Density and tailored breast cancer screening: practice and prediction – an overview

Wengert, Georg; Helbich, Thomas H.; Kapetas, Panagiotis; Baltzer, Pascal; Pinker, Katja

doi:10.1177/2058460118791212

Cited by 15 publications

(23 citation statements)

References 109 publications

(151 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In particular, concerns regarding overdiagnosis and subsequent overtreatment, and the harms associated with false positive recalls for assessment lead some to call for an overhaul of the system or abandoning population mammographic screening programs (4)(5)(6)(7)(8)(9). In addition, the reduced sensitivity of mammography in those with high-mammographic density has led to question the role of supplementary screening in this group (10,11).…”

Section: Introductionmentioning

confidence: 99%

“A Natural Progression”: Australian Women's Attitudes About an Individualized Breast Screening Model

Lippey

Keogh

Mann

et al. 2019

Cancer Prevention Research

100

View full text Add to dashboard Cite

Individualized screening is our logical next step to improve population breast cancer screening in Australia. To explore breast screening participants' views of the current program in Victoria, Australia, examine their openness to change, and attitudes toward an individualized screening model, this qualitative work was performed from a population-based breast screening cohort. This work was designed to inform the development of a decision aid to facilitate women's decisions about participating in individualized screening, and to elicit Australian consumer perspectives on the international movement toward individualized breast screening. A total of 52 women participated in one of four focus groups, and were experienced with screening with 90% of participants having had more than three mammograms. Focus group discussion was facilitated following three main themes: (i) experience of breast screening; (ii) breast cancer risk perception, and (iii) views on individualized screening. Participants had strong, positive, emotional ties to breast screening in its current structure but were supportive, with some reservations, of the idea of individualized screening. There was good understanding about the factors contributing to personalized risk and a wide range of opinions about the inclusion of genetic testing with genetic testing being considered a foreign and evolving domain. Individualized breast screening that takes account of risk factors such as mammographic density, lifestyle, and genetic factors would be acceptable to a population of women who are invested in the current system. The communication and implementation of a new program would be critical to its acceptance and potential success. Reservations may be had in regards to uptake of genetic testing, motivations behind the change, and management of the women allocated to a lower risk category.

show abstract

Section: Introductionmentioning

confidence: 99%

“A Natural Progression”: Australian Women's Attitudes About an Individualized Breast Screening Model

Lippey

Keogh

Mann

et al. 2019

Cancer Prevention Research

100

View full text Add to dashboard Cite

show abstract

“…MD assessment by radiologists and digital software show good agreement [6, 7], with both qualitative and quantitative methods of measuring MD showing an association between high MD and risk of developing BC [8]. High MD is not only a risk factor for BC, but it reduces the prospect of detecting a BC, since surrounding breast tissue “masks” the malignancy, known as the masking effect [9]. Accordingly, the 5th edition of BI-RADS breast composition categorization aims at better assessment of density by emphasizing this masking effect [10].…”

Section: Introductionmentioning

confidence: 99%

Mammographic density is a potential predictive marker of pathological response after neoadjuvant chemotherapy in breast cancer

et al. 2019

View full text Add to dashboard Cite

BackgroundOur aim is to study if mammographic density (MD) prior to neoadjuvant chemotherapy is a predictive factor in accomplishing a pathological complete response (pCR) in neoadjuvant-treated breast cancer patients.MethodsData on all neoadjuvant treated breast cancer patients in Southern Sweden (2005–2016) were retrospectively identified, with patient and tumor characteristics retrieved from their medical charts. Diagnostic mammograms were used to evaluate and score MD as categorized by breast composition with the Breast Imaging-Reporting and Data System (BI-RADS) 5th edition. Logistic regression was used in complete cases to assess the odds ratios (OR) for pCR compared to BI-RADS categories (a vs b-d), adjusting for patient and pre-treatment tumor characteristics.ResultsA total of 302 patients were included in the study population, of which 57 (18.9%) patients accomplished pCR following neoadjuvant chemotherapy. The number of patients in the BI-RADS category a, b, c, and d were separately 16, 120, 140, and 26, respectively. In comparison to patients with BI-RADS breast composition a, patients with denser breasts had a lower OR of accomplishing pCR: BI-RADS b 0.32 (95%CI 0.07–0.1.5), BI-RADS c 0.30 (95%CI 0.06–1.45), and BI-RADS d 0.06 (95%CI 0.01–0.56). These associations were measured with lower point estimates, but wider confidence interval, in premenopausal patients; OR of accomplishing pCR for BI-RADS d in comparison to BI-RADS a: 0.03 (95%CI 0.00–0.76).ConclusionsThe likelihood of accomplishing pCR is indicated to be lower in breast cancer patients with higher MD, which need to be analysed in future studies for improved clinical decision-making regarding neoadjuvant treatment.

show abstract

“…information for the stratification of breast cancer risk [18]. In principle, analysis of the relationship between the known singular and independent risk factors "age" and "breast density" and the occurrence of breast cancer is of interest [10]. For women older than 50 years in whom a breast cancer-relevant gene mutation has been detected, intensified surveillance including an annual MRI examination is recommended [4].…”

Section: Discussionmentioning

confidence: 99%

“…Scientific approaches focus on the development of risk-adjusted early detection concepts for women also outside of high-risk groups for breast cancer [10]. However, knowledge of the combination of risk constellations is currently still limited.…”

Section: Introductionmentioning

confidence: 99%

Stratification of Breast Cancer Risk in Terms of the Influence of Age and Mammographic density

Weigel

Heindel

Dietz

et al. 2020

Rofo

View full text Add to dashboard Cite

Purpose Analysis of the influence of the singular risk factors age and breast density on the 2-year incidence of breast cancer among participants in the German mammography screening program. Materials and Methods The multicenter study includes 111 456 subsequent round digital mammographic screening examinations from four screening units with prospective visual categorization of breast density. Based on detection in screening and during the 2-year interval after negative screening participation (interval cancers), 2-year breast cancer incidences (2 YBCI) (‰) were calculated in the 5-year age groups (5 YAG) of the target group 50–69 years and in the BI-RADS density categories ACR 1–4. Multivariate statistical evaluations were carried out using logistic regression models. Results With an increase in the 5 YAG, the 2 YBCI increased by 5.0 ‰, 6.7 ‰, 8.5 ‰ to 9.7 ‰, and was significantly different among 55–59, 60–64 and 65–69-year-old women compared to the youngest reference group 50–54 years (odds ratio (OR): 1.34; 1.68; and 1.93; p-value < 0.0001). With an increase in density categories 1–4, the 2 YBCI increased from 2.6 ‰, to 5.8 ‰, 9.6 ‰, and 9.7 ‰. The 2 YBCI differed significantly in breast density categories 2, 3, 4 from reference group 1 (OR: 2.17; 3.65; and 3.76; p-value < 0.0001). Only within the two main breast density groups 2 (frequency 44.3 %) and 3 (44.7 %), a significant increase in the 2 YBCI was observed across the 5 YAG (category 2: 3.7–8.9 ‰; category 3: 5.8–11.7 ‰; p-value < 0.001 each). The 2 YBCI was above the median of 7.5 ‰ in women with breast density category 2 and aged 65–69 years, as well as in women with breast density categories 3 and 4 aged 55–69 years. A 2 YBCI below the median was seen in women between 50–54 years regardless of breast density, as well as women in category 1 in all age groups. Conclusion Within the main breast density categories 2 and 3 (almost 90 % of participants), incidences increase with age to double. A consistently low incidence is found regardless of breast density at a young screening age and in women with the lowest breast density. Key Points: Citation Format

show abstract

Density and tailored breast cancer screening: practice and prediction – an overview

Cited by 15 publications

References 109 publications

“A Natural Progression”: Australian Women's Attitudes About an Individualized Breast Screening Model

“A Natural Progression”: Australian Women's Attitudes About an Individualized Breast Screening Model

Mammographic density is a potential predictive marker of pathological response after neoadjuvant chemotherapy in breast cancer

Stratification of Breast Cancer Risk in Terms of the Influence of Age and Mammographic density

Contact Info

Product

Resources

About