Long-term Risk of False-Positive Screening Results and Subsequent Biopsy as a Function of Mammography Use

Blanchard, K; Colbert, James A.; Kopans, Daniel B.; Moore, Richard H.; Halpern, Elkan F.; Hughes, Kevin S.; Smith, Barbara L.; Tanabe, Kenneth K.; Michaelson, James

doi:10.1148/radiol.2402050107

Cited by 33 publications

(14 citation statements)

References 29 publications

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“…Christiansen (2000) found a FP probability of 22% after five screening mammograms under biennial screening for an intermediate-risk woman and median radiologist (15), compared to estimates for our population of 38-40%. Studies of benign biopsy have found a probability of 8-9% after 10 screening rounds (12,13), which are similar to our estimate. Based on our review, we believe ours is the first study to incorporate covariate effects and variation among radiologists into estimates of cumulative FP biopsy recommendation rates.…”

Section: Discussionsupporting

confidence: 91%

“…They will undergo 17 examinations if they start biennial screening at age 40, 24 if they start annual screening at age 50, and 34 if they start annual screening at age 40. Estimates of the probability that a woman will experience at least one FP recall after 10 screening examinations range from 29% to 77% (10)(11)(12), and are about 8-9% for benign biopsy (12,13). These estimates, however, are based on extrapolations, are limited by statistical methodology that assumes women participating in multiple screening rounds are representative of all women recommended for screening, and do not take into account factors shown in prior studies to be associated with wide variability in FP rates, such as radiologist recall rates (14)(15)(16)(17) and patient age, breast density, hormone therapy use, and screening interval (6,15,18).…”

Section: Introductionmentioning

confidence: 99%

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Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

Hubbard

Kerlikowske

Flowers

et al. 2012

Obstetrical &Amp; Gynecological Survey

112

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

Hubbard

Kerlikowske

Flowers

et al. 2012

Obstetrical &Amp; Gynecological Survey

112

View full text Add to dashboard Cite

show abstract

“…Our results confirm the previous observation by Blanchard et al [6] that the majority of false-positive findings occur early in a woman's screening experience. The overall PPV of BI-RADS 3, 4, and 5 in women under aged 50 and below in this study was 9.1 versus 41.6% in women aged 50 and above in the comparison group.…”

Section: Discussionsupporting

confidence: 92%

Predictive value of BI-RADS classification for breast imaging in women under age 50

Kennedy

Markert

Alexander

et al. 2011

Breast Cancer Res Treat

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In this study, we assessed the positive-predictive value (PPV) of mammography and/or ultrasonography in women age 50 based on recommendations for biopsies and final pathology results. We performed a retrospective analysis of all mammography and ultrasonography reports issued from 9/2005 to 1/2007 resulting in biopsy among women aged 18-50 at a large county hospital. Data included demographics, imaging modality, breast density, type of finding, BI-RADS, and final pathology. Results were compared to women aged >50 at the same institution. Four hundred and seventy-five biopsies in 395 patients were reviewed. The PPV of BI-RADS 3 (n = 11) was 9.1%, BI-RADS 4 (n = 440) 5.9%, and BI-RADS 5 (n = 24) 66.7%. Forty three (9%) were malignant, of which 31 (6.5%) were invasive carcinomas and 12 (2.5%) were noninvasive. None of the biopsies on patients aged <30 were malignant. Recommended biopsies based on mammography alone were malignant in 20.2% (20/99) compared to 3.4% (7/205) for ultrasonography alone, and 8.9% (15/168) for both mammography and ultrasonography. Suspicious calcifications were malignant in 25% compared to 6.8% for masses/nodules and 3.6% for cysts. Lesions larger than 2 cm are more likely to be malignant (11.8%) than lesions between 1 and 2 cm (3.6%) or below 1 cm (4.3%). The PPV of the current screening modalities diminishes markedly in women under the age of 50 and even more below the age of 40. Calcifications and masses larger than 2 cm should be biopsied, but the current BI-RADS criteria may benefit from revision for other findings in young patients.

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“…Mammography is the current gold standard, but can have false negative rates of up to 20% [26]. The diagnosis of breast cancer relies on the histological examination of tissue biopsies, or cytology of fine-needle aspirates, which are both invasive procedures.…”

Section: Introductionmentioning

confidence: 99%

Circulating miR-148b and miR-133a as biomarkers for breast cancer detection

Shen

Schrauder

et al. 2014

Oncotarget

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Circulating microRNAs have drawn a great deal of attention as promising novel biomarkers for breast cancer. However, to date, the results are mixed. Here, we performed a three-stage microRNA analysis using plasma samples from breast cancer patients and healthy controls, with efforts taken to address several pitfalls in detection techniques and study design observed in previous studies. In the discovery phase with 122 Caucasian study subjects, we identified 43 microRNAs differentially expressed between breast cancer cases and healthy controls. When those microRNAs were compared with published data from other studies, we identified three microRNAs, including miR-148b, miR-133a and miR-409-3p, whose plasma levels were significantly higher in breast cancer cases than healthy controls and were also significant in previous independent studies. In the validation phase with 50 breast cancer cases and 50 healthy controls, we validated the associations with breast cancer detection for miR-148b and miR-133a (P = 1.5×10−6 and 1.3×10−10, respectively). In the in-vitro study phase, we found that both miR-148b and miR-133a were secreted from breast cancer cell lines, showing their secretory potential and possible tumor origin. Thus, our data suggest that both miR-148b and miR-133a have potential use as biomarkers for breast cancer detection.

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Long-term Risk of False-Positive Screening Results and Subsequent Biopsy as a Function of Mammography Use

Abstract: Prompt annual attendance for mammographic screening reduces the occurrence of false-positive mammographic results.

Cited by 33 publications

References 29 publications

Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography

Predictive value of BI-RADS classification for breast imaging in women under age 50

Circulating miR-148b and miR-133a as biomarkers for breast cancer detection

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