Is single reading with computer-aided detection (CAD) as good as double reading in mammography screening? A systematic review

Azavedo, Edward; Zackrisson, Sophia; Mejàre, Ingegerd; Arnlind, Marianne Heibert

doi:10.1186/1471-2342-12-22

Cited by 64 publications

(58 citation statements)

References 69 publications

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“…However, its contribution to routine screening remains a question of debate. In a systematic review, Azavedo et al concluded that there is insufficient evidence to determine whether CAD could replace a second reader [31]. On the other hand, recent studies have shown that the addition of breast tomosynthesis to digital mammography improves the cancer detection rate in mammography screening and may reduce false positive referrals [32,33].…”

Section: Discussionmentioning

confidence: 98%

Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: A prospected population based study in the south of The Netherlands

Klompenhouwer

Voogd

Heeten

et al. 2015

European Journal of Cancer

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Section: Discussionmentioning

confidence: 98%

Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: A prospected population based study in the south of The Netherlands

Klompenhouwer

Voogd

Heeten

et al. 2015

European Journal of Cancer

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“…Environmental factors such as changes in reproductive patterns, physical inactivity, and obesity also play a major role in BC incidence [8,9]. With an aim of improving patient prognosis and survival in BC, newer techniques have been introduced, including full-field digital mammography (FFDM), digital breast tomosynthesis, and computer-aided tomography [10,11]. The management of BC also depends on various factors, such as tumor stage, menopausal status, histological features, and patient age [12].…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant chemotherapy of breast cancer with pirarubicin versus epirubicin in combination with cyclophosphamide and docetaxel

Shi

Wei

et al. 2015

Tumor Biol.

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Breast cancers (BC) are treated with surgery, radiotherapy, and chemotherapy. Neoadjuvant chemotherapy (NACT) is an emerging treatment option in many cancers and is given before primary therapy to shrink tumor size. The efficacy of NACT in varied settings of BC, such as inoperable tumors, borderline resectable tumors, and breast-conserving surgery, has been debated extensively in literature, and the results remain unclear and depended on a wide variety of factors such as cancer type, disease extent, and the specific combination of chemotherapy drugs. This study was performed to examine the efficacy, toxicity, and tolerability of pirarubicin (THP) and epirubicin (EPI) in combination with docetaxel and cyclophosphamide in a NACT setting for BC. A total of 48 patients with stage II or III breast cancers were randomly divided into two groups: THP group and EPI group. The patients in THP group received 2-4 cycles of neoadjuvant chemotherapy with DTC regimen (docetaxel, THP, cyclophosphamide), while patients in the EPI group received 2-4 cycles of DEC regimen (docetaxel, EPI, cyclophosphamide) before surgery. The incidence of adverse reactions and the efficacy of the treatment regimen were compared between the two groups. Prognostic evaluation indexes were estimated by Kaplan-Meier survival analysis, including the 5-year disease-free survival (DFS) and overall survival (OS). The overall response rate in THP group was 83.3 %, and the EPI group showed a response rate of 79.2 %, with no statistically significant difference in response rate between the two groups. The incidence of cardiac toxicity, myelosuppression, nausea, and vomiting in the THP group was significantly lower than the EPI group (all P < 0.05). The incidence of hepatic toxicity, alopecia, and diarrhea in the THP group was also lower than the EPI group, but these differences were not statistically significant. The 5-year DFS and OS in THP versus EPI groups were 80 versus 76 % (DFS) and 86 versus 81 % (OS), respectively. Our study found that NACT with DTC regimen and DEC regimen were both very effective in treatment of BC. However, THP-based combination therapy was associated with significantly lower incidence of cardiac toxicity, myelosuppression, nausea, and vomiting.

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“…4 When comparing dual to single reading, studies have shown that sensitivity increased by 5-10% without a significant effect on recall rates. 5 Consensus arbitration of discordant double read cases also improved reading performance since it decreased recall rates and increased Positive Predictive Value (PPV). 4,6,7 Since consensus arbitration was not practised locally, as per radiologists' choice, women who were recalled by one radiologist experienced additional examinations during further assessment clinics.…”

Section: Introductionmentioning

confidence: 99%

A retrospective audit of the first screening round of the Maltese breast screening programme

2017

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Purpose: To analyse whether the screening performance parameters of the Maltese National Breast Screening Programme first screening round met requirements set by European standards. The association between screening age and results of screening performance parameters was also investigated. Method:Quantitative methodology was used to review examinations of women who were recalled for a technical recall or further assessment rates. All accessible members of the population recalled during the first round were retrospectively reviewed resulting in a sample of 2300 recalled examinations.Results: Malta's first screening round met the European Guidelines recommendations for technical repeat rate (0.26%), early recall rate (0.45%), breast cancer detection rate (13.77 per 1000 women) and Positive Predictive Value of screening test (7.58%). However, local recall rate (18.53%) and further assessment rate (18.27%) were higher than recommended.The Chi square test showed a statistically significant difference (p<0.05) in recall rates between the compared age groups, as younger women (51-55 years) were more likely to have a negative diagnosis after the initial mammogram whereas older women (56-60 years) were more likely to be recalled. There was no age discrepancy (p>0.05) in local breast cancer detection rate and positive predictive value of screening test. Conclusion:Although the Maltese first screening round performed well, this study found deficiencies in recall and further assessment rates, which according to literature may result in psychological morbidity and inefficient use of screening resources. This study also concluded that when a cohort is analysed, age is not as significant as the screening round itself (first/subsequent). KeywordsBreast cancer, breast screening programme, screening performance parameter, false positive mammogram, age effect IntroductionBreast cancer is the most common cancer among Maltese women and accounts for a third of all female cancer deaths. Every one in twelve Maltese women will get breast cancer in her lifetime; a significantly higher proportion than the European average. 1 In October 2009, Malta's Department for Health agreed to implement a National Breast Screening Programme (MNBSP). 2 The aim of screening was to reduce morbidity and mortality from the disease without adversely affecting the health of participants. 3,4 Key to achieving this aim were high levels of quality within the entire screening process. 4 The MNBSP strives to protect the dignity and privacy of women, while offering an effective service at the highest levels of quality to diagnose and treat breast cancers at the earliest possible stage, and also meeting the European clinical standards. 4 The first MNBSP round commenced in October 2009 and ended in February 2013. The local screening programme provided free screening, every three years for all women aged 50 to 60, resident in the Maltese Islands. This age range was selected for the first screening round since this age group was deemed to be the 'most at risk'...

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Is single reading with computer-aided detection (CAD) as good as double reading in mammography screening? A systematic review

Cited by 64 publications

References 69 publications

Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: A prospected population based study in the south of The Netherlands

Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: A prospected population based study in the south of The Netherlands

Neoadjuvant chemotherapy of breast cancer with pirarubicin versus epirubicin in combination with cyclophosphamide and docetaxel

A retrospective audit of the first screening round of the Maltese breast screening programme

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