OBJECTIVE. The objective of this study was to determine if restrictive risk-based mammographic screening could miss breast cancers that population-based screening could detect. MATERIALS AND METHODS. Through a retrospective search of records at a single institution, we identified 552 screen-detected breast cancers in 533 patients. All in situ and invasive breast cancers detected at screening between January 1, 2011, and December 31, 2014, were included. Medical records were reviewed for history, pathology, cancer size, nodal status, breast density, and mammographic findings. Mammograms were interpreted by one of 14 breast imaging radiologists with 3–30 years of experience, all of whom were certified according to the Mammography Quality Standards Act. Patient ages ranged from 36 to 88 years (mean, 61 years). The breast cancer risks evaluated were family history of breast cancer and dense breast tissue. Positive family history was defined as a first-degree relative with breast cancer. Dense breast parenchym...

https://www.ajronline.org/doi/pdf/10.2214/AJR.17.18120

Harms of Restrictive Risk-Based Mammographic Breast Cancer Screening

BACKGROUND

A risk-based model was developed for recommendations for mammography screening of women in their 40s. We determined retrospectively the proportion of women already diagnosed in their 40s with breast cancer (BC) who would have been recommended for mammography screening by this model.



METHODS

Information was obtained from 404 women who were diagnosed with BC in their 40s from 1990 to 1998 at a large midwestern hospital. Data on BC detection method, mammography history, and BC risk factors existing before diagnosis were obtained from 353 of these women by mailed questionnaires. Data for an additional 51 women who had died were obtained by chart review. Two algorithms, the Exact Age Procedure (EAP) and the Grouped Age Procedure (GAP), were used to calculate the proportion of women who would have been recommended for mammography screening based on age, race, and BC risk factors.



RESULTS

Of women diagnosed with BC in their 40s, 74.5% would have been recommended for screening by the EAP and 70.5% by the GAP. The model would have recommended screening for approximately one half of the women who had no conventional risk factors (54% by EAP, 48% by GAP).



CONCLUSION

Although use of the risk-based model could result in more recommendations for screening than individual recommendations based on patient-physician discussions about the woman's risk factors, one in four women diagnosed with breast cancer in their 40s would not have been recommended for mammography screening. Cancer 2002; 94:2830–5. © 2002 American Cancer Society.



DOI 10.1002/cncr.10579

Evaluating a risk-based model for mammographic screening of women in their forties.

OBJECTIVE. The purpose of this article is to compare commonly used breast cancer risk assessment models, describe the machine learning approach and big data in risk prediction, and summarize the po...

https://www.ajronline.org/doi/pdf/10.2214/AJR.18.20345

Risk Stratification for Screening Mammography: Benefits and Harms

Risk of risk-based mammography screening, ages 40 to 49 [4] (multiple letters)

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Risk of risk-based mammography screening, ages 40 to 49 [4] (multiple letters)