Update on new technologies in digital mammography

Patterson, Stephanie K.; Roubidoux, Marilyn A.

doi:10.2147/ijwh.s49332

Cited by 17 publications

(9 citation statements)

References 63 publications

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“…Reading DBT images roughly doubles the interpretation time for mammograms [29]. Secondly, the price of new digital mammographic units with DBT capability entails an upfront investment [41]. A dedicated workstation is also needed to interpret DBT images, also requiring additional funding [41].…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, the price of new digital mammographic units with DBT capability entails an upfront investment [41]. A dedicated workstation is also needed to interpret DBT images, also requiring additional funding [41]. Information technology and image archiving infrastructure is substantially higher for DBT, for example DBT storage space can be 100 to 200 times that of DM [41].…”

Section: Discussionmentioning

confidence: 99%

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The cost-effectiveness of digital breast tomosynthesis in a population breast cancer screening program

et al. 2020

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Objectives To evaluate at which sensitivity digital breast tomosynthesis (DBT) would become cost-effective compared to digital mammography (DM) in a population breast cancer screening program, given a constant estimate of specificity. Methods In a microsimulation model, the cost-effectiveness of biennial screening for women aged 50–75 was simulated for three scenarios: DBT for women with dense breasts and DM for women with fatty breasts (scenario 1), DBT for the whole population (scenario 2) or maintaining DM screening (reference). For DM, sensitivity was varied depending on breast density from 65 to 87%, and for DBT from 65 to 100%. The specificity was set at 96.5% for both DM and DBT. Direct medical costs were considered, including screening, biopsy and treatment costs. Scenarios were considered to be cost-effective if the incremental cost-effectiveness ratio (ICER) was below €20,000 per life year gain (LYG). Results For both scenarios, the ICER was more favourable at increasing DBT sensitivity. Compared with DM screening, 0.8–10.2% more LYGs were found when DBT sensitivity was at least 75% for scenario 1, and 4.7–18.7% when DBT sensitivity was at least 80% for scenario 2. At €96 per DBT, scenario 1 was cost-effective at a DBT sensitivity of at least 90%, and at least 95% for scenario 2. At €80 per DBT, these values decreased to 80% and 90%, respectively. Conclusion DBT is more likely to be a cost-effective alternative to mammography in women with dense breasts. Whether DBT could be cost-effective in a general population highly depends on DBT costs. Key Points • DBT could be a cost-effective screening modality for women with dense breasts when its sensitivity is at least 90% at a maximum cost per screen of €96. • DBT has the potential to be cost-effective for screening all women when sensitivity is at least 90% at a maximum cost per screen of €80. • Whether DBT could be used as an alternative to mammography for screening all women is highly dependent on the cost of DBT per screen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of digital breast tomosynthesis in a population breast cancer screening program

et al. 2020

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“…MD is, therefore, defined as fibroglandular mammary tissue consisting of fibroblasts, epithelial cells and connective tissue [ 5 ]. The most commonly used tool for assessing MD on a mammogram is the breast imaging reporting and data systems (BI-RADS) [ 6 ]. The BI-RADS divides MD into four major categories, as illustrated in Fig.…”

Section: Introductionmentioning

confidence: 99%

An overview of mammographic density and its association with breast cancer

2018

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In 2017, breast cancer became the most commonly diagnosed cancer among women in the US. After lung cancer, breast cancer is the leading cause of cancer-related mortality in women. The breast consists of several components, including milk storage glands, milk ducts made of epithelial cells, adipose tissue, and stromal tissue. Mammographic density (MD) is based on the proportion of stromal, epithelial, and adipose tissue. Women with high MD have more stromal and epithelial cells and less fatty adipose tissue, and are more likely to develop breast cancer in their lifetime compared to women with low MD. Because of this correlation, high MD is an independent risk factor for breast cancer. Further, mammographic screening is less effective in detecting suspicious lesions in dense breast tissue, which can lead to late-stage diagnosis. Molecular differences between dense and non-dense breast tissues explain the underlying biological reasons for why women with dense breasts are at a higher risk for developing breast cancer. The goal of this review is to highlight the current molecular understanding of MD, its association with breast cancer risk, the demographics pertaining to MD, and the environmental factors that modulate MD. Finally, we will review the current legislation regarding the disclosure of MD on a traditional screening mammogram and the supplemental screening options available to women with dense breast tissue.

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“…Breast density refers to the percentage of dense tissue in the entire breast. Depending on its density, fibroglandular mammary tissue has different characteristics and results in different compositions on radiographs (Pettersson et al, 2014;Patterson et al, 2014). Breast density is an independent predictor of breast cancer risk.…”

Section: Introductionmentioning

confidence: 99%

Breast Density of Mammography is Correlated with Reproductive Risk Factors Regardless of Menopausal Status: A Cross-Sectional Study of the Korean National Screening Program

Lee

2020

Asian Pac J Cancer Prev

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Objective: To clarify the limitations of mammography screening for women with dense breasts, we examined breast density and its effects on screening results. Patients and Methods: We performed a cross-sectional, observational study on women who underwent mammography. Data from the National Cancer Screening Program(NCSP) from 2009 to 2013 were used. The study population consisted of participants with high breast density. We used a logistic regression analysis to evaluate the relationships between breast density and reproductive factors and screening results according to menopause status. Results: High breast density was reported for 57.5% of all participants (3,417,319 participants). Screening results indicated breast density of <25%, 25-50%, 51-75%, and ≥76% for 16.4%, 26.3%, 37.8%, and 19.5%, respectively, of participants. According to the screening results, high breast density was correlated with high deferment and recall rates. Reproductive factors, especially parity, breastfeeding, and use of oral contraceptives, had consistent effects on screening results of premenopausal and postmenopausal women. Regardless of menopausal status, age, early onset of menarche (15 years or younger), fewer live births (≤1 birth), and previous benign breast disease were correlated with increased breast density. In postmenopausal women, early-onset menopause and longer-term hormone replacement therapy (≥2 years) also independently increased breast density. Conclusion: Breast density influenced screening results, which could increase the rate of recall. Breast density was also influenced by reproductive factors, with patterns similar to those of breast cancer risk, regardless of menopausal status. We need to identify high-risk women with high density who would probably benefit from supplemental breast cancer screening.

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Update on new technologies in digital mammography

Cited by 17 publications

References 63 publications

The cost-effectiveness of digital breast tomosynthesis in a population breast cancer screening program

The cost-effectiveness of digital breast tomosynthesis in a population breast cancer screening program

An overview of mammographic density and its association with breast cancer

Breast Density of Mammography is Correlated with Reproductive Risk Factors Regardless of Menopausal Status: A Cross-Sectional Study of the Korean National Screening Program

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