Computer aids and human second reading as interventions in screening mammography: Two systematic reviews to compare effects on cancer detection and recall rate

Background: There are two competing methods for improving the accuracy of a radiologist interpreting screening mammograms: computer aids (CAD) or independent second reading. Methods: Bibliographic databases were searched for clinical trials. Meta-analyses estimated impacts of CAD and double reading on odds ratios for cancer detection and recall rates. Sub-group analyses considered double reading with arbitration. Results: Ten studies compared single reading with CAD to single reading. Seventeen compared double to single reading. Double reading increases cancer detection and recall rates. Double reading with arbitration increases detection rate (CI: 1.02-1.15) and decreases recall rate (CI: 0.92-0.96). CAD does not have a significant effect on cancer detection rate (CI: 0.96-1.13) and increases recall rate (95% CI: 1.09-1.12). However, there is considerable heterogeneity in the impact on recall rate in both sets of studies. Conclusion: The evidence that double reading with arbitration enhances screening is stronger than that for single reading with CAD

Addition of ultrasound to mammography in the case of dense breast tissue: systematic review and meta-analysis.

BACKGROUND: Mammography is less effective in detecting cancer in dense than in fatty breasts. METHODS: We undertook a systematic search in PubMed to identify studies on women with dense breasts who underwent screening with mammography supplemented with ultrasound. A meta-analysis was undertaken on the proportion of cancers detected only by ultrasound, out of all screen-detected cancers, and the proportion of women with negative mammography who were referred for assessment following ultrasound screening. RESULTS: Twenty-nine studies satisfied our inclusion criteria. The proportion of total cancers detected only by ultrasound was 0.29 (95% CI: 0.27-0.31), consistent with an approximately 40% increase in the detection of cancers compared to mammography. In the studied populations, this translated into an additional 3.8 (95% CI: 3.4-4.2) screen-detected cases per 1000 mammography-negative women. About 13% (32/248) of cancers were in situ from 17 studies with information on this subgroup. Ultrasound approximately doubled the referral for assessment in three studies with these data. CONCLUSIONS: Studies have consistently shown an increased detection of breast cancer by supplementary ultrasound screening. An inclusion of supplementary ultrasound into routine screening will need to consider the availability of ultrasound and diagnostic assessment capacities.Department of Health Policy Research Programme (106/0001). Cancer Research UK (grants C8162/A16892 and C569/A16891)

Overestimation of the effect of moving from one to two-view mammography in France.

Comparison of interval breast cancer rates for two-versus single-view screening mammography: a population-based study. [Breast. 2009]]]> eng oai:serval.unil.ch:BIB_4A6B19AFD932 2022-02-19T02:20:52Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_4A6B19AFD932 Faut-il traiter les dyslipidémies chez les personnes âgées et très âgées. [Should we treat dyslipidemia in the elderly and the oldest old?]. info:eu-repo/semantics/altIdentifier/pmid/19994670 Doser Joz-Roland, N. Büla, C. Rodondi, N. info:eu-repo/semantics/review article 2009 Revue Médicale Suisse, vol. 5, no. 224, pp. 2211-2218 info:eu-repo/semantics/altIdentifier/pissn/1660-9379 urn:issn:1660-9379 <![CDATA[Therapy of dyslipidemia in the elderly and the oldest old remains controversial. Several studies have shown benefits of statins on secondary prevention of cardiovascular disease in older adults up to 80 years, but data remain scarce after that age. Fewer studies have assessed the impact of statins in primary prevention in the elderly. Most studies have not included adults older than 75 years, and absolute risk reduction is far lower compared to secondary prevention. Use of statins for primary prevention in this age group should be based on individual decision, taking into account patient's functional and cognitive status, comorbidities and other therapies to avoid drugs interactions, with the help of shared-decision making