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Screening Mammogram (screening + mammogram)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Impact of reproductive factors and lactation on breast carcinoma in situ risk

INTERNATIONAL JOURNAL OF CANCER, Issue 1 2004
Kathleen Meeske
Abstract Incidence rates for breast carcinoma in situ (CIS) have increased markedly over the past 20 years. Breast CIS, detected primarily on mammography, now represents 30,45% of all screened detected breast cancers. We conducted a large population-based case-control study to evaluate the impact of reproductive factors and lactation on breast CIS risk. Case subjects were newly diagnosed with breast CIS at ages 35,64 years between March 1, 1995 and May 31, 1998 (n = 567), resided in Los Angeles County and were born in the United States. Control subjects (n = 614), identified through random digit dialing, fulfilled the same eligibility criteria and were required to have had at least one screening mammogram in the 2-year period before their interview. Women with a positive family history of breast cancer had a 2-fold increase in breast CIS risk. Parous women were at reduced risk relative to nulligravid women (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.46,1.00). Among nulliparous women, pregnancy was unrelated to breast CIS risk. Among parous women, risk declined with each additional term pregnancy (p -trend = 0.003). No associations were found with age at first term pregnancy, induced abortion or miscarriage. Long duration of breast-feeding (,24 months) was associated with increased risk (OR = 2.00, 95% CI = 1.11,3.60). The observed effects of family history and pregnancy on breast CIS risk are consistent with those observed for invasive breast cancer. The results for breast-feeding are contrary to what has been observed in studies of invasive breast cancer. © 2004 Wiley-Liss, Inc. [source]

The pattern of breast cancer screening utilization and its consequences

CANCER, Issue 1 2002
James Michaelson Ph.D.
Abstract BACKGROUND The objective of this study was to describe the pattern of screening utilization and its consequences in terms of tumor size and time of tumor appearance of invasive breast carcinoma among a population of women who were examined at a large service screening/diagnostic program over the last decade. METHODS Utilization of mammography was assessed from a population of 59,899 women who received 196,891 mammograms at the Massachusetts General Hospital Breast Imaging Division from January 1, 1990 to March 1, 1999, among which 604 invasive breast tumors were found. Two hundred six invasive, clinically detected tumors also were seen during this period among women who had no record of a previous mammogram. Additional information was available on screening of women from March 1, 1999 to June 1, 2001. RESULTS Fifty percent of the women who used screening did not begin until the age of 50 years, although 25% of the invasive breast tumors were found in women age < 50 years. Relatively few of the women who used screening returned promptly for their annual examinations; by 1.5 years, only 50% had returned. Approximately 25% of the invasive breast tumors were found in women for whom there was no record of a previous screening mammogram, and these tumors were larger (median, 15 mm) than the screen-detected tumors (median, 10 mm). Approximately 30% of the 604 invasive breast tumors in the screening population were found on nonmammographic grounds, and they also were larger (median, 15 mm) than the screen-detected tumors (median, 10 mm). However, only 3% of these 604 tumors were found by nonmammographic criteria within 6 months of the previous negative examination, and only 12% were found within 1 year. By back calculating the likely size of each of these tumors at the time of the negative mammogram, it could be seen that most tumors probably emerged as larger, palpable masses not because they were missed at the previous negative mammogram, because most were too small then to have been detected, but because too much time had been allowed to pass. CONCLUSIONS Far too many women did not comply with the American Cancer Society recommendation of prompt annual screening from the age of 40 years. Consequently, almost 50% of the invasive tumors emerged as larger and, thus, potentially more lethal, palpable masses. Cancer 2002;94:37,43. © 2002 American Cancer Society. [source]

Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms

JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2008
N Borecky
Summary Three cases of fibroadenoma associated with carcinoma are reported. These cases were diagnosed within a screening programme as a result of suspicious mammographic findings, and the diagnosis of malignancy was confirmed preoperatively by core biopsy in all cases. The mammographic findings suggestive of carcinoma within fibroadenoma were irregularity of margins in one case and associated new suspicious pleomorphic and linear calcifications in the two other cases. The preoperative diagnosis of carcinoma within fibroadenoma was provided by ultrasound-guided core biopsy in two cases and core biopsy under stereotactic guidance in one case. Whereas asymptomatic fibroadenoma with benign imaging appearances usually does not require further investigation, fibroadenoma with atypical imaging features requires a triple test investigation. [source]

Screening mammography performance and cancer detection among black women and white women in community practice

CANCER, Issue 1 2004
Karminder S. Gill M.S.P.H.
Abstract BACKGROUND Despite improvement in mammography screening attendance, black women continue to have poorer prognosis at diagnosis than white woman. Data from the Carolina Mammography Registry were used to evaluate whether there may be differences in mammography performance or detected cancers when comparing black women with white women who are screened by mammography. METHODS Prospectively collected data from community-based mammography facilities on 468,484 screening mammograms (79,397 in black women and 389,087 in white women) were included for study. Mammograms were linked to a pathology data base for identification of cancers. Sensitivity, specificity, positive predictive value, and cancer detection rates were compared between black women and white women. Logistic regression methods were used to control for covariates associated with performance characteristics. Differences in cancer characteristics were compared between black women and white women using chi-square statistics. RESULTS Screening mammography performance results for black women compared with white women were as follows: sensitivity, odds ratio (OR) = 1.07 (95% confidence interval [95% CI], 0.83,1.39); specificity, OR = 1.02 (95% CI, 0.98,1.06); and positive predictive value, OR = 1.07 (95% CI, 0.94,1.23). Among women with no previous screening, black women had a larger proportion of invasive tumors that measured , 2 cm (38% vs. 26%; P = 0.04). The cancer detection rate was highest among black women who reported symptoms at screening (13.9 per 1000 black women vs. 7.9 per 1000 white women). Invasive cancers in black women were poorer grade (P = 0.001), and more often had negative estrogen receptor status and progesterone receptor status (P < 0.001). CONCLUSIONS Overall, screening mammography performed equally well in black women and white women controlling for age, breast density, and time since previous mammogram. Black women who reported symptoms had larger and higher grade tumors compared with white women. Educational efforts need to be strengthened to encourage black women to react sooner to symptoms, so that the tumors detected will be smaller and black women will have a better prognosis when they appear for mammography. Cancer 2004;100:139,48. © 2003 American Cancer Society. [source]