Differences in breast cancer risk after benign breast disease by type of screening diagnosis

 Differences in breast cancer risk after benign breast disease by type of screening diagnosis

 

by Javier Louro, Marta Román, Margarita Posso, Laura Comerma, Carmen Vidal, Francina Saladié, Rodrigo Alcantara, Mar Sanchez, M. Jesús Quintana, Javier del Riego, Joana Ferrer, Lupe Peñalva, Xavier Bargalló, Miguel Prieto, María Sala, Xavier Castells

 

The Breast: Open Access: Published: October 03, 2020

 

We aimed to assess differences in breast cancer risk across benign breast disease diagnosed at prevalent or incident screens.

 

Highlights

•Breast cancer risk after a benign breast disease varied with the screening type.

•Incident benign breast disease had a higher breast cancer risk than prevalent.

•The risk remained increased regardless of benign breast disease subtype.

Stand-alone artificial intelligence - The future of breast cancer screening?

Stand-alone artificial intelligence - The future of breast cancer screening?

by Ioannis Sechopoulos, Ritse M. Mann 

The Breast: FULL LENGTH ARTICLE| VOLUME 49, P254-260, FEBRUARY 01, 2020

Although computers have had a role in interpretation of mammograms for at least two decades, their impact on performance has not lived up to expectations. However, in the last five years, the field of medical image analysis has undergone a revolution due to the introduction of deep learning convolutional neural networks – a form of artificial intelligence (AI). Because of their considerably higher performance compared to conventional computer aided detection methods, these AI algorithms have resulted in renewed interest in their potential for interpreting breast images in stand-alone mode.

[Comment] Tomosynthesis in breast screening: great expectations?

[Comment] Tomosynthesis in breast screening: great expectations?

The Lancet. Oncology, ISSN: 1474-5488, Vol: 20, Issue: 6, Page: 745-746

Digital breast tomosynthesis, also known as three-dimensional mammography, has been under investigation as a replacement for or complement to two-dimensional (2D) digital mammography in breast cancer screening for some years, with several prospective, population-based trials reporting increased cancer detection.1 So far, published studies have been of paired design, in which each woman is her own control—ie, imaged with both digital mammography and digital breast tomosynthesis, read and reported in separate reading groups with either stand-alone digital breast tomosynthesis, or digital breast tomosynthesis in combination with digital mammography or so-called synthetic digital mammography in the digital tomosynthesis group.

[Articles] Two-view digital breast tomosynthesis versus digital mammography in a population-based breast cancer screening programme (To-Be): a randomised, controlled trial

[Articles] Two-view digital breast tomosynthesis versus digital mammography in a population-based breast cancer screening programme (To-Be): a randomised, controlled trial

The Lancet. Oncology, ISSN: 1474-5488, Vol: 20, Issue: 6, Page: 795-805

This study indicated that digital breast tomosynthesis including synthetic 2D mammograms was not significantly different from standard digital mammography as a screening tool for the detection of breast cancer in a population-based screening programme. Economic analyses and follow-up studies on interval and consecutive round screen-detected breast cancers are needed to better understand the effect of digital breast tomosynthesis in population-based breast cancer screening.

Mammographic density and breast cancer risk in breast screening assessment cases and women with a family history of breast cancer.

Mammographic density and breast cancer risk in breast screening assessment cases and women with a family history of breast cancer.

Author(s) Duffy, Stephen W; Morrish, Oliver W E; Allgood, Prue C; Black, Richard; Gillan, Maureen G C; Willsher, Paula; Cooke, Julie; Duncan, Karen A; Michell, Michael J; Dobson, Hilary M; Maroni, Roberta; Lim, Yit Y; Purushothaman, Hema N; Suaris, Tamara; Astley, Susan M; Young, Kenneth C; Tucker, Lorraine; Gilbert, Fiona J

Source European journal of cancer (Oxford, England : 1990); Jan 2018; vol. 88 ; p. 48-56

Publication Date Jan 2018

Place of Publication England

DOI 10.1016/j.ejca.2017.10.022

Accession Number 29190506

ISSN 1879-0852

PubMed ID 29190506

Publication Type(s) Journal Article

Database Medline

Abstract

BACKGROUNDMammographic density has been shown to be a strong independent predictor of breast cancer and a causative factor in reducing the sensitivity of mammography. There remain questions as to the use of mammographic density information in the context of screening and risk management, and of the association with cancer in populations known to be at increased risk of breast cancer.AIMTo assess the association of breast density with presence of cancer by measuring mammographic density visually as a percentage, and with two automated volumetric methods, Quantra™ and VolparaDensity™.METHODSThe TOMosynthesis with digital MammographY (TOMMY) study of digital breast tomosynthesis in the Breast Screening Programme of the National Health Service (NHS) of the United Kingdom (UK) included 6020 breast screening assessment cases (of whom 1158 had breast cancer) and 1040 screened women with a family history of breast cancer (of whom two had breast cancer). We assessed the association of each measure with breast cancer risk in these populations at enhanced risk, using logistic regression adjusted for age and total breast volume as a surrogate for body mass index (BMI).RESULTSAll density measures showed a positive association with presence of cancer and all declined with age. The strongest effect was seen with Volpara absolute density, with a significant 3% (95% CI 1-5%) increase in risk per 10 cm3 of dense tissue. The effect of Volpara volumetric density on risk was stronger for large and grade 3 tumours.CONCLUSIONSAutomated absolute breast density is a predictor of breast cancer risk in populations at enhanced risk due to either positive mammographic findings or family history. In the screening context, density could be a trigger for more intensive imaging.

Breast cancer screening offers few benefits to women over 70

Breast cancer screening offers few benefits to women over 70, finds study [research news].  BMJ 2014; 348:g2333.

Wise, J.

http://www.bmj.com/highwire/filestream/691661/field_highwire_article_pdf/0/bmj.g2333

Extending the Netherlands’ breast cancer screening programme to include women over the age of 70 did not lead to a fall in the number of advanced stage breast cancers detected, even though the number of early stage tumours detected rose, an evaluation has found. The study’s leader, Gerrit-Jan Liefers, a surgical oncologist and head of the geriatric oncology research group at Leiden University Medical Centre, said that if the programme were effective he would expect the incidence of advanced stage cancer to decrease, because any cancer would have been detected at an earlier stage. The study’s finding “implies that the effect of
screening in elderly women is limited and leads to a large proportion of overdiagnosis,” he said.

The benefits and harms of breast cancer screening

The benefits and harms of breast cancer screening: An independent review. British journal of cancer, 2013, 108 p.2205-40.

Marmot, M.G., et al.

http://www.nature.com/bjc/journal/v108/n11/full/bjc2013177a.html

The breast cancer screening programmes in the United Kingdom currently invite women aged 50–70 years for screening mammography every 3 years. Since the time the screening programmes were established, there has been debate, at times sharply polarised, over the magnitude of their benefit and harm, and the balance between them. The expected major benefit is reduction in mortality from breast cancer. The major harm is overdiagnosis and its consequences; overdiagnosis refers to the detection of cancers on screening, which would not have become clinically apparent in the woman’s lifetime in the absence of screening. Professor Sir Mike Richards, National Cancer Director, England, and Dr Harpal Kumar, Chief Executive Officer of Cancer Research UK, asked Professor Sir Michael Marmot to convene and chair an independent panel to review the evidence on benefits and harms of breast screening in the context of the UK breast screening programmes. The panel, authors of this report, reviewed the extensive literature and heard testimony from experts in the field who were the main contributors to the debate. 

Perceived risk and adherence to breast cancer screening guidelines among women with a familial history of breast cancer

Perceived risk and adherence to breast cancer screening guidelines among women with a familial history of breast cancer: A review of the literature. The breast, August 2013, Vol. 22(4), p.395-404.

Walker, M.J., et al.

http://www.sciencedirect.com/science/article/pii/S0960977612002494

A small positive association has been consistently demonstrated between perceived breast cancer risk and mammography use. Evidence specific to women with familial breast cancer risk has not been previously reviewed.

Sorting through the arguments on breast screening

Sorting through the arguments on breast screening.  JAMA, 2013, 309(24), p.2553-4.

Marmot, M.G.

http://jama.jamanetwork.com/article.aspx?articleid=1691913

Views on the benefits and harms of breast cancer screening are sharply polarized and increasingly vocal. Allegations of harming women are flung in both directions. The antiscreeners claim that benefit is minimal and overdiagnosis is so frequent that women are being subject to unnecessary interventions and treatment. The proscreeners claim that if the critics win the day, women will be deprived of the benefits that screening brings of early diagnosis and reductions in mortality from breast cancer.

Screening has not reduced deaths from breast cancer

Screening has not reduced deaths from breast cancer. BMJ 2013; 346: f3780

Wise, J.

http://www.bmj.com/content/346/bmj.f3780.full?rss=1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%253A+bmj%252Frecent+%2528Latest+from+BMJ%2529

Mammographic screening has not had any effect, so far, on breast cancer mortality at the population level in England, a new analysis concludes.

Breast cancer screening - time to move forward?

Breast cancer screening - time to move forward? The lancet, April 2012, Vol. 379(9823), p.1289-90.

Cuzick, J.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60543-1/fulltext?rss=yes

Peter Gøtzsche's Mammography Screening: Truth, Lies and Controversy provides more insight into the polarisation and irrationality of the debate on breast cancer screening than any useful information about the impact of screening in reducing breast cancer mortality.

Detection of breast cancer

Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA, April 2012, Vol. 307(13), p.1394-1404.

Berg, W.A., et al.

http://jama.ama-assn.org/content/307/13/1394.short?rss=1

The addition of screening ultrasound or MRI to mammography in women at increased risk of breast cancer resulted in not only a higher cancer detection yield but also an increase in false-positive findings.

Anxiety after an abnormal screening mammography is a serious problem

Anxiety after an abnormal screening mammography is a serious problem. The Breast, Vol. 21(1), Feb. 2012, p. 83-88.

Keyzer-Dekker, C.M.G., et al.

http://www.sciencedirect.com/science/article/pii/S0960977611003213

The aim of this study was to analyze the possible negative psychological consequences of a false positive screening mammogram (FPSM). We compared anxiety evoked by first (FSM) versus repeat screening mammogram (RSM). Questionnaires were completed prior to the diagnosis and during follow up.

Minor influence of self-selection bias on the effectiveness of breast cancer screening in case-control studies in the Netherlands

Minor influence of self-selection bias on the effectiveness of breast cancer screening in case-control studies in the Netherlands. Journal of medical screening, Sept 2011, Vol. 18(3), p. 142-146

Paap, E., et al.

http://jms.rsmjournals.com/content/18/3/142.short?rss=1

Self-selection bias is considered to be a problem when evaluating the effectiveness of breast cancer service screening in case-control studies. Using the incidence-based mortality method (IBM), a correction factor for the potential influence of self-selection can be derived from a group of non-screened women and a group of not-invited women.

The low uptake of breast screening in cities is a major public health issue and be due to organisational factors

The low uptake of breast screening in cities is a major public health issue and may be due to organisational factors: A Census-based record linkage study. The Breast, Oct 2011, Vol. 20(5), p.460-463

Kinnear, H. et al.

http://www.thebreastonline.com/article/PIIS0960977611000993/abstract?rss=yes

Cancer screening uptake is generally lower in UK cities but quantifying city-level effects from causes due to population composition that comprise cities is hampered by data limitations. The reduced uptake of screening in cities is a major public health issue; the effects are large and a large proportion of the population are affected, organisational factors appear to be the primary cause. Strategies to correct this imbalance might help reduce inequalities in health.