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Lancet Digit Health 2022 Jul;4(7):e558-e565

Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.

Artificial intelligence (AI) could have the potential to accurately classify mammograms according to the presence or absence of radiological signs of breast cancer, replacing or supplementing human readers (radiologists). The UK National Screening Committee's assessments of the use of AI systems to examine screening mammograms continues to focus on maximising benefits and minimising harms to women screened, when deciding whether to recommend the implementation of AI into the Breast Screening Programme in the UK. Maintaining or improving programme specificity is important to minimise anxiety from false positive results. Read More

Lancet Digit Health 2022 Jul;4(7):e507-e519

Department of Diagnostic and Interventional Radiology and Neuroradiology, University-Hospital Essen, Essen, Germany.

Background: We propose a decision-referral approach for integrating artificial intelligence (AI) into the breast-cancer screening pathway, whereby the algorithm makes predictions on the basis of its quantification of uncertainty. Algorithmic assessments with high certainty are done automatically, whereas assessments with lower certainty are referred to the radiologist. This two-part AI system can triage normal mammography exams and provide post-hoc cancer detection to maintain a high degree of sensitivity. Read More

Eur Radiol 2022 Jun 24. Epub 2022 Jun 24.

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Center for Clinical Imaging Data Science, Yonsei University, College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea.

Objectives: To evaluate how AI-CAD triages calcifications and to compare its performance to an experienced breast radiologist.

Methods: Among routine mammography performed between June 2016 and May 2018, 535 lesions detected as calcifications only on mammography in 500 women (mean age, 48.8 years) that were additionally interpreted with additional magnification views were included in this study. Read More

J Pers Med 2022 May 25;12(6). Epub 2022 May 25.

Radiology Unit, Mater Olbia Hospital (Qatar Foundation Endowment and Policlinico Universitario Agostino Gemelli IRCCS Foundation), Strada Statale 125 Orientale Sarda, 07026 Olbia, Italy.

Invasive lobular carcinoma is the second most common histologic form of breast cancer, representing 5% to 15% of all invasive breast cancers. Due to an insidious proliferative pattern, invasive lobular carcinoma remains clinically and radiologically elusive in many cases. Breast magnetic resonance imaging (MR) is considered the most accurate imaging modality in detecting and staging invasive lobular carcinoma and it is strongly recommended in pre-operative planning for all ILC. Read More

Healthcare (Basel) 2022 Jun 14;10(6). Epub 2022 Jun 14.

Health Services Academy (HSA), Quaid-i-Azam University, Islamabad 44000, Pakistan.

Late diagnosis of treatable breast cancer is the reason for higher breast cancer mortality. Until now, no public breast cancer facility has been established in the Islamabad Capital Territory. First, a Federal Breast Screening Center (FBSC) was established. Read More

Healthcare (Basel) 2022 Jun 2;10(6). Epub 2022 Jun 2.

Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.

The aim of this study was to investigate the influence of previous mammography screening on the performance of breast cancer detection. The screened women were divided into first-visit and follow-up groups for breast cancer screening. The positive predictive value (PPV), cancer detection rate (CDR), and recall rate were used to evaluate and analyze the overall screening performance among the two groups. Read More

Diagnostics (Basel) 2022 Jun 2;12(6). Epub 2022 Jun 2.

Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.

: We aimed to develop a novel interpretable artificial intelligence (AI) model algorithm focusing on automatic detection and classification of various patterns of calcification distribution in mammographic images using a unique graph convolution approach. : Images from 292 patients, which showed calcifications according to the mammographic reports and diagnosed breast cancers, were collected. The calcification distributions were classified as diffuse, segmental, regional, grouped, or linear. Read More

Diagnostics (Basel) 2022 May 29;12(6). Epub 2022 May 29.

Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.

The purpose of this study was to determine the feasibility of a deep convolutional neural network (dCNN) to accurately detect abnormal axillary lymph nodes on mammograms. In this retrospective study, 107 mammographic images in mediolateral oblique projection from 74 patients were labeled to three classes: (1) "breast tissue", (2) "benign lymph nodes", and (3) "suspicious lymph nodes". Following data preprocessing, a dCNN model was trained and validated with 5385 images. Read More

Cancers (Basel) 2022 Jun 15;14(12). Epub 2022 Jun 15.

Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.

Breast cancer screening is associated with harms, such as false-positives and overdiagnoses, and, thus, novel screen tests can be considered. Liquid biopsies have been proposed as a novel method for the early detection of cancer, but low cell-free DNA tumor fraction might pose a problem for the use in population screening. Using breast cancer microsimulation model MISCAN-Fadia, we estimated the outcomes of using liquid biopsies in breast cancer screening in women aged 50 to 74 in the United States. Read More

JAMA Oncol 2022 Jun 23. Epub 2022 Jun 23.

Department of Radiology, University of Washington School of Medicine, Seattle.

Importance: Diagnostic delays in breast cancer detection may be associated with later-stage disease and higher anxiety, but data on multilevel factors associated with diagnostic delay are limited.

Objective: To evaluate individual-, neighborhood-, and health care-level factors associated with differences in time from abnormal screening to biopsy among racial and ethnic groups.

Design, Setting, And Participants: This prospective cohort study used data from women aged 40 to 79 years who had abnormal results in screening mammograms conducted in 109 imaging facilities across 6 US states between 2009 and 2019. Read More

Curr Oncol 2022 Jun 15;29(6):4300-4314. Epub 2022 Jun 15.

College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia.

Breast cancer is the most commonly diagnosed cancer among women in the Kingdom of Saudi Arabia and other Middle East countries. This analytical cross-sectional study assessed knowledge, attitude towards breast cancer, and barriers to mammogram screening among 414 randomly selected female healthcare workers from multiple healthcare facilities in northern Saudi Arabia. Of the studied population, 48. Read More

Curr Oncol 2022 May 30;29(6):3922-3932. Epub 2022 May 30.

Department of Radiology and Diagnostic Imaging, University of Alberta, 2A2.41 WMC 8440-112 Street, Edmonton, Alberta, AB T6G 2B7, Canada.

The biased randomization and other quality concerns about the Canadian National Breast Screening Studies (CNBSS) were documented and criticized for decades, even by several individuals very close to the research. CNBSS were the outlier studies among several RCTs of the era and yet were given equal weighting and occasionally higher importance than the remainder of the canon of mammography RCTs. These studies have had an ongoing influence on subsequent evidence review, guideline formation, and, ultimately, patient access to screening. Read More

Curr Oncol 2022 May 30;29(6):3894-3910. Epub 2022 May 30.

Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON M4N3M5, Canada.

Overdetection (often referred to as overdiagnosis) of cancer is the detection of disease, such as through a screening program, that would otherwise remain occult through an individual's life. In the context of screening, this could occur for cancers that were slow growing or indolent, or simply because an unscreened individual would have died from some other cause before the cancer had surfaced clinically. The main harm associated with overdetection is the subsequent overdiagnosis and overtreatment of disease. Read More

BMC Womens Health 2022 06 22;22(1):249. Epub 2022 Jun 22.

New York Medical College, Valhalla, NY, 10595, USA.

Background: Barriers to breast cancer screening remain despite Medicaid expansion for preventive screening tests and implementation of patient navigation programs under the Affordable Care Act. Women from underserved communities experience disproportionately low rates of screening mammography. This study compares barriers to breast cancer screening among women at an inner-city safety-net center (City) and those at a suburban county medical center (County). Read More

Eur J Public Health 2022 Jun 23. Epub 2022 Jun 23.

Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark.

Background: Reductions in breast cancer mortality observed over the last three decades are partly due to improved patient management, which may erode the benefit-harm balance of mammography screening.

Methods: We estimated the numbers of women needed to invite (NNI) to prevent one breast cancer death within 10 years. Four scenarios of screening effectiveness (5-20% mortality reduction) were applied on 10,580 breast cancer deaths among Norwegian women aged 50-75 years from 1986 to 2016. Read More

Am Soc Clin Oncol Educ Book 2022 Apr;42:1-7

Queen's University, Kingston, Ontario, Canada.

Breast cancer has become one of the leading causes of morbidity and mortality in low- and middle-income countries, where 62% of the world's total new cases are diagnosed. Therefore, the productivity loss because of premature death resulting from female breast cancer is also on the rise. The major challenge in low- and middle-income countries is to reduce the proportion of women presenting with advanced-stage disease, a challenge unlikely to be overcome by adoption of expensive national mammography screening programs. Read More

J Racial Ethn Health Disparities 2022 Jun 22. Epub 2022 Jun 22.

MD Anderson Cancer Center at Cooper, Camden, NJ, USA.

Aims/purpose: To evaluate current day challenges and beliefs about breast cancer screening for Black women in two diverse northeast communities in the midst of the COVID-19 pandemic.

Background: Breast cancer is the second leading cause of cancer-related death in women in the USA. Although Black women are less likely to be diagnosed with breast cancer, they suffer a higher mortality. Read More

AJR Am J Roentgenol 2022 Jun 22. Epub 2022 Jun 22.

Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele (Milan), Italy.

Contrast-enhanced mammography (CEM) is rapidly expanding as a credible alternative to MRI in various clinical settings. To compare CEM and MRI for neoadjuvant therapy (NAT) response assessment in patients with breast cancer. This prospective study included 51 patients (mean age, 46±11 years) with biopsy-proven breast cancer from May 2015 to April 2018 who were candidates for NAT. Read More

Sante Publique 2020 ;2(HS2):7-17

Introduction: Over the past decade, the balance between the benefits and harms of breast cancer screening (BCS) has been widely debated. To date, no French study has interrogated women's points of view and preferences (in the economic sense) for this controversial screening. This study aims to bridge this gap. Read More

J West Afr Coll Surg 2020 Jul-Sep;10(3):30-35. Epub 2022 May 4.

Department of Radiology, Asokoro District Hospital, Abuja, Nigeria.

Introduction: Mammography is a major tool for the screening and diagnosis of breast cancer globally. Poor funding and lack of good public health education for mammography in resource-limited countries limit access to mammographic services. In these settings, patients bear the cost of breast cancer screening from out-of-pocket expenses. Read More

Ann Surg Oncol 2022 Jun 20. Epub 2022 Jun 20.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Background: Determination of implant size is crucial for patients with breast cancer undergoing one-stage breast reconstruction. The purpose of this study is to predict the implant size based on the breast volume measured by mammography (MG) with a fully automated method, and by breast magnetic resonance imaging (MRI) with a semi-automated method, in breast cancer patients with direct-to-implant reconstruction.

Patients And Methods: This retrospective study included 84 patients with breast cancer who underwent direct-to-implant reconstruction after nipple-sparing or skin-sparing mastectomy and preoperative MG and MRI between April 2015 and April 2019. Read More

Cogn Res Princ Implic 2022 Jun 20;7(1):52. Epub 2022 Jun 20.

Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta University, DNRM, CA-2003, 1469 Laney Walker Blvd, Augusta, GA, 30912-2697, USA.

Many studies have shown that using a computer-aided detection (CAD) system does not significantly improve diagnostic accuracy in radiology, possibly because radiologists fail to interpret the CAD results properly. We tested this possibility using screening mammography as an illustrative example. We carried out two experiments, one using 28 practicing radiologists, and a second one using 25 non-professional subjects. Read More

Am J Prev Med 2022 Jun 16. Epub 2022 Jun 16.

Division of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, California. Electronic address:

Introduction: Decision aids for breast cancer screening are increasingly being used by physicians, but the association between physician practice decision-aid use and mammography rates remains uncertain. Using national data, this study examines the association between practice-level decision-aid use and mammography use among older women.

Methods: Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems (n=1,236) were linked to 2016 and 2017 Medicare fee-for-service beneficiary data from eligible beneficiaries (n=439,684) aged 65-74 years. Read More

Breast Cancer Res Treat 2022 Jun 17. Epub 2022 Jun 17.

Department of Oncology, Mayo Clinic, Rochester, MN, USA.

Purpose: To identify the practice patterns related to use of surveillance mammography in male breast cancer (MaBC) survivors.

Methods: Using administrative claims data from OptumLabs Data Warehouse, we identified men who underwent surgery for breast cancer during 2007-2017. We calculated the proportion of men who had at least one mammogram (a) within 13 months for all patients and (b) within 24 months amongst those who maintained their insurance coverage for at least that length of time after surgery. Read More

Cancer Epidemiol Biomarkers Prev 2022 Jun 17:OF1-OF10. Epub 2022 Jun 17.

Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Background: We evaluated differences in diagnostic mammography performance based on women's race/ethnicity.

Methods: This cohort study included 267,868 diagnostic mammograms performed to evaluate screening mammogram findings at 98 facilities in the Breast Cancer Surveillance Consortium between 2005 and 2017. Mammogram assessments were recorded prospectively and breast cancers occurring within one year were ascertained. Read More

Front Oncol 2022 31;12:858696. Epub 2022 May 31.

Hematology Department, Peking Union Medical College Hospital, Beijing, China.

Background: The objective of this work was to discriminate between primary breast lymphoma (PBL) and breast cancer by systematically analyzing clinical characteristics, laboratory examination results, ultrasound features, and mammography findings to establish a diagnostic model for PBL and to analyze the influence of surgical treatment on the prognosis of PBL patients.

Method: We analyzed 20 PBL and 70 breast cancer patients treated during the same period by comparing several characteristics: clinical features, such as age, tumor position, and breast complaints; laboratory examination findings, such as the lactate dehydrogenase (LDH) level, and imaging features such as the maximum diameter, shape, margins, aspect ratio, and calcification of the mass and axillary lymph node involvement. A diagnostic model was then developed using logistic regression analysis. Read More

Breast J 2022 24;2022:7087408. Epub 2022 Mar 24.

Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore.

Objectives: To evaluate the potential of contrast-enhanced spectral mammography (CESM) in reducing benign breast biopsy rate, thereby improving resource utilization. To explore its potential as a value-adding modality in the management of BI-RADS 4/5 lesions.

Materials And Methods: This was a prospective study conducted between July 2016 and September 2018. Read More

Breast J 2022 26;2022:8565490. Epub 2022 May 26.

Health Information Technology Research Center, Isfahan University of Medical Science, Isfahan, Iran.

Introduction: Incidence of breast cancer (BC) in 2020 is about 2.26 million new cases. It is the first common cancer accounting for 11. Read More

JAMA Netw Open 2022 Jun 1;5(6):e2216784. Epub 2022 Jun 1.

Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.

Importance: Whether the benefits of notifying women about breast density outweigh the potential harms to inform current and future mammogram screening practice remains unknown.

Objective: To assess the effect of mammographic breast density notification and information provision on women's intention to seek supplemental screening and psychological outcomes.

Design, Setting, And Participants: A 3-arm online randomized clinical trial was conducted from August 10 to 31, 2021. Read More

Eur Radiol 2022 Jun 15. Epub 2022 Jun 15.

Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway.

Objectives: Artificial intelligence (AI) has shown promising results when used on retrospective data from mammographic screening. However, few studies have explored the possible consequences of different strategies for combining AI and radiologists in screen-reading.

Methods: A total of 122,969 digital screening examinations performed between 2009 and 2018 in BreastScreen Norway were retrospectively processed by an AI system, which scored the examinations from 1 to 10; 1 indicated low suspicion of malignancy and 10 high suspicion. Read More