MRI Screening Reduces Interval Breast Cancer in Women with Dense                     Breasts

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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Global tissue stiffness on breast MR elastography: High-risk dense breast patients have higher stiffness compared to average-risk dense breast patients.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10541 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10541-10541

Author(s):

Bhavika K. Patel ◽

Kay Pepin ◽

Kathy R Brandt ◽

Gina L. Mazza ◽

Barbara A. Pockaj ◽

...

Keyword(s):

Breast Cancer ◽

High Risk ◽

Cancer Risk ◽

Menopausal Status ◽

Risk Groups ◽

Average Risk ◽

Tissue Stiffness ◽

Tissue Properties ◽

Dense Breasts ◽

Risk Patients

10541 Background: Biomechanical tissue properties may vary in the breasts of patients at elevated risk for breast cancer. We aim to quantify in vivo biomechanical tissue properties in various breast densities and in both normal risk and high risk women using Magnetic Resonance Imaging (MRI)/MRE and examine the association of biomechanical properties of the breast with cancer risk. Methods: In this IRB–approved prospective single-institution study, we recruited two groups of women differing by breast cancer risk to undergo a 3.0 T dynamic contrast enhanced MRI/MRE of the breast. Low-average risk women were defined as having no personal or significant family history of breast cancer, no prior high risk breast biopsies and a negative mammography within 12 months. High-risk breast cancer patients were recruited from those patients who underwent standard of care breast MR. Within each breast density group (non-dense versus dense), two-sample t-tests were used to compare breast stiffness, elasticity, and viscosity across risk groups (low-average vs high). Results: There were 50 low-average risk and 86 high-risk patients recruited to the study. The risk groups were similar on age (mean age = 55.6 and 53.6 years), density (68% vs. 64% dense breasts) and menopausal status (66.0% vs. 69.8%). Among patients with dense breasts, mean stiffness, elasticity, and viscosity were significantly higher in high risk patients ( N = 55) compared to low-average risk patients ( N = 34; all p < 0.001). In the multivariate logistic regression model, breast stiffness remained a significant predictor of risk status (OR=4.26, 95% CI [1.96, 9.25]) even after controlling for breast density, MRI BPE, age, and menopausal status. Similar results were seen for breast elasticity (OR=4.88, 95% CI [2.08, 11.43]) and viscosity (OR=11.49, 95% CI [1.15, 114.89]). Conclusions: Structurally-based, quantitative biomarker of tissue stiffness obtained from global 3D breast MRE is associated with differences in breast cancer risk in dense breasts. As such, tissue stiffness could provide a novel prognostic marker to help identify the subset of high-risk women with dense breasts who would benefit from increased surveillance.[Table: see text]

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Long-term risk of screen-detected and interval breast cancer after false-positive results at mammography screening: joint analysis of three national cohorts

British Journal of Cancer ◽

10.1038/s41416-018-0358-5 ◽

2018 ◽

Vol 120 (2) ◽

pp. 269-275 ◽

Cited By ~ 4

Author(s):

Marta Román ◽

Solveig Hofvind ◽

My von Euler-Chelpin ◽

Xavier Castells

Keyword(s):

Breast Cancer ◽

False Positive ◽

Mammography Screening ◽

Joint Analysis ◽

Interval Breast Cancer ◽

Positive Results

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Prognosis in women with interval breast cancer: population based observational cohort study

BMJ ◽

10.1136/bmj.e7536 ◽

2012 ◽

Vol 345 (nov16 1) ◽

pp. e7536-e7536 ◽

Cited By ~ 23

Author(s):

M. Kalager ◽

R. M. Tamimi ◽

M. Bretthauer ◽

H.-O. Adami

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Population Based ◽

Observational Cohort Study ◽

Interval Breast Cancer ◽

Observational Cohort

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What do women know about breast density? A public screening program perspective

10.1101/2020.04.02.20048371 ◽

2020 ◽

Author(s):

Monique Robertson ◽

Ellie C Darcey ◽

Evenda K Dench ◽

Louise Keogh ◽

Kirsty McLean ◽

...

Keyword(s):

Breast Cancer ◽

Breast Density ◽

Screening Program ◽

Mammographic Screening ◽

Descriptive Data ◽

Additional Information ◽

Dense Breasts ◽

Increased Risk ◽

Main Message ◽

First Time

AbstractBackgroundThis study assesses knowledge of breast density, one of breast cancer’s strongest risk factors, in women attending a public mammographic screening program in Western Australia that routinely notifies women if they have dense breasts.MethodsSurvey data was collected from women who were notified they have dense breasts and women who had not (controls). Descriptive data analysis was used to summarize responses.ResultsOf the 6183 women surveyed, over 85% of notified women knew that breast density makes it difficult to see cancer on a mammogram (53.9% in controls). A quarter of notified women knew that having dense breasts puts women at increased risk for breast cancer (13.2% in controls). Overall, 50.1% of notified women indicated that they thought the amount of information provided was “just right” and 24.9% thought it was “too little”, particularly women notified for the first time (32.1%).ConclusionThe main message of reduced sensitivity of mammography in women with dense breasts provided by the screening program appears to be getting though. However, women are largely unaware that increased breast density is associated with increased risk. Women notified of having dense breasts for the first time could potentially benefit from additional information.

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Mammographic Breast Density: Effect on Imaging and Breast Cancer Risk

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2010.0085 ◽

2010 ◽

Vol 8 (10) ◽

pp. 1157-1165 ◽

Cited By ~ 47

Author(s):

Renee W. Pinsky ◽

Mark A. Helvie

Keyword(s):

Breast Cancer ◽

Breast Density ◽

Menopausal Status ◽

Masking Effect ◽

Mammographic Breast Density ◽

Ultrasound Screening ◽

High Risk Women ◽

Dense Breasts ◽

Reduction Strategies ◽

Risk Reduction Strategies

Mammographic breast density has been studied for more than 30 years. Greater breast density not only is related to decreased sensitivity of mammograms because of a masking effect but also is a major independent risk factor for breast cancer. This article defines breast density and reviews literature on quantification of mammographic density that is key to future clinical and research protocols. Important influences on breast density are addressed, including age, menopausal status, exogenous hormones, and genetics of density. Young women with dense breasts benefit from digital mammographic technique. The potential use of supplemental MRI and ultrasound screening techniques in high-risk women and women with dense breasts is explored, as are potential risk reduction strategies.

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