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By Osvaldo Pirani Radiologo
Antony Raikhlin, Belinda Curpen, Ellen Warner, Carrie Betel, Barbara Wright, Roberta Jong
OBJECTIVE: In July 2011, the provincial government of Ontario, Canada, approved funding for the addition of annual breast MRI to mammography screening for all women 30-69 years old considered to be at high risk for breast cancer. The purpose of this study was to evaluate the diagnostic performance of screening breast MRI as compared with mammography in a population-based high-risk screening program. MATERIALS AND METHODS: A retrospective review identified 650 eligible high-risk women who underwent screening breast MRI and mammography between July 2011 and January 2013 at one institution...
April 2015: AJR. American Journal of Roentgenology
Jessica M Engel, Trista J Stankowski-Drengler, Rachel V Stankowski, Hong Liang, Suhail A Doi, Adedayo A Onitilo
OBJECTIVE: The value of annual mammography remains an area of debate because of concerns regarding risk versus benefit. The potential for harm due to overdiagnosis and treatment of clinically insignificant cancers may not be captured by breast cancer-specific mortality. Instead, we examined all-cause mortality as a function of missed annual mammography examinations before breast cancer diagnosis. MATERIALS AND METHODS: Primary breast cancer cases diagnosed in the Marsh-field Clinic Health System from 2002 through 2008 were identified for retrospective review, and whether annual mammography examinations had been performed in the 5 years before diagnosis was assessed...
April 2015: AJR. American Journal of Roentgenology
Louise M Henderson, Thad Benefield, J Michael Bowling, Danielle D Durham, Mary W Marsh, Bruce F Schroeder, Bonnie C Yankaskas
OBJECTIVE: The purpose of this study was to determine whether the technologist has an effect on the radiologists' interpretative performance of diagnostic mammography. MATERIALS AND METHODS: Using data from a community-based mammography registry from 1994 to 2009, we identified 162,755 diagnostic mammograms interpreted by 286 radiologists and performed by 303 mammographic technologists. We calculated sensitivity, false-positive rate, and positive predictive value (PPV) of the recommendation for biopsy from mammography for examinations performed (i...
April 2015: AJR. American Journal of Roentgenology
Diana L Miglioretti, Laura Ichikawa, Robert A Smith, Lawrence W Bassett, Stephen A Feig, Barbara Monsees, Jay R Parikh, Robert D Rosenberg, Edward A Sickles, Patricia A Carney
OBJECTIVE: Using a combination of performance measures, we updated previously proposed criteria for identifying physicians whose performance interpreting screening mammography may indicate suboptimal interpretation skills. MATERIALS AND METHODS: In this study, six expert breast imagers used a method based on the Angoff approach to update criteria for acceptable mammography performance on the basis of two sets of combined performance measures: set 1, sensitivity and specificity for facilities with complete capture of false-negative cancers; and set 2, cancer detection rate (CDR), recall rate, and positive predictive value of a recall (PPV1) for facilities that cannot capture false-negative cancers but have reliable cancer follow-up information for positive mammography results...
April 2015: AJR. American Journal of Roentgenology
Diana L Lam, Pari V Pandharipande, Janie M Lee, Constance D Lehman, Christoph I Lee
OBJECTIVE: The goals of this article are to provide an overview of controversial aspects of imaging-based screening and to elucidate potential risks that may offset anticipated benefits. CONCLUSION: Current controversial topics associated with imaging-based screening include false-positive results, incidental findings, overdiagnosis, radiation risks, and costs. Alongside the benefits of screening, radiologists should be prepared to discuss these additional diagnostic consequences with providers and patients to better guide shared decision making regarding imaging-based screening...
November 2014: AJR. American Journal of Roentgenology
Janice S Sung, Jie Li, Glenys Da Costa, Sujata Patil, Kimberly J Van Zee, D David Dershaw, Elizabeth A Morris
OBJECTIVE: The purpose of this study was to evaluate the effect of the use of preoperative breast MRI on surgical and long-term outcomes among women with early-stage breast cancer undergoing breast conservation therapy. MATERIALS AND METHODS: A retrospective review yielded the cases of 174 women with stage 0, I, or II breast cancer who underwent preoperative MRI between 2000 and 2004. A control group of 174 patients who did not undergo preoperative MRI before breast conservation therapy was matched by age, histopathologic finding, stage, and surgeon...
June 2014: AJR. American Journal of Roentgenology
Julianne S Greenberg, Marcia C Javitt, Jason Katzen, Sara Michael, Agnes E Holland
OBJECTIVE: The objective of our study was to assess the clinical performance of combined 2D-3D digital breast tomosynthesis (DBT), referred to as "3D DBT," compared with 2D digital mammography (DM) alone for screening mammography in a community-based radiology practice. MATERIALS AND METHODS: Performance outcomes measures were assessed for 14 radiologists who interpreted more than 500 screening mammography 3D DBT studies after the initiation of tomosynthesis. Outcomes from screening mammography during the study period between August 9, 2011, and November 30, 2012, using 3D DBT (n = 23,149 patients) versus 2D DM (n = 54,684 patients) were compared...
September 2014: AJR. American Journal of Roentgenology
Luke Partyka, Ana P Lourenco, Martha B Mainiero
OBJECTIVE: Digital breast tomosynthesis (DBT) has been shown to improve the sensitivity of screening mammography. DBT may have the most potential impact in cases of subtle mammographic findings such as architectural distortion (AD). The objective of our study was to determine whether DBT provides better visualization of AD than digital mammography (DM) and whether sensitivity for cancer detection is increased by the addition of DBT as it relates to cases of mammographically occult AD...
July 2014: AJR. American Journal of Roentgenology
Robert A Smith, Karla Kerlikowske, Diana L Miglioretti, Mette Kalager
New England Journal of Medicine, Volume 367, Issue 21, November 2012.
November 22, 2012: New England Journal of Medicine
Sandhya Pruthi, Bobbie S Gostout, Noralane M Lindor
Women with a germline BRCA1 or BRCA2 mutation or a hereditary predisposition for breast and ovarian cancer have substantial risk of breast or ovarian cancer relative to the general US population. Health care professionals can be instrumental in identifying women at increased risk through obtaining a comprehensive family history and becoming familiar with family history characteristics associated with hereditary predisposition for breast and ovarian cancer. BRCA carriers and women at very high risk benefit from multidisciplinary, individualized medical evaluation and risk management...
December 2010: Mayo Clinic Proceedings
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