Implementation of service screening with mammography in Sweden: from pilot study to nationwide programme

2000 ◽  
Vol 7 (1) ◽  
pp. 14-18 ◽  
Author(s):  
S. Olsson ◽  
I. Andersson ◽  
I. Karlberg ◽  
N. Bjurstam ◽  
E. Frodis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Pilot Study ◽  
Early Detection ◽  
Mammography Screening ◽  
Recall Rate ◽  
County Council ◽  
National Average ◽  
Negative Relation ◽  
Average Recall

Establishment of mammography screening in Sweden has progressed logically from pilot study through clinical trials to service screening. Screening with mammography for early detection of breast cancer has been provided by all Sweden's 26 county councils since 1997. It took 23 years from the initial pilot study through clinical trials to the establishment of mammography service screening through out Sweden.In the screening rounds completed by 1995–96, and provided by all but one county council, 1 040 000 women participated, corresponding to 81% of those invited. The national average recall rate was 2.2%, and consequently 23 000 women were recalled for additional investigations. Eleven county councils invited women aged 40–74, six invited women aged 50–69, the remaining eight invited women between both these age intervals.Mammography outside screening programmes—clinical mammography—is available throughout Sweden. About 100 000 women a year were referred for clinical mammography and about 50% of these were either younger or older than those invited for screening. A negative relation between the use of clinical mammography and participation in the screening programmes was noticed.

scholarly journals Comment on: ‘Screening’ for Breast Cancer: Misguided Research Misinforming Public Policies, by O. S. Miettinen

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Karin Huwiler ◽  
Beat Thürlimann ◽  
Thomas Cerny ◽  
Marcel Zwahlen
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Mammography Screening ◽  
Public Policies ◽  
Medical Board

AbstractOur commentary of the article “‘Screening’ for Breast Cancer: Misguided Research Misinforming Public Policies” has two main parts. First we address some of the methodological points raised by Professor Miettinen. Then we review more specific aspects of the Swiss Medical Board statement on mammography screening for early detection of breast cancer.

Cortisol Levels and Responses to Mammography Screening in Breast Cancer Survivors: A Pilot Study

2003 ◽  
Vol 65 (5) ◽  
pp. 842-848 ◽  
Author(s):  
Laura S. Porter ◽  
Merle Mishel ◽  
Virginia Neelon ◽  
Michael Belyea ◽  
Etta Pisano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pilot Study ◽  
Cancer Survivors ◽  
Mammography Screening ◽  
Breast Cancer Survivors ◽  
Cortisol Levels

scholarly journals Participation in Mammography Screening Accomplishes an Enduring and Significant Reduction in Breast Cancer Mortality in the Era of Modern Therapy: An Observational Study Spanning 52 Years

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 56s-56s
Author(s):  
R. Smith ◽  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Cancer Mortality ◽  
Mammography Screening ◽  
Breast Cancer Mortality ◽  
Mortality Rates ◽  
Trial Period ◽  
Breast Cancer Death ◽  
Self Selection ◽  
Screening Trial

Background: A significant decrease in breast cancer mortality has been demonstrated in populations invited to mammography screening. There have been questions regarding the value of mammography in the era of modern therapies, and the relative contribution of mammography screening and modern therapy on mortality reduction. Aim: We have sought to clarify the extent to which early detection through mammography screening contributes to the reduction of breast cancer death in the era of modern adjuvant therapies. We address this question by studying five decades of continuous data from a stable population spanning the pre- and postscreening and adjuvant therapy periods. Methods: We analyzed changes in breast cancer mortality in a stable population in Dalarna County, Sweden, among women aged 40-69 years during the 52 years from 1964 through 2015. Mortality data were obtained from the National Cause of Death Register in Sweden, and incidence data from the Swedish National Cancer Registry. Crude and incidence-based mortality rates were compared among four successive 13-year periods: the prescreening period from 1964 through 1976, the Swedish Two-County randomized screening trial period from 1977 through 1989, and two service screening periods from 1990-2002 and from 2003-2015. Furthermore, we measured the effect of early detection upon breast cancer mortality in women exposed to mammography screening by comparison with breast cancer death in women not exposed to mammography screening, within these three screening periods. Data were analyzed by Poisson regression, with corrections for lead time and self-selection bias. Results: There were 5844 incident cases and 1425 breast cancer deaths during the 52 years of observation. The relative breast cancer mortality rates associated with exposure to screening, adjusted for self-selection bias, were 0.46 (95% CI 0.30-0.69) in the trial period (1977-1989), 0.44 (95% CI 0.30-0.65) in the 1990-2002 period, and 0.37 (95% CI 0.24-0.56) in the 2003-2015 period. The significant reductions in incidence-based breast cancer mortality associated with exposure to screening were independent of contemporaneous changes in therapy. Conclusion: The combination of early detection of breast cancer through mammography screening and the resultant earlier treatment has significantly reduced breast cancer mortality in Dalarna County in the women exposed to screening, compared with the women not participating in screening, by a factor of 2.2 in the screening trial period, increasing to a factor of 2.7 in the most recent service screening period. These mortality benefits can be attributed to the far greater effectiveness of modern therapeutic methods upon cancers detected at screening compared with the poorer effectiveness of the same therapeutic methods in women not participating in screening.

The screening value of mammography for breast cancer : an overview of 22 systematic reviews with evidence mapping (Preprint)

2021 ◽  
Author(s):  
Jiyuan Shi Jr ◽  
Ya Gao Sr ◽  
Peng Wang 2nd ◽  
Liang Zhao ◽  
Shuang Wu 4th ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Reviews ◽  
Mammography Screening ◽  
Meta Analysis ◽  
Breast Cancer Mortality ◽  
Digital Breast Tomosynthesis ◽  
Recall Rate ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Evidence Mapping

UNSTRUCTURED Several meta-analyses have evaluated the screening value of mammography for breast cancer, but the overall results have remained mixed or inconclusive. Comprehensive literature search was conducted for SRs (systematic reviews) in Chinese Biomedical Databases (CBM), Cochrane Library, EMBASE, and PubMed until July 10, 2020. SRs with meta-analysis reported the benefit and performance of mammography screening were included. Two reviewers independently extracted data and performed the methodological quality assessments using The Risk Of Bias In Systematic Reviews (ROBIS). The characteristics of included SRs, the results of the quality of Risk of bias (RoBs) assessment and the pooled estimates of effect size were descriptively summarized using systematically structured tables and evidence mapping. Twenty two systematic reviews with meta-analysis were included. Only 13.6% of SRs were assessed as low-risk bias according to the overall risk of bias rating results in ROBIS tool. Pooled estimates for a reduction in breast cancer mortality attributable to mammography screening were range from 0.51 (OR, 95% CI: 0.46-0.55) to 1.04 (RR, 95% CI: 0.84-1.27). Sensitivity of difference mammography was ranged from 55% to 91%, specificity of difference mammography was ranged from 84% to 97%. According to the results of included SRs suggested, the statistically significant was observed that digital breast tomosynthesis (DBT) increased the cancer detected rate (CDR) and reduced the recall rate compared to digital mammography (DM), DM increased the CDR compared to screen-film mammography (SFM), and add DBT to digital or synthetic mammography increases the sensitivity, specificity, and CDR than DBT alone. Further study should investigate the value of different imaging technology in breast cancer screening.

Abstract 713: Proteomic early detection biomarkers for ER+ breast cancer to improve mammography screening

2017 ◽  
Author(s):  
Carly B. Garrison ◽  
Tracey Marsh ◽  
Matthew Buas ◽  
Yuzheng Zhang ◽  
Margaret Pepe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Mammography Screening

scholarly journals Empowering Latina breast cancer patients to make informed decisions about clinical trials: a pilot study

2018 ◽  
Vol 8 (3) ◽  
pp. 439-449 ◽  
Author(s):  
Patricia Chalela ◽  
Edgar Muñoz ◽  
Kipling J Gallion ◽  
Virginia Kaklamani ◽  
Amelie G Ramirez
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Pilot Study ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Informed Decisions

scholarly journals Long-Term Breast Cancer Survival Affected by Overdiagnosis

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 204s-204s
Author(s):  
C. Fann
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Early Detection ◽  
Effective Treatment ◽  
Mammography Screening ◽  
Cancer Survival ◽  
Breast Cancer Survival ◽  
Sufficient Information

Background: Overdetected breast cancers (BCs) via mammography screening that are biologically nonprogressive and unnecessary to receive treatment is of great concern for population-based screening. Most previous studies estimated overdiagnosis by excess incidence due to the introduction of screening compared with background incidence derived from randomized control trial, which require population incident-based BC data and the strong assumption of lead-time distribution, few studies have been adopted by using merely follow-up data on BCs. Aim: To assess respective independent contributions of overdiagnosis and curation to long-term breast cancer survival by the application of the novel zero-inflated statistical model to a longitudinal follow up empirical data with sufficient information based on patient-based data. Methods: We designed a retrospective cohort composed of 1346 patients diagnosed with invasive breast cancer in Falun Central Hospital of Dalarna County, Sweden, through international collaboration. A novel zero-inflated cured or overdiagnosis regression model was conducted. The zero part represents both types of nonprogressive cancer without potential of dying from BC, the cured due to treatment and the overdiagnosed due to mammography screening. These 2 types would be distinguished by detection modes (screen-detected cases and interval cancer plus cancers from nonparticipants). The count part represents the progressive breast cancer with potential of dying from BC associated with prognostic factors during follow-up. Results: The probability for nonprogressive BC (the zero part) was 56.14%. The probability of zero due to curation resulting from early detection and effective treatment was 44.34%. Overdiagnosis resulting from mammography screening program was 8.94% and high awareness was 2.86%. Among 43.86% progressive BC (the count part), 32.11% patients undergoing subsequent adjuvant therapies still remained alive after 15-year follow-up when adjusting for significant prognostic factors. The 15-year prognosis-adjusted cumulative survival of BC was dropped from 88.25% to 74.80% after correcting for the zero-inflated part of overdiagnosis. Conclusion: The proposed zero-inflated model with 15 years of follow-up data revealed 12% due to overdiagnosis after taking out the probability of zero due to curation as a result of early detection and effective treatment from the total zero part.

scholarly journals Comparison of Gradient-Based Edge Detectors Applied on Mammograms

2021 ◽  
Vol 66 (2) ◽  
pp. 5
Author(s):  
C. Moroz-Dubenco
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Edge Detection ◽  
Mammography Screening ◽  
System A ◽  
Interpretation System ◽  
Edge Detectors ◽  
Gradient Based ◽  
Automated Interpretation ◽  
Image Orientation

Breast cancer is one of the most common types of cancer amongst women, but it is also one of the most frequently cured cancers. Because of this, early detection is crucial, and this can be done through mammography screening. With the increasing need of an automated interpretation system, a lot of methods have been proposed so far and, regardless of the algorithms, they all share a step: pre-processing. That is, identifying the image orientation, detecting the breast and eliminating irrelevant parts. This paper aims to describe, analyze, compare and evaluate six of the most commonly used edge detection operators: Sobel, Roberts Cross, Prewitt, Farid and Simoncelli, Scharr and Canny. We detail the algorithms, their implementations and the metrics used for evaluation and continue by comparing the operators both visually and numerically, finally concluding that Canny best suit our needs.

scholarly journals Comparison of Mammography and Ultrasonography for Early Detection of Breast Cancer

2021 ◽  
Vol 15 (7) ◽  
pp. 1450-1455
Author(s):  
Samina Mahmood ◽  
M Nawaz Anjum ◽  
Faiza Farooq ◽  
S.Amir Gilani ◽  
Mehreen Fatima ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Early Detection ◽  
Meta Analysis ◽  
Recall Rate ◽  
Screening Methods ◽  
Major Purpose ◽  
High Recall ◽  
Dense Breasts ◽  
High Recall Rate

Aim: This systematic review is specifically aimed to compare mammography and ultrasonography in early detection of breast cancer. For this systematic review, major purpose is to compare both screening methods and also analyze the performance of supplemental ultrasonography for early detection of breast cancer. Methodology: For this systematic review, total 23 studies are included which follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic articles from year 2007 to from year 2017 on PUB Med, online Willey library, and Science Direct site were searched by using keywords related to sonographic and mammography imaging for breast cancer. Results: Out of 23 studies, 12 studies are conducted on women with dense breasts. Twenty studies performed their imaging with hand held ultrasound (HHUS). Out of twenty-three studies, sixteen studies followed BI-RADS procedures. In eleven studies that used joint methods, it was observed that mammography (MAM) has 65% whereas ultrasound (US) has 68% efficiency for early detection of breast cancer. 88% area under a cover (AUCs) among MAM and 98% among US imaging was observed. No major difference was found in sensitivity and specificity of both techniques. Conclusion: Study concludes that Ultrasound is more efficient to diagnose factors suggestive of breast cancer that cannot be detected on mammography. It also has the potential to evaluate cancer among dense breast women but unfortunately in some cases, it may cause a high recall rate. Keywords: Breast, Cancer, Mammography, Ultrasonography, Screening.

Feasibility of integrating the Outcomes4Me smartphone navigation application into the care of breast cancer patients (FIONA).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1570-1570
Author(s):  
Steven J. Isakoff ◽  
Maya Said ◽  
Agnes H. Kwak ◽  
Eva Glieberman ◽  
Amanda Stroiney ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Pilot Study ◽  
Patient Engagement ◽  
Medical Center ◽  
Treatment Options ◽  
Academic Medical Center ◽  
Patient Reported ◽  
Clinical Trial Information

1570 Background: Patients diagnosed with breast cancer (BC) face complex decisions about their care and many studies have shown that improved patient engagement results in increased satisfaction and better outcomes. Patient engagement includes education, treatment option selection, symptom tracking and reporting, and clinical trial opportunities. We conducted a pilot study to determine the feasibility of introducing the Outcomes4Me patient engagement app into the standard of care experience of BC patients. Methods: This was a pilot study (NCT04262518) conducted at an academic medical center. Eligible patients had any subtype of stage 1-4 BC and were on any type of chemo-, hormonal-, targeted-, or radiation-therapy for BC during the study period. Participants downloaded the app on their smartphone and their app usage was evaluated. Surveys were administered at baseline and end of study. Clinicians caring for patients using the app were surveyed at the end of the study. The primary endpoint was feasibility, defined as at least 40% of patients engaging with the app at least 3 times over the 12-week study period. Additional endpoints included usability, satisfaction, correlation of patient reported data with the EHR, clinical trial matching, and patient experience. Results: Between June 2020 and December 2020, 107 patients enrolled; results are reported for 90 patients with complete data as of 1/24/21. Baseline demographics: median age 53 (range: 27-77); 90% White, 4% Black, 3% Asian; 66% had hormone positive/HER2-, 20% HER2+, and 13% triple negative BC; 31% had stage 4 disease. At study entry, 93% had never used an app to help with their disease or treatment options. Over the 12 week study period, 58% of patients engaged with the app at least 3 times, meeting the primary feasibility endpoint. Patients engaged with the app on average 5.5 days (range: 0-40) with 20% engaging on more than 10 days during the study. The mean System Usability Score was 71 (median = 76) and was similar across age groups. The 5 app features deemed most (‘somewhat’ or ‘very’) helpful were: background about their BC (76%), information about treatment options (74%), newsfeed about their BC (70%), symptom tracking (65%), and clinical trial information (65%). 53% said that the app helped them keep track of symptoms and 33% said they are more likely to explore or enroll in a clinical trial after using the app. Conclusions: Integration of the Outcomes4Me app into the care management of BC patients is feasible with acceptable usability. Our results suggest that use of a patient smartphone app may be helpful for many aspects of patient education and engagement for patients with BC. The results also suggest that this type of intervention can help patients better track their symptoms and make them aware of clinical trials, potentially facilitating the management of side effects and accelerating clinical trials recruitment. Clinical trial information: NCT04262518.

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