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Identification of Risk Factors for Interval Breast Cancer in a Population-based Screening Program.

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|November 25, 2025
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This summary is machine-generated.

High breast density, family history of breast cancer, and suboptimal radiologist performance increase interval breast cancer (IBC) risk. Auditing radiologist performance is crucial for enhancing early cancer detection in mammography screening programs.

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Area of Science:

  • Radiology
  • Oncology
  • Public Health

Background:

  • Limited evidence exists on factors influencing interval breast cancer (IBC) risk.
  • Key factors potentially affecting IBC risk include radiologist interpretation, patient age, breast density, and family history.

Purpose of the Study:

  • To investigate risk factors for IBC in women undergoing mammography screening in Taiwan.
  • To identify associations between mammography screening performance and IBC risk.

Main Methods:

  • Retrospective study of mammograms from a Taiwanese population-based screening program (2004-2018).
  • Analysis included over 2.8 million women and 6.5 million mammographic examinations.
  • Multivariable regression models assessed the impact of breast density, family history, and radiologist performance metrics (audit scores, recall rate, cancer detection rate) on IBC risk.

Main Results:

  • Higher IBC risk was observed in women with a family history of breast cancer (1.41 per 1000 person-years) and extremely dense breasts (1.15 per 1000 person-years).
  • Suboptimal radiologist performance, indicated by lower audit scores (0-4) and lower recall/detection rates, was associated with increased IBC risk.
  • Asymmetry was the most common finding in missed IBCs (22%).

Conclusions:

  • High breast density, family history of breast cancer, and suboptimal radiologist performance are independent risk factors for IBC.
  • Performance auditing and targeted strategies are essential for improving early cancer detection in mammography screening programs.