Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MAMMOGRAPHY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed2006

Improving the concordance of mammography assessment and management recommendations.

PURPOSE: To retrospectively compare the concordance of initial and final assessment categories for mammograms with management recommendations made before and after the final rules of the Mammography Quality Standards Act (MQSA) were in effect for screening and diagnostic mammography. MATERIALS AND METHODS: The study included mammograms from 1996 to 2001 from the seven mammography registries of the Breast Cancer Surveillance Consortium (BCSC). The authors defined the pre-MQSA period as January 1, 1996-April 27, 1999, and the post-MQSA period as April 28, 1999-December 31, 2001 (2470151 screening and 194199 diagnostic mammograms). Assessment was cross-classified according to management recommendation. Changes in concordance between assessment and recommendation were evaluated by year and by period (before and after MQSA) for computer-linked data and for all data by using Pearson chi(2) test to evaluate differences. Mantel-Haenszel chi(2) test was used to measure change in concordance over time. Each registry and the BCSC Statistical Coordinating Center had a Federal Certificate of Confidentiality and approval from each institution's review board for protection of human subjects to collect and send data to coordinating center and conduct research with these data. Active consent was required at only one site in this HIPAA-compliant study. RESULTS: Concordance increased significantly in the post-MQSA period for Breast Imaging Reporting and Data System categories 3-5 assessments at both screening and diagnostic mammography. The most substantial improvements were in the use of the management recommendation for "additional imaging," which decreased from 41% in 1996 to 15% in 2001 for screening mammograms with an initial assessment of category 4 (P < .001). Recommendation for short-interval follow-up in women with screening mammograms with a category 3 final assessment increased from 51% in 1996 to 76% in 2001 (P < .001). Concordance for diagnostic mammograms assigned category 0 improved from 65% in the pre-MQSA period to 81% in the post-MQSA period (P < .001). CONCLUSION: This analysis demonstrates that over a relatively short period of time, major improvement in radiology reporting has occurred.

Breast Neoplasms↗
PubMed1985

Breast cancer screening: the underuse of mammography.

The early detection of breast cancer is promoted by the American Cancer Society (ACS) and the American College of Radiology (ACR) by encouraging the regular use of three types of screening: breast self-examination (BSE), the clinical breast examination, and mammography. In August 1983, the ACS publicized seven recommendations pertaining to screening, including a revised statement about the routine use of mammography for women between the ages of 40 and 49 years. In response to the ACS statement, the present study assessed compliance with the updated recommendations for all three types of screening. The results show reasonable rates of compliance for the BSE (53%-69%) and clinical examination (70%-78%). In contrast, only 19% of the women between the ages of 35 and 49 and 25% of the women older than 50 reported complying with the recommendation to undergo one baseline screening mammogram. In addition, only 9% of the mammograms were obtained for the early detection of disease, which is the rationale for the recommendation. In fact, it appears that mammography is being performed mainly for the diagnosis of symptomatic women instead of the screening of asymptomatic women. Some implications for health education by physicians and the professional education by physicians and the professional education of physicians in the use of mammography are discussed.

Adult↗
PubMed1987

Light scanning versus mammography in breast cancer detection.

Transillumination light scanning of the breast was compared with screen-film mammography in a prospective study of 1,110 women referred to an outpatient imaging department. Each method was interpreted independently of the other but with knowledge of physical examination findings. Of 24 biopsy-proved cancers, 14 (58%) were detected with light scanning and 21 (88%) with mammography. The 77 false-positive light scan examinations were attributed to technical factors and the inability of light scanning to distinguish malignant from benign conditions on the basis of imaging features. Of the ten false-negative light scan examinations, two were retrospectively reclassified as positive, but light scans in the other eight cases remained normal in appearance. The authors conclude that transillumination light scanning is not competitive with mammography as a screening method for breast cancer detection. furthermore, they were unable to identify a select subpopulation of women who might benefit from light scanning as an adjunct to mammography.

Biopsy↗
PubMed1988

Underuse of screening mammography by family physicians.

Although the American College of Radiology, the National Cancer Institute, and the American Cancer Society recommend screening mammography for women more than 40 years old, there is little compliance with these recommendations. Primary-care physicians are often reluctant to refer patients for the procedure, whereas the patients are usually willing to undergo the procedure. This survey documents the underuse of screening mammography by family physicians who are members of the Michigan Academy of Family Physicians. The underuse of mammography by this physician sample was due to two main factors: The physicians perceived far more disadvantages than advantages with mammography and perceived problems (with, e.g., equipment, effectiveness, and patient acceptance) as pervasive. To change the attitudes and referral behavior of family physicians, one must take into account the specific, negative perceptions of the procedure and place an emphasis on the initial referral, since subsequent referrals are easier to implement.

Adult↗
PubMed1988

Patient discomfort during screen-film mammography.

Vigorous compression is required to minimize radiation dose and maximize image quality for screen-film mammography. Of 356 women who adequately completed a questionnaire following mammography, 171 (48%) reported mammography to be comfortable, 135 (38%) uncomfortable but tolerable, 39 (11%) very uncomfortable, and only 11 (3%) found the examination to be intolerable. Only 14 women (4%) indicated that they would not return for mammography at our facility in the future. Because of this high level of acceptance of compression by women, technologists and radiologists should not hesitate to use vigorous compression to optimize image quality and decrease radiation dose to the patient.

Adult↗
PubMed1989

Mammography registry: considerations and options.

Radiologists are being urged to provide high-quality low-cost screening mammography to all women over 40 years of age. A mammography registry coupled with existing cancer registries would permit the quality and effectiveness of screening efforts to be evaluated. Standards of care would be determined that would permit quality assessment at individual centers and that could enhance medicolegal defense. The organizing group should consist of physician users, experts in mammography, statisticians, and administrators. Data regarding the number and type of studies, findings, interpretations, and recommendations could be collected and reported easily and cheaply with a standardized form. The registry could be financed by federal, state, or private funds; the latter are most preferable, but a combination of the three is most feasible. Screening mammography presents a serious public health challenge that is best addressed by the organization and support of a registry by radiologists.

Costs and Cost Analysis↗
PubMed1990

Standardization of image quality and radiation dose in mammography.

Image quality is the cornerstone to the practice of high-quality mammography. To ensure high quality in the practice of mammography, the American College of Radiology has established a voluntary program for the accreditation of mammographic screening sites. Between August 15, 1987, and February 1, 1989, 647 mammography units completed the accreditation program. Data collected from those units are presented, demonstrating that broad ranges of image quality and dose currently exist among mammographic screening sites. Reasons are discussed for the wide ranges observed, and steps are proposed to narrow the ranges of image quality and dose in the practice of mammography.

Accreditation↗
PubMed1992

Breast cancer recurrence after lumpectomy and irradiation: role of mammography in detection.

Between 1977 and 1989, 102 of 1,145 patients treated with lumpectomy and radiation as an alternative to mastectomy required subsequent biopsy for suspected ipsilateral recurrence. The authors reviewed the mammograms of 58 of those patients for whom at least two sets of mammograms were available, including one set obtained within 3 months of the subsequent repeated biopsy. Of 38 biopsy-proved recurrences, 13 (34%) were detected with mammography alone, 17 (45%) with palpation alone, and eight (21%) with both mammography and palpation. While standard mammographic criteria for biopsy were followed, distortions and calcifications inherent to posttreatment appearances necessitated judicious modifications. As anticipated, sensitivities and positive predictive values showed more impairment within the lumpectomy quadrant. In addition, all cases of purely in situ cancer were detected solely with mammography. Mammography plays an important complementary role to physical examination in posttreatment follow-up. On the basis of these findings, a follow-up algorithm for the ongoing evaluation of these patients was developed.

Adult↗
PubMed1992

Digital mammography and related technologies: a perspective from the National Cancer Institute.

The National Cancer Institute held a workshop entitled "Breast Imaging: State-of-the-Art and Technologies of the Future" in September 1991. This article describes some of the presentations given at the workshop as well as relevant data in the literature and discusses their implications. The workshop faculty identified digital mammography as the evolving technology with the greatest potential impact on management of breast cancer. On the basis of the workshop findings and literature review, the author proposed to form the National Digital Mammography Development Group, which will stimulate research in digital mammography and its integration with related technologies: image processing for improved lesion contrast, automated computer-aided diagnosis for enhanced breast cancer detection and characterization, and teleradiology for facilitated radiologic consultation with recognized experts in the field. It is expected that the National Digital Mammography Development Group will facilitate transfer of advanced digital imaging technology to breast cancer clinics.

Female↗
PubMed1994

Population-based mammography screening in Swedish clinical practice: prevalence and incidence screening in Uppsala County.

PURPOSE: To evaluate the results of a population-based mammography screening program in Uppsala County, Sweden, and to compare the findings with those of the randomized Swedish studies. MATERIALS AND METHODS: There were 43,074 women (aged 40-69 years) who were invited to the first screening round. Women aged 40-54 years were examined with two-view mammography, whereas women aged 55-69 years were examined with one-view mammography. During the second screening round, two-view mammography was used to screen dense breasts. RESULTS: The attendance rate was 87% in the first screening round and 78% in the second screening round. The recall rate for further examination was 4.6% in the first round and 5.7% in the second round. On average, five cancers were found per 1,000 women examined in both screening rounds. The rate of advanced breast cancers of stage II or higher decreased statistically significantly from 0.16% in the first screening round to 0.08% in the second screening round (P = .007). CONCLUSION: The results of the Swedish two-county study can be duplicated in clinical practice.

Aged↗
PubMed1995

Bilateral breast cancer: early detection with mammography.

PURPOSE: To assess the contribution of mammography in the detection of cancer in the contralateral breast in women with bilateral breast cancer. MATERIALS AND METHODS: Mammograms and clinical records of 77 patients with bilateral breast cancer were reviewed in a retrospective study. RESULTS: The contralateral cancer was detected at mammography in 68 of 77 patients (88%) and identified at mammography alone in 50 patients (65%). No statistically significant differences in either mammographic detection rates or stage of the contralateral cancer were noted in patients younger than 50 years (n = 25) compared with those 50 years of age or older (n = 52). Cancers detected at annual screening mammography were of lower stage than cancers in unscreened patients. In the screened group, 41% of tumors were ductal carcinoma in situ alone and 23% were stage II or III, compared with 22% and 50%, respectively, in the unscreened group. CONCLUSION: Mammographic examination and follow-up in patients with unilateral breast cancer allow detection of the majority of contralateral breast cancers and earlier stage cancers.

Age Factors↗
PubMed1995

Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent.

PURPOSE: To evaluate the comparative accuracy of magnetic resonance (MR) imaging relative to mammography and ultrasonography (US) for assessing the extent of breast tumors. MATERIALS AND METHODS: Histologic results and preoperative imaging findings (mammography, US, MR imaging) were analyzed regarding tumor size and multifocality of 61 tumors in 60 women undergoing mastectomy for carcinoma. RESULTS: In 10% of cases, the index tumor was not seen at mammography. With US, 15% of the index tumors were not recognized, while MR imaging missed 2% of the index tumors. On mammographic and US images, tumor size was underestimated significantly (P < .005), by 14% and 18%, respectively, while MR imaging showed no significant difference in size compared with that found in a pathologic evaluation. Mammography showed 31% of the additional invasive lesions, while US showed 38% and MR imaging showed 100%. CONCLUSION: MR imaging was the most accurate of the three preoperative imaging modalities in assessing the size and number of malignant lesions in the breast.

Adult↗
PubMedDate not supplied

Women's views on breast cancer risk and screening mammography: a qualitative interview study.

BACKGROUND: To promote informed decision making about mammography, clinicians are urged to present women with complete, relevant information about breast cancer and screening. Understanding women's current beliefs may help guide such efforts by uncovering misunderstandings, conceptual gaps, and areas of concern. OBJECTIVE: The authors sought to learn how women view breast cancer, their personal risk of breast cancer, and how screening mammography affects that risk. METHODS: Forty-one open-ended semistructured telephone interviews with women selected from a national database by quota sampling to ensure a wide range in demographics of the participants. RESULTS: Almost all respondents viewed breast cancer as a uniformly progressive disease that begins in a silent curable form (typically found by mammograms) and, unless treated early, invariably grows, spreads, and kills. Some women felt that any abnormality found must be treated, even if it was not malignant. None had heard of potentially nonprogressive cancers, and when informed, most felt that the uncertain prognosis of such lesions reinforced the need to find and treat disease as soon as possible. Women expressed a wide range of views about their personal risk of breast cancer. Although some saw breast cancer as a central threat to their health, many others cited heart disease, other cancers, violence, and trauma as greater concerns. Most recognized the importance of "uncontrollable" factors for breast cancer such as age, sex, family history, and genetics. However, other "controllable" factors with little or no demonstrated link to breast cancer (e.g., smoking, diet, toxic exposures, "bad attitudes") were given equal or greater prominence, suggesting that many women feel considerable personal responsibility for their level of breast cancer risk. Similarly, although women recognized that mammography was not perfect, almost all believed that failure to have mammograms put one at risk for premature and preventable death. When asked how mammography worked, almost all repeated the message that "early detection saves lives," suggesting that advanced cancer (and perhaps most cancer deaths) reflected a failure of early detection. The belief in the benefit of early detection was so strong that some women advocated scaring other women into getting mammograms because it is "better to be safe than sorry." CONCLUSIONS: Women view breast cancer as a uniformly progressive disease rarely curable unless caught early. The exaggerated importance many attribute to a variety of controllable factors in modifying personal risk and the "danger" seen in failing to have mammograms may lead women diagnosed with breast cancer to blame themselves.

Adult↗
PubMedDate not supplied

Determining sensitivity of mammography from screening data, cancer incidence, and receiver-operating characteristic curve parameters.

OBJECTIVES: A mathematical model is presented that allows the computation of the sensitivity and specificity of breast screening based on receiver-operating characteristic (ROC) curve shape, the positive predictive value (PPV) of screening mammography, and the cancer incidence, f. METHODS: The normal and cancer populations are modeled as normal distributions with independent means and standard deviations. The distributions are scaled such that the area of the normal population is equal to 1-f and that of the cancer population is f. The PPV for screening mammography is used to determine the operating point on the ROC curve. Knowing this leads directly to the computation of sensitivity and specificity. The derivation is general and is applicable to both symmetrical and asymmetrical ROC curves. RESULTS: For symmetric ROC curves and typical values for the PPV of mammography (about 8%) and cancer incidence (f= 0.003), an A(z) value of 0.95 was required to achieve 63% sensitivity and an A. value of 0.98 led to 86% sensitivity. CONCLUSION: A model was developed that should allow researchers to deduce sensitivity and specificity for screening mammography based on ROC curve measurements and using realistic values of PPV and f. This model allows A. values to be related to the probability of breast cancer detection.

Breast Neoplasms↗
PubMed1995

Mammography interventions for 65- to 74-year-old HMO women. Program effectiveness and predictors of use.

This study evaluated the impact of two interventions designed to encourage mammography use among HMO women aged 65-74 who had not had a mammogram within the past year and had not used their referral for a free mammogram. Ninety days after the referral mailing, women were randomized to receive (a) a survey, (b) a survey in addition to telephone mammography counseling, or (c) a survey, telephone counseling, and a letter. Follow-up data indicated that only 13% of control group women compared to 27% who received phone counseling and 32% who received counseling and a letter obtained a mammogram within 120 days following the baseline survey and/or intervention. Results of the logistic regression analysis indicated that having received either of the interventions, mammography history, access ease, breast cancer/mammography beliefs, and having a friend or family member with breast cancer were independently and significantly related to mammography use.

Aged↗
PubMed1994

Evaluation of the effect on breast cancer mortality of population based mammography screening programmes.

OBJECTIVE: To evaluate, by analysis of breast cancer mortality data from all the 26 Swedish counties for the years 1971 to 1990, whether the effect of the introduction of mammography screening in Sweden can be assessed by observation from existing mortality data. METHODS: A Poisson regression model was used to study whether a decrease in breast cancer mortality among women aged 50-74 years was associated with the extent of mammography screening in different counties and periods. RESULTS: In regions where mammography screening had been introduced, breast cancer mortality tended to be decreased, on average, compared with regions without screening. If a 10 year time lag between the start of screening and its full effect on mortality is assumed then the estimated reduction in breast cancer mortality associated with introduction of screening was 19% with a 95% confidence interval ranging from -3% to 37%. CONCLUSIONS: The results suggest that the effect of mammography screening may be studied using existing routine mortality data and appropriate statistical modelling. This way of assessing the outcome of the screening is valuable when continuously monitoring a screening programme that has become a public health routine.

Age Factors↗
PubMed2005

Acculturation and mammography screening among Hispanic women living in farmworker communities.

The relationship between acculturation and mammography screening practices among Hispanic women is unclear due to inconsistent study findings. The purpose of this research was to further investigate the effect of acculturation on mammography screening practices among Hispanic women and to explore the effect of biculturalism on mammography screening. Hispanic female farmworkers (N = 716) who were 50 years of age and older living in communities in Texas, New Mexico, and California were interviewed at their homes. Data collection was conducted from November 2001 to February 2002. Logistic regression models showed no significant effect for acculturation for the entire sample. Post hoc stratified analysis found that bicultural study participants in California were 3 times more likely to be adherent to screening compared to those with low acculturation. Study findings suggest that distinct differences might exist for Hispanic women living in farmworker communities in California, and perhaps other communities not on the United States-Mexico border. Women in such communities with low levels of acculturation can be targeted for interventions to increase mammography adherence.

Acculturation↗
PubMed2002

Analysis of the cost-effectiveness of mammography promotion by volunteers in rural communities.

The Community Trial of Breast Cancer Screening Promotion assessed the effectiveness and cost-effectiveness of mammography promotion by community volunteer groups in rural areas using three different intervention approaches: individual counseling, community activities, and a combined intervention including both. Societal costs of the interventions were calculated and used in conjunction with measures of effectiveness to calculate cost-effectiveness in terms of cost per additional mammogram and cost per year of life saved. Methods of collecting and using cost information to assess the cost-effectiveness of community interventions are described. The Community Activities intervention was found to be the most cost-effective, at approximately $2,000 for each additional regular mammography user in the community. The cost per year of life saved associated with mammography promotion was approximately $56,000 per year of life saved. Exploratory analyses suggest that the most cost-effective method of promoting mammography use may vary with the target population.

Aged↗