Breast cancer diagnosis, mammography improved by considering patient risk

June 17, 2014

A new approach to examining mammograms that takes into account a woman's health risk profile would reduce the number of cancer instances missed and also cut the number of false positives, according to a paper being presented at a conference of the Institute for Operations Research and the Management Sciences (INFORMS).

Mehmet U.S. Ayvaci of the University of Texas Dallas will present his research group's findings about the role of risk profiling in the interpretation of mammograms at Advances in Decision Analysis, a conference sponsored by the INFORMS Decision Analysis Society (DAS). The conference takes place June 16-18 at Georgetown University in Washington, DC.

The researchers found that providing radiologists with the patient's risk profile information for breast cancer at the most advantageous time when examining the mammogram , together with statistical weighting based on profile risk, reduces false negatives by 3.7%, thus alerting women whose cancer would have gone undiagnosed at an early stage, when treatment is most effective. It also reduces false positives by 3.23%, thus cutting unnecessary healthcare costs and sparing patients' needless distress.

Risk factors include family history, reproductive history, age, and ethnicity, and others forming the risk profile information.

The paper examines the tricky questions of whether providing risk profile information about women being screened for cancer biases radiologists and, if there is bias, whether this bias actually helps make readings more accurate.

Historically, available clinical evidence has been inconclusive on the use of profile information when interpreting mammograms. One position is that profile information helps radiologists make better decisions and should be employed when reading mammograms. A contradictory position holds that profile information may bias the radiologists. However, whether bias always causes harm is unclear.

The authors explored profile information and potential bias in mammography interpretation using a decision science technique called linear opinion pooling, which assigns weights to better aggregate probability estimates.

They analyzed the decision performance of three groups: (1) a mammogram-only reading, with no risk profile information about the patient, (2) an unbiased reading, in which radiologists consult the risk profile after examining the mammogram and (3) biased or "influenced" readings, in which radiologists consult a woman's risk profile as they examine the mammogram. Then they examined the conditions in which profile information could help improve biopsy decisions.

Numerical analysis using a clinical dataset from the Breast Cancer Surveillance Consortium revealed that use of profile information with an appropriate weight could reduce the false positives and the number of missed cancers when compared to cases where profile information was not examined.

Breast cancer is the second most deadly non-skin . In 2013, approximately 232,000 diagnoses were made and about 39,000 women died from the disease.

Explore further: The mammography dilemma: Complex benefits and harms of mammography require individualized approach

Related Stories

The mammography dilemma: Complex benefits and harms of mammography require individualized approach

April 1, 2014
A comprehensive review of 50 year's worth of international studies assessing the benefits and harms of mammography screening suggests that the benefits of the screening are often overestimated, while harms are underestimated. ...

What age should women start mammograms? The two sides of the screening debate

November 1, 2013
Mammography works: It can detect cancer. On that point, at least, most experts agree.

False-positive mammograms can trigger long-term distress

March 19, 2013
(HealthDay)—Women who have a false-positive mammogram result—when breast cancer is first suspected but then dispelled with further testing—can have lingering anxiety and distress up to three years after the misdiagnosis, ...

False-positive mammograms don't deter women from future screening, study finds

April 21, 2014
(HealthDay)—False-positive mammograms do increase anxiety, but the feeling is short-lived and most women go on to have breast screening in the future, new research suggests.

African-American women more likely to be diagnosed with higher risk breast cancer

June 9, 2014
A research study led by cancer specialists at MedStar Washington Hospital Center found that African-American women frequently present with biologically less favorable subtypes of breast cancer.

Recommended for you

Stem cell therapy attacks cancer by targeting unique tissue stiffness

July 26, 2017
A stem cell-based method created by University of California, Irvine scientists can selectively target and kill cancerous tissue while preventing some of the toxic side effects of chemotherapy by treating the disease in a ...

Understanding cell segregation mechanisms that help prevent cancer spread

July 26, 2017
Scientists have uncovered how cells are kept in the right place as the body develops, which may shed light on what causes invasive cancer cells to migrate.

Study uncovers potential 'silver bullet' for preventing and treating colon cancer

July 26, 2017
In preclinical experiments, researchers at VCU Massey Cancer Center have uncovered a new way in which colon cancer develops, as well as a potential "silver bullet" for preventing and treating it. The findings may extend to ...

Compound shows promise in treating melanoma

July 26, 2017
While past attempts to treat melanoma failed to meet expectations, an international team of researchers are hopeful that a compound they tested on both mice and on human cells in a petri dish takes a positive step toward ...

Study may explain failure of retinoic acid trials against breast cancer

July 25, 2017
Estrogen-positive breast cancers are often treated with anti-estrogen therapies. But about half of these cancers contain a subpopulation of cells marked by the protein cytokeratin 5 (CK5), which resists treatment—and breast ...

Breaking the genetic resistance of lung cancer and melanoma

July 25, 2017
Researchers from Monash University and the Memorial Sloan Kettering Cancer Center (MSKCC, New York) have discovered why some cancers – particularly lung cancer and melanoma – are able to quickly develop deadly resistance ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.