Risk stratification of women with false-positive test results in mammography screening based on mammographic morphology and density: a case control study
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Risk stratification of women with false-positive test results in mammography screening based on mammographic morphology and density : a case control study. / Winkel, Rikke Rass; von Euler-Chelpin, My Catarina; Lynge, Elsebeth; Diao, Pengfei; Lillholm, Martin; Kallenberg, Michiel; Forman, Julie Lyng; Nielsen, Michael Bachmann; Uldall, Wei Yao; Nielsen, Mads; Vejborg, Ilse Merete Munk.
In: Cancer Epidemiology, Vol. 49, 08.2017, p. 53-60.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Risk stratification of women with false-positive test results in mammography screening based on mammographic morphology and density
T2 - a case control study
AU - Winkel, Rikke Rass
AU - von Euler-Chelpin, My Catarina
AU - Lynge, Elsebeth
AU - Diao, Pengfei
AU - Lillholm, Martin
AU - Kallenberg, Michiel
AU - Forman, Julie Lyng
AU - Nielsen, Michael Bachmann
AU - Uldall, Wei Yao
AU - Nielsen, Mads
AU - Vejborg, Ilse Merete Munk
PY - 2017/8
Y1 - 2017/8
N2 - Background:The long-term risk of breast cancer is increased in women with false-positive (FP) mammography screening results. We investigated whether mammographic morphology and/or density can be used to stratify these women according to their risk of future breast cancerMethods:We undertook a case-control study nested in the population-based screening programme in Copenhagen, Denmark. We included 288 cases and 288 controls based on a cohort of 4743 women with at least one FP-test result in 1991–2005 who were followed up until 17 April 2008. Film-based mammograms were assessed using the Breast Imaging-Reporting and Data System (BI-RADS) density classification, the Tabár classification, and two automated techniques quantifying percentage mammographic density (PMD) and mammographic texture (MTR), respectively. The association with breast cancer was estimated using binary logistic regression calculating Odds Ratios (ORs) and the area under the receiver operating characteristic (ROC) curves (AUCs) adjusted for birth year and age and invitation round at the FP-screenResults:Significantly increased ORs were seen for BI-RADS D(density)2-D4 (OR 1.94; 1.30-2.91, 2.36; 1.51-3.70 and 4.01; 1.67-9.62, respectively), Tabár’s P(pattern)IV (OR 1.83; 1.16-2.89), PMD Q(quartile)2-Q4 (OR 1.71; 1.02-2.88, 1.97; 1.16-3.35 and 2.43; 1.41-4.19, respectively) and MTR Q4 (1.97; 1.12-3.46) using the lowest/fattiest category as referenceConclusion: All four methods, capturing either mammographic morphology or density, could segregate women with FP-screening results according to their risk of future breast cancer − using already available screening mammograms. Our findings need validation on digital mammograms, but may inform potential future risk stratification and tailored screening strategiesAbbreviations:ACRthe American College of RadiologyAUCarea under the ROC curveBI-RADSBreast Imaging Reporting and Data SystemCCcraniocaudalDCISductal carcinoma in situFPfalse-positiveHRThormone replacement treatmentMLOmediolateral obliqueMTRmammographic texture resemblancePMDPercentage Mammographic DensityROCreceiver-operating characteristic
AB - Background:The long-term risk of breast cancer is increased in women with false-positive (FP) mammography screening results. We investigated whether mammographic morphology and/or density can be used to stratify these women according to their risk of future breast cancerMethods:We undertook a case-control study nested in the population-based screening programme in Copenhagen, Denmark. We included 288 cases and 288 controls based on a cohort of 4743 women with at least one FP-test result in 1991–2005 who were followed up until 17 April 2008. Film-based mammograms were assessed using the Breast Imaging-Reporting and Data System (BI-RADS) density classification, the Tabár classification, and two automated techniques quantifying percentage mammographic density (PMD) and mammographic texture (MTR), respectively. The association with breast cancer was estimated using binary logistic regression calculating Odds Ratios (ORs) and the area under the receiver operating characteristic (ROC) curves (AUCs) adjusted for birth year and age and invitation round at the FP-screenResults:Significantly increased ORs were seen for BI-RADS D(density)2-D4 (OR 1.94; 1.30-2.91, 2.36; 1.51-3.70 and 4.01; 1.67-9.62, respectively), Tabár’s P(pattern)IV (OR 1.83; 1.16-2.89), PMD Q(quartile)2-Q4 (OR 1.71; 1.02-2.88, 1.97; 1.16-3.35 and 2.43; 1.41-4.19, respectively) and MTR Q4 (1.97; 1.12-3.46) using the lowest/fattiest category as referenceConclusion: All four methods, capturing either mammographic morphology or density, could segregate women with FP-screening results according to their risk of future breast cancer − using already available screening mammograms. Our findings need validation on digital mammograms, but may inform potential future risk stratification and tailored screening strategiesAbbreviations:ACRthe American College of RadiologyAUCarea under the ROC curveBI-RADSBreast Imaging Reporting and Data SystemCCcraniocaudalDCISductal carcinoma in situFPfalse-positiveHRThormone replacement treatmentMLOmediolateral obliqueMTRmammographic texture resemblancePMDPercentage Mammographic DensityROCreceiver-operating characteristic
KW - Breast cancer risk
KW - Mammography screening
KW - False positive
KW - Mammographic density
KW - Texture
KW - BI-RADS
KW - Tabar
U2 - 10.1016/j.canep.2017.05.006
DO - 10.1016/j.canep.2017.05.006
M3 - Journal article
C2 - 28558329
VL - 49
SP - 53
EP - 60
JO - Cancer Epidemiology
JF - Cancer Epidemiology
SN - 1877-7821
ER -
ID: 183636475