scholarly journals 965The estimated impact of improved breast screening tests targeted at women with dense breasts

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Pietro Procopio ◽  
Louiza Velentzis ◽  
A Dennis Petrie ◽  
G Bruce Mann ◽  
Anne M Kavanagh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Density ◽  
Screening Test ◽  
Tumour Size ◽  
Screening Tests ◽  
Masking Effect ◽  
Interval Cancers ◽  
Dense Breasts

Abstract Background There is increasing interest in risk-based breast cancer screening, including interventions to improve outcomes for women with mammographically dense breasts. Methods Policy1-Breast is a continuous-time, multiple-cohort micro-simulation whole-population model which incorporates breast cancer risk, life-course breast density, menopause, hormone therapy use and screening participation. Outcomes include cancer diagnoses and characteristics (invasive/DCIS, tumour size, grade), mode of detection (screen-detected/interval/other) and mortality (breast cancer and other cause). Policy1-Breast validates well against key observed clinical outcomes in Australia. We estimate changes in outcomes within and outside the BreastScreen program upon the introduction of a hypothetical screening test with improved sensitivity for women with dense breasts. Results We estimate that introducing in year 2020 a screening test for women in the highest quintile of breast density at age 50 that halves the masking effect of their breast density would, by 2026-2030, increase diagnosis rates of population-level invasive cancers ( 10%) and screen-detected cancers (20%) and decrease rates of interval cancers (17%) and community-detected cancers (6%). Conclusions Targeted screening tests with improved sensitivity for women with dense breasts are expected to markedly reduce interval cancers and other cancers diagnosed outside the BreastScreen program, while increasing all cancer diagnoses due to increased rates of screen-detected cancers. Key messages Specialised breast cancer screening tests directed at women with very high breast density are expected to reduce interval cancers and increase overall cancer diagnoses. Population simulation models such as Policy1-Breast can complement trial evidence by evaluating a range of scenarios and estimating short and long-term implications.

scholarly journals The Effect of California’s Breast Density Notification Legislation on Breast Cancer Screening

2016 ◽  
Vol 8 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Stephanie Lynn Chau ◽  
Amy Alabaster ◽  
Karin Luikart ◽  
Leslie Manace Brenman ◽  
Laurel A. Habel
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Density ◽  
Screening Mammography ◽  
Median Income ◽  
Cancer History ◽  
Screening Guidelines ◽  
Younger Women ◽  
Dense Breasts

Purpose: Half of US states mandate women be notified if they have dense breasts on their mammogram, yet guidelines and data on supplemental screening modalities are limited. Breast density (BD) refers to the extent that breast tissue appears radiographically dense on mammograms. High BD reduces the sensitivity of screening mammography and increases breast cancer risk. The aim of this study was to determine the potential impact of California’s 2013 BD notification legislation on breast cancer screening patterns. Methods: We conducted a cohort study of women aged 40 to 74 years who were members of a large Northern California integrated health plan (approximately 3.9 million members) in 2011-2015. We calculated pre- and post-legislation rates of screening mammography and magnetic resonance imaging (MRI). We also examined whether women with dense breasts (defined as BI-RADS density c or d) had higher MRI rates than women with nondense breasts (defined as BI-RADS density a or b). Results: After adjustment for race/ethnicity, age, body mass index, medical facility, neighborhood median income, and cancer history, there was a relative 6.6% decrease (relative risk [RR] 0.934, confidence interval [CI] 0.92-0.95) in the rate of screening mammography, largely driven by a decrease among women <50 years. While infrequent, there was a relative 16% increase (RR 1.16, CI 1.07-1.25) in the rate of screening MRI, with the greatest increase among the youngest women. In the postlegislation period, women with extremely dense breasts (BI-RADS d) had 2.77 times (CI 1.93-3.95) the odds of a MRI within 9 months of a screening mammogram compared with women with nondense breasts (BI-RADS b). Conclusions: In this setting, MRI rates increased in the postlegislation period. In addition, women with higher BD were more likely to have supplementary MRI. The decrease in mammography rates seen primarily among younger women may have been due to changes in national screening guidelines.

scholarly journals A cross-sectional study exploring the justification of opportunistic breast cancer screening in Thailand

2021 ◽  
Author(s):  
Bhoowit Lerttiendamrong ◽  
Lertpong Satapongpeera ◽  
Mawin Vongsaisuwon
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Density ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Screening Mammography ◽  
Breast Ultrasonography ◽  
Cross Sectional ◽  
Dense Breasts

Objective: Breast cancer is currently the most common malignant disease in Thailand. The present study aims to evaluate the most beneficial method of breast cancer screening in different breast densities by analyzing the benefits of screening mammography with additional breast ultrasonography classified by breast density. Method: 49 middle-aged and elderly Bangkokian women who had undergone both mammography and ultrasonography were picked at random for analysis. BI-RADS scores were assigned based on mammography results alone and based on combined mammography and ultrasonography results. Concordance/discordance rates between the 2 radiographic techniques were compared in women stratified based on their breast densities. Results: All of our participants were given a score between BIRADS 1 and 3, while over 40% of participants are in the BIRADS 2 category. 60% of subjects with extremely dense breasts benefit from screening mammography with additional breast ultrasonography, while only 50% of samples with heterogeneous density and 34.21% samples with heterogeneous fibroglandular breasts benefit from the extra intervention. Conclusion: Our study concludes that women with higher breast density are more likely to benefit from screening using ultrasonography in addition to mammography as opposed to mammography screening alone. We recommend both mammography and ultrasonography for initial breast cancer screening. For follow-up visits, we suggest the screening method in accordance with breast density, using ultrasonography alone for women with high breast densities and mammography for women with heterogeneously dense breasts.

Dedicated Dual-Head Gamma Imaging for Breast Cancer Screening in Women with Mammographically Dense Breasts

Radiology ◽  
2011 ◽  
Vol 258 (1) ◽  
pp. 106-118 ◽  
Author(s):  
Deborah J. Rhodes ◽  
Carrie B. Hruska ◽  
Stephen W. Phillips ◽  
Dana H. Whaley ◽  
Michael K. O’Connor
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Gamma Imaging ◽  
Dense Breasts

scholarly journals Tumour Size at Detection According to Different Measures of Mammographic Breast Density

2009 ◽  
Vol 16 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Carolyn Nickson ◽  
Anne M Kavanagh
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Tumour Size ◽  
Mammographic Screening ◽  
Cancer Prognosis ◽  
Mammographic Breast Density ◽  
Interval Cancers ◽  
Dense Area ◽  
Screening Strategies ◽  
Continuous Measures

Objectives Breast cancer prognosis is better for smaller tumours. Women with high breast density are at higher risk of breast cancer and have larger screen-detected and interval cancers in mammographic screening programmes. We assess which continuous measures of breast density are the strongest predictors of breast tumour size at detection and therefore the best measures to identify women who might benefit from more intensive mammographic screening or alternative screening strategies. Setting and methods We compared the association between breast density and tumour size for 1007 screen-detected and 341 interval cancers diagnosed in an Australian mammographic screening programme between 1994 and 1996, for three semi-automated continuous measures of breast density: per cent density, dense area and dense area adjusted for non-dense area. Results After adjustment for age, hormone therapy use, family history of breast cancer and mode of detection (screen-detected or interval cancers), all measures of breast density shared a similar positive and significant association with tumour size. For example, tumours increased in size with dense area from an estimated mean 2.2 mm larger in the second quintile (β = 2.2; 95% Cl 0.4–3.9, P < 0.001) to mean 6.6 mm larger in the highest decile of dense area (β = 6.6; 95% Cl 4.4–8.9, P < 0.001), when compared with first quintile of breast density. Conclusions Of the breast density measures assessed, either dense area or per cent density are suitable measures for identifying women who might benefit from more intensive mammographic screening or alternative screening strategies.

ACR BI-RADS Breast Density and its correlation with breast cancer screening program

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ghada Khaled Ahmed ◽  
Mounir Sobhy Guirguis ◽  
Mona Gamalluldin Alsayed Alkaphoury
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Density ◽  
Screening Program ◽  
Dense Breast ◽  
Egyptian Population ◽  
Breast Cancer Screening Program ◽  
Cancer Screening Program

Abstract Background Breast cancer remains one of the leading causes of death in women over the age of 40 years. Breast cancer screening is used to identify women with asymptomatic cancer with the goal of enabling women to undergo less invasive treatments that lead to better outcomes, ideally at earlier stages and before the cancer progresses. Mammography is the best-studied breast cancer screening modality and the only recommended imaging tool for screening the general population of women. Objective to correlate the relation between ACR density of breast and breast cancer in screening program. Patients and Methods Our study included 40 women of breast cancer were depicted radiologically and histo-pathologically diagnosed after outreaching for screening by Digital Mammography by the Egyptian National Breast Cancer Screening Program in Ain Shams University Hospitals at period from January 2018 to October 2019.Their data were collected from the medical records of the program. Their age ranged between 40 and 65 years. Results According to the BI-RADS 5th edition 2013, cases were classified into four classes as follows: 6 were ACR-A (15.0%), 21 were ACR-B (52.5%), 12 were ACR-C (30.0%) and 1 were ACR-D (2.5%), So according to our study results dense breast shouldn’t be considered as a risk factor for breast cancer as we observed that the percentage of breast cancer in our study increases the most with average breast density ACR class B then increases with ACR class C and A respectively. Conclusion dense breast is not a risk factor for breast cancer, so further researches are needed to study the relationship between breast density and breast cancer in Egyptian population, to elucidate the role of breast density estimation in prediction of breast cancer considering the genotypical and phenotypical differences of the Egyptian population.

A prospective study of an AI-based breast cancer screening solution for resource-constrained settings.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13586-e13586
Author(s):  
Richa Bansal ◽  
Bharat Aggarwal ◽  
Lakshmi Krishnan
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Sensitivity And Specificity ◽  
Breast Tissue ◽  
Dense Breast ◽  
Resource Constrained ◽  
Dense Breast Tissue ◽  
Dense Breasts ◽  
Low Sensitivity

e13586 Background: Screening mammography is often found to have low sensitivity in women with high density breast tissues. Alternate modalities of breast USG and MRI require high-quality expensive equipment making the regular screening with these modalities less affordable and accessible, particularly in resource-constrained settings This study evaluates the clinical performance of an AI-based test (Thermalytix) that uses machine learning on breast thermal images which could potentially be a low-cost solution for breast screening in low- and middle-income countries (LMICs). Methods: The prospective comparative study conducted from December 2018 to January 2020 evaluated the performance of Thermalytix in women with dense and non-dense breast tissue who presented for a health check-up at a hospital. All women underwent Thermalytix and mammography. Further investigations were recommended for participants who were reported as positive on either test. Sensitivity and specificity of Thermalytix were evaluated across age-groups, menopausal status, and breast densities. Results: Among the 687 women recruited for the study, 459 women who satisfied the inclusion criteria were included in the analysis. 168 women had ACR categories ‘c’ or ‘d’ dense breasts, of which 37 women had an inconclusive mammography report (BI-RADS 0). Overall, 21 women were detected with breast cancer in the study. Thermalytix demonstrated an overall sensitivity of 95.2% (95% CI, 76.1-99·9) and a specificity of 88.6% (95% CI, 85.2-91.4). Among women with dense breast tissue (n=168), Thermalytix showed a sensitivity of 100% (95% CI, 69.2-100) and a specificity of 81.7% (95% CI, 74.7-87.4). In women with ACR categories ‘c’ and ‘d’ dense breasts, mammography reported 22% of them as inconclusive (BI-RAD 0), while in the same sub-set of the population Thermalytix demonstrated a sensitivity of 100%. Conclusions: The AI-based Thermalytix demonstrated high sensitivity and specificity in the study cohort. It also fared well in women younger than 50 years and pre-menopausal women where routine mammography screening yields low sensitivity. Overall, this study introduces Thermalytix, a promising radiation-free, automated, and privacy-aware test that can supplement mammography for routine screening of women, especially in women with dense breast tissue, and has the potential to influence the clinical practice in LMICs by making breast cancer screening portable and affordable. Performance of Thermalytix and mammography in women with high breast densities (ACR categories ‘c’ and ‘d’ breasts). Clinical trial information: NCT04688086. [Table: see text]

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