Minimizing misclassification of hormone users at mammography screening

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Public Health

Background:

• Mammography screening is crucial for early breast cancer detection.
• Hormone therapy (HT) use can influence mammogram interpretation.
• Accurate classification is vital to minimize false positives and interval cancers.

Purpose of the Study:

• To evaluate the impact of prior mammogram comparison interval on screening misclassification risk.
• To specifically assess this impact on current hormone therapy users.
• To determine if using 4-year-old priors reduces misclassification compared to 2-year-old priors.

Main Methods:

• Retrospective analysis of mammography screening data (1993-2005) from Fyn, Denmark.
• Utilized prescription drug data to identify hormone therapy (HT) users.
• Employed logistic regression to analyze false positive risk and interval cancer proportion based on comparison mammogram age, hormone use, and other factors.

Main Results:

• Current HT users showed a reduced false positive risk (0.69) and interval cancer proportion (0.66) when 4-year-old priors were used versus 2-year-old priors.
• Using 4-year-old priors also lowered false positive risk in never users.
• No significant impact on classification for never and past HT users was observed with varying comparison mammogram ages.

Conclusions:

• Comparing current mammograms with those from 4 years prior can significantly reduce misclassification in current hormone therapy users.
• This strategy may enhance the accuracy of mammography screening for specific patient populations.
• Further validation through replication in diverse settings is recommended.