TY - JOUR
T1 - Mammographic density is the main correlate of tumors detected on ultrasound but not on mammography
AU - Häberle, Lothar
AU - Fasching, Peter A.
AU - Brehm, Barbara
AU - Heusinger, Katharina
AU - Jud, Sebastian M.
AU - Loehberg, Christian R.
AU - Hack, Carolin C.
AU - Preuss, Caroline
AU - Lux, Michael P.
AU - Hartmann, Arndt
AU - Vachon, Celine M.
AU - Meier-Meitinger, Martina
AU - Uder, Michael
AU - Beckmann, Matthias W.
AU - Schulz-Wendtland, Rüdiger
N1 - Publisher Copyright:
© 2016 UICC
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography.
AB - Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography.
KW - mammographic density
KW - mammography screening
KW - masking
KW - risk prediction
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U2 - 10.1002/ijc.30261
DO - 10.1002/ijc.30261
M3 - Article
C2 - 27389655
AN - SCOPUS:84983087211
SN - 0020-7136
VL - 139
SP - 1967
EP - 1974
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 9
ER -