scholarly journals Density and tailored breast cancer screening: practice and prediction – an overview

2018 ◽  
Vol 7 (9) ◽  
pp. 205846011879121 ◽  
Author(s):  
Georg J Wengert ◽  
Thomas H Helbich ◽  
Panagiotis Kapetas ◽  
Pascal AT Baltzer ◽  
Katja Pinker
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Density ◽  
Cancer Detection ◽  
Public Awareness ◽  
Breast Cancer Detection ◽  
Screening Methods ◽  
Average Risk ◽  
Screening Practice

Mammography, as the primary screening modality, has facilitated a substantial decrease in breast cancer-related mortality in the general population. However, the sensitivity of mammography for breast cancer detection is decreased in women with higher breast densities, which is an independent risk factor for breast cancer. With increasing public awareness of the implications of a high breast density, there is an increasing demand for supplemental screening in these patients. Yet, improvements in breast cancer detection with supplemental screening methods come at the expense of increased false-positives, recall rates, patient anxiety, and costs. Therefore, breast cancer screening practice must change from a general one-size-fits-all approach to a more personalized, risk-based one that is tailored to the individual woman’s risk, personal beliefs, and preferences, while accounting for cost, potential harm, and benefits. This overview will provide an overview of the available breast density assessment modalities, the current breast density screening recommendations for women at average risk of breast cancer, and supplemental methods for breast cancer screening. In addition, we will provide a look at the possibilities for a risk-adapted breast cancer screening.

scholarly journals Breast Cancer Screening Trials: Endpoints and Overdiagnosis

2020 ◽  
Author(s):  
Ismail Jatoi ◽  
Paul F Pinsky
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Detection ◽  
Primary Endpoint ◽  
Tumor Detection ◽  
Breast Cancer Detection ◽  
Detection Rates ◽  
Screening Strategies ◽  
Screening Trials

Abstract Screening mammography was assessed in 9 randomized trials initiated between 1963 and 1990, with breast cancer-specific mortality as the primary endpoint. In contrast, breast cancer detection has been the primary endpoint in most screening trials initiated during the past decade. These trials have evaluated digital breast tomosynthesis, magnetic resonance imaging, and ultrasound, and novel screening strategies have been recommended solely on the basis of improvements in breast cancer detection rates. Yet, the assumption that increases in tumor detection produce reductions in cancer mortality has not been validated, and tumor-detection endpoints may exacerbate the problem of overdiagnosis. Indeed, the detection of greater numbers of early stage breast cancers in the absence of a subsequent decline in rates of metastatic cancers and cancer-related mortality is the hallmark of overdiagnosis. There is now evidence to suggest that both ductal carcinoma in situ and invasive cancers are overdiagnosed as a consequence of screening. For each patient who is overdiagnosed with breast cancer, the adverse consequences include unnecessary anxiety, financial hardships, and a small risk of morbidity and mortality from unnecessary treatments. Moreover, the overtreatment of breast cancer, as a consequence of overdiagnosis, is costly and contributes to waste in health-care spending. In this article, we argue that there is a need to establish better endpoints in breast cancer screening trials, including quality of life and composite endpoints. Tumor-detection endpoints should be abandoned, because they may lead to the implementation of screening strategies that increase the risk of overdiagnosis.

Detection rate is not higher for women with BBD history in breast cancer screening

2019 ◽  
Author(s):  
Penghuan Qu ◽  
Xueou Liu ◽  
Yubei Huang ◽  
Ziwei Feng ◽  
Xin Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Detection ◽  
Detection Rate ◽  
Breast Disease ◽  
Cancer Detection Rate ◽  
Breast Cancer Detection ◽  
Breast Cancer Patients ◽  
Contrast Analysis

Abstract Background To investigate whether women with benign breast disease (BBD) history have higher breast cancer detection rate in screening. Methods We reviewed data for 33 001 female participants in Multi-modality Independent Screening Trial (MIST). Corresponding data for 6823 breast cancer patients were retrieved from the Tianjin Breast Cancer Cases Cohort (TBCCC) and analyzed for comparison. Results The breast cancer detection rate was 2.83‰ among women with BBD history and 3.28‰ in women without. Moreover, the proportion of carcinoma in situ (CIS) was also lower in women with BBD history than women without (7.69 versus 20.31%). In contrast, analysis of TBCCC data revealed a higher proportion of CIS in patients with BBD history (5.05%) than patients without (3.26%). Our data showed that a larger proportion of women with BBD history had undergone previous breast examinations. Additionally, among participants diagnosed with both breast cancer and BBD in MIST, we found a lower proportion of CIS in women with BBD history (11.76%) compared to women without (32.14%). Conclusions Women with BBD history were not found to have higher detection rate in breast cancer screening. Women with BBD history were more likely to be proactive in seeking breast examinations and to have breast cancer be diagnosed in clinic.

scholarly journals Biomarker profiling for breast cancer detection: translational research to determine acceptance of a novel breast cancer screening technique

2018 ◽  
Vol 8 (1) ◽  
pp. 44-51
Author(s):  
Nick Carcioppolo ◽  
Katheryn R. Christy ◽  
Jakob D. Jensen ◽  
Andy J. King ◽  
Julie Goonewardene ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Translational Research ◽  
Breast Cancer Screening ◽  
Cancer Detection ◽  
Breast Cancer Detection ◽  
Screening Technique

Minnesota healthcare providers’ breast cancer screening practices at the extremes of age.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13037-e13037
Author(s):  
Deanna Gek Koon Teoh ◽  
Rachel Isaksson Vogel ◽  
Alicia Allen ◽  
Anne Hudson Blaes ◽  
Susan Mason ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Online Survey ◽  
Primary Care Providers ◽  
Screening Methods ◽  
Average Risk ◽  
Care Providers ◽  
Screening Practices

e13037 Background: Breast cancer screening guidelines disagree on the age to initiate and discontinue screening. We sought to determine the age at which Minnesota providers initiate and discontinue breast cancer screening. Methods: A cross-sectional online survey of Minnesota primary care providers was conducted in 2016. The survey queried providers’ breast screening practices for average-risk women. Data were summarized using descriptive statistics and comparisons by professional characteristics were conducted using Chi-squared tests. Results: There were 805 respondents (8% of 10,392 invitees), of which 456 (56.7%) provided primary care to women and were included in the analysis. 316 (72%) were women, 193 (44%) were physicians, 50 (11%) were physician assistants (PAs), and 197 (45%) were advanced practice nurses (APNs). 85% practiced in a community setting. 38% had practiced > 20 years, and 27% had practiced < 10 years. Among respondents, 67%, 77% and 72% recommended screening mammography for women age 40-44, 45-49 and 70+ years, respectively. Compared to male providers, female providers were more likely to screen women age 40-44 years (73% vs. 49%; p < 0.0001) and 45-49 years (81% vs. 66%; p = 0.002), but there was no difference by gender for patients age 70+ years (72% vs. 74%; p = 0.89). Respondents reporting specialized interest in women’s health were more likely to screen women age 40-44 years (73% vs. 61%; p = 0.006), 45-49 years (83% vs 72%; p = 0.007) and older than age 70 years (77% vs. 69%; p = 0.04). Physicians were less likely to screen women age 40-44 and 45-49 years (57% and 71%, respectively; p = 0.001) than PAs (72%, 78%) and APNs (74%, 83%), but APNs were less likely to screen women age 70+ years (65% vs. physicians 79% vs. PAs 76%; p = 0.006). Number of years in practice was not associated with a difference in age at initiation of screening, however, increasing number of years in practice was associated with screening women age 70+ years (p = 0.02). Conclusions: Although breast cancer screening practices for average risk women vary by healthcare provider characteristics, a majority of Minnesota primary care providers initiate breast cancer screening between ages 40-49 years, and continue screening women age 70 years and older.

scholarly journals Computer-Aided Detection for Breast Cancer Screening in Clinical Settings: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Rafia Masud ◽  
Mona Al-Rei ◽  
Cynthia Lokker
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Diagnostic Accuracy ◽  
Breast Cancer Screening ◽  
Patient Outcomes ◽  
Cancer Detection ◽  
Breast Cancer Detection ◽  
Clinical Settings ◽  
Computer Aided Detection ◽  
Detection Rates

BACKGROUND With the growth of machine learning applications, the practice of medicine is evolving. Computer-aided detection (CAD) is a software technology that has become widespread in radiology practices, particularly in breast cancer screening for improving detection rates at earlier stages. Many studies have investigated the diagnostic accuracy of CAD, but its implementation in clinical settings has been largely overlooked. OBJECTIVE The aim of this scoping review was to summarize recent literature on the adoption and implementation of CAD during breast cancer screening by radiologists and to describe barriers and facilitators for CAD use. METHODS The MEDLINE database was searched for English, peer-reviewed articles that described CAD implementation, including barriers or facilitators, in breast cancer screening and were published between January 2010 and March 2018. Articles describing the diagnostic accuracy of CAD for breast cancer detection were excluded. The search returned 526 citations, which were reviewed in duplicate through abstract and full-text screening. Reference lists and cited references in the included studies were reviewed. RESULTS A total of nine articles met the inclusion criteria. The included articles showed that there is a tradeoff between the facilitators and barriers for CAD use. Facilitators for CAD use were improved breast cancer detection rates, increased profitability of breast imaging, and time saved by replacing double reading. Identified barriers were less favorable perceptions of CAD compared to double reading by radiologists, an increase in recall rates of patients for further testing, increased costs, and unclear effect on patient outcomes. CONCLUSIONS There is a gap in the literature between CAD’s well-established diagnostic accuracy and its implementation and use by radiologists. Generally, the perceptions of radiologists have not been considered and details of implementation approaches for adoption of CAD have not been reported. The cost-effectiveness of CAD has not been well established for breast cancer screening in various populations. Further research is needed on how to best facilitate CAD in radiology practices in order to optimize patient outcomes, and the views of radiologists need to be better considered when advancing CAD use.

scholarly journals ROLE OF MODERN IMAGING TECHNIQUES IN ADDITIONAL VIZUALISATION OF BREAST CANCER: LITERATURE REVIEW

2021 ◽  
Vol 20 (4) ◽  
pp. 99-107
Author(s):  
A. S. Ainakulova ◽  
D. R. Kaidarova ◽  
Zh. Zh. Zholdybai ◽  
N. I. Inozemtceva ◽  
M. O. Gabdullina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Detection ◽  
Breast Imaging ◽  
Screening Program ◽  
Early Stage ◽  
Imaging Techniques ◽  
Breast Cancer Detection ◽  
Cancer Screening Program

Background. Breast cancer is the most common cancer in women worldwide. Despite advances in treatment of breast cancer, early-stage breast cancer detection is limited by screening mammography and often requires additional breast imaging.The purpose of the study was to analyze available data on modern imaging techniques of additional breast visualization used for improving breast cancer screening.Material and methods. The review includes data from randomized controlled trials and meta-analyzes on the effectiveness of breast imaging techniques for early-stage breast cancer detection. The search was carried out in pubmed, Web of science, scopus and cochrane library databases. Out of 100 publications published over the past 7 years, 51 were included in the presented review.Results. Breast cancer screening using various imaging techniques has been carried out in the world for more than 30 years, and over the past 10 years significant progress has been made in improving X-ray, ultrasound and magnetic resonance technologies in the early breast cancer detection. At present, healthcare organizers are faced with the question of choosing a vector for improving the breast cancer screening program by introducing digital tomosynthesis, contrast spectral mammography, or accelerated mri. According to the current results of the analysis of literature data, contrast spectral mammography and accelerated mri have the highest sensitivity, but studies of sensitivity, specificity, positive and negative predictive values (ppv, npv) are ongoing.Conclusion. The data presented in the review confirm the necessity for finding the vector for improving the breast cancer screening program using multicenter prospective trials.

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