Geographical distribution of breast cancers on the mammogram: an interval cancer database

Brown, Matthew; Eccles, C.; Wallis, Matthew

doi:10.1259/bjr.74.880.740317

Cited by 16 publications

(12 citation statements)

References 11 publications

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“…However, the retroglandular area represents a clinically relevant part of the breast for the detection of cancer and we believe that including this part on the mammogram leads to improved breast cancer detection. 7,8 A lower compression force may lead to increased breast thickness and decreased image quality. 4 The thickness differences between the IMD 1 breasts and IMD 2 breasts were small.…”

Section: Discussionmentioning

confidence: 99%

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Paap¹,

Witjes²,

Landsveld-Verhoeven³

et al. 2016

BJR

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Objective: To assess the image quality of mammograms in females with an implanted medical device (IMD), to evaluate pain and anxiety during mammography in these females and to investigate the experience of radiographers. Methods: Image quality was evaluated by two radiographers and one radiologist in the images of females with an IMD participating in the Dutch screening programme (clients). Pain and anxiety were scored using a Numeric Rating Scale in both clients visiting a screening organization and patients from the Isala Hospital, Zwolle. Experience of screening radiographers was collected with a questionnaire. Results: Images of the breast with IMD showed reduced contrast in craniocaudal (CC) and mediolateral-oblique (MLO) views [by both the radiographers and radiologist (range: 11-29%)], less projected breast tissue [only radiographers; CC lateral side: 25.5%, 95% confidence interval (CI): 18.7-32.2] and reduced projection of the pectoral muscle (only radiographers; MLO width pectoral muscle: 31.5%, 95% CI: 24.4-38.7). Clients experienced more pain and anxiety during mammography in the breast with IMD compared to the breast without IMD in the breast (pain difference CC: 0.48 6 0.16, p 5 0.003; pain difference MLO: 0.46 6 0.16, p 5 0.004; anxiety difference 1.30 6 0.22; p , 0.001). Patients experienced more pain (1.05 6 0.12; p , 0.001) and anxiety (1.22 6 0.15; p , 0.001) after placement of IMD. Radiographers are more cautious, more anxious and use less compression during mammography of breasts with IMD. Conclusion: Image quality in a breast with an IMD could be improved by projecting more breast tissue on the mammogram, thereby including (part of) the IMD between the paddles, if required. In addition, radiographers should pay sufficient attention to reducing discomfort both before and during the screening examination. Advances in knowledge: Little is known about the quality of mammography in females with an IMD or how these females and radiographers experience the screening examination. The results of our study showed that having an IMD could result in a suboptimal mammogram and increased discomfort.

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Section: Discussionmentioning

confidence: 99%

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Paap¹,

Witjes²,

Landsveld-Verhoeven³

et al. 2016

BJR

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“…Further, to our knowledge, this is the first study to report that contrast in the retroglandular area is superior with RP. This area represents a clinically relevant part of the breast for the detection of cancer [ 16 , 17 ]. A similar problem has been reported in relation to breast density measurements, where the conclusion was that software needs a correction when FP is used [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of a flexible versus a rigid breast compression paddle: pain experience, projected breast area, radiation dose and technical image quality

Broeders

Voorde²,

Veldkamp

et al. 2014

Eur Radiol

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PurposeTo compare pain, projected breast area, radiation dose and image quality between flexible (FP) and rigid (RP) breast compression paddles.MethodsThe study was conducted in a Dutch mammographic screening unit (288 women). To compare both paddles one additional image with RP was made, consisting of either a mediolateral-oblique (MLO) or craniocaudal-view (CC). Pain experience was scored using the Numeric Rating Scale (NRS). Projected breast area was estimated using computer software. Radiation dose was estimated using the model by Dance. Image quality was reviewed by three radiologists and three radiographers.ResultsThere was no difference in pain experience between both paddles (mean difference NRS: 0.08 ± 0.08, p = 0.32). Mean radiation dose was 4.5 % lower with FP (0.09 ± 0.01 p = 0.00). On MLO-images, the projected breast area was 0.79 % larger with FP. Paired evaluation of image quality indicated that FP removed fibroglandular tissue from the image area and reduced contrast in the clinically relevant retroglandular area at chest wall side.ConclusionsAlthough FP performed slightly better in the projected breast area, it moved breast tissue from the image area at chest wall side. RP showed better contrast, especially in the retroglandular area. We therefore recommend the use of RP for standard MLO and CC views.Key points• Pain experience showed no difference between flexible and rigid breast compression paddles.• Flexible paddles do not depict clinically relevant retroglandular areas as well.• Flexible paddles move breast tissue from image area at the chest wall side.• Rigid paddles depict more breast tissue and shows better contrast.• Rigid breast compression paddles are recommended for standard mediolateral-oblique and craniocaudal views.Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-014-3422-4) contains supplementary material, which is available to authorized users.

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“…Several papers have been published on IC rates from national or local screening programmes (Frisell et al, 1987;Tabar et al, 1987;Day et al, 1995;Johnson and Shekhdar, 1995;Asbury et al, 1996;Blanks and Moss, 1996;Faux et al, 1997;Sylvester et al, 1997aSylvester et al, , 1997bFracheboud et al, 1998Fracheboud et al, , 1999Lynge, 1998;Moss and Blanks, 1998;Rickard et al, 1998;Everington et al, 1999;Exbrayat et al, 1999;Kavanagh et al, 1999;Warren and Duffy, 2000;Brown et al, 2001;Taylor et al, 2002;Zappa et al, 2002;Gorini et al, 2004;Törnberg et al, 2005;Bulliard et al, 2006;Hofvind et al, 2006;Bucchi et al, 2008a). To the best of our knowledge, no data have been published yet on pooled analysis from several BC screening programmes in different European Countries sharing the same screening guidelines (Perry et al, 2006) and data collection protocols, and providing detailed information including histological characteristics which allow for a better understanding of the complexity of IC (Brekelmans et al, 1996;Goel et al, 2007;Bucchi et al, 2008b).…”

Section: Introductionmentioning

confidence: 99%

A pooled analysis of interval cancer rates in six European countries

Törnberg

Kemetli

Ascunce

et al. 2010

European Journal of Cancer Prevention

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The objective of this study was to assess detection rates and interval breast cancer (IC) rates from eight programmes in the European Breast Cancer Screening Network. A common data collection protocol was used to explore differences in IC rates among programmes and discuss their potential determinants. Pooled analysis was used to describe IC rates by age, compliance in screening, recall rate, screening detection (SD) rate and expected breast cancer incidence. Participation in screening averaged 77.9% (range 42.6-88.7%), recall rate 5.4% (range 3.3-17.7%) in the initial and 3.4% (range 1.8-8.9%) in the subsequent screening rounds, and SD rate was 60.4 (range 41.6-91) per 10 000 women in initial and 38.5 (range 31.3-62.6) in subsequent screens. IC rate during first 12 months after screening was 5.9 (range 2.1-7.3) per 10 000 women screened negative and 12.6 (range 6.3-15) in the second year of the interval. IC comprised 28% of the IC and SD cancers. The ratio between IC rate and expected incidence was 0.29 for the first 12 months and 0.63 for the 13-24 months period. Sensitivity was higher for the ages 60-69 years and for initial tests than subsequent tests. There were distinct differences in the IC rates between programmes. The results of this study reveal large variations in screening sensitivity and performance. Pooled evaluation of some process indicators within the European breast cancer screening programmes proved to be feasible and is likely to be useful for the future, particularly if it is performed regularly and extensively.

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Geographical distribution of breast cancers on the mammogram: an interval cancer database

Cited by 16 publications

References 11 publications

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Comparison of a flexible versus a rigid breast compression paddle: pain experience, projected breast area, radiation dose and technical image quality

A pooled analysis of interval cancer rates in six European countries

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