Analysis of patients with false negative mammography and symptomatic breast carcinoma

Murphy, Ian; Dillon, Marcus L.; Doherty, Ann O'; McDermott, Enda; Kelly, G.; O’Higgins, N.; Hill, A. D. K.

doi:10.1002/jso.20801

Cited by 51 publications

(41 citation statements)

References 40 publications

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“…In our study, in women referred to the outpatient clinic of a tertiary referral hospital, the sensitivity of the techniques was similar (92.9%), with a specificity of 98.7 and 97.0% for mammography and breast tomosynthesis, respectively. The sensitivity of mammography is high in comparison to other studies [2][3][4][5][6][7][8][9][10][11]. This may be due to the fact that our BI-RADS-3 findings were considered positive.…”

Section: Discussioncontrasting

confidence: 69%

“…Mammography is currently the first choice of imaging investigation in symptomatic women despite its well-known limitations. The false-negative rate of mammography ranges from 8 to 66% in symptomatic women, depending on factors such as breast density and tumor type [2][3][4][5][6][7][8][9][10][11]. This apparent lack of sensitivity is considered to be caused by the misinterpretation of architectural distortion, asymmetrical density, and fibroglandular tissue overlapping the cancer, thus obscuring the margins of the cancer.…”

Section: Introductionmentioning

confidence: 94%

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Breast tomosynthesis in clinical practice: initial results

et al. 2009

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The purpose of this study was to assess the potential value of tomosynthesis in women with an abnormal screening mammogram or with clinical symptoms. Mammography and tomosynthesis investigations of 513 woman with an abnormal screening mammogram or with clinical symptoms were prospectively classified according to the ACR BI-RADS criteria. Sensitivity and specificity of both techniques for the detection of cancer were calculated. In 112 newly detected cancers, tomosynthesis and mammography were each false-negative in 8 cases (7%). In the false-negative mammography cases, the tumor was detected with ultrasound (n = 4), MRI (n = 2), by recall after breast tomosynthesis interpretation (n = 1), and after prophylactic mastectomy (n = 1). Combining the results of mammography and tomosynthesis detected 109 cancers. Therefore in three patients, both mammography and tomosynthesis missed the carcinoma. The sensitivity of both techniques for the detection of breast cancer was 92.9%, and the specificity of mammography and tomosynthesis was 86.1 and 84.4%, respectively. Tomosynthesis can be used as an additional technique to mammography in patients referred with an abnormal screening mammogram or with clinical symptoms. Additional lesions detected by tomosynthesis, however, are also likely to be detected by other techniques used in the clinical work-up of these patients.

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Section: Discussioncontrasting

confidence: 69%

Section: Introductionmentioning

confidence: 94%

Breast tomosynthesis in clinical practice: initial results

et al. 2009

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“…Even with these high performance values, the overall reduction of mortality in women ages 40 to 49 years due to mammography screening is limited to 15% to 16% (compared with 25%-35% reduction observed for those ages 50 to 69 years), demonstrating the inability of current mammographic modalities to detect early-age cancer (17). The incidence of mammographically occult primary tumors (e.g., falsenegative results) is particularly significant in smaller tumors (T1N0 or DCIS), particularly in women with dense breasts and women younger than 50 years (3,(18)(19)(20)(21). In addition, a meta-analysis of the proportional incidence of interval breast cancers revealed rates between 19% and 27% (22).…”

Section: Discussionmentioning

confidence: 99%

A Multiparametric Serum Marker Panel as a Complementary Test to Mammography for the Diagnosis of Node-Negative Early-Stage Breast Cancer and DCIS in Young Women

Lacombe

Mangé

Bougnoux

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: The sensitivity of mammography for the detection of small lesions, including node-negative early-stage (T1N0) primary breast cancer (PBC) and ductal carcinoma in situ (DCIS), is significantly decreased in young patients. From a clinical standpoint, an inconclusive mammogram reflects the inability of clinicians to confidently decide whether patients should be referred for biopsy or for follow-up with repeat imaging.Methods: Specific ELISAs were developed for a panel of 13 well-recognized breast autoantigens (HSP60, FKBP52, PRDX2, PPIA, MUC1, GAL3, PAK2, P53, CCNB1, PHB2, RACK1, RUVBL1, and HER2). Circulating autoantibody levels were measured in a cohort of 396 serum samples from histologically confirmed DCIS (n ¼ 87) or T1N0 PBC (n ¼ 153) and healthy controls (n ¼ 156).Results: Individually, antibodies against CCNB1, FKBP52, GAL3, PAK2, PRDX2, PPIA, P53, and MUC1 demonstrated discriminatory power between breast cancer and healthy control groups. At 90% sensitivity, the overall combined specificity of the autoantibody serum screening test was 42%. Adjustment for higher sensitivities of 95% and 99% resulted in 30% and 21% specificities, respectively (33% and 18% in T1N0 PBC and 28% and 21% in DCIS). Finally, in patients with node-negative early-stage breast cancer younger than 50 years, the autoantibody assay exhibited 59% specificity with a fixed sensitivity at 90%.Conclusions: Our autoantibody panel allows accurate detection of early breast cancer and DCIS, notably in younger patients.Impact: Clinical assessment of this autoantibody panel displays a potential to facilitate clinical management of early-stage breast cancer detection in cases of inconclusive mammogram. Cancer Epidemiol Biomarkers Prev; 23(9); 1834-42. Ó2014 AACR.

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“…1 On the contrary, nipple discharge accounted for up to 4% to 7% of all presenting symptoms in other studies. 2,3 This may be better explained by the unique Chinese culture and help-seeking pattern rather than a true disease pattern. With this understanding, any clinical survey New knowledge added by this study • Blood-stained nipple discharge and an associated breast mass at presentation could suggest a higher chance of malignancy.…”

Section: Introductionmentioning

confidence: 99%

Implications of nipple discharge in Hong Kong Chinese women

2018

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Introduction:There are no recent data on nipple discharge and its association with malignancy in Hong Kong Chinese women. This study reported our 5-year experience in the management of patients with nipple discharge, and our experience of mammography, ultrasonography, ductography, and nipple discharge cytology in an attempt to determine their role in the management of nipple discharge. Methods:Women who attended our Breast Clinic in a university-affiliated hospital in Hong Kong were identified by retrospective review of clinical data from January 2007 to December 2011. They were divided into benign and malignant subgroups. Background clinical variables and investigative results were compared between the two subgroups. We also reported the sensitivity, specificity, and positive and negative predictive values of the investigations that included mammography, ultrasonography, ductography, and cytology. Results:We identified 71 and 31 patients in the benign and malignant subgroups, respectively. The median age at presentation for the benign subgroup was younger than that of the malignant subgroup (48 vs 59 years; P=0.003). A higher proportion of patients in the malignant subgroup than the benign subgroup presented with bloodstained nipple discharge (87.1% vs 47.9%; P=0.002). Mammography had a specificity of 98.4% and Implications of nipple discharge in Hong KongChinese women

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Analysis of patients with false negative mammography and symptomatic breast carcinoma

Cited by 51 publications

References 40 publications

Breast tomosynthesis in clinical practice: initial results

Breast tomosynthesis in clinical practice: initial results

A Multiparametric Serum Marker Panel as a Complementary Test to Mammography for the Diagnosis of Node-Negative Early-Stage Breast Cancer and DCIS in Young Women

Implications of nipple discharge in Hong Kong Chinese women

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