Analytic Hierarchy Process Analysis of Patient Preferences for Contrast-Enhanced Mammography Versus MRI as Supplemental Screening Options for Breast Cancer

Berg, Wendie A.; Bandos, Andriy I.; Sava, M. Gabriela

doi:10.1016/j.jacr.2023.05.014

Cited by 13 publications

(2 citation statements)

References 62 publications

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“…Both the ACR and the National Comprehensive Cancer Network suggest that for women who qualify for MRI, but who cannot access or tolerate it, contrast-enhanced mammography (CEM) can be considered. CEM is better tolerated than MRI and shows similar cancer detection rates, but CEM is not yet approved by the US Food and Drug Administration for screening. Supplemental screening ultrasonography shows lower added cancer detection rates than other methods, averaging 2 to 3 per 1000 after DM and only 1.1 per 1000 each year in a recent study after DBT .…”

Section: Dense Breast Screeningmentioning

confidence: 99%

USPSTF Breast Cancer Screening Guidelines Do Not Go Far Enough

Berg

2024

JAMA Oncol

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Section: Dense Breast Screeningmentioning

confidence: 99%

USPSTF Breast Cancer Screening Guidelines Do Not Go Far Enough

Berg

2024

JAMA Oncol

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“…Although this imaging modality has shown greater sensitivity and specificity for breast cancer detection compared to standard mammography, especially in women with dense breasts (Fallenberg et al 2017, Bozzini et al 2020, its diagnostic performance remains comparable to contrast-enhanced magnetic resonance imaging (CE-MRI) (Patel et al 2018, Lewin et al 2020. Nonetheless, CEM is cost effective and some studies have shown a strong preference of patients for CEM over MRI (Hobbs et al 2015, Berg et al 2023.…”

Section: Introductionmentioning

confidence: 99%

Deep-learning model for background parenchymal enhancement classification in contrast-enhanced mammography

Ripaud,

Jailin,

Quintana

et al. 2024

Phys. Med. Biol.

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Background: Breast Background Parenchymal Enhancement (BPE) is correlated withthe risk of breast cancer. BPE level is currently assessed by radiologists in Contrast-EnhancedMammography (CEM) using 4 classes: minimal, mild, moderate and marked, as describedin Breast Imaging Reporting and Data System (BI-RADS). However, BPE classification re-mains subject to intra- and inter-reader variability. Fully automated methods to assess BPElevel have already been developed in breast Contrast-Enhanced MRI (CE-MRI) and have beenshown to provide accurate and repeatable BPE level classification. However, to our knowledge,no BPE level classification tool is available in the literature for CEM.Materials & Methods: A BPE level classification tool based on Deep Learning (DL) hasbeen trained and optimized on 7012 CEM image pairs (low-energy and recombined images)and evaluated on a dataset of 1013 image pairs. The impact of image resolution, backbonearchitecture and loss function were analyzed, as well as the influence of lesion presence andtype on BPE assessment. The evaluation of the model performance was conducted using dif-ferent metrics including 4-class balanced accuracy and mean absolute error. The results of theoptimized model for a binary classification: minimal/mild versus moderate/marked, were alsoinvestigated.Results: The optimized model achieved a 4-class balanced accuracy of 71.5% (95% CI:71.2–71.9) with 98.8% of classification errors between adjacent classes. For binary classifi-cation, the accuracy reached 93.0%. A slight decrease in model accuracy is observed in thepresence of lesions, but it is not statistically significant, suggesting that our model is robust tothe presence of lesions in the image for a classification task. Visual assessment also confirmsthat the model is more affected by non-mass enhancements than by mass-like enhancements.Conclusion: The proposed BPE classification tool for CEM achieves similar results thanwhat is published in the literature for CE-MRI.

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Re-attendance in supplemental breast MRI screening rounds of the DENSE trial for women with extremely dense breasts

Veenhuizen,

van Grinsven,

Laseur

et al. 2024

Eur Radiol

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Objectives Supplemental MRI screening improves early breast cancer detection and reduces interval cancers in women with extremely dense breasts in a cost-effective way. Recently, the European Society of Breast Imaging recommended offering MRI screening to women with extremely dense breasts, but the debate on whether to implement it in breast cancer screening programs is ongoing. Insight into the participant experience and willingness to re-attend is important for this discussion. Methods We calculated the re-attendance rates of the second and third MRI screening rounds of the DENSE trial. Moreover, we calculated age-adjusted odds ratios (ORs) to study the association between characteristics and re-attendance. Women who discontinued MRI screening were asked to provide one or more reasons for this. Results The re-attendance rates were 81.3% (3458/4252) and 85.2% (2693/3160) in the second and third MRI screening round, respectively. A high age (> 65 years), a very low BMI, lower education, not being employed, smoking, and no alcohol consumption were correlated with lower re-attendance rates. Moderate or high levels of pain, discomfort, or anxiety experienced during the previous MRI screening round were correlated with lower re-attendance rates. Finally, a plurality of women mentioned an examination-related inconvenience as a reason to discontinue screening (39.1% and 34.8% in the second and third screening round, respectively). Conclusions The willingness of women with dense breasts to re-attend an ongoing MRI screening study is high. However, emphasis should be placed on improving the MRI experience to increase the re-attendance rate if widespread supplemental MRI screening is implemented. Clinical relevance statement For many women, MRI is an acceptable screening method, as re-attendance rates were high — even for screening in a clinical trial setting. To further enhance the (re-)attendance rate, one possible approach could be improving the overall MRI experience. Key Points • The willingness to re-attend in an ongoing MRI screening study is high. • Pain, discomfort, and anxiety in the previous MRI screening round were related to lower re-attendance rates. • Emphasis should be placed on improving MRI experience to increase the re-attendance rate in supplemental MRI screening.

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Analytic Hierarchy Process Analysis of Patient Preferences for Contrast-Enhanced Mammography Versus MRI as Supplemental Screening Options for Breast Cancer

Cited by 13 publications

References 62 publications

USPSTF Breast Cancer Screening Guidelines Do Not Go Far Enough

USPSTF Breast Cancer Screening Guidelines Do Not Go Far Enough

Deep-learning model for background parenchymal enhancement classification in contrast-enhanced mammography

Re-attendance in supplemental breast MRI screening rounds of the DENSE trial for women with extremely dense breasts

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