Should tomosynthesis replace mammography for breast cancer screening?

Editorial - no abstract availabl

Accuracy and Outcomes of Screening Mammography in Women With a Personal History of Early-Stage Breast Cancer

Women with a personal history of breast cancer (PHBC) are at risk of developing another breast cancer and are recommended for screening mammography. Few high-quality data exist on screening performance in PHBC women

Perceptions and misperceptions of overdetection of breast cancer.

Editorial piece commenting on: Pappadis MR, Volk RJ, Krishnan S, et al. Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis. BMJ Open 2018;8:e022138

The epidemiology, radiology and biological characteristics of interval breast cancers in population mammography screening.

An interval breast cancer is a cancer that emerges following a negative mammographic screen. This overview describes the epidemiology, and the radiological and biological characteristics of interval breast cancers in population mammography screening. Notwithstanding possible differences in ascertainment of interval breast cancers, there was broad variability in reported interval breast cancer rates (range 7.0 to 49.3 per 10,000 screens) reflecting heterogeneity in underlying breast cancer rates, screening rounds (initial or repeat screens), and the length and phase of the inter-screening interval. The majority of studies (based on biennial screening) reported interval breast cancer rates in the range of 8.4 to 21.1 per 10,000 screens spanning the two-year interval with the larger proportion occurring in the second year. Despite methodological limitations inherent in radiological surveillance (retrospective mammographic review) of interval breast cancers, this form of surveillance consistently reveals that the majority of interval cancers represent either true interval or occult cancers that were not visible on the index mammographic screen; approximately 20-25% of interval breast cancers are classified as having been missed (false-negatives). The biological characteristics of interval breast cancers show that they have relatively worse tumour prognostic characteristics and biomarker profile, and also survival outcomes, than screen-detected breast cancers; however, they have similar characteristics and prognosis as breast cancers occurring in non-screened women. There was limited evidence on the effect on interval breast cancer frequency and outcomes following transition from film to digital mammography screening

Screening women with a personal history of breast cancer: overview of the evidence on breast imaging surveillance

This work reviews the evidence on breast imaging for screening (surveillance) in women with a history of breast cancer (BC). Early detection of second BCs in these women improves their prognosis based on studies using mammography (usually with clinical examinations) for surveillance. Cohort studies have estimated that mammography surveillance has moderate sensitivity (65.4%) and good specificity (98.3%), and have shown that these women are at a higher risk of interval BC than age- and breast density-matched women without a history of BC. Studies of adjunct imaging (ultrasound, magnetic resonance imaging) for surveillance that have reported detection and accuracy measures have generally shown that adjunct imaging detected more second BCs than mammography and added substantially to the amount of false-positive results; however, little evidence exists regarding screening efficacy of adjunct imaging as part of routine surveillance

Overdiagnosis due to screening mammography for women aged 40 years and over

This is a protocol for a Cochrane Review. The objective was to assess the effect of screening mammography for breast cancer on overdiagnosis in women aged 40 years and older at average risk of breast cancer

Radiological clinical trials: Proposal of a problem-finding questionnaire to improve study success

open5AIM To develop a survey to help define the main problems in radiological clinical trials. METHODS Since 2006, we have managed seven different radio-logical clinical trials recruiting patients in academic and non-academic centres. We developed a preliminary questionnaire using a four-round Delphi approach to identify problems occurring in radiological clinical trials run at our centre. We investigated the recruitment experience, involvement of all multi-disciplinary team members and main obstacles to completing the projects. A final round of Delphi processes elucidated solutions to the identified problems.openValdora, Francesca; Bignotti, Bianca; Calabrese, Massimo; Houssami, Nehmat; Tagliafico, AlbertoValdora, Francesca; Bignotti, Bianca; Calabrese, Massimo; Houssami, Nehmat; Tagliafico, Albert

The Challenge of Breast Density– Options for Management and Breast Cancer Screening

Invited commentary on breast density

Overview of tomosynthesis (3D mammography) for breast cancer screening.

This review of the evidence on digital breast tomosynthesis, a 3D-mammography technology, for breast cancer (BC) screening describes two types of studies. Prospective trials comparing tomosynthesis (combined with 2D mammography) with 2D mammography alone in the same participants were based on doublereading practice in mostly biennial screening. These showed incremental BC detection attributed to use of tomosynthesis ranging from 2.2 to 2.7 per 1000 screens. Retrospective studies reported the difference in BC detection between women screened with tomosynthesis (2D plus 3D mammography) or with 2D mammography alone, using single-reading and mostly annual screening. Differences in cancer detection ranged between 0.2 and 2.1 per 1000 screens favoring tomosynthesis. The impact of using tomosynthesis on recall was heterogeneous; however, significant reduction in recall rates was observed among the retrospective studies

Hormone replacement therapy use dramatically increases breast oestrogen receptor expression in obese postmenopausal women

BACKGROUND: It is known that use of hormone replacement therapy (HRT) by postmenopausal women increases the risk of breast cancer. METHOD: In this study, oestrogen receptor (ER)-α expression is examined using standard immunoperoxidase technique. RESULTS: Normal breast samples of 11 Australian postmenopausal women have been included in the ER-α study; the result showed a strong correlation (r(2) = 0.80) between ER-α expression in normal breast epithelial cells and body mass index (BMI) in normal women who currently use HRT. CONCLUSION: This finding confirms that the possibility of increased risk of breast cancer associated with increased ER-α expression in normal breast epithelial cells, in turn associated with high BMI and the use of HRT