Effects of Educating Women on Breast Cancer and Early Detection Post-Katrina

Five years post-Hurricane Katrina, an increasing number of women in New Orleans have been d iagnosed with late stage invasive breast cancer despite the availability of a free breast clinic and mammography screening. Presentation of late-stage breast cancer limits treatment options and poor outcomes are more likely. An evidence-based educational program was provided in a relaxed informal setting to low-income women to increase their awareness of the importance of early detection and screening for breast cancer through the use of screening mammograms. Educating this underserved population of women on the importance of early detection of breast cancer and mammography screening sought to improve patient awareness and potentially increase the use of screening practices.

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Breast Cancer Image Classification: A Review

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/0929867328666201228125208 ◽

2020 ◽

Vol 16 ◽

Author(s):

Pooja Pathak ◽

Anand Singh Jalal ◽

Ritu Rai

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Treatment Options ◽

Breast Cancer Diagnosis ◽

Conventional Approach ◽

Learning Networks ◽

Cad System ◽

Ultrasound Computed Tomography ◽

Core Concepts ◽

Magnetic Resonance Imaging Mri

Background: Breast cancer represents uncontrolled breast cell growth. Breast cancer is the most diagnosed cancer in women worldwide. Early detection of breast cancer improves the chances of survival and increases treatment options. There are various methods for screening breast cancer such as mammogram, ultrasound, computed tomography, Magnetic Resonance Imaging (MRI). MRI is gaining prominence as an alternative screening tool for early detection and breast cancer diagnosis. Nevertheless, MRI can hardly be examined without the use of a Computer-Aided Diagnosis (CAD) framework, due to the vast amount of data. Objective: This paper aims to cover the approaches used in CAD system for the detection of breast cancer. Method: In this paper, the methods used in CAD systems are categories in two classes: the conventional approach and artificial intelligence (AI) approach. The conventional approach covers the basic steps of image processing such as preprocessing, segmentation, feature extraction and classification. The AI approach covers the various convolutional and deep learning networks used for diagnosis. Conclusion: This review discusses some of the core concepts used in breast cancer and presents a comprehensive review of efforts in the past to address this problem.

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

Epidemiologic Methods ◽

10.1515/em-2015-0022 ◽

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.

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

Journal of Medical Screening ◽

10.1136/jms.7.1.14 ◽

2000 ◽

Vol 7 (1) ◽

pp. 14-18 ◽

Cited By ~ 63

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.

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A Culturally Targeted Intervention to Promote Breast Cancer Screening among Low-Income Women in East Baltimore, Maryland

Cancer Control ◽

10.1177/1073274805012004s06 ◽

2005 ◽

Vol 12 (4_suppl) ◽

pp. 34-41 ◽

Cited By ~ 21

Author(s):

Mary A. Garza ◽

Jingyu Luan ◽

Marcela Blinka ◽

Reverend Iris Farabee-Lewis ◽

Charlotte E. Neuhaus ◽

...

Keyword(s):

Breast Cancer ◽

African American ◽

African American Women ◽

Low Income ◽

Mammography Screening ◽

Screening Program ◽

Health Belief ◽

Targeted Intervention ◽

Screening Rate ◽

American Women

In Maryland, outreach initiatives have been unsuccessful in engaging low-income African American women in mammography screening. This study aimed to identify factors influencing screening rates for low-income African American women. Based on the Health Belief Model, a modified time series design was used to implement a culturally targeted intervention to promote a no-cost mammography-screening program. Data were collected from women 40 years of age and older on their history of mammography use and their knowledge and beliefs about breast cancer. A 50% screening rate was achieved among 119 eligible participants. Significant predictors of screening behaviors were perceived barriers, lack of insurance, and limited knowledge. This culturally targeted intervention resulted in an unprecedented screening rate among low-income African American women in Baltimore, Maryland.

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Effect on Survival of Longer Intervals Between Confirmed Diagnosis and Treatment Initiation Among Low-Income Women With Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2012.39.7695 ◽

2012 ◽

Vol 30 (36) ◽

pp. 4493-4500 ◽

Cited By ~ 101

Author(s):

John M. McLaughlin ◽

Roger T. Anderson ◽

Amy K. Ferketich ◽

Eric E. Seiber ◽

Rajesh Balkrishnan ◽

...

Keyword(s):

Breast Cancer ◽

North Carolina ◽

Low Income ◽

Late Stage ◽

Proportional Hazards ◽

Treatment Initiation ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Regression ◽

Proportional Hazards Regression ◽

The Impact

Purpose To determine the impact of longer periods between biopsy-confirmed breast cancer diagnosis and the initiation of treatment (Dx2Tx) on survival. Patients and Methods This study was a noninterventional, retrospective analysis of adult female North Carolina Medicaid enrollees diagnosed with breast cancer from January 1, 2000, through December, 31, 2002, in the linked North Carolina Central Cancer Registry–Medicaid Claims database. Follow-up data were available through July 31, 2006. Cox proportional hazards regression models were constructed to evaluate the impact on survival of delaying treatment ≥ 60 days after a confirmed diagnosis of breast cancer. Results The study cohort consisted of 1,786 low-income, adult women with a mean age of 61.6 years. A large proportion of the patients (44.3%) were racial minorities. Median time from biopsy-confirmed diagnosis to treatment initiation was 22 days. Adjusted Cox proportional hazards regression showed that although Dx2Tx length did not affect survival among those diagnosed at early stage, among late-stage patients, intervals between diagnosis and first treatment ≥ 60 days were associated with significantly worse overall survival (hazard ratio [HR], 1.66; 95% CI, 1.00 to 2.77; P = .05) and breast cancer–specific survival (HR, 1.85; 95% CI, 1.04 to 3.27; P = .04). Conclusion One in 10 women waited ≥ 60 days to initiate treatment after a diagnosis of breast cancer. Waiting ≥ 60 days to initiate treatment was associated with a significant 66% and 85% increased risk of overall and breast cancer–related death, respectively, among late-stage patients. Interventions designed to increase the timeliness of receiving breast cancer treatments should target late-stage patients, and clinicians should strive to promptly triage and initiate treatment for patients diagnosed at late stage.

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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

Journal of Global Oncology ◽

10.1200/jgo.18.73200 ◽

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.

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Annual Mammography Screening: Is it Necessary?

The American Surgeon ◽

10.1177/000313481207800145 ◽

2012 ◽

Vol 78 (1) ◽

pp. 104-106

Author(s):

Veronica Hegar ◽

Kristin Oliveira ◽

Bharat Kakarala ◽

Alicia Mangram ◽

Ernest Dunn

Keyword(s):

Breast Cancer ◽

Breast Imaging ◽

Task Force ◽

Treatment Options ◽

Retrospective Chart Review ◽

Breast Cancer Diagnosis ◽

Screening Mammography ◽

Screening Mammograms ◽

System 1 ◽

Preventative Services

Recent recommendations from the U.S. Preventative Services Task Force suggest that screening mammography for women should be biennial starting at age 50 years and continue to age 74 years. With these recommendations in mind, we proposed a study to evaluate women at our institution in whom breast cancer is diagnosed within 1 year of a previously benign mammogram. A retrospective chart review was performed over a 4-year period. Only patients who had both diagnostic mammograms and previous mammograms performed at our institution and a pathologic diagnosis of breast cancer were included. Benign mammograms were defined as either Breast Imaging Reporting And Data System 1 or 2. Analysis of the time elapse between benign mammogram and subsequent mammogram indicative of the diagnosis of breast cancer was performed. A total of 205 patients were included. The average age was 64 years. From our results, 48 patients, 23 per cent of the total, had a documented benign mammogram at 12 months or less before a breast cancer diagnosis. One hundred forty-three (70%) patients had a benign mammogram at 18 months or less prior. This study raises concern that 2 years between screening mammograms may delay diagnosis and possible treatment options for many women.

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Frequency of late-stage breast cancer diagnoses despite high mammography screening rates in an HMO

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.1526 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 1526-1526

Author(s):

R. Haque ◽

J. E. Schottinger ◽

M. H. Kanter ◽

C. C. Avila ◽

R. Contreras ◽

...

Keyword(s):

Breast Cancer ◽

Late Stage ◽

Mammography Screening ◽

Early Stage ◽

Advanced Tumor Stage ◽

Early Stage Disease ◽

Advanced Tumor ◽

Stage Disease ◽

Late Stage Diagnosis ◽

The Impact

1526 Background: Kaiser Permanente Southern California (KPSC) led the nation in screening women for breast cancer (BCa) with a mammography rate of nearly 90% in 2007 according to 2008 Healthcare Effectiveness Data and Information Set (HEDIS) measures. Despite successes in improving screening rates in this health plan that serves 3+ million diverse members, the percentage of women diagnosed with late stage BCa (stage III, IV) remained stable, varying from 12.9% (N∼323) in 2003 to 10.8% (N∼270) in 2007. To identify patient and health care factors associated with late stage diagnosis and the impact of its enhanced screening implementation guidelines, KPSC undertook this study. Methods: This cross-sectional study included a cohort of 10,580 BCa patients from 2003–2007. We compared women diagnosed with late stage disease versus those with early stage disease (stages I, II). P values (2-sided) were based on the chi-square distribution. Adjusted odds ratios and 95% confidence intervals were estimated using unconditional logistic regression. Results: Factors that were positively associated with late stage diagnosis in the univariate analyses included age, lack of recent mammography screening, worse tumor features, 80+ years of age, minority race, lower geocoded household income, increased healthcare visits, and use of Pap testing (P < 0.01 for all variables). Factors significantly associated with late stage diagnosis in the multivariate model included only lack of recent mammography screening (OR = 1.35, 95% CI: 1.14–1.58) and worse tumor features including high grade (grade 3, OR = 2.58, 95% CI: 1.96–3.40), positive lymph nodes (OR = 53.49, 95% CI: 39.90–71.72), and HER-2+ tumors (OR = 1.40, 95% CI: 1.13–1.72). Conclusions: Targeting older women, those with lower utilization, and women who did not have a recent mammogram may help further lower the prevalence of late stage diagnoses. However, given the extent of the health plan's previous efforts to enhance BCa screening rates, a ceiling effect may limit additional benefit. Additional efforts to decrease the rate of advanced tumor stage at diagnosis may include improving interpretation of mammograms or earlier detection of aggressive tumors by enhanced BRCA genetic testing. No significant financial relationships to disclose.

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