RAZOR: A Phase II Open Randomized Trial of Screening Plus Goserelin and Raloxifene Versus Screening Alone in Premenopausal Women at Increased Risk of Breast Cancer.

Ovarian suppression in premenopausal women is known to reduce breast cancer risk. This study aimed to assess uptake and compliance with ovarian suppression using the luteinizing hormone releasing hormone (LHRH) analogue, goserelin, with add-back raloxifene, as a potential regimen for breast cancer prevention. Women at ≥30% lifetime risk breast cancer were approached and randomized to mammographic screening alone (C-Control) or screening in addition to monthly subcutaneous injections of 3.

Topological modeling and classification of mammographic microcalcification clusters.

Goal: The presence of microcalcification clusters is a primary sign of breast cancer; however, it is difficult and time consuming for radiologists to classify microcalcifications as malignant or benign. In this paper, a novel method for the classification of microcalcification clusters in mammograms is proposed.

Methods: The topology/connectivity of individual microcalcifications is analyzed within a cluster using multiscale morphology.

Mammographic features of breast cancers at single reading with computer-aided detection and at double reading in a large multicenter prospective trial of computer-aided detection: CADET II.

Purpose: To evaluate the mammographic features of breast cancer that favor lesion detection with single reading and computer-aided detection (CAD) or with double reading.

Materials And Methods: The Computer Aided Detection Evaluation Trial II study was approved by the ethics committee, and all participants provided written informed consent. A total of 31,057 women were recruited from three screening centers between September 2006 and August 2007.

Increasing participant recruitment into large-scale screening trials: experience from the CADET II study.

Objectives: Multicentre randomized trials frequently encounter difficulties in meeting their recruitment targets, resulting in extension of the trial and delays in implementation of the findings. We report on recruitment strategies implemented in a randomized evaluation of computer-aided detection in women attending routine screening in the UK Breast Screening Programme.

Setting: The target population for the trial was identified from an existing NHS database of women aged 50-70 invited for routine mammography in Coventry, Manchester and Nottingham, UK.

Assessing the usefulness of a novel MRI-based breast density estimation algorithm in a cohort of women at high genetic risk of breast cancer: the UK MARIBS study.

Introduction: Mammographic breast density is one of the strongest known risk factors for breast cancer. We present a novel technique for estimating breast density based on 3D T1-weighted Magnetic Resonance Imaging (MRI) and evaluate its performance, including for breast cancer risk prediction, relative to two standard mammographic density-estimation methods.

Methods: The analyses were based on MRI (n = 655) and mammography (n = 607) images obtained in the course of the UK multicentre magnetic resonance imaging breast screening (MARIBS) study of asymptomatic women aged 31 to 49 years who were at high genetic risk of breast cancer.

Promoting interdisciplinarity through educational initiative: a qualitative evaluation.

This paper describes a multi-professional teaching innovation that took place at The University of Manchester during October 2001. Ideas for the project were first established in December 2000 when a multi-professional team of educationalists began exploring ways in which three disparate student groups could be brought together as part of an integrated learning activity (). For this reason, a problem-based learning scenario was developed to encourage nursing, midwifery, and medical students to share their previous knowledge and principles of care.

Single reading with computer-aided detection for screening mammography.

Background: The sensitivity of screening mammography for the detection of small breast cancers is higher when the mammogram is read by two readers rather than by a single reader. We conducted a trial to determine whether the performance of a single reader using a computer-aided detection system would match the performance achieved by two readers.

Methods: The trial was designed as an equivalence trial, with matched-pair comparisons between the cancer-detection rates achieved by single reading with computer-aided detection and those achieved by double reading.

A pilot study of compositional analysis of the breast and estimation of breast mammographic density using three-dimensional T1-weighted magnetic resonance imaging.

Purpose: A method and computer tool to estimate percentage magnetic resonance (MR) imaging (MRI) breast density using three-dimensional T(1)-weighted MRI is introduced, and compared with mammographic percentage density [X-ray mammography (XRM)].

Materials And Methods: Ethical approval and informed consent were obtained. A method to assess MRI breast density as percentage volume occupied by water-containing tissue on three-dimensional T(1)-weighted MR images is described and applied in a pilot study to 138 subjects who were imaged by both MRI and XRM during the Magnetic Resonance Imaging in Breast Screening study.

Variable size computer-aided detection prompts and mammography film reader decisions.

Introduction: The purpose of the present study was to investigate the effect of computer-aided detection (CAD) prompts on reader behaviour in a large sample of breast screening mammograms by analysing the relationship of the presence and size of prompts to the recall decision.

Methods: Local research ethics committee approval was obtained; informed consent was not required. Mammograms were obtained from women attending routine mammography at two breast screening centres in 1996.

Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view.

Introduction: Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies.

Single reading with computer-aided detection and double reading of screening mammograms in the United Kingdom National Breast Screening Program.

Purpose: To retrospectively determine if the use of a computer-aided detection (CAD) system can improve the performance of single reading of screening mammograms to match that of double reading in the United Kingdom.

Materials And Methods: Local research ethics committee approval was obtained; informed consent was not required. This study included a sample of 10 267 mammograms obtained in women aged 50 years or older who underwent routine screening at one of two breast screening centers in 1996.

Breaking bad news: qualitative evaluation of an interprofessional learning opportunity.

This paper analyses the effects of bringing together a small group of nursing and medical students to learn the skills needed to break bad news to patients. It outlines the qualitative and quantitative methods used, to provide the reader with a comprehensive account of the teaching, learning and research strategies drawn on during the study. The paper examines the evaluation phase, as this aspect is of greatest import if such initiatives are to flourish.

Interprofessional education in a midwifery curriculum: the learning through the exploration of the professional task project (LEAPT).

Objective: to develop interprofessional education for students of midwifery, nursing and medicine. To foster collaborative working and learning between students of midwifery, nursing and medicine.

Design: a quasi-experimental method to evaluate the outcomes of an intervention (a problem-based learning (PBL) scenario) with interprofessional students and facilitators.

Linear structures in mammographic images: detection and classification.

We describe methods for detecting linear structures in mammograms, and for classifying them into anatomical types (vessels, spicules, ducts, etc). Several different detection methods are compared, using realistic synthetic images and receiver operating characteristic (ROC) analysis. There are significant differences (p < 0.

Learning together: clinical skills teaching for medical and nursing students.

Objective: To evaluate the feasibility and effectiveness of shared learning of clinical skills for medical and nursing students at the University of Manchester.

Design: Medical and nursing students learned clinical skills in either uniprofessional or multiprofessional groups. These groups rotated through skills stations taught by multiprofessional facilitators.

Bayesian evaluation of breast cancer screening using data from two studies.

The mean sojourn time (the duration of the period during which a cancer is symptom free but potentially detectable by screening) and the screening sensitivity (the probability that a screen applied to a cancer in the preclinical screen detectable period will result in a positive diagnosis) are two important features of a cancer screening programme. Little data from any single study are available on the potential effectiveness of mammographic screening for breast cancer in women with a family history of the disease, despite this being an important public health issue. We develop a method of estimation, from two separate studies, of the two parameters, assuming that transition from no disease to preclinical screen detectable disease, and from preclinical disease to clinical disease, are Poisson processes.

Learning together: use of simulated patients with nursing and medical students for breaking bad news.

This article reports a small research study on the use of simulated patients for teaching medical and nursing students how to break bad news. A total of 34 nursing and medical students undertook the activity in mixed groups. Data obtained from free response questionnaires and a focus group were analysed and independently coded to identify recurrent themes across the data and the two student groups.

Costs and benefits of a one stop clinic compared with a dedicated breast clinic: randomised controlled trial.

Objective: To determine the cost to the NHS and the impact on anxiety of a one stop clinic for assessing women with suspected breast cancer.

Study Design: Randomised controlled trial.

Participants: Women aged 35 or over referred with a breast lump.