Computer-aided detection of masses at mammography: interactive decision support versus prompts.

Purpose: To compare effectiveness of an interactive computer-aided detection (CAD) system, in which CAD marks and their associated suspiciousness scores remain hidden unless their location is queried by the reader, with the effect of traditional CAD prompts used in current clinical practice for the detection of malignant masses on full-field digital mammograms.

Materials And Methods: The requirement for institutional review board approval was waived for this retrospective observer study. Nine certified screening radiologists and three residents who were trained in breast imaging read 200 studies (63 studies containing at least one screen-detected mass, 17 false-negative studies, 20 false-positive studies, and 100 normal studies) twice, once with CAD prompts and once with interactive CAD.

Standalone computer-aided detection compared to radiologists' performance for the detection of mammographic masses.

Objectives: We developed a computer-aided detection (CAD) system aimed at decision support for detection of malignant masses and architectural distortions in mammograms. The effect of this system on radiologists' performance depends strongly on its standalone performance. The purpose of this study was to compare the standalone performance of this CAD system to that of radiologists.

Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography.

Objectives: To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms.

Methods: Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was available twice, once processed with a tissue equalisation (TE) algorithm and once with local contrast optimisation (PV).

Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates.

Objectives: To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme.

Methods: Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens.

Breast cancer screening results 5 years after introduction of digital mammography in a population-based screening program.

Purpose: To compare full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) with screen-film mammography (SFM) in a population-based breast cancer screening program for initial and subsequent screening examinations.

Materials And Methods: The study was approved by the regional medical ethics review board. Informed consent was not required.

Breast arterial calcifications are correlated with subsequent development of coronary artery calcifications, but their aetiology is predominantly different.

Objective: To study whether calcifications in breast arteries, as seen on mammograms, predict future development of coronary artery calcifications.

Methods: We studied 499 women, aged 49-70 years, participating in a breast cancer screening program and investigated whether arterial calcifications in the breast (BAC) are associated with coronary arterial calcifications (CAC) after 9 years follow-up. Mammograms were reviewed for the presence of BAC.

Importance of comparison of current and prior mammograms in breast cancer screening.

Purpose: To retrospectively determine the influence of comparing current mammograms with prior mammograms on breast cancer detection in screening and to investigate a protocol in which prior mammograms are viewed only when necessary.

Materials And Methods: Institutional review board approval was not required. Participants gave written informed consent.

Vitamin K intake and calcifications in breast arteries.

Objectives: Vitamin K is an important co-factor in the production of proteins that inhibit vascular calcification. A low dietary Vitamin K intake has been associated with aortic and coronary calcifications and an elevated cardiovascular risk. Calcifications in the arteries of the breasts have also been associated with cardiovascular risk, but whether there is a relation with a low Vitamin K intake has not yet been studied.

Arterial calcifications seen on mammograms: cardiovascular risk factors, pregnancy, and lactation.

Purpose: To retrospectively assess if mammographic calcium deposits are related to coronary heart disease (CHD) risk factors and reproductive factors in a subset of women participating in the European Prospective Investigation into Cancer and Nutrition study.

Materials And Methods: The study was approved by the institutional review board of the University Medical Center Utrecht; informed consent was obtained. Mammograms were evaluated by two radiologists for the presence of breast arterial calcifications (BAC) in the Prospect cohort, a breast cancer screening population of women aged 49-70 years (mean, 57 years) within the European Prospective Investigation into Cancer and Nutrition study.

Arterial calcification found on breast cancer screening mammograms and cardiovascular mortality in women: The DOM Project. Doorlopend Onderzoek Morbiditeit en Mortaliteit.

Breast arterial calcification (BAC) has been associated with diabetes and hypertension. This prompted the authors to study the relation between BAC and cardiovascular mortality in a cohort of 12,239 women aged 50-68 years who participated in a population-based breast cancer screening project (DOM Project) in Utrecht, the Netherlands, during the period 1975-1977. Mortality data from 16-19 years of follow-up were available.

Mammograms may convey more than breast cancer risk: breast arterial calcification and arterio-sclerotic related diseases in women of the DOM cohort.

In a cohort of 12,239 women aged 50-69, who participated in a population-based breast cancer screening project (DOM-project) in Utrecht, The Netherlands, as well as being coded for micro-calcifications indicative of breast cancer, the mammograms were also coded for arterial calcifications. This allowed for a secondary analysis of associations between breast arterial calcification (BAC) and the occurrence of arteriosclerosis-associated morbidity (ie diabetes, hypertension, albuminuria, stroke, thrombosis and myocardial infarction). Arterial calcifications were seen on screening mammograms in 9.

Breast arterial calcifications: association with diabetes mellitus and cardiovascular mortality. Work in progress.

Purpose: To determine the relationship between breast arterial calcification, diabetes mellitus, and subsequent cardiovascular and noncardiovascular mortality.

Materials And Methods: A prospective cohort study was carried out in 12,239 women aged 50-68 years who participated in a breast cancer screening program. The screening mammograms were coded for the presence of breast arterial calcification.

Breast cancer induction due to mammographic screening in hereditarily affected women.

Breast cancer induction due to mammographic screening has aroused considerable controversy in the discussion of the safety of this procedure. We have attempted to shed some light on this problem by approaching it from both a theoretical and a mathematical point of view. We found that about 99% of mammographically induced breast cancers occur in the group of women who are carriers of a breast cancer gene.

Breast size as a determinant of breast cancer.

Objective: To determine whether breast size as reflected in cup size is independently associated with Wolfe's mammographic patterns.

Design: Univariate and multivariate associations between the waist/hip ratio (WHR), body mass index (BMI), cup size, age, parity, age at menarche menopausal status and Wolfe's mammographic parenchymal patterns were determined by (multiple) linear logistic regression.

Setting: Population based mammographic breast cancer screening project.

Exclusion from mammographic screening of women genetically predisposed to breast cancer will probably eliminate mammographically induced breast cancer.

In this paper we present our view on the contribution of mammography examinations to breast cancer induction in patients with hereditary breast cancer predisposition. We contradict the usual reasoning that the benefits of early breast cancer detection outweigh the small number of induced breast cancers. Though this tenet is justified in the majority of women, yet in a small, readily identifiable group of hereditary effected women, radiation even in small doses may enhance oncogenesis.

Abdominal fat predominance in women is associated with a decreased prevalence of the high risk P2, DY mammographic breast patterns.

Body fat distribution was studied in relation to mammographic breast morphology in a cross-sectional sample of 583 women aged 41-75 years participating in the DOM project, a regional breast cancer detection project in Utrecht, the Netherlands. The waist/hip ratio (WHR) was used as an indicator of body fat topography. Mammographic breast morphology was categorized according to the parenchymal breast patterns (N1, P1, P2, DY) as defined by Wolfe.