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Performing Data Mining And Integrative Analysis Of Biomarker in Breast Cancer Using Multiple Publicly Accessible Databases
Published on: May 17, 2019
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Mammographic breast density: How it affects performance indicators in screening programmes?
Margarita Posso1, Javier Louro2, Mar Sánchez3
1Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain.
European Journal of Radiology
|January 3, 2019
Summary
Higher breast density significantly reduces digital mammography screening effectiveness, lowering sensitivity and increasing interval cancer rates. Women aged 60-69 with dense breasts may benefit from alternative screening technologies.
Area of Science:
- Radiology
- Oncology
- Public Health
Background:
- Breast density is a key factor influencing mammography screening performance.
- Understanding its impact is crucial for optimizing breast cancer detection strategies.
Purpose of the Study:
- To investigate the effect of breast density on various digital mammography screening performance indicators.
- To identify specific breast density categories and age groups with suboptimal screening outcomes.
Main Methods:
- Retrospective analysis of 499,251 digital mammograms from 177,164 women (aged 50-69) in Spain (2004-2015).
- Breast density classified using the BI-RADS System (categories 1-4).
- Statistical analysis using generalized estimating equations to assess screening performance metrics.
Main Results:
- Sensitivity decreased from 89.2% (BI-RADS 1) to 67.9% (BI-RADS 4).
- Positive Predictive Values (PPV-1 and PPV-2) also decreased with increasing breast density.
- Highest interval cancer rates observed in BI-RADS 4 (dense breasts).
- Women aged 60-69 with BI-RADS 4 density showed the lowest sensitivity (54.9%) and highest interval cancer rate (3.8 per 1000).
Conclusions:
- Increasing breast density negatively impacts screening performance, characterized by reduced sensitivity and PPV, and elevated interval cancer rates.
- Women aged 60-69 with dense breasts (>75% glandular) exhibit the poorest screening results.
- These findings suggest that women with dense breasts may be suitable candidates for alternative breast cancer screening technologies.
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