Improve Breast Cancer Screening Research Articles

Determinants of breast cancer screening behavior amongst Nigerian women using the transtheoretical model

Breast cancer is a leading cause of morbidity and mortality amongst women in developing and developed countries. Breast Self-Examination (BSE), mammography and clinical examination are amongst the most effective methods of early detection, however uptake remains low. The Transtheoretical Model (TTM) has been used in many other countries to characterize behavioral shifts related to enable the adoption of more focused tactics for improving breast cancer screening behaviors among Nigerian women. A cross-sectional research study was conducted to assess the level of knowledge and uptake of breast cancer screening practice based on the various stages of readiness and change predictors using the Transtheoretical Model (TTM). The model was applied to identify and characterise key behavioural determinants such as decision balance, stage of change, and process of change (POC) for breast cancer screening through breast self-examination and mammography. A total of 265 adult female respondents in Kaduna State, Northwest, Nigeria was sampled out of which ninety-one (91%) had no family history of breast cancer. Although 80.3% had knowledge of breast cancer disease, 68% of respondents knew how to conduct BSE and only 55% practiced it. In terms of BSE behaviour staging, 29.4% and 26.7% respondents are in the preparation and maintenance stages respectively. In terms of mammography adoption, most respondents (34%) are in the preparation stage. Review of process of change determinants show that breast cancer screening behaviour are driven more by experiential determinants as compared to behaviour determinants. Addressing the complex factors influencing BSE and mammography practice requires a comprehensive social behaviour change approach that may sustaining positive behaviour-driving factors and minimise inhibitive factors that can promote breast cancer screening.

Mammography screening among women attending primary healthcare centers in Monastir, Tunisia

Abstract Background Breast cancer is the leading cancer among women worldwide. Early detection through mammography screening improves prognosis and enhances survival rate for this disease. The aim of this study was to identify the factors associated with mammography screening utilization among women attending primary healthcare centers. Methods A cross-sectional study was conducted in four primary healthcare centers in Monastir governorate in October 2023 using a pre-tested questionnaire. Women aged over 45 years-old were included as they were the target group in the breast cancer screening strategy. Univariate then multivariate analyses were performed in order to identify the factors associated with mammography screening utilization. Data was analyzed by SPSS 21.0. Results A total of 192 women were included in the study with a mean age of 56.7±8.8 years-old. Among them, 79.7 % (n = 153) were married and 51.6% (n = 98) had three children and less. A total of 55.3 % (n = 94) had a primary education level. Regarding participants’ practices of breast cancer screening, 35% of our participants have had mammogram. Univariate analysis showed that the knowledge about breast cancer symptoms (p = 0.015), practicing Breast self-examination (BSE) (p = 0.002), being aware about mammography (p = 0.001) and the recommended age of the screening at 45 years-old (p = 0.001) were significantly associated with adherence to breast cancer screening. Multivariate analysis revealed that practicing BSE (ORa=2.60 [95%CI: 1.22-5.55] and knowing the recommended age of mammography screening (ORa=2.28 [95%CI: 1.17-4.45] were significant (P < 0.05) predictors of mammography screening utilization. Conclusions Mammography screening rate is low. This study had provided some informations about factors influencing mammography screening. Policymakers and public health practitioners should consider the identified factors when developing intervention programs to improve breast cancer screening. Key messages • There is a need to conduct education sessions in schools to raise awareness about breast cancer screening at an early age. • Social media can be a tool for health education on mammography screening.

Our journey toward implementation of digital breast tomosynthesis in breast cancer screening: the Malmö Breast Tomosynthesis Screening Project.

The purpose is to describe the Malmö Breast Tomosynthesis Screening Project from the beginning to where we are now, and thoughts for the future. In two acts, we describe the efforts made by our research group to improve breast cancer screening by introducing digital breast tomosynthesis (DBT), all the way from initial studies to a large prospective population-based screening trial and beyond. Our studies have shown that DBT has significant advantages over digital mammography (DM), the current gold standard method for breast cancer screening in Europe, in many aspects except a major one-the increased radiologist workload introduced with DBT compared with DM. It is foreseen that AI could be a viable solution to overcome this problem. We have proved that one-view DBT is a highly efficient screening approach with respect to diagnostic performance.

Interventions to reduce racial/ethnic disparities across the breast cancer care continuum.

160 Background: In the United States, racial/ethnic disparities in adoption of breast cancer evidence-based practices (EBPs) persist along the cancer care continuum. This scoping review applied an implementation science lens to describe the current evidence base for interventions to reduce disparities, synthesizing evidence on effective interventions while highlighting gaps in the literature. Methods: A formalized search strategy identified USA-based interventional studies aiming to improve adoption of an EBP along the breast cancer care continuum among racially/ethnically minoritized patients. Relevant articles from 1/2010 - 8/2022 (Medline, Embase, Cochrane, and Scopus) were included. For each article, two reviewers screened and extracted data, with a third resolving discrepancies. The PRISMA-ScR checklist and JBO Manual for Evidence Synthesis framework were followed. Results: Our search strategy yielded 45,215 articles. After applying inclusion/exclusion criteria, 59 articles were retained, targeting screening (85%, 50 of 59), treatment (12%, 7 of 59), and survivorship (5%, 3 of 59) (2 targeted multiple areas). No articles targeted end-of-life care. Of these, 49% (29 of 59) were randomized controlled trials (RCTs). Among 24 screening RCTs, the most common interventions—and fraction with statistically significant improved screening uptake—were patient navigation (100%, 11 of 11) and patient education (80%, 4 of 5). Among 4 treatment RCTs, 3 targeted adjuvant chemotherapy uptake. Of these, 1 had significant improvements and used patient navigation. The 2 studies without significant improvements used a patient tracking tool/alert system or patient education. Among 2 survivorship RCTs, one used email interventions, resulting in significantly improved physical activity and dietary health. A second used a nurse-facilitated internet support group, resulting in significantly improved physical/psychological symptoms. Early to mid-stage implementation outcomes (acceptability, adoption, appropriateness, feasibility, or fidelity) were commonly measured (81%, 48 of 59). No study measured later stage implementation outcomes (sustainability or costs). Conclusions: In multiple studies, patient navigation and education improved breast cancer screening among racially/ethnically minoritized populations. In one study, patient navigation improved completion of adjuvant treatment. Despite these studies, patient navigation is not reimbursed for cancer screening, and adoption has not been widespread. Future studies should focus on evaluating and improving later stage implementation outcomes (sustainability and costs). Based on these results, insurance reimbursement mechanisms for screening-related navigation may be warranted. Future breast cancer care delivery disparities research should also be expanded to include treatment, survivorship, and end-of-life care.

Transforming Breast Cancer Care and Clinical Outcomes: Local Experience in Yanbu Industrial City, Saudi Arabia

ObjectiveThis study aimed to enhance outcomes for women undergoing breast cancer screening in a low utilization setting by implementing structured improvement cycles. MethodsImprovement cycles were conducted using the Plan-Do-Study-Act (PDSA) methodology. Three cycles were implemented: (1) dedicating a specific day for breast screening and increasing appointment slots; (2) establishing a breast screening clinic with same-day registration; and (3) introducing a breast surgery clinic to expedite biopsy procedures for BI-RADS-4 category cases. ResultsFollowing each improvement cycle, dramatic increases in patient attendance were observed. In 2021, there was a 67.5% rise compared to the previous year, and a 72% increase in 2022 compared to 2021 figures. Patient characteristics revealed that 60% of attendees were new patients, with 53% of cancer and precancerous cases observed in women below 50 years old. Before the third cycle, the estimated diagnosis turnaround time (TAT) showed that only 23% of patients had their biopsy completed within five working days. However, after the third cycle (n = 131), 63.5% of biopsies were done within five working days. ConclusionStructured improvement cycles guided by the PDSA methodology effectively enhanced breast cancer screening outcomes. These cycles led to increased patient attendance, expedited biopsy procedures, and improved access to timely diagnosis. The findings highlight the importance of systematic approaches in optimizing breast cancer screening and improving patient care. MicroAbstractThis study aimed to improve breast cancer screening outcomes using structured Plan-Do-Study-Act (PDSA) cycles. Implementing dedicated screening days, same-day registration, and expedited biopsy procedures. Turnaround improved from 23% to 63.5% within 5 days post-third cycle. PDSA-guided cycles dramatically improved patient attendance, expedited biopsy procedures, and timely diagnosis, optimizing breast cancer screening and patient care.

Exploring factors associated with uptake of breast cancer screening among a subset of women in a South African metropolitan area: research to inform public health interventions

Aim Breast cancer represents a significant global health concern and remains a leading cause of cancer-related mortality, particularly among women in developing countries. Despite the South African Department of Health recommending early breast cancer detection to improve overall survival rates and enhance patients’ quality of life, there is lack of awareness among women regarding the importance of regular breast cancer screening and available options. This study investigates the factors associated with breast cancer screening uptake among a subset of women attending public health services in a South African metropolitan area. Methods A cross-sectional survey of adult women attending primary health care services at a community health centre was conducted in February-March 2020. Data on sociodemographics, health beliefs, access to information, and breast cancer screening uptake were subjected to descriptive and logistic regression analyses. Results Out of 252 women, 48.0% were older than 30 years, 69.4% were unemployed, and 56.0% self-reported breast cancer screening non-uptake. After adjusting for other variables, marital status, employment status, home language, and perceived breast cancer screening benefits were significantly associated with breast cancer screening uptake. Married women were twice (AoR: 2.3; CI: 1.19-4.58) as likely to self-report breast cancer screening than their unmarried counterparts. Employed women were almost thrice (AoR: 2.6; CI: 1.41-4.83) as likely to self-report breast cancer screening uptake relative to unemployed women. Women whose home language was Sesotho were almost twice (AoR: 1.9; CI: 1.05-3.43) as likely to self-report breast cancer screening than women reporting other home languages. Self-reported uptake of breast cancer screening was also more likely with every unit increase in perceived benefit scores (AoR: 1.1; CI: 1.02-1.16). Conclusions A significant proportion of women were in the age range where breast cancer screening is typically recommended, with more than half self-reporting breast cancer screening non-uptake. Results highlight the necessity of addressing socioeconomic, cultural and individual perceptions to improve breast cancer screening rates and promote early detection.

Abstract A154: Mammograms Across Missouri: A Qualitative Evaluation among Healthcare Providers to Improve Breast Cancer Screening in Rural Communities

Abstract Introduction: Breast cancer is the leading cause of cancer-related deaths among women, with rural communities having the highest rates of breast cancer mortality. Despite this burden, many women begin mammography later than recommended and the mammography screening rate remains low, with a previously reported declining trend, particularly among rural women compared to urban women. This study seeks to identify barriers to breast cancer screening and examine strategies to overcome these barriers in rural Missouri. Methods: In partnership with the Missouri Cancer Consortium and the Missouri Comprehensive Cancer Control Programs, we conducted key informant interviews with mammography health providers at health centers in each of ten counties with the highest breast cancer mortality and lowest screening mammography rates in Missouri. Semi-structured interviews included questions about seeking and delivering breast cancer screening as well as provider experiences with patient navigation, mobile mammography, and the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Data were analyzed using a deductive-inductive thematic approach in NVivo 14. Results: We conducted 14 interviews with health providers across 12 health sites. The majority of these sites used patient navigation (67%), mobile mammography (80%), and the CDC NBCCEDP (67%) as strategies to improve access to breast healthcare. Health providers frequently mentioned “no-shows” as a major challenge to providing breast healthcare, along with limited transportation, cost, fear, and competing work priorities as the major barriers faced by patients in seeking breast healthcare. Patient navigation and mobile mammography were beneficial in bringing breast healthcare closer to the community, while the CDC NBCCEDP covered screening and follow-up costs. The main facilitating factors to implementing these strategies were having dedicated staff and funding for patient navigation, and existing partnerships with other health institutions for mobile mammography. However, health providers identified several implementing challenges for the strategies. This included limited staff capacity and difficulty contacting or following up patients to schedule appointments for patient navigation and mobile mammography. For the CDC NBCCEDP, the challenges included difficulty identifying eligible patients and extensive paperwork in the enrollment process. Providers recommended increasing staff capacity to support patient navigation, using digital technology in identifying and enrolling women for the CDC NBCCEDP, and integrating mobile mammography with the CDC NBCCEDP to improve implementation efficiency. Discussion: The integration of multiple component strategies within breast healthcare may address the multi-level barriers women face in accessing breast cancer screening. This study contributes to the identification of organizational supports and informs development of policies needed to enhance the adoption and implementation of strategies that support the effective delivery of breast healthcare. Citation Format: Thembekile Shato, Carmen Vardeman, Sarah J. Chavez, Ashley C. Holmes, Joann Lee, Xarria Lewis, Katie Manga, Misty Phillips, Keisha Windham, Bettina F. Drake. Mammograms Across Missouri: A Qualitative Evaluation among Healthcare Providers to Improve Breast Cancer Screening in Rural Communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A154.

Abstract A128: Adherence to mammography screening guidelines by family history of breast cancer in Guam: Preliminary results of HIPIMR study

Abstract Background: In Guam, breast cancer is the most common cancer affecting women, accounting for approximately 34% of all cancer cases. The risk of developing breast cancer is higher for women with a first-degree relative diagnosed with the disease (FHBC). The American Cancer Society recommends annual mammograms for women aged 45-54, with the option to start screening at 40-44. For women aged 55 and older, biennial or annual screenings are advised. Our study aims to investigate the relationship between having a first-degree relative with breast cancer (FHBC) and adherence to these screening guidelines. Methods: This research utilizes preliminary data from the Hawai‘i and Pacific Island Mammography Registry (HIPIMR), a collaborative effort between the University of Hawai‘i Cancer Center and the University of Guam Cancer Research Center, which collects health and breast imaging data in Hawai‘i and Guam. Logistic regression was used to assess the association between having a first-degree relative with breast cancer (FHBC) and adherence to breast cancer screening guidelines. The analysis was conducted across different ethnic groups and adjusted for education and age. Results: The study included 1,017 women who filled out a risk factor questionnaire, including questions about FHBC, before undergoing screening mammography at a clinic in Guam from November 2023 to May 2024. Among the participants, almost 40% were CHamoru, 41% Filipino, 5% Micronesian, 7.4% Asian, and 4.4% White. Of the 1,017 participants, 18.3% reported having a FHBC, and 37.1% did not meet the screening guidelines. Women with FHBC were more likely to meet screening recommendations than those without FHBC (OR=1.63, 95% CI: 1.12, 2.38, adjusted for age and education). Micronesian women (OR=0.54, 95% CI: 0.30, 0.97) and Asian women (OR=0.50, 95% CI: 0.31, 0.82) were less likely to follow screening guidelines compared to Filipino women, after adjusting for age and education. Conclusion: Women with a FHBC were more likely to follow screening guidelines. However, a significant percentage of women in Guam do not adhere to these recommendations, particularly Micronesian women, who also have the highest rates of breast cancer in Guam. Therefore, more outreach and education efforts are needed to improve breast cancer screening adherence in this population. Acknowledgement: This research was funded by the National Cancer Institute: The University of Guam/University of Hawaii Cancer Center Partnership to Advance Cancer Health Equity, Grant U54CA143728 (University of Guam)/Grant U54CA143727 (University of Hawaii Cancer Center). Citation Format: Reina Evangelista, Su Bin Jin, John Shepherd, Grazyna Badowski. Adherence to mammography screening guidelines by family history of breast cancer in Guam: Preliminary results of HIPIMR study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A128.

Linguistic difference in the effect of organized programs on socioeconomic inequalities in breast cancer screening: ecological study in Switzerland.

The objective of this study is to examine how the effect of organized mammography screening programs on breast cancer screening participation differ between socioeconomic strata and how this relationship may be modified by the context of linguistic differences. Switzerland, marked by its diverse linguistic landscape, reflects cultural variations alongside differences in public health strategies. The goal of this study was to assess potential socioeconomic differences in regional mammography screening programs effectiveness to improve breast cancer screening participation. Data on 14 173 women in the regionally adapted breast cancer screening age range was drawn from five cross-sectional waves of the nationally representative Swiss Health Interview Survey (1997-2017). Socioeconomic indicators included education, household income, and employment status. Poisson regression was used to estimate the adjusted prevalence ratios of up-to-date (last 2 years) mammography uptake. Inequality was assessed using relative index of inequality and the slope index of inequality. Organized screening programs were generally effective and increased up-to-date mammography uptake by close to 20 percentage points in both regions. While in the Latin cantons, screening programs had no impact on socioeconomic inequalities in screening, it reduced inequalities for women with lower education in the German cantons. This modification effect of screening programs was not seen for income and employment-related inequalities and did not differ across linguistic regions. Public health agencies should consider the different cultural reception of programs as addressing these differences could help ensure that breast cancer screening initiatives are not only effective, but also culturally equitable across different socioeconomic groups.

Effectiveness of adjunctive ultrasound after mammography in improving breast cancer screening findings from a study in Malaysian women

Effectiveness of adjunctive ultrasound after mammography in improving breast cancer screening findings from a study in Malaysian women

Enhancing Accuracy in Breast Density Assessment Using Deep Learning: A Multicentric, Multi-Reader Study.

The evaluation of mammographic breast density, a critical indicator of breast cancer risk, is traditionally performed by radiologists via visual inspection of mammography images, utilizing the Breast Imaging-Reporting and Data System (BI-RADS) breast density categories. However, this method is subject to substantial interobserver variability, leading to inconsistencies and potential inaccuracies in density assessment and subsequent risk estimations. To address this, we present a deep learning-based automatic detection algorithm (DLAD) designed for the automated evaluation of breast density. Our multicentric, multi-reader study leverages a diverse dataset of 122 full-field digital mammography studies (488 images in CC and MLO projections) sourced from three institutions. We invited two experienced radiologists to conduct a retrospective analysis, establishing a ground truth for 72 mammography studies (BI-RADS class A: 18, BI-RADS class B: 43, BI-RADS class C: 7, BI-RADS class D: 4). The efficacy of the DLAD was then compared to the performance of five independent radiologists with varying levels of experience. The DLAD showed robust performance, achieving an accuracy of 0.819 (95% CI: 0.736-0.903), along with an F1 score of 0.798 (0.594-0.905), precision of 0.806 (0.596-0.896), recall of 0.830 (0.650-0.946), and a Cohen's Kappa (κ) of 0.708 (0.562-0.841). The algorithm achieved robust performance that matches and in four cases exceeds that of individual radiologists. The statistical analysis did not reveal a significant difference in accuracy between DLAD and the radiologists, underscoring the model's competitive diagnostic alignment with professional radiologist assessments. These results demonstrate that the deep learning-based automatic detection algorithm can enhance the accuracy and consistency of breast density assessments, offering a reliable tool for improving breast cancer screening outcomes.

Behavioral Interventions to Improve Breast Cancer Screening Outreach

Despite public health efforts, breast cancer screening rates remain below national goals. To evaluate whether bulk ordering, text messaging, and clinician endorsement increase breast cancer screening rates. Two concurrent, pragmatic, randomized clinical trials, each with a 2-by-2 factorial design, were conducted between October 25, 2021, and April 25, 2022, in 2 primary care regions of an academic health system. The trials included women aged 40 to 74 years with at least 1 primary care visit in the past 2 years who were eligible for breast cancer screening. Patients in trial A were randomized in a 1:1 ratio to receive a signed bulk order for mammogram or no order; in a factorial design, patients were concurrently randomized in a 1:1 ratio to receive or not receive text message reminders. Patients in trial B were randomized in a 1:1 ratio to receive a message signed by their primary care clinician (clinician endorsement) or from the organization (standard messaging); in a factorial design, patients were concurrently randomized in a 1:1 ratio to receive or not receive text message reminders. The primary outcome was the proportion of patients who completed a screening mammogram within 3 months. Among 24 632 patients included, the mean (SD) age was 60.4 (7.5) years. In trial A, at 3 months, 15.4% (95% CI, 14.6%-16.1%) of patients in the bulk order arm and 12.7% (95% CI, 12.1%-13.4%) in the no order arm completed a mammogram, showing a significant increase (absolute difference, 2.7%; 95% CI, 1.6%-3.6%; P < .001). In the text messaging comparison arms, 15.1% (95% CI, 14.3%-15.8%) of patients receiving a text message completed a mammogram compared with 13.0% (95% CI, 12.4%-13.7%) of those in the no text messaging arm, a significant increase (absolute difference of 2.1%; 95% CI, 1.0%-3.0%; P < .001). In trial B, at 3 months, 12.5% (95% CI, 11.3%-13.7%) of patients in the clinician endorsement arm completed a mammogram compared with 11.4% (95% CI, 10.3%-12.5%) of those in the standard messaging arm, which was not significant (absolute difference, 1.1%; 95% CI, -0.5% to 2.7%; P = .18). In the text messaging comparison arms, 13.2% (95% CI, 12.0%-14.4%) of patients receiving a text message completed a mammogram compared with 10.7% (95% CI, 9.7%-11.8%) of those in the no text messaging arm, a significant increase (absolute difference, 2.5%; 95% CI, 0.8%-4.0%; P = .003). These findings show that text messaging women after initial breast cancer screening outreach via either electronic portal or mailings, as well as bulk ordering with or without text messaging, can increase mammogram completion rates. ClinicalTrials.gov Identifier: NCT05089903.

Abstract PO5-12-01: Characteristics of Patients Served by Participants in a Survivorship Navigator Learning Collaborative

Abstract Patient navigation is demonstrated to be a successful model for improving breast cancer screening and early detection, particularly for women in under-resourced communities. The effectiveness of this model has not yet been explored in cancer survivorship. Our research assesses the feasibility of community-based patient navigation after a breast cancer diagnosis. This analysis focuses on the role of patient navigators in providing community-based peer support for women living with breast cancer. We conducted an analysis of data from the Breast Cancer Survivorship Patient Navigator Virtual Learning Collaborative (VLC), a case-based, iterative, virtual training program designed to increase capacity of community-based patient navigators to support women diagnosed with breast cancer. Navigators participated in a 14-week practice-based curriculum focused on improving community support for breast cancer survivors. Each session included a brief lecture followed by a case presentation by a participant. Lecture topics include Breast Cancer 101, Psychosocial support, Treatment options, Clinical trials, Sexual Health, Palliative Care, Genetic Testing, and Trauma. All participants were asked to present at least one de-identified case for discussion, using an 55-item case presentation template. The template included data on patient demographics, diagnosis, treatment, and support. To encourage active learning, navigators were encouraged to present challenging cases for discussion focused on identifying solutions and providing peer support. This analysis focuses on the characteristics of patients presented by community navigators from January 2021 to May 2023. A total of 92 de-identified patient cases were presented by 71 patient navigators and community health workers. (Table 1) The majority of patients were diagnosed within 12 months (62%), with early stage (Stages I-III) disease (78%), and were in active treatment or had not yet started treatment (67%). More than half of the cases had tumors that were HR+ (54%) and nearly half were HER2- (43%); 9% of cases were triple negative and 9% were triple positive. Tumor characteristics were not reported for 27% of cases. Individuals diagnosed with metastatic breast cancer (MBC) compared with those diagnosed with early stage disease were more likely to be Black (59% v 39%), single (56% v 31%), not currently employed (100% v 46%), younger (average age 52 v 55 years old) and insured through Medicaid (56% v 17%) Individuals living with MBC relied more heavily on professional support compared to those diagnosed with early stage disease. The majority of MBC patients relied on the clinical care team (67%) and friends and family (67%) for support, with a large number also receiving support from faith-based organizations (56%), compared to those with early stage disease who relied on friends and family (90%) and the clinical care team (54%). Both groups relied on navigators (33% v 35%) and social workers (44% v 34%), while those with MBC relied more frequently on paid caregivers (44% v 3%), disability services (22% v 6%). The data indicates that individuals with MBC had more unmet needs, including practical support (55% v 33%) and disability (55% v 14%). Supportive care needs vary considerably based on stage of diagnosis, while community-based supportive services are often designed to meet the needs of those diagnosed with early stage disease. Community-based survivorship navigators more readily engage with patients with early stage disease who are newly diagnosed or in active treatment. Individuals with MBC have fewer community-based resources and are less likely to connect with a community-based navigator. Data from our Breast Cancer Survivorship Patient Navigator VLC points to the potential to identify gaps in community-based survivorship care. Future research should focus on expanding the reach of community navigators and ensuring community-based support for patients across all stages. Table 1 Demographics of Patients Presented at VLC Citation Format: Tamara Hamlish, Talia Holzman Castetllands. Characteristics of Patients Served by Participants in a Survivorship Navigator Learning Collaborative [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-12-01.

Association of breast cancer with quantitative mammographic density measures for women receiving contrast-enhanced mammography.

Women with high mammographic density have an increased risk of breast cancer. They may be offered contrast-enhanced mammography to improve breast cancer screening performance. Using a cohort of women receiving contrast-enhanced mammography, we evaluated whether conventional and modified mammographic density measures were associated with breast cancer. Sixty-six patients with newly diagnosed unilateral breast cancer were frequency matched on the basis of age to 133 cancer-free control individuals. On low-energy craniocaudal contrast-enhanced mammograms (equivalent to standard mammograms), we measured quantitative mammographic density using CUMULUS software at the conventional intensity threshold ("Cumulus") and higher-than-conventional thresholds ("Altocumulus," "Cirrocumulus"). The measures were standardized to enable estimation of odds ratio per adjusted standard deviation (OPERA). In multivariable logistic regression of case-control status, only the highest-intensity measure (Cirrocumulus) was statistically significantly associated with breast cancer (OPERA = 1.40, 95% confidence interval = 1.04 to 1.89). Conventional Cumulus did not contribute to model fit. For women receiving contrast-enhanced mammography, Cirrocumulus mammographic density may better predict breast cancer than conventional quantitative mammographic density.

A novel visible and near-infrared hyperspectral imaging platform for automated breast-cancer detection

Background: Breast cancer is a leading cause of cancer-related deaths among women worldwide. Early and accurate detection is crucial for improving patient outcomes. Our study utilizes Visible and Near-Infrared Hyperspectral Imaging (VIS-NIR HSI), a promising non-invasive technique, to detect cancerous regions in ex-vivo breast specimens based on their hyperspectral response.Methods: In this paper, we present a novel HSI platform integrated with fuzzy c-means clustering for automated breast cancer detection. We acquire hyperspectral data from breast tissue samples, and preprocess it to reduce noise and enhance hyperspectral features. Fuzzy c-means clustering is then applied to segment cancerous regions based on their spectral characteristics.Results: Our approach demonstrates promising results. We evaluated the quality of the clustering using metrics like Silhouette Index (SI), Davies-Bouldin Index (DBI), and Calinski-Harabasz Index (CHI). The clustering metrics results revealed an optimal number of 6 clusters for breast tissue classification, and the SI values ranged from 0.68 to 0.72, indicating well-separated clusters. Moreover, the CHI values showed that the clusters were well-defined, and the DBI values demonstrated low cluster dispersion. Additionally, the sensitivity, specificity, and accuracy of our system were evaluated on a dataset of breast tissue samples. We achieved an average sensitivity of 96.83%, specificity of 93.39%, and accuracy of 95.12%. These results indicate the effectiveness of our HSI-based approach in distinguishing cancerous and non-cancerous regions.Conclusions: The paper introduces a robust hyperspectral imaging platform coupled with fuzzy c-means clustering for automated breast cancer detection. The clustering metrics results support the reliability of our approach in effectively segmenting breast tissue samples. In addition, the system shows high sensitivity and specificity, making it a valuable tool for early-stage breast cancer diagnosis. This innovative approach holds great potential for improving breast cancer screening and, thereby, enhancing our understanding of the disease and its detection patterns.

232 (PB-139) Poster - Multi-modal AI-based imaging for improving breast cancer screening across breast densities: A pilot study

232 (PB-139) Poster - Multi-modal AI-based imaging for improving breast cancer screening across breast densities: A pilot study

Optimizing the Patient Experience for Women With Disabilities in the Breast Imaging Clinic.

While there are varying opinions on what age to begin and at what interval to perform breast cancer screening, screening mammography is recommended for all women irrespective of disability. Unfortunately, women with disabilities are more likely to present with later-stage disease and higher mortality owing to the barriers for more widespread screening in this population. Women with disabilities may experience challenges accessing breast imaging services, and imaging centers may have suboptimal facilities and staff who are inexperienced in caring for this population. Efforts to increase accessibility by employing universal design to increase ease of access and provide training to improve the patient experience will go far to improve outcomes for patients with disabilities. To date, there exists no comprehensive guidance on how to improve breast cancer screening programs for women with disabilities. The purpose of this paper is to review barriers to screening faced by patients with disabilities, describe strategies to overcome these barriers, and provide guidance for radiologists and referring providers in selecting the best exam for the individual patient.

The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors

IntroductionBreast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran.MethodsThis quasi-experimental study was conducted on 162 women aged 30–69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22.ResultsThe intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group.ConclusionOverall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors.

Advancing health equity in improving breast cancer screening with the use of a mobile mammography bus in marginalised population: quality improvement project

BackgroundBreast cancer, the second leading cause of cancer-related deaths in women in the USA, is effectively treated through early detection and screening. This quality improvement (QI) project aimed to improve...

Breast Cancer Screening Behavior among Working Women in Japan: Characteristics and Factors Inhibiting Screening.

Improving breast cancer screening rates is crucial for early detection. However, factors hindering regular screening among working women remain unclear. This study aimed to clarify screening behavior among working women in Japan and associated discouraging factors. Surveys were conducted from April to May 2019 among women aged 40-60 at public offices and companies in Tottori Prefecture. We used two surveys: the "Basic Attributes Questionnaire" and the "Structural Questionnaire on Rejecting Screening." Data analysis involved chi-squared tests, logistic regression analysis, factor analysis, and nonparametric tests. Completed questionnaires analyzed were 668 out of 825 collected (response rate: 81.0%). Most participants were part-time employees with an average age of 51 years. Over 60% reported undergoing regular screening. Logistic regression analysis identified part-time employment, lack of children, a discouraging workplace atmosphere, and absence of personal connections to breast cancer patients as factors associated with avoiding breast cancer screening. Factor analysis identified five factors and 16 items as reasons for not undergoing regular screening. Women who had no spouse, no children or felt that their workplace was not encouraging breast screening felt difficulty in scheduling screening most strongly. Individuals who had part-time employment and had no children, did not know a breast cancer patient, or considered that their workplace environment was not supportive were more likely to avoid undergoing regular breast cancer screening. Also, women who did not undergo regular screening experienced difficulty in scheduling. In the future, the challenge lies in disseminating accurate knowledge about breast cancer to foster awareness without excessive anxiety.