Mammography

About: Mammography is a research topic. Over the lifetime, 20643 publications have been published within this topic receiving 513679 citations.

An evaluation of image descriptors combined with clinical data for breast cancer diagnosis

Abstract: Breast cancer computer-aided diagnosis (CADx) may utilize image descriptors, demographics, clinical observations, or a combination. CADx performance was compared for several image features, clinical descriptors (e.g. age and radiologist’s observations), and combinations of both kinds of data. A novel descriptor invariant to rotation, histograms of gradient divergence (HGD), was developed to deal with round-shaped objects, such as masses. HGD was compared with conventional CADx features. HGD and 11 conventional image descriptors were evaluated using cases from two publicly available mammography data sets, the digital database for screening mammography (DDSM) and the breast cancer digital repository (BCDR), with 1,762 and 362 instances, respectively. Three experiments were done for each data set according to the type of lesion (i.e., all lesions, masses, and calcifications), resulting in six scenarios. For each scenario, 100 training and test sets were generated via resampling without replacement and five machine learning classifiers were used to assess the diagnostic performance of the descriptors. Clinical descriptors outperformed image descriptors in the DDSM sample (three out of six scenarios), and combining the two kind of descriptors was advantageous in five out of six scenarios. HGD was the best descriptor (or comparable to best) in 8 out of 12 scenarios, demonstrating promising capabilities to describe masses. The combination of clinical data and image descriptors was advantageous in most mammography CADx scenarios. A new descriptor based on the divergence of the gradient (HGD) was demonstrated to be a feasible predictor of breast masses’ diagnosis.

Effectiveness of Screening With Annual Magnetic Resonance Imaging and Mammography: Results of the Initial Screen From the Ontario High Risk Breast Screening Program

Abstract: Purpose Results The recall rate was significantly higher among women who had abnormal MRI alone (15.1%; 95% CI, 13.8% to 16.4%) compared with mammogram alone (6.4%; 95% CI, 5.5% to 7.3%). Of the 35 breast cancers detected (16.3 per 1,000; 95% CI, 11.2 to 22.2), none were detected by mammogram alone, 23 (65.7%) were detected by MRI alone (10.7 per 1,000; 95% CI, 6.7 to 15.8), and 25 (71%) were detected among women who were known gene mutation carriers (30.8 per 1,000, 95% CI, 19.4 to 43.7). The positive predictive value was highest for detection based on mammogram and MRI (12.4%; 95% CI, 7.3% to 19.3%). Conclusion Screening with annual MRI combined with mammography has the potential to be effectively implemented into an organized breast screening program for women at high risk for breast cancer. This could be considered an important management option for known BRCA gene mutation carriers. J Clin Oncol 32:2224-2230. © 2014 by American Society of Clinical Oncology

Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature

Abstract: Multiple guidelines exist for the follow-up of breast cancer, with no agreement on frequency or duration. The contribution of routine clinical examination for the detection of potentially treatable relapse, and the impact this has on survival, is unknown. In this study, we systematically review the literature to establish the proportion of potentially treatable locoregional relapses and new contralateral breast cancers detected by clinical examination, mammography and patient self-examination. We analyse whether method of detection of relapse influences outcome. The methods used were systematic review of the literature. MEDLINE, EMBASE, CancerLit, Web of Sciences and EBM reviews were the data sources for the systematic review. All studies with information on proportion of relapses detected by clinical examination, mammography and self-examination were included. A total of 30–40% of potentially treatable relapses are detected by patient self-examination. In studies published before 2000, 15% of such relapse is mammographically detected with 46% detected by routine clinical examination. In those published after 2000, 40% are mammographically detected with 15% detected on routine clinical examination. Patients with ipsilateral breast relapse detected clinically appear to do less well than those with relapse detected by self-examination or mammography. Routine clinical surveillance is responsible for detection of fewer potentially treatable relapses in more modern cohorts as experience with mammography increases. There is no evidence to suggest that clinical examination confers a survival advantage compared with other methods of detection. The data in this analysis suggest that a review of the guidelines on follow-up after breast cancer should be undertaken.

The consequence of undertreating breast cancer in the Elderly

Abstract: BACKGROUND: Recent studies have noted that a large fraction of elderly patients do not receive conventional treatment for breast cancer. The consequences of undertreatment of the elderly have not been adequately assessed. STUDY DESIGN: The senior author's database (PIT) was used to identify women undergoing potentially curative operations for breast cancer between 1978 and 1998. Risk factors, presentation, pathologic findings, treatment, and outcomes of 206 women aged over 70 years were compared with those of 920 younger patients. In addition, conventionally treated and "undertreated" elderly patients were identified, and their characteristics and outcomes were compared. RESULTS: Older patients' cancers were more often visible on mammography, usually as a mass; younger patients' mammograms were less frequently positive, presenting more often with calcifications (p = 0.002). Cancers of the elderly were better differentiated (p CONCLUSIONS: Elderly breast cancer patients are frequently treated with breast conservation, omitting axillary dissection, radiation therapy, and chemotherapy. Despite undertreatment by conventional criteria, the rates of local recurrence and distant metastasis are not increased in comparison with conventionally treated elderly patients. Tamoxifen should be administered to elderly breast cancer patients with invasive tumors because it significantly improves distant control.

Identifying minimally acceptable interpretive performance criteria for screening mammography.

Abstract: Our study contributes important information to existing literature in that we identified six performance cut points important for interpretation of screening mammograms and found that most of the cut points we identified would affect between 20% and 49% of interpreting physicians, who might benefit from additional training to improve their mammogram interpretation skills.