Figure - available from: Cancer
This content is subject to copyright. Terms and conditions apply.
Map of Sweden showing the locations of the 9 counties (each indicated administratively in Sweden by one or two letters of the alphabet) involved in the current study.
Source publication
Background
It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.
Methods
Among 549,091 women, cov...
Citations
... In spite of its principle role in screening, the sensitivity of digital mammography is limited in women with dense breasts [4]. Early detection enables the diagnosis of smaller-sized tumors, with fewer nodal metastases and lower histologic grades, thereby enhancing the effectiveness of treatment [5][6][7]. At present, guidelines have been proposed by the Breast Cancer Surveillance Consortium (BCSC) and the U.S. Preventive Service Task Force (USPSTF) for risk stratification for developing breast cancer to identify high-risk groups and determine the eligibility for supplemental screening and chemoprevention [8]. ...
The purposes of this study were to develop an artificial intelligence (AI) model for future breast cancer risk prediction based on mammographic images, investigate the feasibility of the AI model, and compare the AI model, clinical statistical risk models, and Mirai, a state of-the art deep learning algorithm based on screening mammograms for 1–5-year breast cancer risk prediction. We trained and developed a deep learning model using a total of 36,995 serial mammographic examinations from 21,438 women (cancer-enriched mammograms, 17.5%). To determine the feasibility of the AI prediction model, mammograms and detailed clinical information were collected. C-indices and area under the receiver operating characteristic curves (AUCs) for 1–5-year outcomes were obtained. We compared the AUCs of our AI prediction model, Mirai, and clinical statistical risk models, including the Tyrer–Cuzick (TC) model and Gail model, using DeLong’s test. A total of 16,894 mammograms were independently collected for external validation, of which 4002 were followed by a cancer diagnosis within 5 years. Our AI prediction model obtained a C-index of 0.76, with AUCs of 0.90, 0.84, 0.81, 0.78, and 0.81, to predict the 1–5-year risks. Our AI prediction model showed significantly higher AUCs than those of the TC model (AUC: 0.57; p < 0.001) and Gail model (AUC: 0.52; p < 0.001), and achieved similar performance to Mirai. The deep learning AI model using mammograms and AI-powered imaging biomarkers has substantial potential to advance accurate breast cancer risk prediction.
... A more current survey of European screening programs showed a wide variation but significant reductions of BC mortality when comparing screened to non-screened women [12]. Duffy et al. [35] found that in the population of women regularly undergoing mammography screening the proportion of BC fatal after 10 years was reduced by 50%, somewhat less so in intermittent participants (− 36%). For women participating at five consecutive screening rounds the risk of dying from BC was reduced by 74%, and after statistical adjustments for self-selection to 66% (HR: 0.34) [36]. ...
Study goal
We compared the survival rates of women with breast cancer (BC) detected within versus outside the mammography screening program (MSP) “donna”.
Methods
We merged data from the MSP with the data from corresponding cancer registries to categorize BC cases as within MSP (screen-detected and interval carcinomas) and outside the MSP. We analyzed the tumor stage distribution, tumor characteristics and the survival of the women. We further estimated hazard ratios using Cox-regressions to account for different characteristics between groups and corrected the survival rates for lead-time bias.
Results
We identified 1057 invasive (ICD-10: C50) and in-situ (D05) BC cases within the MSP and 1501 outside the MSP between 2010 and 2019 in the Swiss cantons of St. Gallen and Grisons. BC within the MSP had a higher share of stage I carcinoma (46.5% vs. 33.0%; p < 0.01), a smaller (mean) tumor size (19.1 mm vs. 24.9 mm, p < 0.01), and fewer recurrences and metastases in the follow-up period (6.7% vs. 15.6%, p < 0.01). The 10-year survival rates were 91.4% for women within and 72.1% for women outside the MSP (p < 0.05). Survival difference persisted but decreased when women within the same tumor stage were compared. Lead-time corrected hazard ratios for the MSP accounted for age, tumor size and Ki-67 proliferation index were 0.550 (95% CI 0.389, 0.778; p < 0.01) for overall survival and 0.469 (95% CI 0.294, 0.749; p < 0.01) for BC related survival.
Conclusion
Women participating in the “donna” MSP had a significantly higher overall and BC related survival rate than women outside the program. Detection of BC at an earlier tumor stage only partially explains the observed differences.
... For the screening of breast cancer, mammography is the method that is most widely employed. As an illustration, it is advised that women who are forty years old or older go through a mammographic screening [3,4]. The digital mammogram and the digital breast tom synthesis (DBT) are the two instruments that make up the majority of mammography. ...
The disease known as breast cancer continues to be one of the most common and potentially fatal diseases that affect women all over the world. In order to provide effective therapy and more favorable outcomes for patients, early detection and correct diagnosis are absolutely necessary. This research explores the integration of operational research (OR) methodologies and advanced statistical methods within machine learning frameworks to enhance the prediction accuracy of breast cancer outcomes. By harnessing the power of nonlinear optimization and statistical techniques, including regression analysis and probability distribution models, we aim to refine the predictive capabilities of existing algorithms. The research employs a comprehensive dataset derived from clinical trials and patient records, analyzed through a series of machine learning models that incorporate elements of combinatorial optimization, decision analysis, and stochastic modeling. Key performance metrics, such as accuracy, sensitivity, and specificity, are evaluated against standard benchmarks to determine the efficacy of the integrated approaches. Preliminary results indicate that incorporating OR and statistical methods significantly improves model robustness and predictive accuracy. The study not only demonstrates the potential of applied mathematics in medical diagnostics but also provides a framework for future research in enhancing machine learning models for health outcomes prediction through mathematical innovations. This investigation contributes to the field of mathematical oncology by demonstrating how applied nonlinear analysis can bridge the gap between theoretical mathematical approaches and practical clinical applications, offering new pathways for early and more accurate detection of breast cancer.
... Prevention is a key strategy to lower BC burden, as has been demonstrated by the reduction of BC-related mortality since the introduction of mammography for population screening programs. 43 ...
Background
The polygenic risk score (PRS) allows the quantification of the polygenic effect of many low‐penetrance alleles on the risk of breast cancer (BC). This study aimed to evaluate the performance of two sets comprising 77 or 313 low‐penetrance loci (PRS77 and PRS313) in patients with BC in the Czech population.
Methods
In a retrospective case‐control study, variants were genotyped from both the PRS77 and PRS313 sets in 1329 patients with BC and 1324 noncancer controls, all women without germline pathogenic variants in BC predisposition genes. Odds ratios (ORs) were calculated according to the categorical PRS in individual deciles. Weighted Cox regression analysis was used to estimate the hazard ratio (HR) per standard deviation (SD) increase in PRS.
Results
The distributions of standardized PRSs in patients and controls were significantly different ( p < 2.2 × 10 ⁻¹⁶ ) with both sets. PRS313 outperformed PRS77 in categorical and continuous PRS analyses. For patients in the highest 2.5% of PRS313, the risk reached an OR of 3.05 (95% CI, 1.66–5.89; p = 1.76 × 10 ⁻⁴ ). The continuous risk was estimated as an HR per SD of 1.64 (95% CI, 1.49–1.81; p < 2.0 × 10 ⁻¹⁶ ), which resulted in an absolute risk of 21.03% at age 80 years for individuals in the 95th percentile of PRS313. Discordant categorization into PRS deciles was observed in 248 individuals (9.3%).
Conclusions
Both PRS77 and PRS313 are able to stratify individuals according to their BC risk in the Czech population. PRS313 shows better discriminatory ability. The results support the potential clinical utility of using PRS313 in individualized BC risk prediction.
... The golden standard for breast cancer diagnosis is defi nitely MMG, which represents the principal modality of early detection for women at average risk [22]. Early detection allows the diagnosis of tumors of small sizes with few nodal metastases and less histologic-grade progression, making the treatment more eff ective [23]. Literature data show substantial benefi ts for women who undergo mammography screening versus those not participating in screening [23]. ...
... Early detection allows the diagnosis of tumors of small sizes with few nodal metastases and less histologic-grade progression, making the treatment more eff ective [23]. Literature data show substantial benefi ts for women who undergo mammography screening versus those not participating in screening [23]. ...
Breast cancer is the most common type of cancer in women worldwide. It can be spread when cancer cells get into the blood or lymph system and then are carried to other parts of the body. As it is one of the leading causes of death among women, this study aims to identify the most relevant risk factors for breast cancer through several prevention methods for early detection. The social impact of breast cancer is so strong that the World Health Organization (WHO) has established 19 October as International Breast Cancer Day. The pink ribbon is the symbol of this important day worldwide. The objective is precisely to raise awareness among the population about the disease and promote access to timely and effective diagnoses, checks, and treatments. Good prevention should be carried out through behavior or lifestyle modifications (e.g., diet, physical activity, alcohol limitation, etc.). Although, certain risk factors cannot be modified (e.g., aging, family history). Screenings are a fundamental tool to deal with breast cancer, even if sometimes they are not enough as in the case of interval cancers or in cases of particularly ambiguous presentation. Worldwide organizations recommend screening by means of ultrasound, mammography, and magnetic resonance, with appropriate follow-up for an abnormal screening test. To avoid overdiagnosis and overtreatment that can lead to long-term complications and false negatives, these screening differs by recommended ages and frequency. Identification of women at risk for BRCA1 and BRCA2 mutations is also recommended with a referral for genetic testing and, in the presence of dubious lesions, a biopsy is needed. In order to fight this disease, is important to act on time, so, information is fundamental. First of all, the female population should be conscious of risk factors and of the importance of breast examinations from a young age, lastly, they should be aware of the possibility of joining programs of free screening.
... The most common procedure implemented almost in every country as the breast cancer screening is mammography which allows for the early dia gnosis. This method is effective and reduces the number of advanced and fatal breast cancers [5]. ...
ntroduction: Breast cancer is the leading cause of neoplasm mortality among women. Several revention strategies have been implemented to early detect and prevent the cancer occurrence. The most effective protocol includes prevention mastectomy for the high-risk patients. In our study, we have compared the efficacy of subcutaneous mastectomy (SCM) and skin sparing mastectomy (SSM) in long-term follow up. Methods: We have included 201 female patients who have been treated at our department over the course of 20 years between 2000 and 2019. All the patients were at high risk of developing breast cancer and therefore were indicated for the prophylactic mastectomy. The main indication was the presence of the mutation in the BRCA1 or BRCA2 cluster, however, even in the lack of such mutation, the family history was sufficient for the mastectomy indication. Patients underwent either SCM, SSM or areola sparing mastectomy (ASM), and were allocated to aforementioned groups, respectively. We have collected the data regarding the reconstruction method along with age, weight, height, body mass index (BMI) and presence of predisposing genetic mutations such as BRCA positivity. Results: The patients who underwent SSM compared to those who underwent SCM were of higher age, with higher BMI and body mass. The patients in SSM group had statistically significantly higher BMI than in ASM. There was no difference in efficacy between patients who underwent SSM and SCM. The majority of patients (91.5%) were positive for BRCA1 or BRCA2 mutation. In our study, only four patients were tested negative for known breast cancer inducing mutation (three in SCM and one in SSM). The most common reconstruction method was an abdominal flap and breast implant. Conclusions: Prophylactic mastectomy is a reliable strategy for significantly reducing the number of breast cancer incidence in high-risk patients regardless of the selected method of mastectomy. These operations allow for the subsequent reconstruction with the whole spectrum of reconstructive options.
... 2, 3 The current gold standard for screening and early detection of breast cancer is mammography based on a mortality reduction of up to 41% for women regularly participating. 4 While ultrasound and magnetic resonance imaging (MRI) are available as additional screening tools for early breast cancer detection, their utilization for this specific purpose is limited due to various constraints. 5, 6 Moreover, breast cancer screening programs are not implemented in every country and even if implemented not all women have access to ...
... It also serves as a diagnostic tool for women presenting with symptoms [4]. Participation in mammographic screening has been associated with a substantial reduction (by 30%) in breast cancer mortality based on randomized trials of screening programs [5]. This efficacy is attributed to its ability to detect subtle architectural distortions and microcalcifications before a lesion becomes palpable [6]. ...
Introduction
Breast cancer is a significant public health concern in Jordan. It is the most common cancer among Jordanian women. Despite its high incidence and advanced stage at time of diagnosis, the uptake of breast cancer screening in Jordan is low. This study aims to compare clinical outcomes of both screening and diagnostic mammogram among women in Jordan.
Methods
A retrospective cohort of 1005 women who underwent mammography in breast imaging unit in a tertiary hospital in Jordan. It aimed to investigate outcomes of screening and diagnostic mammography. recall rates, clinical manifestations and cancer rates were investigated.
Results
A total of 1005 participants were involved and divided into screening group (n = 634) and diagnostic group (n = 371). Women in the diagnostic group were more likely to be younger, premenopausal, smokers with higher BMI. Among the screening group, 22.3% were labeled with abnormal mammogram, 26% recalled for ultrasound, 46 patients underwent tissue biopsy and a total of 12 patients had a diagnosis of breast carcinoma. Among the diagnostic group, the most commonly reported symptoms were a feeling of breast mass, mastalgia and nipple discharge. Abnormal mammogram was reported in 50.4% of women, a complementary ultrasound was performed for 205 patients. A diagnostic Tru-cut biopsy for 144 patients and diagnostic excisional biopsy for 17 patients were performed. A total of 131 had a diagnosis of carcinoma.
Conclusion
With the high possibility of identifying a carcinoma in mammography among symptomatic women and low uptake of screening mammogram, efforts to increase awareness and improve access to screening services are crucial in reducing the burden of breast cancer in Jordan.
... Аналіз зарубіжного досвіду засвідчує, що підвищення обізнаності жінок щодо важливості регулярного обстеження та удосконалення організації мамографічного скринінгу дозволяє суттєво підвищити ефективність лікування та скоротити передчасну смертність внаслідок РМЗ в економічно розвинутих країнах світу, для яких притаманна висока захворюваність на РМЗ [3,19]. Зокрема, завдяки запровадженню програм скринінгової мамографії у країнах Західної та Північної Європи вдалося на 25-30% знизити смертність внаслідок РМЗ жінок у віці від 50 до 74 років [12]. ...
Annotation. Breast cancer (BC) is an urgent public health problem in Ukraine, ranking first in the structure of the incidence of malignant neoplasms and mortality among the female population. The aim of the study was to analyze the incidence, mortality, and timeliness of BC diagnosis in Ukraine and its regions in the dynamics for 2014-2022 to substantiate the possibilities of improving secondary prevention of breast cancer. The study used the methods of statistical grouping, generalization, comparison, correlation, graphical, dynamic, and spatial analysis to analyze the data of the National Cancer Registry of Ukraine, the National Health Service and the International Agency for Research on Cancer/WHO. It has been discovered that in Ukraine, more than 14 thousand women are diagnosed with breast cancer for the first time in their lives every year, almost 5 thousand die from this cause, and the number of women with breast cancer is more than 167 thousand. The primary incidence of breast cancer tends to increase, and there is a pronounced regional variation in rates. The age-standardized incidence rates of breast cancer in Ukraine are significantly lower than in the European region, but mortality rates are close to European ones, which is caused by insufficient treatment effectiveness due to delayed diagnosis of breast cancer in Ukraine. It is shown that Ukraine has significant reserves for improving the system of timely breast cancer detection. Today, less than a third of breast cancer cases are detected during medical examinations and there is a tendency to decrease this indicator (from 50.0% in 2014 to 28.8% in 2022). This situation is one of the reasons for the high rate of breast cancer neglect, which increased from 20.2% in 2014 to 29.7% in 2022. An extremely low level of coverage of women in target groups with screening mammography examinations (3.7%) included in the program of medical guarantees, as well as an unsatisfactory level of health awareness and activity of women, which is evidenced by a low rate (17.26%) of mammography examinations by women in case of referral to this study, was established. Improving the system of secondary prevention of breast cancer requires increasing the activity of primary health care physicians in referring target groups of women for screening mammography, as well as expanding educational work among women and forming a conscious attitude to their health and understanding the importance of regular mammography for the timely detection of breast cancer.
... [3]. To reduce the burden and mortality caused by breast cancer, early diagnosis is essential [4][5][6]. ...
Purpose
Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women.
Methods
The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases.
Results
Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I.
Conclusions
For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China.
