scholarly journals Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
My von Euler-Chelpin ◽  
Martin Lillholm ◽  
Ilse Vejborg ◽  
Mads Nielsen ◽  
Elsebeth Lynge
Keyword(s):  
Breast Density ◽  
Breast Imaging ◽  
Breast Tissue ◽  
Screening Program ◽  
Population Based ◽  
Screening Mammography ◽  
Dense Breast Tissue ◽  
Density Score ◽  
Screening Sensitivity ◽  
Low Sensitivity

Abstract Background Screening mammography works better in fatty than in dense breast tissue. Computerized assessment of parenchymal texture is a non-subjective method to obtain a refined description of breast tissue, potentially valuable in addition to breast density scoring for the identification of women in need of supplementary imaging. We studied the sensitivity of screening mammography by a combination of radiologist-assessed Breast Imaging Reporting and Data System (BI-RADS) density score and computer-assessed parenchymal texture marker, mammography texture resemblance (MTR), in a population-based screening program. Methods Breast density was coded according to the fourth edition of the BI-RADS density code, and MTR marker was divided into quartiles from 1 to 4. Screening data were followed up for the identification of screen-detected and interval cancers. We calculated sensitivity and specificity with 95% confidence intervals (CI) by BI-RADS density score, MTR marker, and combination hereof. Results Density and texture were strongly correlated, but the combination led to the identification of subgroups with different sensitivity. Sensitivity was high, about 80%, in women with BI-RADS density score 1 and MTR markers 1 or 2. Sensitivity was low, 67%, in women with BI-RADS density score 2 and MTR marker 4. For women with BI-RADS density scores 3 and 4, the already low sensitivity was further decreased for women with MTR marker 4. Specificity was 97–99% in all subgroups. Conclusion Our study showed that women with low density constituted a heterogenous group. Classifying women for extra imaging based on density only might be a too crude approach. Screening sensitivity was systematically high in women with fatty and homogenous breast tissue.

scholarly journals Relationship between Mammographic Density and Age in the United Arab Emirates Population

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Young-Joon Kang ◽  
Soo Kyung Ahn ◽  
Seung Ja Kim ◽  
Hyeyoung Oh ◽  
Jaihong Han ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Breast Density ◽  
Breast Imaging ◽  
Screening Program ◽  
Age Groups ◽  
Significant Negative Correlation ◽  
Geographic Area ◽  
Screening Mammography ◽  
Mammographic Breast Density ◽  
The Relationship

Objective. Higher breast density is a strong, independent risk factor for breast cancer. Breast density varies by age, ethnicity, and geographic area although dense breast tissue has been associated with younger age and premenopausal status. The relationship between breast density and age in women in the United Arab Emirates (UAE) has not been determined. This study evaluated breast density in the UAE population and its relationship with age. Methods. Women participating in the national cancer screening program from August 2015 to May 2018 who underwent screening mammography were included. Breast parenchymal density was classified according to the American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) from category a (almost entirely fatty) through d (extremely dense). Subjects were divided into six age groups, and the association between age and breast density was evaluated. Results. Of the 4911 women included, 1604 (32.7%), 2149 (43.8%), 1055 (21.5%), and 103 (2.1%) were classified as having categories a–d breast density, respectively. A significant negative correlation was observed between age and breast density category (p<0.001). Women of mean age 44 ± 7 years had the highest breast density, whereas those of mean age 56 ± 14 years had the lowest breast density. Comparisons of Emirati women with Lebanese and Western women showed that breast density was lower in Emirati women than in the other populations. Conclusions. To our knowledge, this is the first study to evaluate the relationship between mammographic breast density and age in UAE women. As in other populations, age was inversely related to breast density, but the proportion of Emirati women with dense breasts was lower than in other populations. Because this study lacked demographic, clinical, and histopathological data, further evaluation is required.

scholarly journals Postmenopausal Dense Breasts Maintain Premenopausal Levels of GH and Insulin-like Growth Factor Binding Proteins in Vivo

2020 ◽  
Vol 105 (5) ◽  
pp. 1617-1628 ◽  
Author(s):  
Nina Dabrosin ◽  
Charlotta Dabrosin
Keyword(s):  
Postmenopausal Women ◽  
Breast Density ◽  
Breast Tissue ◽  
Normal Breast Tissue ◽  
Normal Breast ◽  
Dense Breast ◽  
Breast Cancers ◽  
Dense Breast Tissue ◽  
Dense Breasts

Abstract Context Dense breast tissue is associated with 4 to 6 times higher risk of breast cancer by poorly understood mechanisms. No preventive therapy for this high-risk group is available. After menopause, breast density decreases due to involution of the mammary gland. In dense breast tissue, this process is haltered by undetermined biological actions. Growth hormone (GH) and insulin-like binding proteins (IGFBPs) play major roles in normal mammary gland development, but their roles in maintaining breast density are unknown. Objective To reveal in vivo levels of GH, IGFBPs, and other pro-tumorigenic proteins in the extracellular microenvironment in breast cancer, in normal breast tissue with various breast density in postmenopausal women, and premenopausal breasts. We also sought to determine possible correlations between these determinants. Setting and Design Microdialysis was used to collect extracellular in vivo proteins intratumorally from breast cancers before surgery and from normal human breast tissue from premenopausal women and postmenopausal women with mammographic dense or nondense breasts. Results Estrogen receptor positive breast cancers exhibited increased extracellular GH (P &lt; .01). Dense breasts of postmenopausal women exhibited similar levels of GH as premenopausal breasts and significantly higher levels than in nondense breasts (P &lt; .001). Similar results were found for IGFBP-1, -2, -3, and -7 (P &lt; .01) and for IGFBP-6 (P &lt;.05). Strong positive correlations were revealed between GH and IGFBPs and pro-tumorigenic matrix metalloproteinases, urokinase-type plasminogen activator, Interleukin 6, Interleukin 8, and vascular endothelial growth factor in normal breast tissue. Conclusions GH pathways may be targetable for cancer prevention therapeutics in postmenopausal women with dense breast tissue.

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]

Supplemental Breast Cancer Screening With Molecular Breast Imaging for Women With Dense Breast Tissue

2016 ◽  
Vol 207 (2) ◽  
pp. 450-457 ◽  
Author(s):  
Robin B. Shermis ◽  
Keith D. Wilson ◽  
Malcolm T. Doyle ◽  
Tamara S. Martin ◽  
Dawn Merryman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Imaging ◽  
Breast Tissue ◽  
Dense Breast ◽  
Molecular Breast Imaging ◽  
Dense Breast Tissue

Screening Ultrasound for Women with Dense Breasts in the Age of Patient-centered Care

2018 ◽  
Vol 1 ◽  
pp. 14
Author(s):  
Stamatia Destounis ◽  
Andrea Arieno ◽  
Amanda Santacroce
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Breast Imaging ◽  
Breast Tissue ◽  
Patient Centered Care ◽  
Dense Breast ◽  
Patient Centered ◽  
Dense Breast Tissue ◽  
Dense Breasts ◽  
Centered Care

As the field of medicine moves toward practicing patient-centered care, radiologists in breast imaging must continue to look for ways to increase the value of their practice in the eyes of patients. Providing adjunct screening of women with dense breasts provides such an opportunity. The presence of dense breast tissue is not only an independent risk factor for breast cancer but also a risk factor for the delayed diagnosis of breast cancer as dense tissue reduces the efficacy of screening mammograms due to the tissue masking effect. As legislation for notifying women of their breast density becomes commonplace, both women and referring physicians need to understand the risks of dense breast tissue as well as the benefits of additional screening affords. Breast radiologists can become integral to their patients’ care team by offering education to both referring providers and patients on the topic of dense breasts and supplemental screening solutions, such as screening breast ultrasound, which has been shown to have benefit in overcoming mammography’s shortcomings in this demographic of women.

Comparison of subjective and fully automated methods for measuring mammographic density

2017 ◽  
Vol 59 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Nataliia Moshina ◽  
Marta Roman ◽  
Sofie Sebuødegård ◽  
Gunvor G Waade ◽  
Giske Ursin ◽  
...  
Keyword(s):  
Mammographic Density ◽  
Breast Density ◽  
Screening Program ◽  
Weighted Kappa ◽  
Screening Mammography ◽  
Point Scale ◽  
Mean Values ◽  
Automated Method ◽  
Cancer Screening Program ◽  
Density Assessment

Background Breast radiologists of the Norwegian Breast Cancer Screening Program subjectively classified mammographic density using a three-point scale between 1996 and 2012 and changed into the fourth edition of the BI-RADS classification since 2013. In 2015, an automated volumetric breast density assessment software was installed at two screening units. Purpose To compare volumetric breast density measurements from the automated method with two subjective methods: the three-point scale and the BI-RADS density classification. Material and Methods Information on subjective and automated density assessment was obtained from screening examinations of 3635 women recalled for further assessment due to positive screening mammography between 2007 and 2015. The score of the three-point scale (I = fatty; II = medium dense; III = dense) was available for 2310 women. The BI-RADS density score was provided for 1325 women. Mean volumetric breast density was estimated for each category of the subjective classifications. The automated software assigned volumetric breast density to four categories. The agreement between BI-RADS and volumetric breast density categories was assessed using weighted kappa (kw). Results Mean volumetric breast density was 4.5%, 7.5%, and 13.4% for categories I, II, and III of the three-point scale, respectively, and 4.4%, 7.5%, 9.9%, and 13.9% for the BI-RADS density categories, respectively ( P for trend < 0.001 for both subjective classifications). The agreement between BI-RADS and volumetric breast density categories was kw = 0.5 (95% CI = 0.47–0.53; P < 0.001). Conclusion Mean values of volumetric breast density increased with increasing density category of the subjective classifications. The agreement between BI-RADS and volumetric breast density categories was moderate.

scholarly journals The impact of breast density notification on rescreening rates within a population-based mammographic screening program

2022 ◽  
Vol 24 (1) ◽  
Author(s):  
Sarah Pirikahu ◽  
Helen Lund ◽  
Gemma Cadby ◽  
Elizabeth Wylie ◽  
Jennifer Stone
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Breast Density ◽  
Screening Program ◽  
Population Based ◽  
Mammographic Screening ◽  
Younger Women ◽  
Screening Programs ◽  
The Impact

Abstract Background High participation in mammographic screening is essential for its effectiveness to detect breast cancers early and thereby, improve breast cancer outcomes. Breast density is a strong predictor of breast cancer risk and significantly reduces the sensitivity of mammography to detect the disease. There are increasing mandates for routine breast density notification within mammographic screening programs. It is unknown if breast density notification impacts the likelihood of women returning to screening when next due (i.e. rescreening rates). This study investigates the association between breast density notification and rescreening rates using individual-level data from BreastScreen Western Australia (WA), a population-based mammographic screening program. Methods We examined 981,705 screening events from 311,656 women aged 40+ who attended BreastScreen WA between 2008 and 2017. Mixed effect logistic regression was used to investigate the association between rescreening and breast density notification status. Results Results were stratified by age (younger, targeted, older) and screening round (first, second, third+). Targeted women screening for the first time were more likely to return to screening if notified as having dense breasts (Percentunadjusted notified vs. not-notified: 57.8% vs. 56.1%; Padjusted = 0.016). Younger women were less likely to rescreen if notified, regardless of screening round (all P < 0.001). There was no association between notification and rescreening in older women (all P > 0.72). Conclusions Breast density notification does not deter women in the targeted age range from rescreening but could potentially deter younger women from rescreening. These results suggest that all breast density notification messaging should include information regarding the importance of regular mammographic screening to manage breast cancer risk, particularly for younger women. These results will directly inform BreastScreen programs in Australia as well as other population-based screening providers outside Australia who notify women about breast density or are considering implementing breast density notification.

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