Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study

Abstract

Objectives To examine how lifestyle, hormonal, and other factors influence the sensitivity and specificity of mammography. Methods Women recruited into the Million Women Study completed a questionnaire about various personal factors before routine mammographic screening. A sample of 122 355 women aged 50-64 years were followed for outcome of screening and incident breast cancer in the next 12 months. Sensitivity and specificity were calculated by using standard definitions, with adjustment for potential confounding factors. Results Breast cancer was diagnosed in 726 (0.6%) women, 629 in screen positive and 97 in screen negative women; 3885 (3.2%) were screen positive but had no subsequent diagnosis of breast cancer. Overall sensitivity was 86.6% and specificity was 96.8%. Three factors had an adverse effect on both measures: use of hormone replacement therapy (sensitivity: 83.0% (95% confidence interval 77.4% to 87.6%), 84.7% (73.9% to 91.6%), and 92.1% (87.6% to 95.0%); specificity: 96.8% (96.6% to 97.0%), 97.8% (97.5% to 98.0%), and 98.1% (98.0% to 98.2%), respectively, for current, past, and never use); previous breast surgery v no previous breast surgery (sensitivity: 83.5% (75.7% to 89.1%) v 89.4% (86.5% to 91.8%); specificity: 96.2% (95.8% to 96.5%) v 97.4% (97.3% to 97.5%), respectively); and body mass index < 25 v ≥ 25 (sensitivity: 85.7% (81.2% to 89.3%) v 91.0% (87.5% to 93.6%); specificity: 97.2% (97.0% to 97.3%) v 97.4% (97.3% to 97.6%), respectively). Neither sensitivity nor specificity varied significantly according to age, family history of breast cancer, parity, past oral contraceptive use, tubal ligation, physical activity, smoking, or alcohol consumption. Conclusions The efficiency, and possibly the effectiveness, of mammographic screening is lower in users of hormone replacement therapy, in women with previous breast surgery, and in thin women compared with other women.

Delays in the diagnosis of six cancers: analysis of data from the National Survey of NHS Patients: Cancer

“…First, because of diagnosis by screening. From the literature, it would be expected that a significant numbers of breast cancers would be screendetected (Banks et al, 2004). Our sensitivity analysis showed that for the female population in the age range for breast cancer screening, fewer patients saw their GP prior to diagnosis than those outside the age range, suggesting that screen-detected cancers were responsible for many of those apparently bypassing the GP.…”

Studying the Proteomic Pattern of Cancerous Tissue in Patients With Breast Cancer and Its' Comparing With Healthy Breast

“…However, there is a sharp increase in incidence of breast cancer. The incidence increases as age [6].…”

“…Markers are effective not only in early diagnosis but also in predicting the therapeutic response to chemotherapy [6].…”

Atrankinės Mamografinės Patikros Vykdymo Patirtis Nacionaliniame Vėžio Institute

“…Taigi liko neįvertinta radiologų darbo kokybė bei neatlikta detalesnė analizė, kodėl nebuvo nustatyta ryšio tarp intervalinių navikų skaičiaus ir krūties audinio tankumo. Turime neužmiršti, kad dauguma autorių kaip vieną svarbiausių mamografinio tyrimo jautrumą ribojančių veiksnių nurodo didelį krūties audinio tankumą, o tai tiesiogiai koreliuoja su intervalinių navikų dažniu [14][15][16][17][18][19]. Šis tyrimas -tai pirmas bandymas atlikti intervalinių navikų skaičiavimą AMPP vykdymo metu.…”