Diagnostic Mammography

About: Diagnostic Mammography is a research topic. Over the lifetime, 294 publications have been published within this topic receiving 7479 citations.

Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007.

Abstract: Breast cancer outcomes in low- and middle-income countries (LMCs) correlate with the degree to which 1) cancers are detected at early stages, 2) newly detected cancers can be diagnosed correctly, and 3) appropriately selected multimodality treatment can be provided properly in a timely fashion. The Breast Health Global Initiative (BHGI) invited international experts to review and revise previously developed BHGI resource-stratified guideline tables for early detection, diagnosis, treatment, and healthcare systems. Focus groups addressed specific issues in breast pathology, radiation therapy, and management of locally advanced disease. Process metrics were developed based on the priorities established in the guideline stratification. The groups indicated that cancer prevention through health behavior modification could influence breast cancer incidence in LMCs. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies. Government intervention is needed to address drug-delivery problems relating to high cost and poor access. Guideline dissemination and implementation research plays a crucial role in improving care. Adaptation of technology is needed in LMCs, especially for breast imaging, pathology, radiation therapy, and systemic treatment. Curricula for education and training in LMCs should be developed, applied, and studied in LMC-based learning laboratories to aid information transfer of evidence-based BHGI guidelines.

Digital breast tomosynthesis: initial experience in 98 women with abnormal digital screening mammography.

Abstract: OBJECTIVE. The purpose of our study was to compare the image quality of tomosynthesis with that of conventional mammography and to estimate the recall rate of screening when tomosynthesis is used in addition to mammography.MATERIALS AND METHODS. Women with an abnormal screening mammography were recruited sequentially. Consenting women underwent tomosynthesis of the affected breast corresponding to the views obtained with diagnostic mammography. The study radiologist compared the image quality, including lesion conspicuity and feature analysis, of tomosynthesis with diagnostic film-screen mammography and assessed the need for recall when tomosynthesis was added to digital screening mammography. Screening recalls were considered unnecessary when tomosynthesis did not show a corresponding abnormality or allowed definitely benign lesion characterization. Fisher's exact test was used to determine the association of equivalence and recall status with mammographic finding type.RESULTS. There were 99 digital scre...

National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium

Abstract: Data from a large, diverse set of breast imaging facilities in the Breast Cancer Surveillance Consortium, linked to state cancer registries, provide performance benchmarks for diagnostic mammography in the era of digital mammography.

Breast Cancer Surveillance Consortium: a national mammography screening and outcomes database.

Abstract: M ammography is the primary method of detecting early stage breast cancer and has been shown in randomized clinical trials to reduce breast cancer mortality, especially among women 50 years old and older [1-5]. Authorities in cancer screening have bong recognized that the level of efficacy of screening demonstrated in randomized clinical trials may not pertain to community practice for several reasons [6]. These reasons include possible differences in the population groups receiving screening, lower accuracy of screening mammography in the community, and lower compliance with diagnostic follow-up and treatment in community practice, which may result in more adverse outcomes. Screening effectiveness in community practice today could exceed that estimated in trials because the technical and interpretative quality of mammography has improved since the trials were performed. Furthermore, clinical trial efficacy has been estimated on the basis of assignment to receive screening; to the extent that women assigned to screening were not screened or that women in the control groups were screened, efficacy in trials may have been underestimated. To optimally evaluate the performance of mammography in a community setting, the screening prevalence and patterns and the associated sensitivity, specificity, and predictive value of mammography in community screening programs should be determined by linkage with cancer outcomes [7, 8]. A program of monitoring should also provide data on specific populations, such as rural and minority subgroups, that are traditionally underserved by screening programs and that may have different breast cancer mortality rates [9]. Before the Mammography Quality Standards Act (MQSA) of 1992, most mammography facilities in the United States did not maintain records that could provide reliable and comprehensive data to evaluate the performance of screening mammography [10]. The concept of a medical audit of outcomes data had been proposed [ 1 1 ] but has not been routinely practiced in the community. The interim regulations of the MQSA mandated maintaining mammography data and performing a medical outcomes audit [12]. In practical terms, the medical audit requirement of the MQSA was limited to an analysis of patients with tests interpreted as “suspicious abnormality” or “highly suggestive for malignancy,” which permits evaluation of the positive predictive value of such interpretations. However, the MQSA does not require linkage to populationbased cancer registry data or another source of pathology data, without which it is impossible to accurately assess the outcomes of patients with mammograms interpreted as having normal findings. To understand the full effect of

Performance Parameters for Screening and Diagnostic Mammography: Specialist and General Radiologists

Abstract: PURPOSE: To evaluate performance parameters for radiologists in a practice of breast imaging specialists and general diagnostic radiologists who interpret a large series of consecutive screening and diagnostic mammographic studies. MATERIALS AND METHODS: Data (ie, patient age; family history of breast cancer; availability of previous mammograms for comparison; and abnormal interpretation, cancer detection, and stage 0–I cancer detection rates) were derived from review of mammographic studies obtained from January 1997 through August 2001. The breast imaging specialists have substantially more initial training in mammography and at least six times more continuing education in mammography, and they interpret 10 times more mammographic studies per year than the general radiologists. Differences between specialist and general radiologist performances at both screening and diagnostic examinations were assessed for significance by using Student t and χ2 tests. RESULTS: The study involved 47,798 screening and 13...