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Breast Density (breast + density)
Selected AbstractsChange in Mammographic Breast Density Associated with the Use of Depo-ProveraTHE BREAST JOURNAL, Issue 4 2003Charlotte L. Dillis MD Abstract: We report two cases in which routine mammograms showed a significant increase in breast density compared to previous studies. Review of patient histories revealed that both women had been receiving contraceptive injections of Depo-Provera at the time of their earlier mammograms. Breast density increased after Depo-Provera was discontinued. We postulate that Depo-Provera has a suppressive effect on breast density. Alterations in breast density may have implications regarding breast cancer risk. Etiologies of generalized change in breast density are reviewed. [source] The relationship between breast density and bone mineral density in postmenopausal womenCANCER, Issue 9 2004Diana S. M. Buist Ph.D., M.P.H. Abstract BACKGROUND It is not well understood whether breast density is a marker of cumulative exposure to estrogen or a marker of recent exposure to estrogen. The authors examined the relationship between bone mineral density (BMD; a marker of lifetime estrogen exposure) and breast density. METHODS The authors conducted a cross-sectional analysis among 1800 postmenopausal women , 54 years. BMD data were taken from two population-based studies conducted in 1992,1993 (n = 1055) and in 1998,1999 (n = 753). The authors linked BMD data with breast density information collected as part of a mammography screening program. They used linear regression to evaluate the density relationship, adjusted for age, hormone therapy use, body mass index (BMI), and reproductive covariates. RESULTS There was a small but significant negative association between BMD and breast density. The negative correlation between density measures was not explained by hormone therapy or age, and BMI was the only covariate that notably influenced the relationship. Stratification by BMI only revealed the negative correlation between bone and breast densities in women with normal BMI. There was no relationship in overweight or obese women. The same relationship was seen for all women who had never used hormone therapy, but it was not significant once stratified by BMI. CONCLUSIONS BMD and breast density were not positively associated although both are independently associated with estrogen exposure. It is likely that unique organ responses obscure the relationship between the two as indicators of cumulative estrogen exposure. Cancer 2004. © 2004 American Cancer Society. [source] Development, standardization, and testing of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging studiesJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2001Debra M. Ikeda MD Abstract The purpose of this study was to develop, standardize, and test reproducibility of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging (MRI) examinations. To standardize breast MRI lesion description and reporting, seven radiologists with extensive breast MRI experience developed consensus on technical detail, clinical history, and terminology reporting to describe kinetic and architectural features of lesions detected on contrast-enhanced breast MR images. This lexicon adapted American College of Radiology Breast Imaging and Data Reporting System terminology for breast MRI reporting, including recommendations for reporting clinical history, technical parameters for breast MRI, descriptions for general breast composition, morphologic and kinetic characteristics of mass lesions or regions of abnormal enhancement, and overall impression and management recommendations. To test morphology reproducibility, seven radiologists assessed morphology characteristics of 85 contrast-enhanced breast MRI studies. Data from each independent reader were used to compute weighted and unweighted kappa (,) statistics for interobserver agreement among readers. The MR lexicon differentiates two lesion types, mass and non-mass-like enhancement based on morphology and geographical distribution, with descriptors of shape, margin, and internal enhancement. Lexicon testing showed substantial agreement for breast density (, = 0.63) and moderate agreement for lesion type (, = 0.57), mass margins (, = 0.55), and mass shape (, = 0.42). Agreement was fair for internal enhancement characteristics. Unweighted kappa statistics showed highest agreement for the terms dense in the breast composition category, mass in lesion type, spiculated and smooth in mass margins, irregular in mass shape, and both dark septations and rim enhancement for internal enhancement characteristics within a mass. The newly developed breast MR lexicon demonstrated moderate interobserver agreement. While breast density and lesion type appear reproducible, other terms require further refinement and testing to lead to a uniform standard language and reporting system for breast MRI. J. Magn. Reson. Imaging 2001;13:889,895. © 2001 Wiley-Liss, Inc. [source] Invasive breast cancers detected by screening mammography: A detailed comparison of computer-aided detection-assisted single reading and double readingJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2009JN Cawson Summary To compare double reading plus arbitration for discordance, (currently best practice, (BP)) with computer-aided-detection (CAD)-assisted single reading (CAD-R) for detection of invasive cancers detected within BreastScreen Australia. Secondarily, to examine characteristics of cancers detected/rejected using each method. Mammograms of 157 randomly selected double-read invasive cancers were mixed 1:9 with normal cancers (total 1569), all detected in a BreastScreen service. Cancers were detected by two readers or one reader (C2 and C1 cancers, ratio 70:30%) in the program. The 1569 film-screen mammograms were read by two radiologists (reader A (RA) and reader B(RB)), with findings recorded before and after CAD. Discordant findings with BP were resolved by arbitration. We compared CAD-assisted reading (CAD-RA, CAD-RB) with BP, and CAD and arbitration contribution to findings. We correlated cancer size, sensitivity and mammographic density with detection methods. BP sensitivity 90.4% compared with CAD-RA sensitivity 86.6% (P = 0.12) and CAD-RB 94.3% (P = 0.14). CAD-RB specificity was less than BP (P = 0.01). CAD sensitivity was 93%, but readers rejected most positive CAD prompts. After CAD, reader's sensitivity increased 1.9% and specificity dropped 0.2% and 0.8%. Arbitration decreased specificity 4.7%. Receiving operator curves analysis demonstrated BP accuracy better than CAD-RA, borderline significance (P = 0.07), but not CAD-RB. Secondarily, cancer size was similar for BP and CAD-R. Cancers recalled after arbitration (P = 0.01) and CAD-R (P = 0.10) were smaller. No difference in cancer size or sensitivity between reading methods was found with increasing breast density. CAD-R and BP sensitivity and cancer detection size were not significantly different. CAD-R specificity was significantly lower for one reader. [source] Change in Mammographic Breast Density Associated with the Use of Depo-ProveraTHE BREAST JOURNAL, Issue 4 2003Charlotte L. Dillis MD Abstract: We report two cases in which routine mammograms showed a significant increase in breast density compared to previous studies. Review of patient histories revealed that both women had been receiving contraceptive injections of Depo-Provera at the time of their earlier mammograms. Breast density increased after Depo-Provera was discontinued. We postulate that Depo-Provera has a suppressive effect on breast density. Alterations in breast density may have implications regarding breast cancer risk. Etiologies of generalized change in breast density are reviewed. [source] The relationship between breast density and bone mineral density in postmenopausal womenCANCER, Issue 9 2004Diana S. M. Buist Ph.D., M.P.H. Abstract BACKGROUND It is not well understood whether breast density is a marker of cumulative exposure to estrogen or a marker of recent exposure to estrogen. The authors examined the relationship between bone mineral density (BMD; a marker of lifetime estrogen exposure) and breast density. METHODS The authors conducted a cross-sectional analysis among 1800 postmenopausal women , 54 years. BMD data were taken from two population-based studies conducted in 1992,1993 (n = 1055) and in 1998,1999 (n = 753). The authors linked BMD data with breast density information collected as part of a mammography screening program. They used linear regression to evaluate the density relationship, adjusted for age, hormone therapy use, body mass index (BMI), and reproductive covariates. RESULTS There was a small but significant negative association between BMD and breast density. The negative correlation between density measures was not explained by hormone therapy or age, and BMI was the only covariate that notably influenced the relationship. Stratification by BMI only revealed the negative correlation between bone and breast densities in women with normal BMI. There was no relationship in overweight or obese women. The same relationship was seen for all women who had never used hormone therapy, but it was not significant once stratified by BMI. CONCLUSIONS BMD and breast density were not positively associated although both are independently associated with estrogen exposure. It is likely that unique organ responses obscure the relationship between the two as indicators of cumulative estrogen exposure. Cancer 2004. © 2004 American Cancer Society. [source] Screening mammography performance and cancer detection among black women and white women in community practiceCANCER, Issue 1 2004Karminder 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] Mammography screening in African American womenCANCER, Issue S1 2003Evaluating the research Abstract BACKGROUND Notwithstanding some controversy regarding the benefits of screening mammography, it is generally assumed that the effects are the same for women of all race/ethnic groups. Yet evidence for its efficacy from clinical trial studies comes primarily from the study of white women. It is likely that mammography is equally efficacious in white and African American women when applied under relatively optimal clinical trial conditions, but in actual practice African Americans may not be receiving equal benefit, as reflected in their later stage at diagnosis and greater mortality. METHODS Initial searches of Medline using search terms related to screening mammography, race, and other selected topics were supplemented with national data that are routinely published for cancer surveillance. Factors that potentially compromise the benefits of mammography as it is delivered in the current health care system to African American women were examined. RESULTS While there have been significant improvements in mammography screening utilization, observational data suggest that African American women may still not be receiving the full benefit. Potential explanatory factors include low use of repeat screening, inadequate followup for abnormal exams, higher prevalence of obesity and, possibly, breast density, and other biologic factors that contribute to younger age at diagnosis. CONCLUSIONS Further study of biologic factors that may contribute to limited mammography efficacy and poorer breast cancer outcomes in African American women is needed. In addition, strategies to increase repeat mammography screening and to ensure that women obtain needed followup of abnormal mammograms may increase early detection and improve survival among African Americans. Notwithstanding earlier age at diagnosis for African American women, mammography screening before age 40 years is not recommended, but screening of women aged 40,49 years is particularly critical. Cancer 2003;97(1 Suppl):258,72. © 2003 American Cancer Society. DOI 10.1002/cncr.11022 An erratum to this article is published in Cancer (2003) 97(8) 2047. [source] | ||||||||||