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 1,387 records · Page 77Linked to original sources
PubMed2000

Apparent ipsilateral decrease in breast size at mammography: a sign of infiltrating lobular carcinoma.

PURPOSE: To assess if infiltrating lobular carcinoma (ILC) is associated with an ipsilateral mammographic decrease in breast size. MATERIALS AND METHODS: Mammographic change in size was evaluated by measuring the distance from the nipple to the pectoralis major muscle on the mediolateral oblique view of the diagnostic mammogram and on a preceding mammogram in 30 patients with ILC. Clinical, mammographic, and histopathologic findings were retrospectively reviewed. RESULTS: Five patients (17%) had an ipsilateral decrease in mammographic size. No patients noticed a physical decrease in breast size. Patients with an ipsilateral decrease in mammographic size most commonly had breast thickening at examination (four of five patients [80%], P < .001) and either a focal asymmetry density (three of five patients [60%]) or architectural distortion (one of five patients [20%]) at mammography; those patients with no change in size most commonly had a palpable mass (six of 25 patients [24%]) or normal findings (19 of 25 patients [76%]) and a mass (13 of 25 patients [52%]) at mammography. The mean tumor size was 66 mm for those with an ipsilateral size decrease and 16 mm for those with no size decrease (P < .001). At histologic analysis, tumors associated with an ipsilateral decrease in mammographic size had more diffuse involvement of the breast, and discrete masses were not seen. CONCLUSION: An apparent decrease in mammographic size may help identify cases of ILC, especially when associated with thickening at clinical examination and focal asymmetric density at mammography.

Adult↗
PubMed2001

Mammographic characteristics of 115 missed cancers later detected with screening mammography and the potential utility of computer-aided detection.

PURPOSE: To retrospectively determine the mammographic characteristics of cancers missed at screening mammography and assess the ability of computer-aided detection (CAD) to mark the missed cancers. MATERIALS AND METHODS: A multicenter retrospective study accrued 1,083 consecutive cases of breast cancer detected at screening mammography. Prior mammograms were available in 427 cases. Of these, 286 had lesions visible in retrospect. The 286 cases underwent blinded review by panels of radiologists; a majority recommended recall for 112 cases. Two experienced radiologists compared prior mammograms in 110 of these cases with the subsequent screening mammograms (when cancer was detected), noting mammographic characteristics of breast density, lesion type, size, morphology, and subjective reasons for possible miss. The prior mammograms were then analyzed with a CAD program. RESULTS: There were 110 patients with 115 cancers. On the prior mammograms with missed cancers, 35 (30%) of the 115 lesions were calcifications, with 17 of 35 (49%) clustered or pleomorphic. Eighty of the 115 (70%) were mass lesions, with 32 of 80 (40%) spiculated or irregular. For calcifications and masses, the most frequently suggested reasons for possible miss were dense breasts (12 of 35; 34%) and distracting lesions (35 of 80; 44%), respectively. CAD marked 30 (86%) of 35 missed calcifications and 58 (73%) of 80 missed masses. CONCLUSION: Detection errors affected cases with calcifications and masses. CAD marked most (77%; 88 of 115) cancers missed at screening mammography that radiologists retrospectively judged to merit recall.

Adult↗
PubMedDate not supplied

AAPM/RSNA physics tutorial for residents: digital mammography: an overview.

Recent advances in digital detector technology have paved the way to full-field digital mammography (FFDM) systems. The performance of these systems has evolved to the point where replacement of screen-film mammography (SFM) systems is becoming realistic. Despite some commonality between the two techniques, there are fundamental differences in how images are recorded, displayed, and stored. These differences necessitate an understanding of the principles of detection and the characteristics of digital images. Several approaches have been taken in the development of FFDM systems: (a) slot scanning with a scintillator and a charge-coupled device (CCD) array, (b) a flat-panel scintillator and an amorphous silicon diode array, (c) a flat-panel amorphous selenium array, (d) a tiled scintillator with fiberoptic tapers and a CCD array, and (e) photostimulable phosphor plates (computed radiography). Although the initial cost of an FFDM system is high compared with that of an SFM system, digital mammography has inherent advantages, such as wide dynamic range, reduction in recall rates, potential for reduction in radiation dose, increased patient throughput, postprocessing capability, and digital acquisition. These advantages and the rapidly occurring technologic developments will help establish FFDM as a mainstay of breast evaluation.

Breast Neoplasms↗
PubMed1998

Imaging modalities in Peyronie's disease. An intrapersonal comparison of ultrasound sonography, X-ray in mammography technique, computerized tomography, and nuclear magnetic resonance in 20 patients.

OBJECTIVE: Peyronie's disease is an ill-understood condition afflicting men in their 40s with the reported age ranging from 18 to 68 years. It is characterized by a plaque in the tunica albuginea which leads to penile deformity making sexual intercourse difficult if not impossible and is often accompanied by severe pain upon erection in the early stage; erectile dysfunction is present in about 2% of cases. Diagnosis rests upon medical history, clinical examination with plaque palpation and autophotography in two planes. These diagnostic steps are not plaque-specific and therefore we wanted to assess which imaging modalities would allow for an objective determination of the plaque status. MATERIALS AND METHODS: We evaluated 20 patients with Peyronie's disease. All patients underwent clinical examination including autophotography and the subsequent use of the following imaging techniques: (1) ultrasound (US) using a 7.5-MHz transducer with a profile for semiquantitative density analysis; (2) X-ray in mammography technique in two planes; (3) computerized tomography (CT) with a density profile, and (4) magnetic resonance imaging (NMR). RESULTS: (1) Degree of deviation: Penile deviation ranged from 15 degrees to 63 degrees. It was best assessed using radiography in mammography technique reflecting the results obtained by autophotography. (2) Calcifications: Plaque calcifications were seen in 12 patients, 8 had no calcifications but thickening of the tunica albuginea only, 2 also had a fibrosis of the corpus cavernosum distant to the plaque. Calcifications were visualized using ultrasound sonography (12/12), radiographically (12/12), CT (12/12), NMR (9/12). Thickening of the tunica albuginea only was visualized using ultrasound sonography (7/8), radiographically (0/8), CT (2/8), NMR (6/8). (3) Morphological pattern in ultrasound: Three distinct patterns could be detected: (type 1) the plaque appeared as a thickening of the tunica albuginea without acoustic shadowing and only minimal density increase in the histogram profile; (type 2) moderately calcified plaque with typical ultrasound shadow but minimal density increase in the density profile; (type 3) severely calcified plaque with typical acoustic shadowing and density increase in the histogram profile. (4) Plaque inflammation: Only NMR with gadolinium DTPA showed periplaque inflammation. CONCLUSIONS: High-resolution ultrasound sonography is the best imaging modality in assessment of plaques. NMR is the modality of choice to monitor the inflamed plaque. X-ray in mammography technique and CT are not necessary in daily routine.

Calcinosis↗
PubMedDate not supplied

Reader variability in mammography and its implications for expected utility over the population of readers and cases.

The multiple-reader, multiple-case (MRMC) approach to receiver operating characteristic (ROC) analysis is becoming the dominant assessment paradigm in medical imaging. Its most common version involves having many readers read every patient case in the study, a critical feature since differences among competing imaging modalities are often dominated by differences in reader performance. The present authors have carried out MRMC ROC analysis on a uniquely large data set for mammography. The analysis quantifies the great range of observed reader skill in that data set. It also demonstrates that the sample sizes are sufficiently large that the conclusions generalize to the populations sampled here with little uncertainty from the finite sample size. A schematic approach to bracketing the utility matrix is then used to study trends in the resulting expected utility functions that correspond to the range of observed ROC curves. This is done for both the screening and the diagnostic context. The results raise 2 hypotheses for further investigation. First, it is possible that the present ambiguity surrounding the effectiveness of mammography is due in part to the observed range of reader skills and corresponding expected utility functions. Second, it is possible that computer-assisted modalities for mammography may lead to improvements in the expected utility function not only for screening but also in the diagnostic context, especially for the lower performing readers.

Data Interpretation, Statistical↗
PubMedDate not supplied

Factors influencing mammography screening of Chinese American women.

OBJECTIVE: To explore factors influencing breast cancer screening behavior among Chinese women residing in the United States. DESIGN: A descriptive study guided by the health belief model adapted for Chinese American women. An English-language questionnaire was modified, translated, and pretested before use in the study sample. Data were analyzed using descriptive and multivariate analysis techniques. SETTING: An urban area in Michigan in 2001. PARTICIPANTS: A consecutive nonprobability sample of 206 Chinese American women age 40 and older. MAIN OUTCOME MEASURE: The percentage of women age 40 and older who received a mammogram in the past year. RESULTS: Access to health care, perceived barriers to mammography screening, need for breast health care, and information-seeking behavior had direct effects on Chinese American women's mammography screening utilization. Cultural affiliation had an indirect effect on breast cancer screening behavior, moderated through access to health care. The variance in mammography screening explained by these factors was 51%. CONCLUSION: Effective strategies for promoting breast cancer screening among Chinese American women should address ways to improve information-seeking behaviors and access to health care. Cultural affiliation and beliefs should be considered when counseling Chinese American women regarding breast cancer screening.

Acculturation↗
PubMed2003

Integrating self-referral for mammography into organised screening: results from an Italian experience.

OBJECTIVE: To compare self-referred screenees with respondents to invitation for main performance indicators of mammography screening. SETTING: First round of an organised, population-based screening programme in six districts of northern Italy. METHODS: The screening test was a two-view mammography. Eligible women aged 50-69 years were invited. Self-referred attendees were accepted if they were eligible for screening and had not yet been invited or had been invited >6 months before presentation. Age-specific performance indicators were compared with the calculation of their ratio and 95% confidence intervals (CIs). Total ratios were age standardised. In situ carcinomas were excluded. RESULTS: The eligible population was 183 542 women. There were 112 188 respondents to invitation and 20 280 self-referred attendees. Self-referral rate was inversely related to age. Performance indicators were as follows: recall rate, 5.6% for self-referred attendees vs 5.5% for respondents (ratio 1.02, 95% CI 0.96 to 1.08); total aspiration cytology rate, 37.3% vs 28.3% (1.37, 1.24 to 1.51); biopsy rate, 17.0 vs 12.6 x 1000 (1.51, 1.35 to 1.67); total detection rate, 10.7 vs 7.5 x 1000 (1.70, 1.48 to 1.94); detection rate of pT1 carcinoma, 7.0 vs 6.1 x 1000 (1.35, 1.14 to 1.59); detection rate of pT2-4 carcinoma, 3.5 vs 1.2 x 1000 (3.51, 2.75 to 4.43); false-positive rate, 4.5% vs 4.7% (0.93, 0.87 to 0.99); positive predictive value (PPV) of mammography, 19.1% vs 13.5% (1.59, 1.39 to 1.82); PPV of biopsy, 63.7% vs 60.6% (1.13, 0.98 to 1.29); detected:expected ratio, 5.02 vs 3.37 (1.49, 1.28 to 1.74). All differences were more pronounced among or restricted to women aged 50-54 years. CONCLUSIONS: Self-referred screenees were similar to respondents to invitation in main indicators of screening feasibility such as recall rate and PPV of biopsy, while showing important increases in detection rates and detected:expected ratios, especially among women aged 50-54 years.

Aged↗
PubMed1996

An overview of the Swedish randomised mammography trials: total mortality pattern and the representivity of the study cohorts.

OBJECTIVES: To analyse the cause of death pattern in the cohorts of women included in the Swedish randomised mammography screening trials by comparing the groups of invited and control women both with each other and with the general population of Swedish women. SETTING: Since 1977 four randomised trials of mammography screening have been performed in Sweden: Malmö, Kopparberg and Ostergötland (the two county trial), Stockholm, and Gothenburg. DESIGN: Overview of four randomised mammography screening trials. RESULTS: The total numbers of deaths in the invited and control groups respectively were 15 695 and 11 887 corresponding to a relative risk (RR) of 1.00. There were no significant differences between the invited and control groups for cause-specific mortality, except for breast cancer. When the total mortality in the invited and the control groups was compared with that for Swedish women in general the standardised mortality ratio was close to 100. CONCLUSIONS: The cause of death pattern in the invited group was, except for breast cancer, very similar to that in the control group, showing that the groups were comparable. Similarly, the total mortality including breast cancer mortality in the control group was almost identical to that in Swedish women in general. The same was true, with the exception of breast cancer, for the invited group. These observations confirm that the trial cohorts are representative of Swedish women and indicate that the quantitative results from these trials may safely be generalised to the Swedish populations.

Adult↗
PubMed1996

The Swedish randomised mammography screening trials: analysis of their effect on the breast cancer related excess mortality.

OBJECTIVE: To apply an indirect method for estimation of the breast cancer related excess mortality in the Swedish randomised mammography screening trials. SETTING: Randomised trials on mammography screening have, in Sweden, been performed in the counties of Kopparberg (W) and Ostergötland (E), the so called WE study, and in the three largest cities in Sweden, Stockholm (southern part), Gothenburg, and Malmö. An overview of the trials was presented in the Lancet in 1993 and included 156,911 women in the invited group and 125,866 in the control group. METHODS: The excess mortality in the breast cancer subgroups was estimated by indirect standardisation using official national cause of death statistics according to Statistics Sweden as a reference. RESULTS: The estimated reduction of the breast cancer related mortality was 24% for the whole group (40-74 years at randomisation). The corresponding figures for the age groups 40-49, 50-59, and 60-69 years were 6%, 28%, and 34% respectively. CONCLUSION: The results are very similar to those presented earlier based on the traditional comparison of the breast cancer mortality in the invited and in the control group. This analysis further strengthens previous reports on a beneficial effect of mammography screening, which is especially pronounced in the age group 50-69.

Adult↗
PubMed1997

Excess mortality from breast cancer in relation to mammography screening in northern Sweden.

OBJECTIVES: Previous randomised studies of mammography screening have shown a significant effect on breast cancer mortality, particularly in women aged 50-69 at randomisation. Breast cancer mortality has traditionally been studied by judgments on causes of death, either from cause of death registers or from medical records. In this study an alternative method was used, estimating the excess mortality associated with breast cancer. SETTING: In 1990 two counties of northern Sweden started population based mammography screening of women aged 40-74. The unscreened population in the two other counties of the same region were selected as controls. RESULTS: Excess mortality associated with breast cancer was lower in the screened population, and was discernible three to four years after the start of screening. The relative risk estimate, based on the cumulative excess number of deaths from breast cancer during 1990-95 in the screened versus the control population aged 40-74 (at diagnosis of breast cancer), was 0.72 (95% confidence interval (CI) 0.53 to 0.99). For women aged 50-69 it was 0.67 (95% CI 0.46 to 0.99). In the 50-69 age group the estimated excess number of deaths from breast cancer during 1995 was 17.0 per 100,000 women (95% CI 5.0 to 29.0) in the screened counties and 51.1 per 100,000 (95% CI 30.2 to 71.9) in the unscreened counties. CONCLUSIONS: Population based routine screening has substantial effects on breast cancer mortality in women aged 50-69. Estimation of excess mortality can be used in future studies to evaluate the effects of mammography screening on breast cancer mortality.

Adult↗
PubMed2005

Repeat mammography screening among low-income and minority women: a qualitative study.

Regular mammography screening can reduce breast cancer mortality, yet low-income African American and Hispanic women underutilize mammography screening and are often diagnosed at a later stage, resulting in increased mortality. We used qualitative research methods to identify factors influencing regular breast cancer screening among African American and Hispanic women. Predisposing factors (including fear of mastectomy and lack of knowledge), enabling factors (including cost and social support) and a reinforcing factor were identified and categorized utilizing the PRECEDE framework. The study identified factors associated with the decision to complete regular mammography screening, and examined differences between African American and Hispanic women who participated in the interviews. Future research should seek to better understand the influence of family/friends, risk perception, and fatalistic beliefs on the decision to obtain regular mammograms.

Black or African American↗
PubMed1990

Increasing the use of mammography: a pilot program.

Despite the effectiveness of mammography, a large percentage of eligible women do not obtain screening mammograms. Two programs designed to increase the use of mammography were designed, implemented and evaluated. One hundred and fifty-six women were recruited and assigned to an Educational plus Psychological program (EP), an Educational program (E), or to a delayed treatment control group (C). Women completed a pretest, a posttest (EP and E only) and a telephone follow-up. At posttest, EP women had greater intention to obtain a mammogram than C women. EP and E women had higher levels of knowledge and higher levels of perceived benefit of mammography than C women. Actual compliance did not differ among the three conditions. Implications for the design of future programs are discussed.

Adult↗
PubMed1999

Implementation of outreach telephone counseling to promote mammography participation.

To increase mammography participation, the authors implemented an outreach intervention translating concepts from expectancy value theory into a motivational interviewing telephone intervention that included the opportunity to schedule a screening appointment. Process data are presented from 491 women who had not scheduled a mammogram within 2 months of receiving a mailed invitation from a managed care organization's centralized breast cancer screening program. A total of 83% of targeted women accepted the counseling calls. Counselors rated 84% of completed calls as either receptive or neutral in tone. Women with prior mammography experience were more likely to be receptive and to schedule a screening appointment during the calls than were women with no prior experience. Topics discussed during the calls also differed between women with and without prior mammography experience. Implications for dissemination of counseling interventions in health care organizations are discussed.

Aged↗
PubMed2004

Combination of digital mammography with semi-automated 3D breast ultrasound.

This paper describes work aimed at combining 3D ultrasound with full-field digital mammography via a semi-automatic prototype ultrasound scanning mechanism attached to the digital mammography system gantry. Initial efforts to obtain high x-ray and ultrasound image quality through a compression paddle are proving successful. Registration between the x-ray mammogram and ultrasound image volumes is quite promising when the breast is stably compressed. This prototype system takes advantage of many synergies between the co-registered digital mammography and pulse-echo ultrasound image data used for breast cancer detection and diagnosis. In addition, innovative combinations of advanced US and X-ray applications are being implemented and tested along with the basic modes. The basic and advanced applications are those that should provide relatively independent information about the breast tissues. Advanced applications include x-ray tomosynthesis, for 3D delineation of mammographic structures, and non-linear elasticity and 3D color flow imaging by ultrasound, for mechanical and physiological information unavailable from conventional, non-contrast x-ray and ultrasound imaging.

Adult↗
PubMed2002

Breast enhanced scintigraphy testing distinguishes between normal, inflammatory breast changes, and breast cancer: a prospective analysis and comparison with mammography.

The detection of breast cancer has primarily focused on anatomic findings, whereas assessment of physiologic information using nuclear imaging has been used for the detection of heart disease. Using this approach, the authors developed a method (breast enhanced scintigraphy test [BEST]) for differentiation of breast tissue by enhancing the delivery of isotope. To determine if this technique could distinguish between normal (Nl), inflammatory changes of the breast (ICB), and breast cancer (CA), 100 women were prospectively studied using BEST imaging, and results were compared with mammography and pathology findings using either biopsy or ductoscopy approaches. Mammography demonstrated a sensitivity and specificity of 69% and 84%, respectively. Using BEST imaging, maximal count activity (MCA) was able to distinguish between Nl, ICB, and CA. The results of 2-tailed t test analysis demonstrated statistically significant differences between Nl and ICB MCA (P </=.001); ICB and CA MCA(P </=.001); and N1 and CA MCA(P </=.001). Using MCA results obtained via BEST imaging, breast tissue was able to be differentiated, whereas mammography was able to detect breast cancer in only 69% of cases and incorrectly identified cancer in 16% of cases.

Adult↗
PubMed2006

The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey.

BACKGROUND: Breast cancer appears to be a disease of both the developing and developed worlds. Among Turkish women, breast cancer is the second leading cause of cancer-related deaths. The aims of this cross-sectional study were to determine levels of knowledge about breast cancer and to evaluate health beliefs concerning the model that promotes breast self- examination (BSE) and mammography in a group of women aged 20-64 in a rural area of western Turkey. METHODS: 244 women were recruited by means of cluster sampling in this study. The questionnaire consisted of sociodemographic variables, a risk factors and signs of breast cancer form and the adapted version of Champion's Health Belief Model Scale (CHBMS). Bivariate correlation analysis, Chi square test, Mann-Whitney U test and logistic regression analysis were performed throughout the data analysis. RESULTS: The mean age of the women was 37.7 +/- 13.7. 49.2% of women were primary school graduates, 67.6% were married. Although 76.6% of the women in this study reported that they had heard or read about breast cancer, our study revealed that only 56.1% of them had sufficient knowledge of breast cancer, half of whom had acquired the information from health professionals. Level of breast cancer knowledge was the only variable significantly associated with the BSE and mammography practice (p = 0.011, p = 0.007). BSE performers among the study group were more likely to be women who exhibited higher confidence and perceived greater benefits from BSE practice, and those who perceived fewer barriers to BSE performance and possessed knowledge of breast cancer. CONCLUSION: By using the CHBMS constructs for assessment, primary health care providers can more easily understand the beliefs that influence women's BSE and mammography practice.

Adult↗
PubMed2004

Inconsistent self-reported mammography history: findings from the National Population Health Survey longitudinal cohort.

BACKGROUND: Self-reported information has commonly been used to monitor mammography utilization across populations and time periods. However, longitudinal investigations regarding the prevalence and determinants of inconsistent responses over time and the impact of such responses on population screening estimates are lacking. METHODS: Based on longitudinal panel data for a representative cohort of Canadian women aged 40+ years (n = 3,537) assessed in the 1994-95 (baseline) and 1996-97 (follow-up) National Population Health Survey (NPHS), we examined the prevalence of inconsistent self-reports of mammography utilization. Logistic regression models were used to estimate the associations between women's baseline sociodemographic and health characteristics and 2 types of inconsistent responses: (i) baseline reports of ever use which were subsequently contradicted by follow-up reports of never use; and (ii) baseline reports of never use which were contradicted by follow-up reports of use prior to 1994-95. RESULTS: Among women who reported having a mammogram at baseline, 5.9% (95% confidence interval (CI): 4.6-7.3%) reported at follow-up that they had never had one. Multivariate logistic regression analyses showed that women with such inconsistent responses were more often outside target age groups, from low income households and less likely to report hormone replacement therapy and Pap smear use. Among women reporting never use at baseline and ever use at follow-up, 17.4% (95%CI: 11.7-23.1%) reported their most recent mammogram as occurring prior to 1994-95 (baseline) and such responses were more common among women aged 70+ years and those in poorer health. CONCLUSIONS: Women with inconsistent responses of type (i), i.e., ever users at baseline but never users at follow-up, appeared to exhibit characteristics typical of never users of mammography screening. Although limited by sample size, our preliminary analyses suggest that type (ii) responses are more likely to be the result of recall bias due to competing morbidity and age. Inconsistent responses, if removed from the analyses, may be a greater source of loss to follow-up than deaths/institutionalization or item non-response.

Adult↗
PubMedDate not supplied

Development of cultural belief scales for mammography screening.

PURPOSE/OBJECTIVES: To develop instruments to measure culturally related variables that may influence mammography screening behaviors in African American women. DESIGN: Instrumentation methodology. SETTING: Community organizations and public housing in the Indianapolis, IN, area. SAMPLE: 111 African American women with a mean age of 60.2 years and 64 Caucasian women with a mean age of 60 years. METHODS: After item development, scales were administered. Data were analyzed by factor analysis, item analysis via internal consistency reliability using Cronbach's alpha, and independent t tests and logistic regression analysis to test theoretical relationships. MAIN RESEARCH VARIABLES: Personal space preferences, health temporal orientation, and perceived personal control. FINDINGS: Space items were factored into interpersonal and physical scales. Temporal orientation items were loaded on one factor, creating a one-dimensional scale. Control items were factored into internal and external control scales. Cronbach's alpha coefficients for the scales ranged from 0.76-0.88. Interpersonal space preference, health temporal orientation, and perceived internal control scales each were predictive of mammography screening adherence. CONCLUSIONS: The three tested scales were reliable and valid. Scales, on average, did not differ between African American and Caucasian populations. IMPLICATIONS FOR NURSING: These scales may be useful in future investigations aimed at increasing mammography screening in African American and Caucasian women.

Adult↗