuk tidak dikesan. Penelitian yang lebih perlu diberikan dalam mentafsir imej mamografi berdensiti BI-RAD II, III dan IV bagi mengelakkan kanser disalah diagnosis atau tidak dikesan di peringkat awal. Pengesanan awal kanser payudara dapat meningkatkan kemandirian pesakit kanser.

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Factors Influencing Trainees’ Interest in Breast Imaging

Canadian Association of Radiologists Journal ◽

10.1177/08465371211049553 ◽

2021 ◽

pp. 084653712110495

Author(s):

Tong Wu ◽

Wyanne Law ◽

Nayaar Islam ◽

Charlotte J. Yong-Hing ◽

Supriya Kulkarni ◽

...

Keyword(s):

Artificial Intelligence ◽

Medical Students ◽

Breast Imaging ◽

Current Level ◽

Common Reason ◽

Training Level ◽

Chi Square ◽

Factors Influencing ◽

Radiology Residents ◽

The Impact

Purpose: To gauge the level of interest in breast imaging (BI) and determine factors impacting trainees’ decision to pursue this subspecialty. Methods: Canadian radiology residents and medical students were surveyed from November 2020 to February 2021. Training level, actual vs preferred timing of breast rotations, fellowship choices, perceptions of BI, and how artificial intelligence (AI) will impact BI were collected. Chi-square, Fisher’s exact tests and univariate logistic regression were performed to determine the impact of trainees’ perceptions on interest in pursuing BI/women’s imaging (WI) fellowships. Results: 157 responses from 80 radiology residents and 77 medical students were collected. The top 3 fellowship subspecialties desired by residents were BI/WI (36%), abdominal imaging (35%), and interventional radiology (25%). Twenty-five percent of the medical students were unsure due to lack of exposure. The most common reason that trainees found BI unappealing was repetitiveness (20%), which was associated with lack of interest in BI/WI fellowships (OR = 3.9, 95% CI: 1.6-9.5, P = .002). The most common reason residents found BI appealing was procedures (59%), which was associated with interest in BI/WI fellowships (OR, 3.2, 95% CI, 1.2-8.6, P = .02). Forty percent of residents reported an earlier start of their first breast rotation (PGY1-2) would affect their fellowship choice. Conclusion: This study assessed the current level of Canadian trainees’ interest in BI and identified factors that influenced their decisions to pursue BI. Solutions for increased interest include earlier exposure to breast radiology and addressing inadequacies in residency training.

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Quantitative Measurements of Breast Density Using Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm8050745 ◽

2019 ◽

Vol 8 (5) ◽

pp. 745 ◽

Cited By ~ 1

Author(s):

Rooa Sindi ◽

Cláudia Sá Dos Reis ◽

Colleen Bennett ◽

Gil Stevenson ◽

Zhonghua Sun

Keyword(s):

Systematic Review ◽

Cluster Analysis ◽

Breast Density ◽

Breast Imaging ◽

Quantitative Assessment ◽

Nearest Neighbor ◽

Meta Analysis ◽

Fatty Tissue ◽

Single Linkage ◽

Meta Analyses

Breast density, a measure of dense fibroglandular tissue relative to non-dense fatty tissue, is confirmed as an independent risk factor of breast cancer. Although there has been an increasing interest in the quantitative assessment of breast density, no research has investigated the optimal technical approach of breast MRI in this aspect. Therefore, we performed a systematic review and meta-analysis to analyze the current studies on quantitative assessment of breast density using MRI and to determine the most appropriate technical/operational protocol. Databases (PubMed, EMBASE, ScienceDirect, and Web of Science) were searched systematically for eligible studies. Single arm meta-analysis was conducted to determine quantitative values of MRI in breast density assessments. Combined means with their 95% confidence interval (CI) were calculated using a fixed-effect model. In addition, subgroup meta-analyses were performed with stratification by breast density segmentation/measurement method. Furthermore, alternative groupings based on statistical similarities were identified via a cluster analysis employing study means and standard deviations in a Nearest Neighbor/Single Linkage. A total of 38 studies matched the inclusion criteria for this systematic review. Twenty-one of these studies were judged to be eligible for meta-analysis. The results indicated, generally, high levels of heterogeneity between study means within groups and high levels of heterogeneity between study variances within groups. The studies in two main clusters identified by the cluster analysis were also subjected to meta-analyses. The review confirmed high levels of heterogeneity within the breast density studies, considered to be due mainly to the applications of MR breast-imaging protocols and the use of breast density segmentation/measurement methods. Further research should be performed to determine the most appropriate protocol and method for quantifying breast density using MRI.

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Breast biopsy patterns and findings among older women undergoing screening mammography: what is the impact of age and comorbidity?

Annals of Epidemiology ◽

10.1016/j.annepidem.2019.06.017 ◽

2019 ◽

Vol 36 ◽

pp. 69

Author(s):

S. Advani ◽

D. Braithwaite ◽

L. Abraham ◽

D.S.M. Buist ◽

E.S. O’Meara ◽

...

Keyword(s):

Older Women ◽

Breast Biopsy ◽

Screening Mammography ◽

The Impact

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Breast density in women with premature ovarian failure or postmenopausal women using hormone therapy: analytical cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/s1516-31802010000400007 ◽

2010 ◽

Vol 128 (4) ◽

pp. 211-214 ◽

Cited By ~ 9

Author(s):

Patrícia Magda Soares ◽

César Cabello ◽

Luis Alberto Magna ◽

Eduardo Tinois ◽

Cristina Laguna Benetti-Pinto

Keyword(s):

Hormone Therapy ◽

Postmenopausal Women ◽

Breast Density ◽

Premature Ovarian Failure ◽

Cross Sectional Study ◽

Ovarian Failure ◽

Sectional Study ◽

Cross Sectional ◽

Significant Difference ◽

The Impact

CONTEXT AND OBJECTIVE: Studies on postmenopausal women have reported increased risk of breast cancer relating to the type and duration of hormone therapy (HT) used. Women with premature ovarian failure (POF) represent a challenge, since they require prolonged HT. Little is known about the impact of prolonged HT use on these women's breasts. This study aimed to evaluate the effects of one type of HT on the breast density of women with POF, compared with postmenopausal women. DESIGN AND SETTING: Cross-sectional study at the Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (Unicamp). METHODS: 31 women with POF and 31 postmenopausal women, all using HT consisting of conjugated equine estrogen combined with medroxyprogesterone acetate, and matched according to HT duration, were studied. Mammography was performed on all subjects and was analyzed by means of digitization or Wolfe's classification, stratified into two categories: non-dense (N1 and P1 patterns) and dense (P2 and Dy). RESULTS: No significant difference in breast density was found between the two groups through digitization or Wolfe's classification. From digitization, the mean breast density was 24.1% ± 14.6 and 18.1% ± 17.2 in the POF and postmenopausal groups, respectively (P = 0.15). Wolfe's classification identified dense breasts in 51.6% and 29.0%, respectively (P = 0.171). CONCLUSION: There was no difference in breast density between the women with POF and postmenopausal women, who had used HT for the same length of time. These results may help towards compliance with HT use among women with POF.

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