http://e-lactancia.org/media/papers/CancerPechoBF-EurJouCan2012.pdf

The European Society of Breast Cancer Specialists recommendations for the management of young women with breast cancer.

Few studies have examined the comparative effectiveness of digital versus film-screen mammography in U.S. community practice. In a large sample of women screened in community settings, digital and ...

Comparative Effectiveness of Digital Versus Film-Screen Mammography in Community Practice in the United States: A Cohort Study

Introduction: Mammographic density is a strong breast cancer risk factor and a major determinant of screening sensitivity. However, there is currently no validated estimation method for full-field digital mammography (FFDM). Methods: The performance of three area-based approaches (BI-RADS, the semi-automated Cumulus, and the fully-automated ImageJ-based approach) and three fully-automated volumetric methods (Volpara, Quantra and single energy x-ray absorptiometry (SXA)) were assessed in 3168 FFDM images from 414 cases and 685 controls. Linear regression models were used to assess associations between breast cancer risk factors and density among controls, and logistic regression models to assess density-breast cancer risk associations, adjusting for age, body mass index (BMI) and reproductive variables. Results: Quantra and the ImageJ-based approach failed to produce readings for 4% and 11% of the participants. All six density assessment methods showed that percent density (PD) was inversely associated with age, BMI, being parous and postmenopausal at mammography. PD was positively associated with breast cancer for all methods, but with the increase in risk per standard deviation increment in PD being highest for Volpara (1.83; 95% CI: 1.51 to 2.21) and Cumulus (1.58; 1.33 to 1.88) and lower for the ImageJ-based method (1.45; 1.21 to 1.74), Quantra (1.40; 1.19 to 1.66) and SXA (1.37; 1.16 to 1.63). Women in the top PD quintile (or BI-RADS 4) had 8.26 (4.28 to 15.96), 3.94 (2.26 to 6.86), 3.38 (2.00 to 5.72), 2.99 (1.76 to 5.09), 2.55 (1.46 to 4.43) and 2.96 (0.50 to 17.5) times the risk of those in the bottom one (or BI-RADS 1), respectively, for Volpara, Quantra, Cumulus, SXA, ImageJ-based method, and BI-RADS (P for trend <0.0001 for all). The ImageJ-based method had as lightly higher ability to discriminate between cases and controls (area under the curve (AUC) for PD = 0.68, P = 0.05), and Quantra slightly lower (AUC = 0.63; P = 0.06), than Cumulus (AUC = 0.65). Conclusions: Fully-automated methods are valid alternatives to the labour-intensive “gold standard” Cumulus for quantifying density in FFDM. The choice of a particular method will depend on the aims and setting but the same approach will be required for longitudinal density assessments.

/pdf/digital-mammographic-density-and-breast-cancer-risk-a-case-2pbunp0w9w.pdf

Digital mammographic density and breast cancer risk: a case-control study of six alternative density assessment methods

Decision support systems help physicians and also play an important role in medical decision-making. They are based on different models, and the best of them are providing an explanation together with an accurate, reliable and quick response. This paper presents a decision support tool for the detection of breast cancer based on three types of decision tree classifiers. They are single decision tree (SDT), boosted decision tree (BDT) and decision tree forest (DTF). Decision tree classification provides a rapid and effective method of categorizing data sets. Decision-making is performed in two stages: training the classifiers with features from Wisconsin breast cancer data set, and then testing. The performance of the proposed structure is evaluated in terms of accuracy, sensitivity, specificity, confusion matrix and receiver operating characteristic (ROC) curves. The results showed that the overall accuracies of SDT and BDT in the training phase achieved 97.07 % with 429 correct classifications and 98.83 % with 437 correct classifications, respectively. BDT performed better than SDT for all performance indices than SDT. Value of ROC and Matthews correlation coefficient (MCC) for BDT in the training phase achieved 0.99971 and 0.9746, respectively, which was superior to SDT classifier. During validation phase, DTF achieved 97.51 %, which was superior to SDT (95.75 %) and BDT (97.07 %) classifiers. Value of ROC and MCC for DTF achieved 0.99382 and 0.9462, respectively. BDT showed the best performance in terms of sensitivity, and SDT was the best only considering speed.

Decision tree classifiers for automated medical diagnosis

Completeness of reporting is associated with quality of systematic reviews and meta-analyses in major radiology journals with a few deficient areas; complete reporting has improved modestly since publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and it is strongly correlated with study quality in these journals.

Association of Study Quality with Completeness of Reporting: Have Completeness of Reporting and Quality of Systematic Reviews and Meta-Analyses in Major Radiology Journals Changed Since Publication of the PRISMA Statement?

Purpose: To (a) compare the performance of full-field digital mammography (FFDM), using hard-copy image reading, with that of screen-film mammography (SFM) within a UK screening program (screening once every 3 years) for women aged 50 years or older and (b) conduct a meta-analysis of published findings along with the UK data. Materials and Methods: The study complied with the UK National Health Service Central Office for Research Ethics Committee guidelines; informed patient consent was not required, since analysis was carried out retrospectively after data anonymization. Between January 2006 and June 2007, a London population-based screening center performed 8478 FFDM and 31 720 SFM screening examinations, with modality determined by the type of machine available at the screening site. Logistic regression was used to assess whether breast cancer detection rates and recall rates differed between screening modalities. For the meta-analysis, random-effects models were used to combine study-specific estimate...

Susan Shiel

Papers

Full-field digital versus screen-film mammography: comparison within the UK breast screening program and systematic review of published data.