scholarly journals Performance of systematic and non-systematic (‘opportunistic’) screening mammography: a comparative study from Denmark

2008 ◽  
Vol 15 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Kristine Bihrmann ◽  
Allan Jensen ◽  
Anne Helene Olsen ◽  
Sisse Njor ◽  
Walter Schwartz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
False Negative ◽  
Population Based ◽  
Screening Mammography ◽  
Opportunistic Screening ◽  
True Negative ◽  
Cancer Data ◽  
European Guidelines ◽  
Adjusted Sensitivity

Objectives Evaluation and comparison of the performance of organized and opportunistic screening mammography. Methods Women attending screening mammography in Denmark in 2000. The study included 37,072 women attending organized screening. Among these, 320 women were diagnosed with breast cancer during follow-up. Opportunistic screening was attended by 2855 women with 26 women being diagnosed with breast cancer. Data on women attending screening were linked with information on cancer status. Each woman was followed with respect to diagnosis of breast cancer (invasive as well as in situ) for a period of two years. Screening outcome and cancer status during follow-up were combined to assess whether the result of the examination was true-positive, true-negative, false-positive or false-negative. Based on this classification, age-adjusted sensitivity and specificity of organized and opportunistic screening were calculated. Results Defining BI-RADS™ 4-5 as a positive screening outcome, the overall sensitivity of opportunistic screening was 33.6% and the specificity was 99.1%. Using BI-RADS™ 3-5 as positive, the sensitivity was 37.4% and the specificity was 97.9%. Organized screening (which was not categorized according to BI-RADS™) had an overall sensitivity of 67.2% and a specificity of 98.4%. Conclusion Our study showed a considerably higher sensitivity in organized screening than in opportunistic screening, while the specificity was fairly similar in the two settings. The findings support implementation of population-based breast screening programmes, as recommended in the ‘European guidelines for quality assurance in breast cancer screening and diagnosis’.

The sensitivity and specificity of screening mammography in primary care setting in Saudi Arabia.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12551-e12551 ◽  
Author(s):  
Abdullah Alkhenizan ◽  
Aneela Hussain ◽  
Adher Alsayed
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Saudi Arabia ◽  
Predictive Value ◽  
Breast Imaging ◽  
Screening Program ◽  
False Negative ◽  
Screening Mammography ◽  
True Negative ◽  
Catchment Population

e12551 Background: Breast cancer is the leading cancer diagnosed in women in Saudi Arabia, accounting for 25% of all cancers diagnosed in women. The mammogram screening program at King Faisal Specialist Hospital and Research Center (KFSHRC) is the only structured screening program in the country. KFSHRC provides primary care services for a catchment population of 30,000 patients. This program covers all women above the age of 40 within this catchment population. Methods: A retrospective review of electronic and paper records were reviewed for mammograms done between January 2002- January 2012. Summary statistics were used to describe patient and examination characteristics. Results from mammograms were reported using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. The stage of diagnosis was reported using the American Joint Committee on Cancer (AJCC) system using stages one through four. ACR BIRADS classification and cancer status definitions mammograms were linked with cancer outcomes to identify true-positive, true-negative, false-positive, and false-negative examinations. On the basis of these classifications, sensitivity, specificity, positive predictive value, and negative predictive value were estimated. All mammograms and tissue biopsies were read by board certified specialists. Results: During the first round of screening 1694 mammograms were analyzed, and 12 cases of cancer were diagnosed. Cancer detection rate (per 1000 examination) was 7.1. Biopsy rate was 3.7 per 100 mammograms. Follow up ultrasounds rate was 2.7 per 100 mammograms. Sensitivity of mammogram screening was 80%, and specificity was 76%. Conclusions: The yield of a structured mammogram screening program in Saudi Arabia is high. There is a need to implement a national program for breast cancer screening in Arabian world in general and within Saudi Arabia in particular.

Preoperative and Longitudinal Serum Levels of CA 125 and CA 15.3 in Patients with Breast Cancer

1989 ◽  
Vol 4 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Y.T. Omar ◽  
A.E. Behbehani ◽  
N. Al-Naqeeb ◽  
MM. Motawy ◽  
M.O. Foudeh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
False Negative ◽  
Serum Levels ◽  
Ca 125 ◽  
True Positive ◽  
True Negative ◽  
Ca 15.3 ◽  
Similar Information

Serum levels of ovarian carcinoma antigen (CA 125) and breast carcinoma antigen (CA 15.3) were determined in 237 patients with breast carcinoma, 121 before any therapy and 116 after initial treatment, during uneventful follow-up or at the time of relapse. The aim was to assess how often the CA 125 test failed, i.e., was false-negative inpatients in whom the CA 15.3 test was true-positive and, more important, whether it gave diagnostic information in patients in whom the CA 15.3 test failed. Before surgery or other initial therapy, serum CA 125 and CA 15.3 gave similar information in 85.1 percent of the patients: true-positive in 4.1 percent and false negative in 81.0 percent; CA 125 gave less information in 13.2 percent; and more information in only 1.7 percent. During follow-up, serum CA 125 and CA 15.3 gave similar information in 73.3 percent of the patients: true-positive (i.e., rising persistently from a nadir or elevated above 65 U/ml) in 23.3 percent, true-negative in 36.2 percent, and false-negative in 13.8 percent; CA 125 gave less information in 25.0 percent: false negative in 22.4 percent and false-positive in 2.6 percent; and more information in only 1.7 percent. Therefore, the CA 125 test appears useless for staging and is redundant when the CA 15.3 test is employed, for management of patients with breast cancer.

scholarly journals A multicenter, hospital-based and non-inferiority study for diagnostic efficacy of automated whole breast ultrasound for breast cancer in China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yujing Xin ◽  
Xinyuan Zhang ◽  
Yi Yang ◽  
Yi Chen ◽  
Yanan Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
False Negative ◽  
Final Analysis ◽  
Age Group ◽  
Surgical Biopsy ◽  
True Negative ◽  
Diagnostic Efficacy ◽  
Negative Results ◽  
Informed Consent Form ◽  
Magnetic Resonance Imaging Mri

AbstractThis study is the first multi-center non-inferiority study that aims to critically evaluate the effectiveness of HHUS/ABUS in China breast cancer detection. This was a multicenter hospital-based study. Five hospitals participated in this study. Women (30–69 years old) with defined criteria were invited for breast examination by HHUS, ABUS or/and mammography. For BI-RADS category 3, an additional magnetic resonance imaging (MRI) test was provided to distinguish the true negative results from false negative results. For women classified as BI-RADS category 4 or 5, either core aspiration biopsy or surgical biopsy was done to confirm the diagnosis. Between February 2016 and March 2017, 2844 women signed the informed consent form, and 1947 of them involved in final analysis (680 were 30 to 39 years old, 1267 were 40 to 69 years old).For all participants, ABUS sensitivity (91.81%) compared with HHUS sensitivity (94.70%) with non-inferior Z tests, P = 0.015. In the 40–69 age group, non-inferior Z tests showed that ABUS sensitivity (93.01%) was non-inferior to MG sensitivity (86.02%) with P < 0.001 and HHUS sensitivity (95.44%) was non-inferior to MG sensitivity (86.02%) with P < 0.001. Sensitivity of ABUS and HHUS are all superior to that of MG with P < 0.001 by superior test.For all participants, ABUS specificity (92.89%) was non-inferior to HHUS specificity (89.36%) with P < 0.001. Superiority test show that specificity of ABUS was superior to that of HHUS with P < 0.001. In the 40–69 age group, ABUS specificity (92.86%) was non-inferior to MG specificity (91.68%) with P < 0.001 and HHUS specificity (89.55%) was non-inferior to MG specificity (91.68%) with P < 0.001. ABUS is not superior to MG with P = 0.114 by superior test. The sensitivity of ABUS/HHUS is superior to that of MG. The specificity of ABUS/HHUS is non-inferior to that of MG. In China, for an experienced US radiologist, both HHUS and ABUS have better diagnostic efficacy than MG in symptomatic individuals.

scholarly journals Risk of primary gastrointestinal cancers following incident non-metastatic breast cancer: a Danish population-based cohort study

2020 ◽  
Vol 7 (1) ◽  
pp. e000413
Author(s):  
Kasper Adelborg ◽  
Dóra Körmendiné Farkas ◽  
Jens Sundbøll ◽  
Lidia Schapira ◽  
Suzanne Tamang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colon Cancer ◽  
Cohort Study ◽  
Metastatic Breast Cancer ◽  
Stomach Cancer ◽  
Metastatic Breast ◽  
Population Based ◽  
Gastrointestinal Cancers ◽  
Increased Risk

ObjectiveWe examined the risk of primary gastrointestinal cancers in women with breast cancer and compared this risk with that of the general population.DesignUsing population-based Danish registries, we conducted a cohort study of women with incident non-metastatic breast cancer (1990–2017). We computed cumulative cancer incidences and standardised incidence ratios (SIRs).ResultsAmong 84 972 patients with breast cancer, we observed 2340 gastrointestinal cancers. After 20 years of follow-up, the cumulative incidence of gastrointestinal cancers was 4%, driven mainly by colon cancers. Only risk of stomach cancer was continually increased beyond 1 year following breast cancer. The SIR for colon cancer was neutral during 2–5 years of follow-up and approximately 1.2-fold increased thereafter. For cancer of the oesophagus, the SIR was increased only during 6–10 years. There was a weak association with pancreas cancer beyond 10 years. Between 1990–2006 and 2007–2017, the 1–10 years SIR estimate decreased and reached unity for upper gastrointestinal cancers (oesophagus, stomach, and small intestine). For lower gastrointestinal cancers (colon, rectum, and anal canal), the SIR estimate was increased only after 2007. No temporal effects were observed for the remaining gastrointestinal cancers. Treatment effects were negligible.ConclusionBreast cancer survivors were at increased risk of oesophagus and stomach cancer, but only before 2007. The risk of colon cancer was increased, but only after 2007.

scholarly journals Effectiveness Of Transient Evoked Otoacoustic Emission (TEOAE) Test For Neonatal Auditory Screening

2018 ◽  
Vol 08 (02) ◽  
pp. 77-81
Author(s):  
Shanila Feroz ◽  
Iqbal Hussain Udaipurwala ◽  
Danish Muhammad Khan ◽  
Fatima Iqbal Hussain
Keyword(s):  
Hearing Loss ◽  
Predictive Value ◽  
False Negative ◽  
Otoacoustic Emission ◽  
Normal Hearing ◽  
Speech Development ◽  
True Negative ◽  
Cross Sectional ◽  
Transient Evoked Otoacoustic Emission

Objective: The purpose of this study is to assess the efficacy of Transient Evoked Otoacoustic Emission (TEOAE) as screening test for auditory function in neonates. Study Design: A cross-sectional study Place and Duration of Study: This study was conducted at United Medical and Dental College, Creek General Hospital, Karachi, from July 2106 to May 2017. A total number of 120 newborn babies were screened for hearing loss before discharge from hospital but 20 were lost for follow up and 100 cases were included in this study. Method: TEOAE was done in all neonates born during this period at 3rd day after birth. Those who were found to have hearing loss, TEOAE was repeated at the end of 1st week and again in 6th week after birth. BERA was done in those cases who showed hearing loss on TEOAE on all three occasions. All the 100 cases were followed up regularly for more than one year for appearance of any sign or symptom related with hearing loss or speech development failure. Result: Out of 100 cases included in this study, 96 were found to have no hearing loss on TEOAE and 1 on BERA test. Remaining three cases were found to have hearing loss on both TEOAE and BERA test. True negative cases where no hearing loss was found on TEOAE and subsequent follow up were 96. True positive cases were 3 where hearing loss was found on TEOAE and BERA and also on subsequent follow-up. False positive case was 1, where hearing loss was detected on TEOAE but BERA showed normal hearing and subsequent follow-up also showed normal hearing and false negative result was not detected in any case. Sensitivity of TEOAE was found to be 100%, specificity is 98.9%, accuracy is 99%, positive predictive value is 75% and negative predictive value is 100% in this study. Conclusion: TEOAE was found to be a cost-effective and practicable method of recognizing congenital hearing loss. It should be done in all newborns as routine screening for hearing loss

Incorporation of relative cerebral blood flow into CT perfusion maps reduces false ’at risk' penumbra

2017 ◽  
Vol 10 (7) ◽  
pp. 657-662 ◽  
Author(s):  
Shlomi Peretz ◽  
David Orion ◽  
David Last ◽  
Yael Mardor ◽  
Yotam Kimmel ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Stroke ◽  
Ct Perfusion ◽  
False Negative ◽  
Stroke Patients ◽  
True Negative ◽  
True Negative Rate ◽  
Negative Rate ◽  
Perfusion Maps

PurposeThe region defined as ‘at risk’ penumbra by current CT perfusion (CTP) maps is largely overestimated. We aimed to quantitate the portion of true ‘at risk’ tissue within CTP penumbra and to determine the parameter and threshold that would optimally distinguish it from false ‘at risk’ tissue, that is, benign oligaemia.MethodsAmong acute stroke patients evaluated by multimodal CT (NCCT/CTA/CTP) we identified those that had not undergone endovascular/thrombolytic treatment and had follow-up NCCT. Maps of absolute and relative CBF, CBV, MTT, TTP and Tmax as well as summary maps depicting infarcted and penumbral regions were generated using the Intellispace Portal (Philips Healthcare, Best, Netherlands). Follow-up CT was automatically co-registered to the CTP scan and the final infarct region was manually outlined. Perfusion parameters were systematically analysed – the parameter that resulted in the highest true-negative-rate (ie, proportion of benign oligaemia correctly identified) at a fixed, clinically relevant false-negative-rate (ie, proportion of ‘missed’ infarct) of 15%, was chosen as optimal. It was then re-applied to the CTP data to produce corrected perfusion maps.ResultsForty seven acute stroke patients met selection criteria. Average portion of infarcted tissue within CTP penumbra was 15%±2.2%. Relative CBF at a threshold of 0.65 yielded the highest average true-negative-rate (48%), enabling reduction of the false ‘at risk’ penumbral region by ~half.ConclusionsApplying a relative CBF threshold on relative MTT-based CTP maps can significantly reduce false ‘at risk’ penumbra. This step may help to avoid unnecessary endovascular interventions.

Serum Levels of Carcinoembryonic Antigen, Gastrointestinal Cancer-Associated Antigen and Alphafetoprotein in Staging and Management of Patients with Advanced Carcinoma of the Stomach

1987 ◽  
Vol 2 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Janusz J. Szymendera ◽  
Andrzej W. Szawlowski ◽  
Marek P. Nowacki ◽  
Malgorzata Kowalska ◽  
Janina A. Kaminska ◽  
...  
Keyword(s):  
Carcinoembryonic Antigen ◽  
Gastrointestinal Cancer ◽  
False Negative ◽  
Serum Levels ◽  
True Positive ◽  
True Negative ◽  
Carcinoma Of The Stomach ◽  
Joint Application ◽  
Serum Cea

Serum levels of carcinoembryonic antigen (CEA), gastrointestinal cancer-associated antigen (GICA or CA 19-9), and alphafetoprotein (AFP) were concurrently determined in patients with carcinoma of the stomach: in 84 preoperatively, and in 67 serially postoperatively. Before surgery, serum CEA gave information about the tumor load analogous to serum GICA in 69% of the patients: true-positive in 25% and false-negative in 43%; less information in 18% and more in 14%. The sensitivity of the test tended to be better in the more advanced stages, and was higher for CEA with GICA than for CEA alone or GICA alone. During follow-up, serum CEA gave information about the presence or absence of active disease analogous to serum GIC A in 78% of the patients: true-positive in 30%, true-negative in 36% and false-negative in 12%; less information in 9% and more in 13%. Neither test gave any false-positive indications. Sensitivity of the test rose from 67% for CEA alone and 60% for GICA alone to 81% for CEA with GICA. Serum AFP was elevated only preoperatively in 2% of patients. We conclude that joint application of CEA and GICA tests gave only slightly better preoperative sensitivity than CEA alone or GICA alone but proved fairly sensitive for postoperative follow-up of the patients. AFP was of little value for either purpose.

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