Accuracy Of Breast Cancer Screening Research Articles

Mammography with deep learning for breast cancer detection.

X-ray mammography is currently considered the golden standard method for breast cancer screening, however, it has limitations in terms of sensitivity and specificity. With the rapid advancements in deep learning techniques, it is possible to customize mammography for each patient, providing more accurate information for risk assessment, prognosis, and treatment planning. This paper aims to study the recent achievements of deep learning-based mammography for breast cancer detection and classification. This review paper highlights the potential of deep learning-assisted X-ray mammography in improving the accuracy of breast cancer screening. While the potential benefits are clear, it is essential to address the challenges associated with implementing this technology in clinical settings. Future research should focus on refining deep learning algorithms, ensuring data privacy, improving model interpretability, and establishing generalizability to successfully integrate deep learning-assisted mammography into routine breast cancer screening programs. It is hoped that the research findings will assist investigators, engineers, and clinicians in developing more effective breast imaging tools that provide accurate diagnosis, sensitivity, and specificity for breast cancer.

The effects of breast density on the benefits of mammograms with adjunctive ultrasonography in breast screening.

Various efforts have been made to improve the accuracy of breast cancer screening. This study aimed to report differences in the contribution of ultrasonography to cancer screening assessments of dense and non-dense breasts. The participants in this study were 29,640 Japanese women in their 40s who underwent breast cancer screening at the Iwate Cancer Society between 2018 and 2021. This included women who chose mammography alone or mammography with adjunctive ultrasonography (overall assessment). They were classified into two groups according to the breast density in mammography: dense breasts and non-dense breasts. Recall rate, breast cancer detection rate, and positive predictive value of the two screening-type groups were evaluated for each breast density group. Of the 29,640 women analyzed, 18,861 (63.6%) underwent mammography alone and 10,779 (36.3%) were by overall assessments. The number of women recalled was higher in the overall assessment group than in the mammography-alone group (2.9% vs. 1.9%, p < 0.01). The proportion of women in whom breast cancer was detected was higher in the overall assessment group than in the mammography-alone group (0.31% [n = 33] vs. 0.15% [n = 28], p < 0.01). For non-dense breasts, there were no significant differences in either the recall rate or the breast cancer detection rate between those who underwent mammography alone and those who underwent overall assessment. Conversely, for dense breasts, the recall rate after mammography alone was lower than that after overall assessment (1.8% vs. 3.8%, p < 0.01), and the breast cancer detection rate was higher after overall assessment than after mammography alone (0.40% vs. 0.18%, p < 0.01). We found the benefits of adjunctive ultrasonography with mammography to differ depending on breast density. This could be used to tailor the selection of screening modalities to individuals.

Pharmacokinetic Analysis of Enhancement-Constrained Acceleration (ECA) reconstruction-based high temporal resolution breast DCE-MRI.

The high spatial and temporal resolution of dynamic contrast-enhanced MRI (DCE-MRI) can improve the diagnostic accuracy of breast cancer screening in patients who have dense breasts or are at high risk of breast cancer. However, the spatiotemporal resolution of DCE-MRI is limited by technical issues in clinical practice. Our earlier work demonstrated the use of image reconstruction with enhancement-constrained acceleration (ECA) to increase temporal resolution. ECA exploits the correlation in k-space between successive image acquisitions. Because of this correlation, and due to the very sparse enhancement at early times after contrast media injection, we can reconstruct images from highly under-sampled k-space data. Our previous results showed that ECA reconstruction at 0.25 seconds per image (4 Hz) can estimate bolus arrival time (BAT) and initial enhancement slope (iSlope) more accurately than a standard inverse fast Fourier transform (IFFT) when k-space data is sampled following a Cartesian based sampling trajectory with adequate signal-to-noise ratio (SNR). In this follow-up study, we investigated the effect of different Cartesian based sampling trajectories, SNRs and acceleration rates on the performance of ECA reconstruction in estimating contrast media kinetics in lesions (BAT, iSlope and Ktrans) and in arteries (Peak signal intensity of first pass, time to peak, and BAT). We further validated ECA reconstruction with a flow phantom experiment. Our results show that ECA reconstruction of k-space data acquired with 'Under-sampling with Repeated Advancing Phase' (UnWRAP) trajectories with an acceleration factor of 14, and temporal resolution of 0.5 s/image and high SNR (SNR ≥ 30 dB, noise standard deviation (std) < 3%) ensures minor errors (5% or 1 s error) in lesion kinetics. Medium SNR (SNR ≥ 20 dB, noise std ≤ 10%) was needed to accurately measure arterial enhancement kinetics. Our results also suggest that accelerated temporal resolution with ECA with 0.5 s/image is practical.

Development and preclinical evaluation of a patient-specific high energy x-ray phase sensitive breast tomosynthesis system.

This article reports the first x-ray phase sensitive breast tomosynthesis (PBT) system that is aimed for direct translation to clinical practice for the diagnosis of breast cancer. To report the preclinical evaluation and comparison of the newly built PBT system with a conventional digital breast tomosynthesis (DBT) system. The PBT system is developed based on a comprehensive inline phase contrast theoretical model. The system consists of a polyenergetic microfocus x-ray source and a flat panel detector mounted on an arm that is attached to a rotating gantry. It acquires nine projections over a 15° angular span in a stop-and-shoot manner. A dedicated phase retrieval algorithm is integrated with a filtered back-projection method that reconstructs tomographic slices. The American College of Radiology (ACR) accreditation phantom, a contrast detail (CD) phantom and mastectomy tissue samples were imaged at the same glandular dose levels by both the PBT and a standard of care DBT system for image quality characterizations and comparisons. The PBT imaging scores with the ACR phantom are in good to excellent range and meet the quality assurance criteria set by the Mammography Quality Standard Act. The CD phantom image comparison and associated statistical analyses from two-alternative forced-choice reader studies confirm the improvement offered by the PBT system in terms of contrast resolution, spatial resolution, and conspicuity. The artifact spread function (ASF) analyses revealed a sizable lateral spread of metal artifacts in PBT slices as compared to DBT slices. Signal-to-noise ratio values for various inserts of the ACR and CD phantoms further validated the superiority of the PBT system. Mastectomy sample images acquired by the PBT system showed a superior depiction of microcalcifications vs the DBT system. The PBT imaging technology can be clinically employed for improving the accuracy of breast cancer screening and diagnosis.

Accuracy of Breast Cancer Screening Using Film Mammography in Comparison to Digital Mammography

Aim of the work: digital mammography may achieve better images than does film mammography in young women, especially those who are less than 50 years old, where breast is characterized by dense breast tissue. This review aimed to compare the accuracy of screening using film mammography versus digital mammography in detection of breast cancer. Methods: an electronic search was conducted in MEDLINE and EMBASE by using PubMed search engine. The search resulted in 48 relevant studies, then after exclusion of duplicated and studies with different outcomes only 4 studies found eligible to be included in this review. The data were extracted using data extraction tables. Results: the search resulted in four potentially relevant studies that reported clinical trials on a comparison between breast cancer screenings using film mammography versus digital mammography. Conclusions: the digital mammography offers advantages over film mammography namely, easier access to images and computer assisted diagnosis, improved means of transmission, retrieval and storage of images; and the use of a lower average dose of radiation without a compromise in diagnostic accuracy

A training system aimed at improving breast cancer screening accuracy in Sapporo city

A training system aimed at improving breast cancer screening accuracy in Sapporo city

An Autoantibody Based Protein Microarray Blood Test to Enhance the Specificity of a Negative Screening Mammogram

Background: Current screening mammography for breast cancer is associated with misdiagnosis in as many as 30% of cases. Objectives: To develop and clinically evaluate a unique autoantibody based protein microarray blood test to improve the accuracy of breast cancer screening. Materials and Methods: A microarray was constructed from commercial antigens and antigens selected from screened cDNA libraries of breast cancer tissue samples. A training set containing 439 healthy controls and 276 biopsy proven breast cancer cases was used to establish a set of separating models between the two groups. These models were used to assign a diagnosis to 285 blind samples from 120 breast cancer patients and 165 healthy controls. Results: The test identified 82 of the 120 breast cancer patients and 160 of the 165 healthy controls. These results can be translated into a sensitivity of 68.3% [CI: 59% -77%] and a specificity of 97% [CI: 93% -99%], with a PPV for this validation set of 94.3% (CI: 87.10% -98.11%), NPV of 80.81% [CI: 74.62% -86.05%] and an AUC of 89.2% [CI: 78% -87%]. Conclusions: The protein microarray can be utilized to reduce the false negative rate of routine screening mammography. Women with a negative mammography and a negative blood test can be reassured and encouraged to continue routine breast cancer screening. A positive test should alert the physician about the possible presence of a breast cancer not detected by routine screening mammography and drive to perform additional investigation, such as breast ultrasound and MRI.

Radiologist Interpretive Volume and Breast Cancer Screening Accuracy in a Canadian Organized Screening Program

To strengthen evidence on which radiologist mammography interpretive volume requirements can be based, we assessed the relation of volume to accuracy in the Quebec Breast Cancer Screening Program. Annual interpretive volume (total, screening, and diagnostic) for all 340 radiologists who interpreted 1315327 screening examinations in the period from 2000 to 2006 was obtained using provincial databases. The association of volume to sensitivity, false-positive rate, and accuracy (sensitivity/false-positive rate) was assessed by multivariable Poisson regression with robust error variance. All statistical tests were two-sided. Radiologists consistently interpreting less than 500 mammograms annually experienced a 58% reduction in accuracy (adjusted accuracy ratio = 0.42; 95% confidence interval [CI] = 0.24 to 0.74) compared with those who consistently interpreted at least 500 mammograms annually. Moreover, accuracy increased progressively as total annual volume increased (P trend = .0005). Radiologists interpreting at least 4000 mammograms annually experienced a 32% increase in accuracy (adjusted accuracy ratio = 1.32; 95% CI = 1.13 to 1.54) compared with those interpreting 500 to 999 mammograms annually. This increase in accuracy is attributable to a reduction in false-positive rate as total volume increased (P trend = .001). Sensitivity changed little with total volume (P trend = .68). Gains in accuracy were greater up to approximately 3000 mammograms interpreted annually. The minimum annual volume of 500 mammograms required in North America is justified; radiologist accuracy may be compromised if interpretive volume is consistently less than this requirement. Raising interpretive volume may help to reduce the frequency of false positives without loss of sensitivity. Possible gains in accuracy may be greater with increases in volume of up to approximately 3000 mammograms interpreted annually.

Is the Breast Cancer Mortality Decrease in Sweden Due to Screening or Treatment? Not the Right Question

screening. In the presence of stable or increasing incidence trends, better treatment is the obvious candidate of this success story. Its synergistic effect with screening has been modeled under different assumptions, taking into account that screening can reduce the rate of death from breast cancer only when followed by treatment (5). Not only is mammography screening likely to have detected breast cancers at earlier stages, allowing the adoption of less harmful and more effective treatments, but also the presence of an organized screening program may have promoted the provision of more effective care by monitoring the treatment quality of screen-detected cancers and by favoring the creation of multidisciplinary units of breast cancer specialists (6). Efforts to disentangle the effects of organized screening, early diagnosis, and treatment based on descriptive population data are therefore unlikely to be a reliable exercise, also because screening itself is intrinsically part of clinical practice (7). In our opinion, it is time to move beyond an apparently never-ending debate (8–10) about the extent to which screening for breast cancer in the 1970s to 1990s has reduced mortality from breast cancer—as if it was isolated from the rest of health care. The current scenario is completely different from the past: asymptomatic patients with screen-detected breast cancers represent a large proportion of the breast cancer patients in developed countries. Current priorities should be to increase the accuracy of breast cancer screening and the appropriateness and availability of treatment, to improve communication, and to advance research. In the European Union, member states have been encouraged (11) to extend breast cancer screening programs to the entire target population, to monitor the quality of the screening process, and to link screening, diagnosis, and treatment in a comprehensive framework of quality-assured health care. Recognition of the merits and limitations of breast cancer screening, as well as of its clinical management, should help design more mature and evidence-based communication with the public and with individuals. In terms of research, the identification of indolent cancers that may be candidates for no or less aggressive treatment, the recognition of clues on how to safely reduce the intensity of screening in low-risk women, and the development of more accurate screening technology would be important steps forward that would be likely to have a large impact on future practice. These improvements would allow lowering the harms, in primis overdiagnosis and overtreatment, and increasing the benefits

Facilitating multi-disciplinary, knowledge-based support for breast cancer screening

In order to increase the accuracy of breast cancer screening, the diagnostics of imaging modalities (X-ray, ultrasound or magnetic resonance (MR)) is assessed alongside results of histopathological or cytopathological studies as well as clinical information about a patient. This procedure is called 'triple assessment' in the UK. We have undertaken a project to develop a multiple ontology-based medical image-annotation and reasoning system to support this procedure. Our system integrates image-annotation tools for drawing, image analysis and feature extraction, with ontologies compliant with the proposed language standard, namely OWL. This integration is carried out by the mapping between images and instances in the ontologies. In this paper, we outline the ambit of the project in further detail and discuss some of the architecture and design issues that we have resolved in order to make our system modular and semantic web-enabled. The resulting knowledge base should not only support medical practitioners in the triple assessment process but also provide a resource from which personalised patient information could be delivered via the web direct to patient or care provider. Finally, we describe the progress that we have made thus far on the implementation of this system.

Effect of false-positive mammograms on return for subsequent screening mammography

Purpose There has been concern that false-positive mammograms may deter women from future screening mammograms. We sought to determine whether false-positive mammograms affected follow-up for rescreening. Methods We studied a cohort of 41,844 women in the Vermont Mammography Registry. We measured the proportion of women returning for the next screening mammogram for 30 months following an initial screening mammogram, and compared rates of follow-up screening at 18 and 30 months in women with false-positive and true-negative initial mammograms. We adjusted for potential confounders using multivariable logistic regression models. Results Of the 2469 women aged 50 years or older with false-positive mammograms, 67.2% (n = 1660) returned at 18 months for rescreening, compared with 63.9% (16,948/26,521) of the women with true-negative mammograms ( P = 0.001). Similarly, 86.8% (2143/2469) of the women with false-positive mammograms returned at 30 months for rescreening, compared with 84.7% (22,466/26,521) of the women with true-negative mammograms ( P = 0.005). After adjusting for age, use of hormone replacement therapy, prior mammography, prior false-positive mammography, and education, women with false-positive mammograms were more likely to return at 18 months (odds ratio [OR] = 1.40; 95% confidence interval [CI]: 1.30 to 1.51) and at 30 months (OR = 1.30; 95% CI: 1.18 to 1.44). Conclusion Despite previous concerns, false-positive screening mammograms did not discourage women from returning for subsequent screening mammography. However, other deleterious effects of false-positive results still warrant improvements in the accuracy of breast cancer screening.

Improving the detection of cancer in the screening of mammograms.

Examination of figures from screening at several different centres, and from the incidence of interval cancers in those programmes, suggests that a single radiologist reading by him/herself would miss 16 to 31% of cancers detectable in the mammograms. This study investigates how the accuracy of breast cancer screening could be improved. Draw a comparison between screening for breast cancer and other inspection tasks that have been studied in the experimental psychological laboratory to suggest two low cost fixes that might improve the accuracy of breast cancer screening. (1) Radiologists should not work for more than half an hour at a time; (2) two radiologists double reading should inspect the same series of mammograms in inverse order; (3) there should be a clerical check to see whether the efficiency of detection decreases with time on task; and (4) a more sophisticated engineering of the screening procedure might be accomplished by assembling a library of mammograms for which the correct diagnosis is known. If these library mammograms were mixed randomly with those to be inspected in some suitable ratio, it would then be possible to provide the radiologist with immediate feedback on the accuracy of (some of) his/her diagnoses. From experimental studies of inspection tasks this should improve diagnostic accuracy. These recommendations, of course, require evaluation in field trials.