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PubMed2006

Current challenges of full field digital mammography.

Full field digital mammography (FFDM) has advantages over screen-film mammography (SFM), but some important challenges remain. The first challenge is related to the specific characteristics of FFDM. It remains unclear, which shape and limiting values of the modulation transfer function have the most influence on the performance of a detector, such as the effect of the image display on the overall image quality and the effect of processing on cancer detection. In order to assess the image quality of FFDM, we have set up a scoring system. The second challenge is related to screening mammography: is the quality of an image the same when it is viewed on different monitors and with different processing algorithms? Is Computer Aided Diagnosis necessary in a screening environment? In FFDM, the effect of different detectors, processing and display possibilities on the image and on cancer detection are not clearly investigated.

Breast Neoplasms↗
PubMed2006

Global quality control perspective for the physical and technical aspects of screen-film mammography--image quality and radiation dose.

The systematic monitoring of image quality and radiation dose is an ultimate solution to ensuring the continuously high quality of mammography examination. At present several protocols exist around the world, and different test objects are used for quality control (QC) of the physical and technical aspects of screen-film mammography. This situation may lead to differences in radiation image quality and dose reported. This article reviews the global QC perspective for the physical and technical aspects of screen-film mammography with regard to image quality and radiation dose. It points out issues that must be resolved in terms of radiation dose and that also affect the comparison.

Body Burden↗
PubMed1994

Comparison of mammography, sonography, and magnetic resonance imaging in the detection of silicone-gel breast implant rupture.

Silicone-gel breast implant rupture is difficult to diagnose preoperatively. A variety of radiological methods have been used for diagnosis. This study prospectively compares film-screen mammography, high-resolution sonography, and magnetic resonance imaging in the diagnosis of implant rupture using predetermined diagnostic criteria. Thirteen patients (24 implants) underwent film-screen mammography, sonography, and magnetic resonance imaging to evaluate the integrity of their implants. All patients subsequently underwent surgical removal of the implants. Preoperatively, the integrity of each implant was rated on a three-level classification system on the basis of one modality by a reviewer who was unaware of the results of the other two modalities. The three imaging modalities achieved the following sensitivities and specificities, respectively: mammography, 69% and 82%; sonography, 54% and 64%; MRI, 69% and 55%. Even though each modality addresses some of the limitations of the others, in this group of patients, there was no clearly superior imaging tool.

Adult↗
PubMed2002

Comparison between sonography and mammography for breast cancer diagnosis in oriental women after augmentation mammaplasty.

Augmentation mammaplasty has become more popular in Taiwan. Therefore, clinical imaging is necessary to evaluate those patients who develop breast cancers. The purpose of this study was to evaluate the detection of breast diseases after augmentation mammaplasty by means of mammography and sonography. A retrospective follow-up study and analysis of diagnostic methods including mammography, sonography, physical examination, and aspiration cytology was conducted on 105 patients who underwent augmentation mammaplasty at Kaohsiung Medical University Hospital between 1989 and 2001. A total of 105 patients were identified in this study, and mean follow-up was 4 years. Two tumors from 8 cancer patients were visible on standard mammograms, and seven tumors were diagnosed as cancer by sonography. One of 15 benign breast tumors was interpreted as a suspected cancer, and 7 tumors were interpreted as normal findings on mammograms. Fourteen of 15 benign breast tumors were diagnosed correctly except for one suspicious case examined by sonography. Sonography showed the highest rate of diagnostic accuracy (91.3%) and mammograms had the lowest rate (73.9%). The accuracy rate of physical examination was 73.9%, and aspiration cytology was 90.0% accurate. This study affirms that sonography is a more useful diagnostic tool than mammography in Taiwanese women who have undergone augmentation mammaplasty.

Adenocarcinoma↗
PubMed1999

The role of mammography in breast cancer prevention.

Screening mammography has been shown to reduce breast cancer mortality by detecting small, nonpalpable, early-stage breast cancers. In 1998, several studies were published, reinforcing the value of screening mammography in women aged 40 years and older. Some studies focused on when screening should begin (age 40 years), while others analyzed the process of screening mammography, with particular attention to recall rates and false-positive studies. Other reports emphasized the limitations of mammographic interpretation, the use of computers to aid in mammographic diagnosis, and screening with ultrasound.

Age Factors↗
PubMed2001

Mammography.

Breast cancer is the most common female malignancy in the USA and second only to lung malignancy in cancer mortality. The only screening modality that effectively detects early breast cancer and decreases mortality is mammography. Because many females turn to obstetrician gynecologists for breast cancer screening, an understanding of the benefits and limitations of mammography and the breast imaging reporting and data system is imperative. Mammography remains the most cost effective and sensitive tool for early detection.

Breast Neoplasms↗
PubMedDate not supplied

Psychosocial factors related to repeat mammography screening over 5 years in African American women.

The purpose of this study was to investigate health beliefs associated with repeat mammography screening in African American women 51 years or older over a 5-year period. Long-term repeat mammography screening is inconsistent in African American women; therefore, this study measured demographic, knowledge, and health belief predictors of repeat screening. The theoretical framework for this study was the health belief model. Baseline data from a larger randomized controlled trial were analyzed using descriptive statistics and logistic regression. The sample consisted of 602 African American women with no breast cancer history and at least 1 reported screening mammogram in the past 5 years. They were recruited from 3 primary care health settings. Having been screened 4 to 5 times in the past 5 years was associated with more knowledge about screening guidelines and fewer perceived barriers to screening. Results point to the importance of collaborating with African American communities to promote life-long mammography screening by increasing access to culturally appropriate information on screening guidelines and ameliorating barriers to screening within the context of the African American experience.

Black or African American↗
PubMed1989

Mammography.

Mammography is the tool of choice for evaluation of the breast. It is the immediate obligation of the obstetrician-gynecologist to increase the utilization of screening mammography. It is the immediate obligation of the radiologist to reduce the cost of mammography and to increase understanding of the postlumpectomy, postradiation therapy mammogram.

Biopsy↗
PubMed1995

History and status of x-ray mammography.

Mammography is a relatively recent addition to the array of x-ray services available for the detection, diagnosis, and staging of cancer. Technological advances over the past two decades have led to substantial improvements in the quality of mammographic images and reductions in patient doses of more than an order of magnitude. Today x-ray mammography is used not only to characterize suspicious regions of breast tissue discovered by physical examination, but also to screen asymptomatic women for the early detection of breast cancer. National programs have been established to help ensure high quality images, accurate interpretations, and efficient utilization of x-radiation in the detection and diagnosis of breast cancer. In all of the advances that have lead to widespread utilization of mammography, physicists have played a substantial role.

Dose-Response Relationship, Radiation↗
PubMed1999

Using peer volunteers to promote mammography education in senior citizens' housing facilities.

A peer volunteer intervention to encourage attendance at mammography education programs was developed and evaluated as part of a multi-intervention study to improve mammography by women 65 years and older. Approximately five to seven women from each of 20 racially and socioeconomically diverse senior citizens' housing facilities were recruited. After completing a training session, they distributed invitations and spoke personally with fellow residents about attending the upcoming program. Attendance rates for facilities with the peer volunteer program were compared with those in facilities without the volunteers. Results of a logistic regression analysis found the volunteer program, in addition to facility size, to have had a statistically significant effect on attendance at the mammography education presentations.

Aged↗
PubMed1983

Computed tomography of breast lesions: comparison with x-ray mammography.

Thirty-three patients with breast lesions demonstrated by mammography were examined with computed tomography (CT) using a standard whole body scanner. Although the CT images were of good diagnostic quality, the amount of new information gained was limited. The diagnostic accuracy of mammography in the hands of an experienced reader was higher than that with CT. We conclude that, although technically a whole body scanner is capable of producing good images of the breast, the number of patients in whom CT should be used instead of or in addition to mammography is limited. The indication for its use was primarily for patients in whom quality mammograms could not be produced because either the breast was unusually dense or extensive breast disease caused technical difficulties in performing mammograms. Computed tomography was also useful if the interpretation of the mammogram was equivocal, regional lymph node enlargement was questioned, invasion of the chest wall by tumor was suspected, and for planning radiotherapy treatment.

Adult↗
PubMedDate not supplied

MR imaging of the breast: comparison with mammography and ultrasound.

Fifty-seven biopsy proven breast masses have been examined at our institution by magnetic resonance (MR), mammography, and ultrasound. The three techniques have been evaluated concerning their capability to visualize the lesion and the diagnostic information obtained. Magnetic resonance proved comparable to mammography and superior to sonography in the fatty to medium dysplastic breasts but inferior to the combined examination by mammography and sonography in the dense breasts. In some selected cases, however, special advantages of MR have been found.

Adenocarcinoma, Scirrhous↗
PubMed1991

The effect of physician-patient communication on mammography utilization by different ethnic groups.

The differential utilization of screening mammography by racial/ethnic groups was examined through 35-minute bilingual, random digit dialed telephone interviews with 1,057 women over age 35 years. Results showed that 71% of hispanic women had never had a mammogram and that only 27% over age 50 years had had one in the year before the survey. White and black women over the age of 50 years were being screened more frequently with 34% of white women and 36% of black women having had a mammogram in the prior year. More than half of the hispanic women over age 50 years had never had a mammogram. Analyses showed that the most important variable that predicted whether women of all racial groups had a mammogram, at any time or within the last year, was whether their doctors had discussed mammography with them. The discussion did not need to be lengthy or complex. Hispanic women, however, were less likely to have physicians who discussed screening with them even though these women reported that they were just as motivated as other women to get a mammogram if their doctor referred them. Suggestions for what primary care physicians can do to increase mammography rates, especially among hispanic women, are discussed.

Adult↗
PubMed1997

A new instrument to measure patient satisfaction with mammography. Validity, reliability, and discriminatory power.

OBJECTIVES: The benefit of mammography depends on repeated use. Therefore, surveying the mammographic quality as judged by the users addresses an important topic. The authors assess the practicality, validity, reliability, and discriminatory power of a new, brief, multidimensional questionnaire for measuring patient satisfaction with mammography. Items measuring discomfort and attitudes toward repeat adherence were included. METHODS: A self-administered questionnaire was given to women from six radiology departments in Norway. Four hundred eighty-eight out of 550 women referred for screening or diagnostic mammography were included. Seventy-seven patients also completed the test/retest study, and 44 women additionally completed an Australian questionnaire. Scores for patient satisfaction on the structure, process, discomfort, and general satisfaction scales of the questionnaire were used as the main outcome measures. RESULTS: Response rate was 89%, and rate of completion was more than 95%. Strict psychometric criteria for construct validity and reliability were satisfied. Because lower levels of satisfaction were detectable with the new questionnaire but not with the Australian questionnaire and because an acceptable degree of variability in response was detected, support for discriminatory power was found. CONCLUSIONS: The discomfort dimension contributed substantially to validity and discriminatory power. Patient behavior with time may be monitored with the new questionnaire, thus representing a valuable tool for scientific and practical purposes.

Adult↗
PubMed2000

Predictors of non-attendance in a population-based mammography screening programme; socio-demographic factors and aspects of health behaviour.

The aim of this study was to identify predictors of non-attendance in a population-based mammography-screening programme in central Sweden, on the basis of telephone interviews with 434 non-attendees and 515 attendees identified in a mammography register. Non-attendance was studied in relation to sociodemographic factors, indicators of general health behaviour, self-rated health and experience of cancer in others and own cancer or breast problems. Being single or being non-employed were the only important socio-demographic predictors of non-attendance. Non-attendance was more likely among women who never visited a dentist, had not visited a doctor in 5 years, had never used oral contraceptives or hormone replacement therapy, had never had cervical smear tests, never drank alcohol, smoked regularly, reported no breast cancer in family or friends or own breast problems. We conclude that socio-demographic factors alone do not appear to constitute strong predictors of non-attendance. General health behaviour and previous experience of cancer and breast disease seem to be more important factors. Our results suggest that in the setting of population-based outreach mammography programmes, previous contacts with the health care system and encouragement from health professionals represent determinants of attendance.

Adult↗
PubMed2002

Age-specific accuracy of initial versus subsequent mammography screening: results from the Ghent breast cancer-screening programme.

The aim of this study was to determine whether age-related differences in the accuracy of mammography breast cancer screening decrease with repeated examination. Data from the first 8 years (May 1992 to April 1999) of the Ghent breast cancer-screening programme were used for analysis. In total, 28 944 mammography examinations were included. The referral rate, cancer detection rate, positive predictive value, sensitivity and specificity were chosen as performance indicators. Values were calculated for women aged 40-49, 50-59 and 60-69 years, at initial versus subsequent examinations, respectively. For first examinations, overall, performance was much lower for the women in their forties than for the older age groups. On subsequent screening, the effect of age disappeared, as expected, or was even reversed for the positive predictive value and sensitivity of the examination. In the light of the ongoing debate over the eligible age for mammography screening, these results support a universal recommendation beginning at the age of 40 years.

Adult↗
PubMed1998

Factors associated with repeat mammography in a New York State public health screening program.

Screening mammography is the most effective method for early detection of breast cancer, but repeat mammography rates are not optimal in most populations. Since 1988, New York State has supported a program of breast cancer screening for underserved, uninsured, or underinsured women. The present study was designed to identify sociodemographic and clinical factors associated with failure to return for repeat mammography screening after a negative initial mammogram. Of women initially screened between 1988 and 1991 (N = 9,485), 27 percent obtained repeat mammograms by 1993. The final logistic regression model contained program site, race and ethnicity, family income, and time since last mammogram.

Adult↗
PubMedDate not supplied

Mammography behavior after receiving a negative BRCA1 mutation test result in the Ashkenazim: a community-based study.

PURPOSE: To define the impact of a negative BRCA1 test result on subsequent breast cancer screening behavior in women. METHODS: Longitudinal study of a community-based sample of Ashkenazi Jews offered testing for the 185delAG BRCA1 mutation in 1996. Of 309 participants, 118 women were mutation negative, of average risk (based on family history of cancer), unaffected with breast cancer, and provided complete data at baseline, and Year 1 and Year 2 follow-up questionnaires. RESULTS: Women age 50 and older had 91.7% compliance with mammography for the year prior to entry (baseline), 88.3% during Year 1, 91.7% during Year 2 (no significant change; P = 0.775). Women under age 50 demonstrated an increase in mammography (49.2% at baseline, 62.7% Year 1, and 67.1% Year 2; P = 0.035). Both groups demonstrated significant decreases in breast cancer worry and perceived risk. Logistic regression analysis on having a mammogram at Year 2 showed that age, physician recommendation, worry, and perceived risk were all significant. CONCLUSION: Receipt of negative BRCA1 test results in a cohort of Ashkenazi Jewish women did not have a negative impact on mammography behavior 2 years after genetic testing.

Adult↗