Screening US in Patients with Mammographically Dense Breasts: Initial Experience with Connecticut Public Act 09-41

Hooley, Regina J.; Greenberg, Kathryn L.; Stackhouse, Rebecca M; Geisel, Jaime; Butler, Reni; Philpotts, Liane E.

doi:10.1148/radiol.12120621

Cited by 367 publications

(336 citation statements)

References 28 publications

(30 reference statements)

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“…[9][10][11][12] The positive predictive value of biopsy in a study by Parris et al 14 was reported to be 5.5%, similar to that reported by Hooley et al 13 (5.6%). These values were lower than our study findings, as well as other reported data, such as those of Berg et al, 8 whose study reported a value of 8.9%.…”

Section: Discussionsupporting

confidence: 77%

“…When reporting on Connecticut's experience in the first year after the mandate, Hooley et al 13 discussed an overall cancer detection rate of 3.2 per 1000. Parris et al, 14 also reporting on their initial experience after the Connecticut law, found a cancer detection rate of 0.18%: approximately 2 cancers per 1000 women.…”

Section: Discussionmentioning

confidence: 99%

“…The characteristics of the cancers diagnosed in our study population were similar to those in previous screening sonographic studies: measuring less than 1 cm and node negative. 2,13,14 Women with dense breast tissue are affected in two ways: dense breast tissue increases the risk of developing breast cancer, and, additionally, dense breast tissue can make breast cancer difficult to perceive. Offering additional screening tools to women with dense breast tissue is important, as it has been reported that the risk values for breast cancer attributable to density of 50% or higher were 16% for all cancers, 12% for screen-detected cancers, 40% for cancers detected within 12 months of negative screen results, and 16% for cancers detected more than 12 months after a screening examination.…”

Section: Discussionmentioning

confidence: 99%

“…Although the technology has reduced specificity, it has been shown to have improved performance in the evaluation of dense breasts. 2,[7][8][9][10][11][12][13][14][15][16][17][18] In a large screening study, adding a single screening sonographic examination to mammography yielded an additional 1.1 to 7.2 cancers per 1000 in a population of high-risk women, although it also increased the number of false-positive findings. 8 At this time, 19 states have passed legislation mandating that women be notified of their breast density, with legislation pending in several more.…”

mentioning

confidence: 99%

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Initial Experience With the New York State Breast Density Inform Law at a Community‐Based Breast Center

Destounis¹,

Arieno²,

Morgan³

2015

J of Ultrasound Medicine

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ammography is the only method of screening that has been shown to reduce breast cancer mortality, with a reduction of approximately 30%. 1 However, the limitations of mammography are well known and include the reduced sensitivity in dense breast tissue, which can be as low as 30% to 48%. 2,3 Detecting cancer in dense breasts has been a challenge to breast imagers; it is an important challenge to overcome, as women with dense breast tissue make up approximately half of the population in women younger than 50 years and approximately one-third in those older than 50 years. 4 Objectives-The purpose of this study was to review our initial experience with the New York State breast density inform law (New York public health law, S2404-C) at our outpatient breast center. We sought to review the findings in patients returning for screening breast sonography after a screening mammogram revealed heterogeneously dense or extremely dense breast tissue.Methods-From January 1, 2013, through May 31, 2014, 102,841 patients who underwent screening mammography were seen at our institution. Of these, 35,153 were determined to have heterogeneously dense breast tissue, and 11,864 were determined to have extremely dense breast tissue. Due to the New York State breast density inform law, these 47,017 patients were notified of their breast density, with 935 patients (2%) returning for 971 screening breast sonographic examinations.Results-Heterogeneously dense breast tissue was noted in 66% of the patients (619), and extremely dense breast tissue was noted in 34% (316). Thirty-one percent of the patients (290) reported no additional risk factors; 68% (635) presented with 1 or more additional risk factors; and 1% (10) were adopted, and the risk status could not be assessed. Twenty-five procedures (2.6%) were performed after screening breast sonography, resulting in 22 benign findings, 1 atypical finding, and 2 malignancies. The overall positive predictive value was 8% (2 of 25), and the overall cancer detection rate was 2.1 per 1000 (2 of 935).Conclusions-Handheld screening breast sonography performed in women with dense breast tissue can aid in the detection of otherwise occult breast cancer, as we found 2 cancers in the study population, with an overall positive predictive value of 8%. The addition of screening sonography in this cohort did lead to an increase in minimally invasive procedures in 2.6%.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Initial Experience With the New York State Breast Density Inform Law at a Community‐Based Breast Center

Destounis¹,

Arieno²,

Morgan³

2015

J of Ultrasound Medicine

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“…However, ultrasound and MRI are not suitable for screening, the former because it is examiner-dependent and time-consuming, the latter because it is expensive and has a greatly varying specificity [12][13][14][15].…”

Section: Biophotonicsmentioning

confidence: 99%

Near‐infrared imaging of breast cancer using optical contrast agents

Poellinger

2012

Journal of Biophotonics

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Breast cancer is the most common malignancy in women worldwide and the second leading cause of cancer death. On the basis of three studies performed by our group, this article reviews the current status of optical breast imaging using extrinsic contrast agents. To date, only two contrast agents have been applied in human studies, indocyanine green (ICG) and omocianine. Both contrast media were used for absorption and fluorescence imaging. Generally speaking, malignant breast lesions exhibited higher absorption contrast as well as higher fluorescence contrast compared to benign lesions or non‐diseased breast tissue. Some groups consider early enhancement characteristics helpful for differentiation between malignant and benign lesions. Late fluorescence ICG imaging – capitalizing on the extravasation of the dye through the wall of tumorous vessels – seems to be a promising technique to distinguish malignant from benign breast lesions. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)

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Evaluation of Adjunctive Ultrasonography for Breast Cancer Detection Among Women Aged 40-49 Years With Varying Breast Density Undergoing Screening Mammography

et al. 2021

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Key Points Question Does the performance of adjunctive ultrasonography for breast cancer detection among women undergoing screening mammography change according to breast tissue density? Findings In this secondary analysis of a randomized clinical trial, screening mammography alone demonstrated low sensitivity, whereas adjunctive ultrasonography improved sensitivity both in dense and nondense breasts. Meaning These findings suggest that adjunctive ultrasonography has the potential to improve the detection of early-stage and invasive cancers across both dense and nondense breasts and to mitigate the flaws of mammographic screening.

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Screening US in Patients with Mammographically Dense Breasts: Initial Experience with Connecticut Public Act 09-41

Abstract: Technologist-performed handheld screening breast US offered to women in the general population with dense breasts can aid detection of small mammographically occult breast cancers (cancer detection rate, 0.8-10 cancers per 1000 women screened), although the overall PPV is low.

Cited by 367 publications

References 28 publications

Initial Experience With the New York State Breast Density Inform Law at a Community‐Based Breast Center

Initial Experience With the New York State Breast Density Inform Law at a Community‐Based Breast Center

Near‐infrared imaging of breast cancer using optical contrast agents

Evaluation of Adjunctive Ultrasonography for Breast Cancer Detection Among Women Aged 40-49 Years With Varying Breast Density Undergoing Screening Mammography

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