Artificial Intelligence Algorithm for Subclinical Breast Cancer Detection.

Importance: Early breast cancer detection is associated with lower morbidity and mortality.

Objective: To examine whether a commercial artificial intelligence (AI) algorithm for breast cancer detection could estimate the development of future cancer.

Design, Setting, And Participants: This retrospective cohort study of 116 495 women aged 50 to 69 years with no prior history of breast cancer before they underwent at least 3 consecutive biennial screening examinations used scores from an AI algorithm (INSIGHT MMG, version 1.

Women's experience of the information provided along with invitation to participate in BreastScreen Norway.

Objectives: To explore how women aged 50-69 invited to BreastScreen Norway perceived the information provided along with the invitation letter, as well as time spent on reading this information.

Methods: An anonymous questionnaire was sent, as a paper-based form along with a physical invitation letter, or as a link to a digital form in a digital invitation letter, to 84,543 women invited to BreastScreen Norway in 2022. The paper-based forms were handed in upon screening attendance.

Initial interpretation scores of screening mammograms and cancer detection in BreastScreen Norway.

Purpose: To explore the association between radiologists' interpretation scores, early performance measures and cumulative reading volume in mammographic screening.

Method: We analyzed 1,689,731 screening examinations (3,379,462 breasts) from BreastScreen Norway 2012-2020, all breasts scored 1-5 by two independent radiologists. Score 1 was considered negative/benign and score ≥2 positive in this scoring system.

AI performance by mammographic density in a retrospective cohort study of 99,489 participants in BreastScreen Norway.

Objective: To explore the ability of artificial intelligence (AI) to classify breast cancer by mammographic density in an organized screening program.

Materials And Method: We included information about 99,489 examinations from 74,941 women who participated in BreastScreen Norway, 2013-2019. All examinations were analyzed with an AI system that assigned a malignancy risk score (AI score) from 1 (lowest) to 10 (highest) for each examination.

Women's attitudes and perspectives on the use of artificial intelligence in the assessment of screening mammograms.

Purpose: To investigate attitudes and perspectives on the use of artificial intelligence (AI) in the assessment of screening mammograms among women invited to BreastScreen Norway.

Method: An anonymous survey was sent to all women invited to BreastScreen Norway during the study period, October 10, 2022, to December 25, 2022 (n = 84,543). Questions were answered on a 10-point Likert scale and as multiple-choice, addressing knowledge of AI, willingness to participate in AI studies, information needs, confidence in AI results and AI assisted reading strategies, and thoughts on concerns and benefits of AI in mammography screening.

Digital breast tomosynthesis in mammographic screening: false negative cancer cases in the To-Be 1 trial.

Objectives: The randomized controlled trial comparing digital breast tomosynthesis and synthetic 2D mammograms (DBT + SM) versus digital mammography (DM) (the To-Be 1 trial), 2016-2017, did not result in higher cancer detection for DBT + SM. We aimed to determine if negative cases prior to interval and consecutive screen-detected cancers from DBT + SM were due to interpretive error.

Methods: Five external breast radiologists performed the individual blinded review of 239 screening examinations (90 true negative, 39 false positive, 19 prior to interval cancer, and 91 prior to consecutive screen-detected cancer) and the informed consensus review of examinations prior to interval and screen-detected cancers (n = 110).

Mammographic features and risk of breast cancer death among women with invasive screen-detected cancer in BreastScreen Norway 1996-2020.

Objectives: We explored associations between mammographic features and risk of breast cancer death among women with small (<15 mm) and large (≥15 mm) invasive screen-detected breast cancer.

Methods: We included data from 17,614 women diagnosed with invasive breast cancer as a result of participation in BreastScreen Norway, 1996-2020. Data on mammographic features (mass, spiculated mass, architectural distortion, asymmetric density, density with calcification and calcification alone), tumour diameter and cause of death was obtained from the Cancer Registry of Norway.

Personalized Breast Cancer Screening: A Risk Prediction Model Based on Women Attending BreastScreen Norway.

Background: We aimed to develop and validate a model predicting breast cancer risk for women targeted by breast cancer screening.

Method: This retrospective cohort study included 57,411 women screened at least once in BreastScreen Norway during the period from 2007 to 2019. The prediction model included information about age, mammographic density, family history of breast cancer, body mass index, age at menarche, alcohol consumption, exercise, pregnancy, hormone replacement therapy, and benign breast disease.

Early screening outcomes before, during, and after a randomized controlled trial with digital breast tomosynthesis.

Purpose: To describe and compare early screening outcomes before, during and after a randomized controlled trial with digital breast tomosynthesis (DBT) including synthetic 2D mammography versus standard digital mammography (DM) (To-Be 1) and a follow-up cohort study using DBT (To-Be 2).

Methods: Retrospective results of 125,020 screening examinations from four consecutive screening rounds performed in 2014-2021 were described and compared for pre-To-Be 1 (DM), To-Be 1 (DM or DBT), To-Be 2 (DBT), and post-To-Be 2 (DM) cohorts. Descriptive analyses of rates of recall, biopsy, screen-detected and interval cancer, distribution of histopathologic tumor characteristics and time spent on image interpretation and consensus were presented for the four rounds including five cohorts, one cohort in each screening round except for the To-Be 1 trail, which included a DBT and a DM cohort.

Experience of pain during mammographic screening by three different compression paddles.

Introduction: Experience of pain during screening mammography is shown to affect further attendance negatively. We aimed to explore the experience of pain during screening mammography using three different breast compression paddles.

Methods: Using a self-report questionnaire, we collected information on pain experienced during mammography from 938 women screened in Bodø at Nordland Hospital County in 2018, as a part of BreastScreen Norway.

Standardised or individualised X-ray tube angle for mediolateral oblique projection in digital mammography?

Introduction: We aimed to investigate whether there were any differences in positioning criteria related to the presentation of the pectoralis major muscle (pectoral muscle) for women of different heights using a standardized 60° X-ray tube angle for mammograms in mediolateral oblique (MLO) projection.

Methods: Data from MLO mammograms of right breasts of 45,193 women screened in BreastScreen Norway 2016-2019 were used. The positioning criteria were related to the pectoral muscle length (measure A and measure B), width and shape and considered adequate or inadequate depending on the degree of fulfilling the criteria.

Quality of life among women with symptomatic, screen-detected, and interval breast cancer, and for women without breast cancer: a retrospective cross-sectional study from Norway.

Purpose: Breast cancers detected at screening need less aggressive treatment compared to breast cancers detected due to symptoms. The evidence on the quality of life associated with screen-detected versus symptomatic breast cancer is sparse. This study aimed to compare quality of life among Norwegian women with symptomatic, screen-detected and interval breast cancer, and women without breast cancer and investigate quality adjusted life years (QALYs) for women with breast cancer from the third to 14th year since diagnosis.

Long-term quality of life among breast cancer survivors eligible for screening at diagnosis: a systematic review and meta-analysis.

Objectives: This study aimed to explore the long-term quality of life (QoL) among breast cancer survivors eligible for mammographic screening at diagnosis and compare that to QoL among women with no history of breast cancer.

Study Design: Systematic review and meta-analysis.

Methods: A systematic review of randomised controlled trials and observational studies published between January 2000 and July 2019 was performed.

Comparability and validity of cancer registry data in the northwest of Russia.

Background: Despite the elaborate history of statistical reporting in the USSR, Russia established modern population-based cancer registries (PBCR) only in the 1990s. The quality of PBCRs data has not been thoroughly analyzed. This study aims at assessing the comparability and validity of cancer statistics in regions of the Northwestern Federal District (NWFD) of Russia.

Visualization of the Nipple in Profile: Does It Really Affect Selected Outcomes in Organized Mammographic Screening?

Objective: To investigate whether having the nipple imaged in profile was associated with breast characteristics or compression parameters, and whether it affected selected outcomes in screening with standard digital mammography or digital breast tomosynthesis.

Methods: In this IRB-approved retrospective study, results from 87 450 examinations (174 900 breasts) performed as part of BreastScreen Norway, 2016-2019, were compared by nipple in profile status and screening technique using descriptive statistics and generalized estimating equations. Unadjusted and adjusted odds ratios with 95% confidence intervals (95% CIs) were estimated for outcomes of interest, including age, breast volume, volumetric breast density, and compression force as covariates.

History and current status of cancer registration in Russia.

Background: Russia, then part of the Union of Soviet Socialist Republics (the USSR), introduced compulsory cancer registration in 1953, but a clear overall contemporary description of the cancer surveillance system in Russia is not available.

Methods: We summarized historical landmarks and the development of the standards of classification and coding of neoplasms in Russia and described current population-based cancer registries' (PBCR) procedures and practices.

Results: Cancer registration is organized according to the administrative division of the Russian Federation.

Factors associated with attendance and attendance patterns in a population-based mammographic screening program.

Objective: To explore the factors associated with attendance and attendance pattern in BreastScreen Norway.

Methods: We evaluated the number of invitations (n = 1,253,995) and attendances, 2015-2019, stratified by age, invitation method, screening unit and time of appointment. Attendance pattern was analysed for women invited 10 times (n = 47,979), 1996-2019.

Interval and Subsequent Round Breast Cancer in a Randomized Controlled Trial Comparing Digital Breast Tomosynthesis and Digital Mammography Screening.

Background Prevalent digital breast tomosynthesis (DBT) has shown higher cancer detection rates and lower recall rates compared with those of digital mammography (DM). However, data are limited on rates and histopathologic tumor characteristics of interval and subsequent round screen-detected cancers for DBT. Purpose To follow women randomized to screening with DBT or DM and to investigate rates and tumor characteristics of interval and subsequent round screen-detected cancers.

Digital breast tomosynthesis in a population based mammographic screening program: Breast compression and early performance measures.

Purpose: We aimed to determine if compression force or pressure could be associated with early performance measures for women screened with digital breast tomosynthesis (DBT) in BreastScreen Norway. Early performance measures included rates of consensus, recall, and screen-detected breast cancer.

Method: Data on compression force and pressure, compressed breast thickness and breast characteristics were extracted from an automated software for density assessment of DBT screening examinations for 25,286 women.

Self-reported Pain Associated With Screening With Digital Breast Tomosynthesis.

Objective: We aimed to investigate self-reported pain during screening with digital breast tomosynthesis (DBT).

Methods: The study was approved by the Regional Committee for Medical and Health Research Ethics in the South East of Norway (2015/424). Women completed a questionnaire about experienced pain directly after the examination, August-November 2019.

Comparing Screening Outcomes for Digital Breast Tomosynthesis and Digital Mammography by Automated Breast Density in a Randomized Controlled Trial: Results from the To-Be Trial.

Background Digital breast tomosynthesis (DBT) is considered superior to digital mammography (DM) for women with dense breasts. Purpose To identify differences in screening outcomes, including rates of recall, false-positive (FP) findings, biopsy, cancer detection rate, positive predictive value of recalls and biopsies, and histopathologic tumor characteristics by density using DBT combined with two-dimensional synthetic mammography (SM) (hereafter, DBT+SM) versus DM. Materials and Methods This randomized controlled trial comparing DBT+SM and DM was performed in Bergen as part of BreastScreen Norway, 2016-2017.

Breast compression and reported pain during mammographic screening.

Introduction: We aimed to investigate the association between breast compression and experienced pain during mammographic screening.

Methods: Using a questionnaire, we collected information on pain experienced during mammography from 1155 women screened in Akershus, February-March 2018, as a part of BreastScreen Norway. The questionnaire provided information on pain using a numeric rating scale (NRS, 0-10) and related factors.

Breast compression and experienced pain during mammography by use of three different compression paddles.

Objectives: We aimed to compare pain experienced during screening mammography, using three different compression paddles: a fixed paddle standardizing pressure (study paddle), a flexible, and a fixed paddle.

Material And Methods: Using a numeric rating scale (NRS), ranged 0-10, we collected information on pain experienced during mammography from a questionnaire completed by 4,675 women screened in Stavanger, May-November 2017, as a part of BreastScreen Norway. The questionnaire also provided information on factors possibly associated with pain.

Automated Volumetric Analysis of Mammographic Density in a Screening Setting: Worse Outcomes for Women with Dense Breasts.

Purpose To describe screening outcomes from BreastScreen Norway stratified by volumetric breast density (VBD). Materials and Methods This retrospective study included data from 107 949 women aged 50-69 years (mean age ± standard deviation, 58.7 years ± 5.