scholarly journals True and Missed Interval Cancer in Organized Mammographic Screening: A Retrospective Review Study of Diagnostic and Prior Screening Mammograms

Author(s):  
Tone Hovda ◽  
Solveig Roth Hoff ◽  
Marthe Larsen ◽  
Linda Romundstad ◽  
Kristine Kleivi Sahlberg ◽  
...  
Author(s):  
Kristina Lång ◽  
Solveig Hofvind ◽  
Alejandro Rodríguez-Ruiz ◽  
Ingvar Andersson

Abstract Objectives To investigate whether artificial intelligence (AI) can reduce interval cancer in mammography screening. Materials and methods Preceding screening mammograms of 429 consecutive women diagnosed with interval cancer in Southern Sweden between 2013 and 2017 were analysed with a deep learning–based AI system. The system assigns a risk score from 1 to 10. Two experienced breast radiologists reviewed and classified the cases in consensus as true negative, minimal signs or false negative and assessed whether the AI system correctly localised the cancer. The potential reduction of interval cancer was calculated at different risk score thresholds corresponding to approximately 10%, 4% and 1% recall rates. Results A statistically significant correlation between interval cancer classification groups and AI risk score was observed (p < .0001). AI scored one in three (143/429) interval cancer with risk score 10, of which 67% (96/143) were either classified as minimal signs or false negative. Of these, 58% (83/143) were correctly located by AI, and could therefore potentially be detected at screening with the aid of AI, resulting in a 19.3% (95% CI 15.9–23.4) reduction of interval cancer. At 4% and 1% recall thresholds, the reduction of interval cancer was 11.2% (95% CI 8.5–14.5) and 4.7% (95% CI 3.0–7.1). The corresponding reduction of interval cancer with grave outcome (women who died or with stage IV disease) at risk score 10 was 23% (8/35; 95% CI 12–39). Conclusion The use of AI in screen reading has the potential to reduce the rate of interval cancer without supplementary screening modalities. Key Points • Retrospective study showed that AI detected 19% of interval cancer at the preceding screening exam that in addition showed at least minimal signs of malignancy. Importantly, these were correctly localised by AI, thus obviating supplementary screening modalities. • AI could potentially reduce a proportion of particularly aggressive interval cancers. • There was a correlation between AI risk score and interval cancer classified as true negative, minimal signs or false negative.


2017 ◽  
Vol 101 (12) ◽  
pp. 1638-1642 ◽  
Author(s):  
Jun Hong Jiang ◽  
Shao Dan Zhang ◽  
Ma Li Dai ◽  
Juan Yuan Yang ◽  
Yan Qian Xie ◽  
...  

Author(s):  
Raúl H. Morales-Borges

AbstractMethylenetetrahydrofolate reductase (MTHFR) mutations have been linked to many diseases. Evidence has been provided to prove that we need to perform pharmacogenetic studies regarding the prevalence of MTHFR mutations and diseases, risks, and the impact on folate requirement in general, but little has been published about Puerto Ricans. A multi center cross-sectional retrospective review study or a prospective pharmacogenetic study of valid genotypes and phenotypes of MTHFR mutations within the different populations of Puerto Ricans and Hispanics are recommended, because differences within them and within the general population are expected.


2021 ◽  
Author(s):  
Bonnie Wei Man Siu ◽  
Eric Shek Kin Lai ◽  
Jessica Pui Yan Lam ◽  
Clement Chan ◽  
Anita Wai Lan Chan ◽  
...  

2010 ◽  
Vol 06 ◽  
pp. 36
Author(s):  
Matthew L Webb ◽  
Blake Cady ◽  
James S Michaelson ◽  
◽  
◽  
...  

Background:Randomized population mammographic screening trials demonstrated a statistically significant mortality reduction in screened women. Studies in Sweden and The Netherlands show that screening is the main reason that the death rate has decreased in the general population, but ony limited data are available to assess this in the US. In a previous report, 75% of breast cancer deaths occurred in the small proportion of unscreened women. This conclusion needs confirmation.Methods:In a large hospital consortium, 6,997 invasive breast cancer diagnoses occurred between 1990 and 1999. Among all subsequent deaths through 2007, breast cancer deaths in Massachusetts women were documented by review of hospital and outpatient records. Regular screening was defined as two or more screening mammograms at intervals of two years or less in asymptomatic women.Results:After 12.5 (range: eight to 17) years of median follow-up, 461 deaths from breast cancer were confirmed. Seventy-two deaths (15.6%) resulted from non-palpable screen-detected cancers, 44 deaths (9.6%) resulted from palpable interval cancers, and a total of 116 deaths (25.2%) occurred in regularly screened women. Three hundred and twenty-two deaths (69.9%) occurred in women who had never had screening mammography, and 23 deaths (5%) occurred after one or more previous mammograms, none within two years of diagnosis. Thus, 345 breast cancer deaths (74.8%) occurred in women who were not regularly screened.Conclusion:The most effective method of avoiding death from breast cancer is for women to participate in regular screening mammography.


2021 ◽  
Vol 28 ◽  
pp. 107327482110394
Author(s):  
Eman Sbaity ◽  
Rachelle Bejjany ◽  
Malek Kreidieh ◽  
Sally Temraz ◽  
Ali Shamseddine

Breast cancer (BC) is the most common cancer in women and men combined, and it is the second cause of cancer deaths in women after lung cancer. In Lebanon, the same epidemiological profile applies where BC is the leading cancer among Lebanese females, representing 38.2% of all cancer cases. As per the Center for Disease Control, there was a decline in BC mortality rate from 2003 to 2012 reflecting the adoption of national mammographic screening as the gold standard for BC detection by Western countries. The aim of this review study is to summarize current recommendations for BC screening and the available modalities for detecting BC in different countries, particularly in Lebanon. It also aims at exploring the impact of screening campaigns on BC early stage diagnosis in Lebanon. Despite the considerable debates whether screening mammograms provides more harm than benefits, screening awareness should be stressed since its benefits far outweigh its risks. In fact, the majority of BC mortality cases in Western countries are non-preventable by the use of screening mammograms alone. As such, Lebanon adopted a public focus on education and awareness campaigns encouraging early BC screening. Several studies showed the impact of early detection that is reflected by an increase in early stage disease and a decrease in more aggressive stages. Further studies should shed the light on the effect of awareness campaigns on early breast cancer diagnosis and clinical down staging at a national scope; therefore, having readily available data on pre- and post-adoption of screening campaigns is crucial for analyzing trends in mortality of breast cancer origin and reduction in advanced stages diseases. There is still room for future studies evaluating post-campaigns knowledge, attitudes, and practices of women having participated, emphasizing on the barriers refraining Lebanese women to contribute in BC screening campaigns.


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