Screening Sensitivity According to Breast Cancer Location

Area of Science:

• Radiology and Imaging
• Oncology
• Public Health

Background:

• Mammography is a key tool in breast cancer screening.
• Understanding factors affecting mammogram sensitivity is crucial for early detection.
• Breast cancer location, body mass index (BMI), and breast density can influence screening accuracy.

Purpose of the Study:

• To investigate the relationship between breast cancer location and screening mammogram sensitivity.
• To determine if body mass index (BMI) or breast density modifies this association.

Main Methods:

• Analysis of interval and screen-detected cancers from the Quebec Breast Cancer Screening Program.
• Localization of breast cancers in mediolateral oblique (MLO) and craniocaudal (CC) mammographic projections.
• Logistic regression and marginal standardization to assess sensitivity and its association with location, BMI, and breast density.

Main Results:

• Overall screening sensitivity was 68%, with no statistical association with cancer location.
• Sensitivity was lower in the MLO posterior inferior area for women with BMI ≥ 25 kg/m².
• Sensitivity was reduced in subareolar areas for women with breast density ≥ 50%.

Conclusions:

• Mammographic sensitivity is diminished in the MLO posterior inferior area for overweight/obese women.
• Subareolar areas show reduced sensitivity in women with dense breasts.
• Radiologists should exercise heightened vigilance in these specific breast regions during screening mammogram interpretation.