Prevalent vs Incident Screen: Why Does It Matter?

There are important differences in the performance and outcomes of breast cancer screening in the prevalent compared to the incident screening rounds. The prevalent screen is the first screening examination using a particular imaging technique and identifies pre-existing, undiagnosed cancers in the population. The incident screen is any subsequent screening examination using that technique.

Performance of screening MRI in high risk patients at initial versus subsequent screen.

Purpose: To compare the characteristics, outcomes, and performance metrics in women undergoing initial breast MRI screening versus subsequent screening.

Methods: A retrospective database search identified screening MRIs performed at an academic practice from 2013 to 2015. MRIs were divided into two groups: (1) initial screens and (2) subsequent screens (interpreted with at least one prior MRI for comparison).

Cancer Yield and Patterns of Follow-up for BI-RADS Category 3 after Screening Mammography Recall in the National Mammography Database.

Background The literature supports the use of short-interval follow-up as an alternative to biopsy for lesions assessed as probably benign, Breast Imaging Reporting and Data System (BI-RADS) category 3, with an expected malignancy rate of less than 2%. Purpose To assess outcomes from 6-, 12-, and 24-month follow-up of probably benign findings first identified at recall from screening mammography in the National Mammography Database (NMD). Materials and Methods This retrospective study included women recalled from screening mammography with BI-RADS category 3 assessment at additional evaluation from January 2009 through March 2018 from 471 NMD facilities.

Risk-Based Screening Mammography for Women Aged <40: Outcomes From the National Mammography Database.

Objective: There is insufficient large-scale evidence for screening mammography in women <40 years at elevated risk. This study compares risk-based screening of women aged 30 to 39 with risk factors versus women aged 40 to 49 without risk factors in the National Mammography Database (NMD).

Methods: This retrospective, HIPAA-compliant, institutional review board-exempt study analyzed data from 150 NMD mammography facilities in 31 states.

Risk Stratification for Screening Mammography: Benefits and Harms.

Objective: The purpose of this article is to compare commonly used breast cancer risk assessment models, describe the machine learning approach and big data in risk prediction, and summarize the potential benefits and harms of restrictive risk-based screening.

Conclusion: The commonly used risk assessment models for breast cancer can be complex and cumbersome to use. Each model incorporates different sets of risk factors, which are weighted differently and can produce different results for the same patient.

BI-RADS Category 5 Assessments at Diagnostic Breast Imaging:Outcomes Analysis Based on Lesion Descriptors.

Rationale And Objectives: The Breast Imaging-Reporting and Data System (BI-RADS) atlas defines category 5 assessments as appropriate only for lesions that are almost certainly cancer, with a positive predictive value (PPV) of ≥95%. This study aims to demonstrate the feasibility of classifying lesions at diagnostic breast imaging with sufficiently high PPV to merit category 5 assessments, and to identify those lesion descriptors that yield such a high PPV.

Materials And Methods: For this Health Insurance Portability and Accountability Act compliant and IRB exempt study, we reviewed diagnostic breast imaging examinations (mammography and/or ultrasound) assessed as highly suggestive of malignancy (BI-RADS category 5).

Linkage of the ACR National Mammography Database to the Network of State Cancer Registries: Proof of Concept Evaluation by the ACR National Mammography Database Committee.

Purpose: The National Mammography Database (NMD) contains nearly 20 million examinations from 693 facilities; it is the largest information source for use and effectiveness of breast imaging in the United States. NMD collects demographic, imaging, interpretation, biopsy, and basic pathology results, enabling facility and physician comparison for quality improvement. However, NMD lacks treatment and clinical outcomes data.

Breast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR.

Early detection decreases breast cancer mortality. The ACR recommends annual mammographic screening beginning at age 40 for women of average risk. Higher-risk women should start mammographic screening earlier and may benefit from supplemental screening modalities.

Screening for Breast Cancer in Women Age 75 Years and Older.

Objective: Older women undergoing regular mammography experience significant reductions in breast cancer mortality, except in women with severe comorbidities or limited life expectancy. Optimizing screening strategies requires informed discussions of benefits and risks given each woman's health status.

Conclusion: This article will review the benefits and risks of screening mammography in women older than 75 years within the context of life expectancy and comorbidities and summarize the current recommendations from professional organizations for screening mammography in older women.

Screening Mammography in Women 40-49 Years Old: Current Evidence.

Objective: Breast cancer is an important health problem for women 40-49 years old, yet screening mammography for this age group remains controversial. This article reviews recent guidelines and supporting evidence on screening mammography in women of this age group.

Conclusion: Evidence supports the benefit of annual screening mammography in women 40-49 years old.

Harmonizing Breast Cancer Screening Recommendations: Metrics and Accountability.

Objective: The purposes of this article are to summarize breast cancer screening recommendations and discuss their differences and similarities and to explain the differences between two national databases to aid in interpretation of their benchmarks.

Conclusion: The American College of Radiology, American Cancer Society, and U.S.

Use of the probably benign (BI-RADS category 3) assessment for masses on breast MRI: Is it transferable to general clinical practice?

The purpose of this study was to identify potential BI-RADS 3 mass descriptors on breast magnetic resonance imaging by systematically defining positive predictive values (PPV). In a blinded retrospective review of BI-RADS 4 masses, reader 1 identified 132 masses and reader 2 identified 76 masses. PPV for mass descriptors and for descriptor combinations was determined.

Comparison of recommendations for screening mammography using CISNET models.

Background: Currently, there are several different recommendations for screening mammography from major national health care organizations, including: 1) annual screening at ages 40 to 84 years; 2) screening annually at ages 45 to 54 years, then biennially at ages 55 to 79 years; and 3) biennial screening at ages 50 to 74 years.

Methods: Mean values of six Cancer Intervention and Surveillance Modeling Network (CISNET) models were used to compare these three screening mammography recommendations in terms of benefits and risks.

Results: Mean mortality reduction was greatest with the recommendation of annual screening at ages 40 to 84 years (39.

Breast Cancer Screening for Average-Risk Women: Recommendations From the ACR Commission on Breast Imaging.

Breast cancer is the most common non-skin cancer and the second leading cause of cancer death for women in the United States. Before the introduction of widespread mammographic screening in the mid-1980s, the death rate from breast cancer in the US had remained unchanged for more than 4 decades. Since 1990, the death rate has declined by at least 38%.

Correlation Between Screening Mammography Interpretive Performance on a Test Set and Performance in Clinical Practice.

Rationale And Objectives: Evidence is inconsistent about whether radiologists' interpretive performance on a screening mammography test set reflects their performance in clinical practice. This study aimed to estimate the correlation between test set and clinical performance and determine if the correlation is influenced by cancer prevalence or lesion difficulty in the test set.

Materials And Methods: This institutional review board-approved study randomized 83 radiologists from six Breast Cancer Surveillance Consortium registries to assess one of four test sets of 109 screening mammograms each; 48 radiologists completed a fifth test set of 110 mammograms 2 years later.

Persistent Untreated Screening-Detected Breast Cancer: An Argument Against Delaying Screening or Increasing the Interval Between Screenings.

Purpose: The aim of this study was to investigate the natural history of untreated screen-detected breast cancer.

Methods: A prospective cohort survey of Society of Breast Imaging fellows concerning the appearance on subsequent mammography of untreated breast cancer detected on screening mammography was conducted.

Results: A representative sample of the 108 actively practicing Society of Breast Imaging fellows (n = 42 [39%]) participated, each reporting outcomes data from his or her entire screening mammography practice.

Association of Patient Age With Outcomes of Current-Era, Large-Scale Screening Mammography: Analysis of Data From the National Mammography Database.

This study analyzes mammography screening data from the National Mammography Database to determine the age cutoff point for screening.

Radiologist Agreement for Mammographic Recall by Case Difficulty and Finding Type.

Purpose: The aim of this study was to assess agreement of mammographic interpretations by community radiologists with consensus interpretations of an expert radiology panel to inform approaches that improve mammographic performance.

Methods: From 6 mammographic registries, 119 community-based radiologists were recruited to assess 1 of 4 randomly assigned test sets of 109 screening mammograms with comparison studies for no recall or recall, giving the most significant finding type (mass, calcifications, asymmetric density, or architectural distortion) and location. The mean proportion of agreement with an expert radiology panel was calculated by cancer status, finding type, and difficulty level of identifying the finding at the patient, breast, and lesion level.

Improving Screening Mammography Outcomes Through Comparison With Multiple Prior Mammograms.

Objective: The objective of the present study is to evaluate the effect of comparison with multiple prior mammograms on the outcomes of screening mammography relative to comparison with a single prior mammogram.

Materials And Methods: We retrospectively analyzed 46,288 consecutive screening mammograms performed at our institution for 22,792 women. We divided these examinations into three groups: those interpreted without comparison with prior mammograms, those interpreted in comparison with one prior examination, and those interpreted in comparison with two or more prior examinations.