Screening Outcomes in Older US Women Undergoing Multiple Mammograms in Community Practice: Does Interval, Age, or Comorbidity Score Affect Tumor Characteristics or False Positive Rates?

Abstract

Background Uncertainty exists about the appropriate use of screening mammography among older women because comorbid illnesses may diminish the benefit of screening. We examined the risk of adverse tumor characteristics and false positive rates according to screening interval, age, and comorbidity. Methods From January 1999 to December 2006, data were collected prospectively on 2993 older women with breast cancer and 137 949 older women without breast cancer who underwent mammography at facilities that participated in a data linkage between the Breast Cancer Surveillance Consortium and Medicare claims. Women were aged 66 to 89 years at study entry to allow for measurement of 1 year of preexisting illnesses. We used logistic regression analyses to calculate the odds of advanced (IIb, III, IV) stage, large (>20 millimeters) tumors, and 10-year cumulative probability of false-positive mammography by screening frequency (1 vs 2 years), age, and comorbidity score. The comorbidity score was derived using the Klabunde approximation of the Charlson score. All statistical tests were two-sided. Results Adverse tumor characteristics did not differ statistically significantly by comorbidity, age, or interval. Cumulative probability of a false-positive mammography result was higher among annual screeners than biennial screeners irrespective of comorbidity: 48.0% (95% confidence interval [CI] = 46.1% to 49.9%) of annual screeners aged 66 to 74 years had a false-positive result compared with 29.0% (95% CI = 28.1% to 29.9%) of biennial screeners. Conclusion Women aged 66 to 89 years who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of a false-positive recommendation than annual screeners, regardless of comorbidity.

Variable Clinical Presentation of an MUC1 Mutation Causing Medullary Cystic Kidney Disease Type 1

“…Although MUC1 is produced in many tissues, we could not find evidence of clinical alterations of organs or tissues besides the kidney. The recall rate for mammograms was 58%, which was similar to the lifetime recall rate of 61.3% in a large study of mammogram screening (16). Renal ultrasounds showed occasional cysts, and medullary cysts were not identified in any patients.…”

Impact of errors in recorded compressed breast thickness measurements on volumetric density classification using volpara v1.5.0 software

“…41, 42 If a woman is misplaced from low density to a high density group, this might lead to anxiety for the woman, possibly increased cases of false positive results and increased possibility of unnecessary tests and potentially 280 overtreatment. This might also lead to false sense of security and loss of confidence in the screening program.…”

Evolución en La Forma De Sospecha Y Extensión De La Cirugía Del Cáncer De Mama en Un Centro De Radio-Oncología

“…Debido a los riesgos y costos del sobrediagnós-tico de tumores sin importancia clínica el debate en torno a este tema es de particular interés para utilización óptima de recursos de salud en países como Chile 8,9 . El impacto del aumento de la sospecha mamográfica es difícil de evaluar, pues este trabajo tiene un diseño descriptivo, observacional y transversal.…”