Relative Timing of Mammography and MRI for Breast Cancer Screening: Impact on Performance Evaluation

被引：0

作者：

Lee, Janie M. ^{[1
,2
]}

Ichikawa, Laura E. ^{[3
]}

Kerlikowske, Karla ^{[4
,5
,6
,7
,8
]}

Buist, Diana S. M. ^{[9
]}

Lee, Christoph I. ^{[10
,11
]}

Sprague, Brian L. ^{[12
,13
,14
]}

Henderson, Louise M. ^{[15
,16
]}

Onega, Tracy ^{[17
,18
]}

Wernli, Karen J. ^{[3
]}

Lowry, Kathryn P. ^{[11
,19
]}

Stout, Natasha K. ^{[20
,21
]}

Tosteson, Anna N. A. ^{[22
,23
,24
]}

Miglioretti, Diana L. ^{[25
]}

机构：

[1] Univ Washington, Dept Radiol, Sect Chief Breast Imaging, Sch Med, Seattle, WA USA

[2] Fred Hutchinson Canc Ctr, Breast Imaging, Seattle, WA USA

[3] Kaiser Permanente Washington Hlth Res Inst, Seattle, WA USA

[4] Univ Calif San Francisco, Dept Vet Affairs, Gen Internal Med Sect, San Francisco, CA USA

[5] San Francisco Vet Affairs Hlth Care Syst, Womens Hlth Comprehens Clin, San Francisco, CA USA

[6] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[7] Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA USA

[8] Univ Calif San Francisco, Dept Biostat, San Francisco, CA USA

[9] Kaiser Permanente Bernard J Tyson Sch Med, Dept Hlth Syst Sci, Pasadena, CA USA

[10] Univ Washington, Sch Med, Dept Radiol, Sch Med, Seattle, WA 98104 USA

[11] Fred Hutchinson Canc Ctr, Seattle, WA USA

[12] Univ Vermont, Larner Coll Med, Canc Ctr, Burlington, VT USA

[13] Vermont Breast Canc Surveillance Syst, Burlington, VT USA

[14] Univ Vermont Canc Ctr, Canc Populat Sci CPS Program, Burlington, VT USA

[15] Univ N Carolina, Dept Surg, Chapel Hill Sch Med, Chapel Hill, NC 27516 USA

[16] Coleader UNC Lineberger Canc Epidemiol Res Program, Carolina Mammog Registry, Chapel Hill, NC USA

[17] Univ Utah, Dept Populat Hlth Sci, Populat Sci, Salt Lake City, UT USA

[18] Univ Utah, Huntsman Canc Inst, Salt Lake City, UT USA

[19] Univ Washington, Dept Radiol, Northwest Screening & Canc Outcomes Res Enterprise, Sch Med, Seattle, WA USA

[20] Harvard Med Sch, Harvard Pilgrim Hlth Care Inst, Dept Populat Med, Boston, MA USA

[21] Harvard Med Sch, Populat Med, Boston, MA USA

[22] Geisel Sch Med Dartmouth, Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USA

[23] Dartmouth Canc Ctr, Populat Sci, Lebanon, NH USA

[24] Geisel Sch Med Dartmouth, Norris Cotton Canc Ctr, Lebanon, NH USA

[25] Univ Calif Davis, Comprehens Canc Ctr, Biostat & Populat Sci & Hlth Dispar Program, Davis, CA USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY | 2024年 / 21卷 / 11期

关键词：

Breast cancer screening; breast MRI; mammography; screening audit; supplemental screening; HIGH-RISK; WOMEN;

D O I：

10.1016/j.jacr.2024.06.020

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Objective: Mammography and MRI screening typically occur in combination or in alternating sequence. We compared multimodality screening performance accounting for the relative timing of mammography and MRI and overlapping follow-up periods. Methods: We identified 8,260 screening mammograms performed 2005 to 2017 in the Breast Cancer Surveillance Consortium, paired with screening MRIs within +/- 90 days (combined screening) or 91 to 270 days (alternating screening). Performance for combined screening (cancer detection rate [CDR] per 1,000 examinations and sensitivity) was calculated with 1-year follow-up for each modality, and with a single follow-up period treating the two tests as a single test. Alternating screening performance was calculated with 1-year follow-up for each modality and also with follow-up ending at the next screen if within 1 year (truncated follow-up). Results: For 3,810 combined screening pairs, CDR per 1,000 screens was 6.8 (95% confidence interval [CI]: 4.6-10.0) for mammography and 12.3 (95% CI: 9.3-16.4) for MRI as separate tests compared with 13.1 (95% CI: 10.0-17.3) as a single combined test. Sensitivity of each test was 48.1% (35.0%-61.5%) for mammography and 79.7% (95% CI: 67.7%-88.0%) for MRI compared with 96.2% (95% CI: 85.9%-99.0%) for combined screening. For 4,450 alternating screening pairs, mammography CDR per 1,000 screens changed from 3.6 (95% CI: 2.2-5.9) to zero with truncated follow-up; sensitivity was incalculable (denominator = 0). MRI CDR per 1,000 screens changed from 12.1 (95% CI 9.3-15.8) to 11.7 (95% CI: 8.9-15.3) with truncated follow-up; sensitivity changed from 75.0% (95% CI 63.8%-83.6%) to 86.7% (95% CI 75.5%-93.2%). Discussion: Updating auditing approaches to account for combined and alternating screening sequencing and to address outcome attribution issues arising from overlapping follow-up periods can improve the accuracy of multimodality screening performance evaluation.

引用

页码：1722 / 1732

页数：11

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