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Sample records for abnormal screening mammogram

  1. Patient navigation reduces time to care for patients with breast symptoms and abnormal screening mammograms.

    PubMed

    McKevitt, Elaine; Dingee, Carol; Warburton, Rebecca; Pao, Jin-Si; Brown, Carl J; Wilson, Christine; Kuusk, Urve

    2018-05-01

    Concern has been raised about delays for patients presenting with breast symptoms in Canada. Our objective was to determine if our Rapid Access Breast Clinic (RABC) improved care for patients presenting with breast symptoms compared to the traditional system (TS). A retrospective chart review tabulated demographic, surgical, pathology and radiologic information. Wait times to care were determined for patients presenting with symptomatic and screen detected breast problems. Time from presentation to surgeon evaluation was shorter in the RABC group for patients with breast symptoms (81 vs 35 days, p < .0001) and abnormal screens (72 vs 40 days, p = .092). Cancer patients with abnormal screens had shorter wait times than patients with breast symptoms in the TS (47 vs 70 days, p = .036). Coordination of imaging and clinical care reduces wait times in patients with both abnormal screening mammograms and symptomatic breast presentations and should be expanded in our province. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Online Support: Impact on Anxiety in Women Who Experience an Abnormal Screening Mammogram

    PubMed Central

    Obadina, Eniola T.; Dubenske, Lori L.; McDowell, Helene E.; Atwood, Amy K.; Mayer, Deborah K.; Woods, Ryan W.; Gustafson, David H.; Burnside, Elizabeth S.

    2014-01-01

    OBJECTIVES To determine whether an online support tool can impact anxiety in women experiencing an abnormal mammogram. MATERIALS AND METHODS We developed an online support system using the Comprehensive Health Enhancement Support System (CHESS) designed for women experiencing an abnormal mammogram as a model. Our trial randomized 130 of these women to online support (the intervention group) or to a list of five commonly used Internet sites (the comparison group). Surveys assessed anxiety and breast cancer worry, and patient satisfaction at three important clinical time points: when women were notified of their abnormal mammogram, at the time of diagnostic imaging, and at the time of biopsy (if biopsy was recommended). RESULTS Study participants in the intervention group showed a significant decrease in anxiety at the time of biopsy compared to the comparison group (p=0.017). However, there was no significant difference in anxiety between the intervention group and the comparison group at the time of diagnostic work-up. We discontinued assessment of patient satisfaction after finding that many women had substantial difficulty answering the questions that referenced their physician, because they did not understand who their physician was for this process of care. CONCLUSION The combination of the inability to identify the physician providing care during the mammography work-up and anxiety effects seen only after an interaction with the breast imaging team may indicate that online support only decreases the anxiety of women in concert with direct interpersonal support from the healthcare team. PMID:25193424

  3. Online support: Impact on anxiety in women who experience an abnormal screening mammogram.

    PubMed

    Obadina, Eniola T; Dubenske, Lori L; McDowell, Helene E; Atwood, Amy K; Mayer, Deborah K; Woods, Ryan W; Gustafson, David H; Burnside, Elizabeth S

    2014-12-01

    To determine whether an online support tool can impact anxiety in women experiencing an abnormal mammogram. We developed an online support system using the Comprehensive Health Enhancement Support System (CHESS) designed for women experiencing an abnormal mammogram as a model. Our trial randomized 130 of these women to online support (the intervention group) or to a list of five commonly used Internet sites (the comparison group). Surveys assessed anxiety and breast cancer worry, and patient satisfaction at three important clinical time points: when women were notified of their abnormal mammogram, at the time of diagnostic imaging, and at the time of biopsy (if biopsy was recommended). Study participants in the intervention group showed a significant decrease in anxiety at the time of biopsy compared to the comparison group (p = 0.017). However, there was no significant difference in anxiety between the intervention group and the comparison group at the time of diagnostic work-up. We discontinued assessment of patient satisfaction after finding that many women had substantial difficulty answering the questions that referenced their physician, because they did not understand who their physician was for this process of care. The combination of the inability to identify the physician providing care during the mammography work-up and anxiety effects seen only after an interaction with the breast imaging team may indicate that online support only decreases the anxiety of women in concert with direct interpersonal support from the healthcare team. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Frequency and Determinants of a Short-Interval Follow-up Recommendation After an Abnormal Screening Mammogram.

    PubMed

    Pelletier, Eric; Daigle, Jean-Marc; Defay, Fannie; Major, Diane; Guertin, Marie-Hélène; Brisson, Jacques

    2016-11-01

    After imaging assessment of an abnormal screening mammogram, a follow-up examination 6 months later is recommended to some women. Our aim was to identify which characteristics of lesions, women, and physicians are associated to such short-interval follow-up recommendation in the Quebec Breast Cancer Screening Program. Between 1998 and 2008, 1,839,396 screening mammograms were performed and a total of 114,781 abnormal screens were assessed by imaging only. Multivariate analysis was done with multilevel Poisson regression models with robust variance and generalized linear mixed models. A short-interval follow-up was recommended in 26.7% of assessments with imaging only, representing 2.3% of all screens. Case-mix adjusted proportion of short-interval follow-up recommendations varied substantially across physicians (range: 4%-64%). Radiologists with high recall rates (≥15%) had a high proportion of short-interval follow-up recommendation (risk ratio: 1.82; 95% confidence interval: 1.35-2.45) compared to radiologists with low recall rates (<5%). The adjusted proportion of short-interval follow-up was high (22.8%) even when a previous mammogram was usually available. Short-interval follow-up recommendation at assessment is frequent in this Canadian screening program, even when a previous mammogram is available. Characteristics related to radiologists appear to be key determinants of short-interval follow-up recommendation, rather than characteristics of lesions or patient mix. Given that it can cause anxiety to women and adds pressure on the health system, it appears important to record and report short-interval follow-up and to identify ways to reduce its frequency. Short-interval follow-up recommendations should be considered when assessing the burden of mammography screening. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  5. Mammogram

    MedlinePlus

    Mammography; Breast cancer - mammography; Breast cancer - screening mammography; Breast lump - mammogram; Breast tomosynthesis ... images. This does not always mean you have breast cancer. Your health care provider may simply need to ...

  6. Automatic detection of anomalies in screening mammograms

    PubMed Central

    2013-01-01

    Background Diagnostic performance in breast screening programs may be influenced by the prior probability of disease. Since breast cancer incidence is roughly half a percent in the general population there is a large probability that the screening exam will be normal. That factor may contribute to false negatives. Screening programs typically exhibit about 83% sensitivity and 91% specificity. This investigation was undertaken to determine if a system could be developed to pre-sort screening-images into normal and suspicious bins based on their likelihood to contain disease. Wavelets were investigated as a method to parse the image data, potentially removing confounding information. The development of a classification system based on features extracted from wavelet transformed mammograms is reported. Methods In the multi-step procedure images were processed using 2D discrete wavelet transforms to create a set of maps at different size scales. Next, statistical features were computed from each map, and a subset of these features was the input for a concerted-effort set of naïve Bayesian classifiers. The classifier network was constructed to calculate the probability that the parent mammography image contained an abnormality. The abnormalities were not identified, nor were they regionalized. The algorithm was tested on two publicly available databases: the Digital Database for Screening Mammography (DDSM) and the Mammographic Images Analysis Society’s database (MIAS). These databases contain radiologist-verified images and feature common abnormalities including: spiculations, masses, geometric deformations and fibroid tissues. Results The classifier-network designs tested achieved sensitivities and specificities sufficient to be potentially useful in a clinical setting. This first series of tests identified networks with 100% sensitivity and up to 79% specificity for abnormalities. This performance significantly exceeds the mean sensitivity reported in literature

  7. Rapid Point-Of-Care Breath Test for Biomarkers of Breast Cancer and Abnormal Mammograms

    PubMed Central

    Phillips, Michael; Beatty, J. David; Cataneo, Renee N.; Huston, Jan; Kaplan, Peter D.; Lalisang, Roy I.; Lambin, Philippe; Lobbes, Marc B. I.; Mundada, Mayur; Pappas, Nadine; Patel, Urvish

    2014-01-01

    Background Previous studies have reported volatile organic compounds (VOCs) in breath as biomarkers of breast cancer and abnormal mammograms, apparently resulting from increased oxidative stress and cytochrome p450 induction. We evaluated a six-minute point-of-care breath test for VOC biomarkers in women screened for breast cancer at centers in the USA and the Netherlands. Methods 244 women had a screening mammogram (93/37 normal/abnormal) or a breast biopsy (cancer/no cancer 35/79). A mobile point-of-care system collected and concentrated breath and air VOCs for analysis with gas chromatography and surface acoustic wave detection. Chromatograms were segmented into a time series of alveolar gradients (breath minus room air). Segmental alveolar gradients were ranked as candidate biomarkers by C-statistic value (area under curve [AUC] of receiver operating characteristic [ROC] curve). Multivariate predictive algorithms were constructed employing significant biomarkers identified with multiple Monte Carlo simulations and cross validated with a leave-one-out (LOO) procedure. Results Performance of breath biomarker algorithms was determined in three groups: breast cancer on biopsy versus normal screening mammograms (81.8% sensitivity, 70.0% specificity, accuracy 79% (73% on LOO) [C-statistic value], negative predictive value 99.9%); normal versus abnormal screening mammograms (86.5% sensitivity, 66.7% specificity, accuracy 83%, 62% on LOO); and cancer versus no cancer on breast biopsy (75.8% sensitivity, 74.0% specificity, accuracy 78%, 67% on LOO). Conclusions A pilot study of a six-minute point-of-care breath test for volatile biomarkers accurately identified women with breast cancer and with abnormal mammograms. Breath testing could potentially reduce the number of needless mammograms without loss of diagnostic sensitivity. PMID:24599224

  8. The classification of normal screening mammograms

    NASA Astrophysics Data System (ADS)

    Ang, Zoey Z. Y.; Rawashdeh, Mohammad A.; Heard, Robert; Brennan, Patrick C.; Lee, Warwick; Lewis, Sarah J.

    2016-03-01

    Rationale and objectives: To understand how breast screen readers classify the difficulty of normal screening mammograms using common lexicon describing normal appearances. Cases were also assessed on their suitability for a single reader strategy. Materials and Methods: 15 breast readers were asked to interpret a test set of 29 normal screening mammogram cases and classify them by rating the difficulty of the case on a five-point Likert scale, identifying the salient features and assessing their suitability for single reading. Using the False Positive Fractions from a previous study, the 29 cases were classified into 10 "low", 10 "medium" and nine "high" difficulties. Data was analyzed with descriptive statistics. Spearman's correlation was used to test the strength of association between the difficulty of the cases and the readers' recommendation for single reading strategy. Results: The ratings from readers in this study corresponded to the known difficulty level of cases for the 'low' and 'high' difficulty cases. Uniform ductal pattern and density, symmetrical mammographic features and the absence of micro-calcifications were the main reasons associated with 'low' difficulty cases. The 'high' difficulty cases were described as having `dense breasts'. There was a statistically significant negative correlation between the difficulty of the cases and readers' recommendation for single reading (r = -0.475, P = 0.009). Conclusion: The findings demonstrated potential relationships between certain mammographic features and the difficulty for readers to classify mammograms as 'normal'. The standard Australian practice of double reading was deemed more suitable for most cases. There was an inverse moderate association between the difficulty of the cases and the recommendations for single reading.

  9. Depression and anxiety diagnoses are not associated with delayed resolution of abnormal mammograms and pap tests among vulnerable women.

    PubMed

    Kronman, Andrea C; Freund, Karen M; Heeren, Tim; Beaver, Kristine A; Flynn, Mary; Battaglia, Tracy A

    2012-04-01

    Delays in care after abnormal cancer screening contribute to disparities in cancer outcomes. Women with psychiatric disorders are less likely to receive cancer screening and may also have delays in diagnostic resolution after an abnormal screening test. To determine if depression and anxiety are associated with delays in resolution after abnormal mammograms and Pap tests in a vulnerable population of urban women. We conducted retrospective chart reviews of electronic medical records to identify women who had a diagnosis of depression or anxiety in the year prior to the abnormal mammogram or Pap test. We used time-to-event analysis to analyze the outcome of time to resolution after abnormal cancer screening, and Cox proportional hazards regression modeling to control for confounding. Women receiving care in six Boston-area community health centers 2004-2005: 523 with abnormal mammograms, 474 with abnormal Pap tests. Of the women with abnormal mammogram and pap tests, 19% and 16%, respectively, had co-morbid depression. There was no difference in time to diagnostic resolution between depressed and not-depressed women for those with abnormal mammograms (aHR = 0.9, 95 CI 0.7,1.1) or Pap tests (aHR = 0.9, 95 CI 0.7,1.3). An active diagnosis of depression and/or anxiety in the year prior to an abnormal mammogram or Pap test was not associated with a prolonged time to diagnostic resolution. Our findings imply that documented mood disorders do not identify an additional barrier to resolution after abnormal cancer screening in a vulnerable population of women.

  10. Hospitalized women's willingness to pay for an inpatient screening mammogram.

    PubMed

    Khaliq, Waseem; Harris, Ché Matthew; Landis, Regina; Bridges, John F P; Wright, Scott M

    2014-01-01

    Lower rates for breast cancer screening persist among low income and uninsured women. Although Medicare and many other insurance plans would pay for screening mammograms done during hospital stays, breast cancer screening has not been part of usual hospital care. This study explores the mean amount of money that hospitalized women were willing to contribute towards the cost of a screening mammogram. Of the 193 enrolled patients, 72% were willing to pay a mean of $83.41 (95% CI, $71.51-$95.31) in advance towards inpatient screening mammogram costs. The study's findings suggest that hospitalized women value the prospect of screening mammography during the hospitalization. It may be wise policy to offer mammograms to nonadherent hospitalized women, especially those who are at high risk for developing breast cancer. © 2014 Annals of Family Medicine, Inc.

  11. Mammograms

    MedlinePlus

    ... mammography facility know about breast implants when scheduling a mammogram. The technologist and radiologist must be experienced in performing mammography on women who have breast implants. If the technologist ...

  12. Performance of a fail-safe system to follow up abnormal mammograms in primary care.

    PubMed

    Grossman, Ellie; Phillips, Russell S; Weingart, Saul N

    2010-09-01

    Missed and delayed breast cancer diagnoses are major sources of potential harm to patients and medical malpractice liability in the United States. Follow-up of abnormal mammogram results is an essential but challenging component of safe breast care. To explore the value of an inexpensive method to follow up abnormal test results, we examined a paper-based fail-safe system. We examined a fail-safe system used to follow up abnormal mammograms at a primary care practice at an urban teaching hospital. We analyzed all abnormal mammogram reports and clinicians' responses to follow-up reminders. We characterized potential lapses identified in this system and used regression models to identify patient, provider, and test result characteristics associated with such lapses. Clinicians responded to fail-safe reminders for 92% of 948 abnormal mammograms. Clinicians reported that they were unaware of the abnormal result in 8% of cases and that there was no follow-up plan in place for 3% of cases. Clinicians with more years of experience were more likely to be aware of the abnormal result (odds of being unaware per incremental year in practice, 0.92; 95% confidence interval, 0.88-0.97) and were more likely to have a follow-up plan. A paper-based fail-safe system for abnormal mammograms is feasible in a primary care practice. However, special care is warranted to ensure full clinician adherence and address staff transitions and trainee-related issues.

  13. Mesh-free based variational level set evolution for breast region segmentation and abnormality detection using mammograms.

    PubMed

    Kashyap, Kanchan L; Bajpai, Manish K; Khanna, Pritee; Giakos, George

    2018-01-01

    Automatic segmentation of abnormal region is a crucial task in computer-aided detection system using mammograms. In this work, an automatic abnormality detection algorithm using mammographic images is proposed. In the preprocessing step, partial differential equation-based variational level set method is used for breast region extraction. The evolution of the level set method is done by applying mesh-free-based radial basis function (RBF). The limitation of mesh-based approach is removed by using mesh-free-based RBF method. The evolution of variational level set function is also done by mesh-based finite difference method for comparison purpose. Unsharp masking and median filtering is used for mammogram enhancement. Suspicious abnormal regions are segmented by applying fuzzy c-means clustering. Texture features are extracted from the segmented suspicious regions by computing local binary pattern and dominated rotated local binary pattern (DRLBP). Finally, suspicious regions are classified as normal or abnormal regions by means of support vector machine with linear, multilayer perceptron, radial basis, and polynomial kernel function. The algorithm is validated on 322 sample mammograms of mammographic image analysis society (MIAS) and 500 mammograms from digital database for screening mammography (DDSM) datasets. Proficiency of the algorithm is quantified by using sensitivity, specificity, and accuracy. The highest sensitivity, specificity, and accuracy of 93.96%, 95.01%, and 94.48%, respectively, are obtained on MIAS dataset using DRLBP feature with RBF kernel function. Whereas, the highest 92.31% sensitivity, 98.45% specificity, and 96.21% accuracy are achieved on DDSM dataset using DRLBP feature with RBF kernel function. Copyright © 2017 John Wiley & Sons, Ltd.

  14. The psychological impact of a false-positive screening mammogram in Barcelona.

    PubMed

    Espasa, Rebecca; Murta-Nascimento, Cristiane; Bayés, Ramón; Sala, Maria; Casamitjana, Montserrat; Macià, Francesc; Castells, Xavier

    2012-12-01

    The purpose of this study was to ascertain the psychological impact of mammographic screening for women who receive negative results and for those who need additional non-invasive and invasive complementary investigations to exclude breast cancer (false positives). One hundred fifty women who attended a breast cancer screening programme in Barcelona, aged 50-69 years, were included in this study: 50 with negative results and 100 with false positive mammograms (50 underwent non-invasive and 50 underwent invasive complementary investigations). Participants worried little until they underwent mammography, but worries increased when a telephone call notified the women of the need for further testing. A substantial proportion of women requiring further assessment reported that they were at least somewhat worried about having breast cancer throughout the screening process (P < 0.0001). Nevertheless, levels of anxiety and depression, measured by the Hospital Anxiety and Depression Scale, showed no statistically significant differences among the three groups. In conclusion, although the women showed no psychological morbidity, there is a substantial psychological response in those with an abnormal screening mammogram.

  15. Medical Advocacy and Supportive Environments for African-Americans Following Abnormal Mammograms.

    PubMed

    Molina, Yamile; Hempstead, Bridgette H; Thompson-Dodd, Jacci; Weatherby, Shauna Rae; Dunbar, Claire; Hohl, Sarah D; Malen, Rachel C; Ceballos, Rachel M

    2015-09-01

    African-American women experience disproportionately adverse outcomes relative to non-Latina White women after an abnormal mammogram result. Research has suggested medical advocacy and staff support may improve outcomes among this population. The purpose of the study was to understand reasons African-American women believe medical advocacy to be important and examine if and how staff can encourage and be supportive of medical advocacy. A convenience-based sample of 30-74-year-old women who self-identified as African-American/Black/of African descent and who had received an abnormal mammogram result was recruited from community-based organizations, mobile mammography services, and the local department of health. This qualitative study included semi-structured interviews. Patients perceived medical advocacy to be particularly important for African-Americans, given mistrust and discrimination present in medical settings and their own familiarity with their bodies and symptoms. Respondents emphasized that staff can encourage medical advocacy through offering information in general in a clear, informative, and empathic style. Cultural competency interventions that train staff how to foster medical advocacy may be a strategy to improve racial disparities following an abnormal mammogram.

  16. Ethnic differences in social support after initial receipt of an abnormal mammogram.

    PubMed

    Molina, Yamile; Hohl, Sarah D; Nguyen, Michelle; Hempstead, Bridgette H; Weatherby, Shauna Rae; Dunbar, Claire; Beresford, Shirley A A; Ceballos, Rachel M

    2016-10-01

    We examine access to and type of social support after initial receipt of an abnormal mammogram across non-Latina White (NLW), African American, and Latina women. This cross-sectional study used a mixed method design, with quantitative and qualitative measures. Women were recruited through 2 community advocates and 3 breast-health-related care organizations. With regard to access, African American women were less likely to access social support relative to NLW counterparts. Similar nonsignificant differences were found for Latinas. Women did not discuss results with family and friends to avoid burdening social networks and negative reactions. Networks' geographic constraints and medical mistrust influenced Latina and African American women's decisions to discuss results. With regard to type of social support, women reported emotional support across ethnicity. Latina and African American women reported more instrumental support, whereas NLW women reported more informational support in the context of their well-being. There are shared and culturally unique aspects of women's experiences with social support after initially receiving an abnormal mammogram. Latina and African American women may particularly benefit from informational support from health care professionals. Communitywide efforts to mitigate mistrust and encourage active communication about cancer may improve ethnic disparities in emotional well-being and diagnostic resolution during initial receipt of an abnormal mammogram. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Mass detection with digitized screening mammograms by using Gabor features

    NASA Astrophysics Data System (ADS)

    Zheng, Yufeng; Agyepong, Kwabena

    2007-03-01

    Breast cancer is the leading cancer among American women. The current lifetime risk of developing breast cancer is 13.4% (one in seven). Mammography is the most effective technology presently available for breast cancer screening. With digital mammograms computer-aided detection (CAD) has proven to be a useful tool for radiologists. In this paper, we focus on mass detection that is a common category of breast cancers relative to calcification and architecture distortion. We propose a new mass detection algorithm utilizing Gabor filters, termed as "Gabor Mass Detection" (GMD). There are three steps in the GMD algorithm, (1) preprocessing, (2) generating alarms and (3) classification (reducing false alarms). Down-sampling, quantization, denoising and enhancement are done in the preprocessing step. Then a total of 30 Gabor filtered images (along 6 bands by 5 orientations) are produced. Alarm segments are generated by thresholding four Gabor images of full orientations (Stage-I classification) with image-dependent thresholds computed via histogram analysis. Next a set of edge histogram descriptors (EHD) are extracted from 24 Gabor images (6 by 4) that will be used for Stage-II classification. After clustering EHD features with fuzzy C-means clustering method, a k-nearest neighbor classifier is used to reduce the number of false alarms. We initially analyzed 431 digitized mammograms (159 normal images vs. 272 cancerous images, from the DDSM project, University of South Florida) with the proposed GMD algorithm. And a ten-fold cross validation was used for testing the GMD algorithm upon the available data. The GMD performance is as follows: sensitivity (true positive rate) = 0.88 at false positives per image (FPI) = 1.25, and the area under the ROC curve = 0.83. The overall performance of the GMD algorithm is satisfactory and the accuracy of locating masses (highlighting the boundaries of suspicious areas) is relatively high. Furthermore, the GMD algorithm can

  18. Understanding the patient-provider communication needs and experiences of Latina and non-Latina White women following an abnormal mammogram.

    PubMed

    Molina, Yamile; Hohl, Sarah D; Ko, Linda K; Rodriguez, Edgar A; Thompson, Beti; Beresford, Shirley A A

    2014-12-01

    Latinas are more likely to delay recommended follow-up care than non-Latina White (NLW) women after an abnormal mammogram result. Ethnic differences in communication needs and experiences with health-care staff and providers may contribute to these delays as well as satisfaction with care. Nonetheless, little research has explored the aspects of communication that may contribute to patient comprehension, adherence to follow-up care, and satisfaction across ethnicity. The purpose of this exploratory, qualitative study was to identify patients' communication needs and experiences with follow-up care among Latina and NLW women who received an abnormal mammogram. We conducted 41 semi-structured interviews with 19 Latina and 22 NLW women between the ages of 40 and 74 who had received an abnormal mammogram. Communication themes indicated that women's needs and experiences concerning abnormal mammograms and follow-up care varied across ethnicity. Latinas and NLW women appeared to differ in their comprehension of abnormal results and follow-up care as a result of language barriers and health literacy. Both groups of women identified clear, empathic communication as being important in patient-provider communication; however, Latinas underscored the need for warm communicative styles, and NLW women emphasized the importance of providing more information. Women with high levels of satisfaction with patient-provider interactions appeared to have positive perspectives of subsequent screening and cancer treatment. To improve patient satisfaction and adherence to follow-up care among Latinas, educational programs are necessary to counsel health-care professionals with regard to language, health literacy, and empathic communication needs in health-care service delivery.

  19. Breast cancers missed by screening radiologists can be detected by reading mammograms at a distance.

    PubMed

    Schreutelkamp, Ineke L; Kwee, Robert M; Veekmans, Peter; Adriaensen, Miraude E A P M

    2018-05-03

    During locally organized quality assurance evaluation sessions for screening radiologists, we noticed that individual screening radiologists did miss tumours which in our opinion could be detected at a distance. To determine whether tumours missed by individual screening radiologists can be detected at a distance. Twenty-eight screening mammograms of 28 females (mean age 63 years, range 49-73) with a pathologically proven malignant tumour missed by individual screening radiologists were mixed with 56 normal screening mammograms of 56 females (mean age 63 years, range 53-74). This test set was independently assessed by a senior screening radiologist and by a radiology resident without prior training in screening mammography at 1.5 m distance from the screen display. Readers were unaware of the prevalence of pathologically proven malignant tumours in the test set. Primary outcome was whether the reader would recall the woman. The senior screening radiologist recalled 28 of 28 women with a pathologically proven malignant tumour (sensitivity of 100%) and 16 of 56 women without pathology (specificity of 71%). The radiology resident recalled 25 of 28 women with a pathologically proven malignant tumour (sensitivity of 89%) and 10 of 56 women without pathology (specificity of 82%). Some malignant tumours missed by an individual screening radiologist can be detected from 1.5 m distance. Therefore, we recommend that screening radiologists consciously take a distant view before closely evaluating the mammogram in detail.

  20. Factors related to noncompliance with screening mammogram appointments among low-income African-American women.

    PubMed Central

    Crump, S. R.; Mayberry, R. M.; Taylor, B. D.; Barefield, K. P.; Thomas, P. E.

    2000-01-01

    Despite current mammography recommendations, screening rates among African-American women are suboptimal. The purpose of this case-control study was to identify the psychological, demographic, and health care system barriers to screening mammography use among low-income African-American women. A total of 574 women with screening mammogram appointments at an urban hospital were interviewed to determine the predictors of mammogram appointment noncompliance. Predictor variables included: demographics; breast cancer knowledge, attitudes, beliefs, and screening practices; and type of health care provider making the referral. Age was inversely related to mammogram appointment noncompliance. Relative to women 40 to 49 years old, women 70 years of age and older were the least likely to miss their appointments (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.2, 0.5). Women referred for mammography by a physician's assistant or nurse practitioner were less likely to miss their appointments than women referred by a physician (OR, 0.3; 95% CI, 0.1, 0.8). Embarrassment, lack of breast symptoms, and forgetfulness also contributed to noncompliance. Key demographic, attitudinal, and health care system factors hinder low-income African-American women from obtaining screening mammograms. These findings have significant health education and policy implications for health care delivery to women in this population. PMID:10881473

  1. Disparities in abnormal mammogram follow-up time for Asian women compared to non-Hispanic Whites and between Asian ethnic groups

    PubMed Central

    Nguyen, KH; Pasick, RJ; Stewart, SL; Kerlikowske, K; Karliner, LS

    2017-01-01

    Background Delays in abnormal mammogram follow-up contribute to poor outcomes. We examined abnormal screening mammogram follow-up differences for non-Hispanic Whites (NHW) and Asian women. Methods Prospective cohort of NHW and Asian women with a Breast Imaging Reporting and Data System abnormal result of 0 or 3+ in the San Francisco Mammography Registry between 2000–2010. We performed Kaplan-Meier estimation for median-days to follow-up with a diagnostic radiologic test, and compared proportion with follow-up at 30, 60 and 90 days, and no follow-up at one-year for Asians overall (and Asian ethnic groups) and NHWs. We additionally assessed the relationship between race/ethnicity and time-to-follow-up with adjusted Cox proportional hazards models. Results Among Asian women, Vietnamese and Filipinas had the longest, and Japanese the shortest, median follow-up time (32, 28, 19 days, respectively) compared to NHWs (15 days). The proportion of women receiving follow-up at 30 days was lower for Asians vs NHWs (57% vs 77%, p<0.0001), and these disparities persisted at 60 and 90 days for all Asian ethnic groups except Japanese. Asians had a reduced hazard of follow-up compared with NHWs (aHR 0.70, 95% CI 0.69–0.72). Asians also had a higher rate than NHWs of no follow-up (15% vs 10%; p<0.001); among Asian ethnic groups, Filipinas had the highest percentage of women with no follow-up (18.1%). Conclusion Asian, particularly Filipina and Vietnamese, women were less likely than NHWs to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. PMID:28603859

  2. Normal and abnormal tissue identification system and method for medical images such as digital mammograms

    NASA Technical Reports Server (NTRS)

    Heine, John J. (Inventor); Clarke, Laurence P. (Inventor); Deans, Stanley R. (Inventor); Stauduhar, Richard Paul (Inventor); Cullers, David Kent (Inventor)

    2001-01-01

    A system and method for analyzing a medical image to determine whether an abnormality is present, for example, in digital mammograms, includes the application of a wavelet expansion to a raw image to obtain subspace images of varying resolution. At least one subspace image is selected that has a resolution commensurate with a desired predetermined detection resolution range. A functional form of a probability distribution function is determined for each selected subspace image, and an optimal statistical normal image region test is determined for each selected subspace image. A threshold level for the probability distribution function is established from the optimal statistical normal image region test for each selected subspace image. A region size comprising at least one sector is defined, and an output image is created that includes a combination of all regions for each selected subspace image. Each region has a first value when the region intensity level is above the threshold and a second value when the region intensity level is below the threshold. This permits the localization of a potential abnormality within the image.

  3. A crisis of visibility: The psychological consequences of false-positive screening mammograms, an interview study.

    PubMed

    Bond, Mary; Garside, Ruth; Hyde, Christopher

    2015-11-01

    To understand the meaning of having a false-positive screening mammogram. Qualitative interview study. Twenty-one women, who had experienced false-positive screening mammograms, took part in semi-structured interviews that were analysed with Interpretive Phenomenological Analysis. This research took place in the United Kingdom. The analysis revealed a wide range of response to having a false-positive mammogram, from nonchalance to extreme fear. These reactions come from the potential for the belief that one is healthy to be challenged by being recalled, as the worst is frequently assumed. For most, the image of the lesion on the X-ray brought the reality of this challenge into sharp focus, as they might soon discover they had breast cancer. Waiting, whether for the appointment, at the clinic or for biopsy results was considered the worst aspect of being recalled. Generally, the uncertainty was quickly resolved with the pronouncement of the 'all-clear', which brought considerable relief and the restoration of belief in the healthy self. However, for some, lack of information, contradictory information, or poor interpersonal communication meant that uncertainty about their health status lingered at least until their next normal screening mammogram. Mammography screening related anxiety lasted for up to 12 years. Breast cancer screening produces a 'crisis of visibility'. Accepting the screening invitation is taking a risk that you may experience unnecessary stress, uncertainty, fear, anxiety, and physical pain. Not accepting the invitation is taking a risk that malignant disease will remain invisible. Statement of contribution What is already known on this subject? More than 50,000 women a year in England have a false-positive mammogram (FPM). Having an FPM can cause anxiety compared with a normal mammogram. The anxiety can last up to 35 months. What does this study add? Refocuses attention from the average response found in quantitative studies to the wide range of

  4. Abnormal Cervical Cancer Screening Test Results

    MedlinePlus

    ... FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test results? • What is the difference between the terms cervical ...

  5. Follow-Up of Abnormal Breast and Colorectal Cancer Screening by Race/Ethnicity.

    PubMed

    McCarthy, Anne Marie; Kim, Jane J; Beaber, Elisabeth F; Zheng, Yingye; Burnett-Hartman, Andrea; Chubak, Jessica; Ghai, Nirupa R; McLerran, Dale; Breen, Nancy; Conant, Emily F; Geller, Berta M; Green, Beverly B; Klabunde, Carrie N; Inrig, Stephen; Skinner, Celette Sugg; Quinn, Virginia P; Haas, Jennifer S; Schnall, Mitchell; Rutter, Carolyn M; Barlow, William E; Corley, Douglas A; Armstrong, Katrina; Doubeni, Chyke A

    2016-10-01

    Timely follow-up of abnormal tests is critical to the effectiveness of cancer screening, but may vary by screening test, healthcare system, and sociodemographic group. Timely follow-up of abnormal mammogram and fecal occult blood testing or fecal immunochemical tests (FOBT/FIT) were compared by race/ethnicity using Population-Based Research Optimizing Screening through Personalized Regimens consortium data. Participants were women with an abnormal mammogram (aged 40-75 years) or FOBT/FIT (aged 50-75 years) in 2010-2012. Analyses were performed in 2015. Timely follow-up was defined as colonoscopy ≤3 months following positive FOBT/FIT; additional imaging or biopsy ≤3 months following Breast Imaging Reporting and Data System Category 0, 4, or 5 mammograms; or ≤9 months following Category 3 mammograms. Logistic regression was used to model receipt of timely follow-up adjusting for study site, age, year, insurance, and income. Among 166,602 mammograms, 10.7% were abnormal; among 566,781 FOBT/FITs, 4.3% were abnormal. Nearly 96% of patients with abnormal mammograms received timely follow-up versus 68% with abnormal FOBT/FIT. There was greater variability in receipt of follow-up across healthcare systems for positive FOBT/FIT than for abnormal mammograms. For mammography, black women were less likely than whites to receive timely follow-up (91.8% vs 96.0%, OR=0.71, 95% CI=0.51, 0.97). For FOBT/FIT, Hispanics were more likely than whites to receive timely follow-up than whites (70.0% vs 67.6%, OR=1.12, 95% CI=1.04, 1.21). Timely follow-up among women was more likely for abnormal mammograms than FOBT/FITs, with small variations in follow-up rates by race/ethnicity and larger variation across healthcare systems. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

  6. Psychological distress, social withdrawal, and coping following receipt of an abnormal mammogram among different ethnicities: a mediation model.

    PubMed

    Molina, Yamile; Beresford, Shirley A A; Espinoza, Noah; Thompson, Beti

    2014-09-01

    To explore ethnic differences in psychological distress and social withdrawal after receiving an abnormal mammogram result and to assess if coping strategies mediate ethnic differences. Descriptive correlational. Two urban mobile mammography units and a rural community hospital in the state of Washington. 41 Latina and 41 non-Latina Caucasian (NLC) women who had received an abnormal mammogram result. Women completed standard sociodemographic questions, Impact of Event Scale-Revised, the social dimension of the Psychological Consequences Questionnaire, and the Brief COPE. Ethnicity, psychological distress, social withdrawal, and coping. Latinas experienced greater psychological distress and social withdrawal compared to NLC counterparts. Denial as a coping strategy mediated ethnic differences in psychological distress. Religious coping mediated ethnic differences in social withdrawal. Larger population-based studies are necessary to understand how ethnic differences in coping strategies can influence psychological outcomes. This is an important finding that warrants additional study among women who are and are not diagnosed with breast cancer following an abnormal mammogram. Nurses may be able to work with Latina patients to diminish denial coping and consequent distress. Nurses may be particularly effective, given cultural values concerning strong interpersonal relationships and respect for authority figures.

  7. Disparities in abnormal mammogram follow-up time for Asian women compared with non-Hispanic white women and between Asian ethnic groups.

    PubMed

    Nguyen, Kim H; Pasick, Rena J; Stewart, Susan L; Kerlikowske, Karla; Karliner, Leah S

    2017-09-15

    Delays in abnormal mammogram follow-up contribute to poor outcomes. In the current study, the authors examined differences in abnormal screening mammogram follow-up between non-Hispanic white (NHW) and Asian women. The authors used a prospective cohort of NHW and Asian women with a Breast Imaging, Reporting and Data System (BI-RADS) abnormal result of category 0 or 3-plus in the San Francisco Mammography Registry between 2000 and 2010. Kaplan-Meier estimation for the median number of days to follow-up with a diagnostic radiologic test was performed, and the authors compared the percentage of women with follow-up at 30 days, 60 days, and 90 days and no follow-up at 1 year for Asian women overall (and Asian ethnic groups) and NHW women. In addition, the authors assessed the relationship between race/ethnicity and time to follow-up with adjusted Cox proportional hazards models. Among Asian women, Vietnamese and Filipina women had the longest, and Japanese women the shortest, median follow-up (32 days, 28 days, and 19 days, respectively) compared with NHW women (15 days). The percentage of women receiving follow-up at 30 days was lower for Asians versus NHWs (57% vs 77%; P<.0001), and these disparities persisted at 60 days and 90 days for all Asian ethnic groups except Japanese. Asian women had a reduced hazard of follow-up compared with NHW women (adjusted hazard ratio, 0.70; 95% confidence interval, 0.69-0.72). Asian women also had a higher rate of receiving no follow-up compared with NHW women (15% vs 10%; P<.001); among Asian ethnic groups, Filipinas were found to have the highest percentage of women with no follow-up (18.1%). Asian women, particularly Filipina and Vietnamese women, were less likely than NHW women to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. Cancer 2017;123:3468-75. © 2017 American Cancer Society. © 2017

  8. [An audit of breast cancer screening mammograms and the variability of radiological practice].

    PubMed

    Moreno-Ramos, M D; Ruíz-García, E

    2016-01-01

    To audit the breast cancer screening mammograms performed in a general hospital and to assess the variation in medical practice in the diagnostic process. A review was carried out on the screening mammograms performed between 1 May 2010 and 30 April 2011, with clinical follow up for two years, and a comparison with the published standards. Of the 3,878 women examined, 368 (9.48%) were called back to complete the study (97 [16.1%] in the initial screening and 271 [8.2%] in revisions). Forty three biopsies (1.1%) were indicated, of which 24 were diagnosed with cancer. The positive predictive value (PPV) in screening studies (PPV1) was 6.52%. For the recommended biopsy (PPV2) it was 55%, with a sensitivity of 100%, a specificity of 91% and a cancer detection rate of 6.1/1,000. There were no false negatives. Twenty tumours were invasive; with no axillary lymph node infiltration was observed 15 of them. In 6 cases, the size of the tumour was less than or equal to 10mm, and in 17 it was less than 15mm. There were a higher percentage of new appointments by two radiologists (12% and 17.2% versus 7.3%) (P<.001). In 217 cases (58.96%; P<.001) only one radiologist indicated new appointments. Of this group, 73% were discharged in the first visit, compared to 47.6% in the non-discrepant group (P<.001). Four of the cancers were detected in these 217 patients. The observed results are adjusted to the reference values. The discordant data are the new appointments rate, both in the initial screening and in the review, with a significant variation depending on the radiology reader. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  9. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach

    PubMed Central

    Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent’s residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40–74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8–112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60–78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0–340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40–240.00). Higher travel impedance was noted

  10. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach.

    PubMed

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who

  11. Bilateral Image Subtraction and Multivariate Models for the Automated Triaging of Screening Mammograms

    PubMed Central

    Celaya-Padilla, José; Martinez-Torteya, Antonio; Rodriguez-Rojas, Juan; Galvan-Tejada, Jorge; Treviño, Victor; Tamez-Peña, José

    2015-01-01

    Mammography is the most common and effective breast cancer screening test. However, the rate of positive findings is very low, making the radiologic interpretation monotonous and biased toward errors. This work presents a computer-aided diagnosis (CADx) method aimed to automatically triage mammogram sets. The method coregisters the left and right mammograms, extracts image features, and classifies the subjects into risk of having malignant calcifications (CS), malignant masses (MS), and healthy subject (HS). In this study, 449 subjects (197 CS, 207 MS, and 45 HS) from a public database were used to train and evaluate the CADx. Percentile-rank (p-rank) and z-normalizations were used. For the p-rank, the CS versus HS model achieved a cross-validation accuracy of 0.797 with an area under the receiver operating characteristic curve (AUC) of 0.882; the MS versus HS model obtained an accuracy of 0.772 and an AUC of 0.842. For the z-normalization, the CS versus HS model achieved an accuracy of 0.825 with an AUC of 0.882 and the MS versus HS model obtained an accuracy of 0.698 and an AUC of 0.807. The proposed method has the potential to rank cases with high probability of malignant findings aiding in the prioritization of radiologists work list. PMID:26240818

  12. Closing the Gap in Mammogram Screening: An Experimental Intervention among Low-Income Hispanic Women in Community Health Clinics

    ERIC Educational Resources Information Center

    Deavenport, Alexis; Modeste, Naomi; Marshak, Helen Hopp; Neish, Christine

    2011-01-01

    A low rate of mammogram screening exists among low-income Hispanic women. To address this disparity, an experimental intervention containing audiovisual and written media was conducted using the health belief model as a framework. The purpose of this study was to determine if low-income Hispanic women, more than 40 years of age, who received…

  13. Does mammogram attendance influence participation in cervical and colorectal cancer screening? A prospective study among 1856 French women.

    PubMed

    Bertaut, Aurélie; Coudert, Julien; Bengrine, Leila; Dancourt, Vincent; Binquet, Christine; Douvier, Serge

    2018-01-01

    We aimed to determine participation rates and factors associated with participation in colorectal (fecal occul blood test) and cervical cancer (Pap-smear) screening among a population of women participating in breast cancer screening. From August to October 2015, a self-administered questionnaire was sent by post to 2 900 women aged 50-65, living in Côte-d'Or, France, and who were up to date with mammogram screening. Polytomic logistic regression was used to identify correlates of participation in both cervical and colorectal cancer screenings. Participation in all 3 screenings was chosen as the reference. Study participation rate was 66.3% (n = 1856). Besides being compliant with mammogram, respectively 78.3% and 56.6% of respondents were up to date for cervical and colorectal cancer screenings, while 46.2% were compliant with the 3 screenings. Consultation with a gynecologist in the past year was associated with higher chance of undergoing the 3 screenings or female cancer screenings (p<10-4), when consultation with a GP was associated with higher chance of undergoing the 3 screenings or organized cancer screenings (p<0.05). Unemployment, obesity, age>59 and yearly flu vaccine were associated with a lower involvement in cervical cancer screening. Women from high socio-economic classes were more likely to attend only female cancer screenings (p = 0.009). Finally, a low level of physical activity and tobacco use were associated with higher risk of no additional screening participation (p<10-3 and p = 0.027). Among women participating in breast screening, colorectal and cervical cancer screening rates could be improved. Including communication about these 2 cancer screenings in the mammogram invitation could be worth to explore.

  14. Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

    SciTech Connect

    Debono, Josephine C, E-mail: josephine.debono@bci.org.au; Poulos, Ann E; Westmead Breast Cancer Institute, Westmead, New South Wales

    The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed toolmore » applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice.« less

  15. Double versus single reading of mammograms in a breast cancer screening programme: a cost-consequence analysis.

    PubMed

    Posso, Margarita C; Puig, Teresa; Quintana, Ma Jesus; Solà-Roca, Judit; Bonfill, Xavier

    2016-09-01

    To assess the costs and health-related outcomes of double versus single reading of digital mammograms in a breast cancer screening programme. Based on data from 57,157 digital screening mammograms from women aged 50-69 years, we compared costs, false-positive results, positive predictive value and cancer detection rate using four reading strategies: double reading with and without consensus and arbitration, and single reading with first reader only and second reader only. Four highly trained radiologists read the mammograms. Double reading with consensus and arbitration was 15 % (Euro 334,341) more expensive than single reading with first reader only. False-positive results were more frequent at double reading with consensus and arbitration than at single reading with first reader only (4.5 % and 4.2 %, respectively; p < 0.001). The positive predictive value (9.3 % and 9.1 %; p = 0.812) and cancer detection rate were similar for both reading strategies (4.6 and 4.2 per 1000 screens; p = 0.283). Our results suggest that changing to single reading of mammograms could produce savings in breast cancer screening. Single reading could reduce the frequency of false-positive results without changing the cancer detection rate. These results are not conclusive and cannot be generalized to other contexts with less trained radiologists. • Double reading of digital mammograms is more expensive than single reading. • Compared to single reading, double reading yields a higher proportion of false-positive results. • The cancer detection rate was similar for double and single readings. • Single reading may be a cost-effective strategy in breast cancer screening programmes.

  16. Abnormality detection of mammograms by discriminative dictionary learning on DSIFT descriptors.

    PubMed

    Tavakoli, Nasrin; Karimi, Maryam; Nejati, Mansour; Karimi, Nader; Reza Soroushmehr, S M; Samavi, Shadrokh; Najarian, Kayvan

    2017-07-01

    Detection and classification of breast lesions using mammographic images are one of the most difficult studies in medical image processing. A number of learning and non-learning methods have been proposed for detecting and classifying these lesions. However, the accuracy of the detection/classification still needs improvement. In this paper we propose a powerful classification method based on sparse learning to diagnose breast cancer in mammograms. For this purpose, a supervised discriminative dictionary learning approach is applied on dense scale invariant feature transform (DSIFT) features. A linear classifier is also simultaneously learned with the dictionary which can effectively classify the sparse representations. Our experimental results show the superior performance of our method compared to existing approaches.

  17. Benefits of double reading of screening mammograms: retrospective study on a consecutive series.

    PubMed

    Caumo, F; Brunelli, S; Zorzi, M; Baglio, I; Ciatto, S; Montemezzi, S

    2011-06-01

    The purpose of this study was to assess the performance of delayed second reading of screening mammograms when added to real-time reading plus immediate assessment. The study setting was the mammography screening programme of an Italian Local Health Unit. Recall rate and cancer detection rate at first reading or informed second reading only were assessed in a cohort of 23,629 women aged 50-69 years screened during 2007-2008. Incremental recall rate, incremental cancer detection rate and incremental cost of second reading were determined. Recall rate was 13.0% at first and 2.7% at second reading (incremental recall rate +21.1%). Overall, recalls were more frequent in the younger decade and in the presence of denser breasts. Cancer detection rate was 7.06‰ (n=167) at first and 0.93‰ (n=22) at second reading (incremental cancer detection rate +13.1%). Compared with first reading, second reading detected more cancers depicted as isolated microcalcifications and distortions (40.9% vs. 16.2%, p=0.02) and at a lower stage (stage 0-I 81.8% vs. 69.5%, p=0.34). The cost of adding delayed second reading was + 3.65 per screened individual or 3,926.61 per incremental cancer detected. The study confirms the efficacy of second reading, even as an adjunct to real-time single reading plus immediate assessment. Incremental recall rate is acceptable in view of the incremental cancer detection rate, and both figures are within the range of literature reports on double-reading performance.

  18. The influence of mammographic technologists on radiologists’ ability to interpret screening mammograms in community practice

    PubMed Central

    Henderson, Louise M.; Benefield, Thad; Marsh, Mary W.; Schroeder, Bruce F.; Durham, Danielle; Yankaskas, Bonnie C.; Bowling, J. Michael

    2014-01-01

    Purpose To determine whether the mammographic technologist has an effect on the radiologists’ interpretative performance of screening mammography in community practice. Materials and Methods In this institutional review board approved retrospective cohort study, we included Carolina Mammography Registry (CMR) data from 372 radiologists and 356 mammographic technologists from 1994 to 2009 who performed 1,003,276 screening mammograms. Measures of interpretative performance (recall rate, sensitivity, specificity, positive predictive value (PPV1), and cancer detection rate (CDR)) were ascertained prospectively with cancer outcomes collected from the state cancer registry and pathology reports. To determine if the mammographic technologist influenced the radiologists’ performance, we employed mixed effects logistic regression models, including a radiologist-specific random effect and taking into account the clustering of examinations across women, separately for screen-film mammography (SFM) and full field digital mammography (FFDM). Results Of the 356 mammographic technologists included, 343 performed 889,347 SFM examinations and 51 performed 113,929 FFDM examinations, and 38 performed both SFM and FFDM. A total of 4,328 cancers were reported for SFM and 564 cancers for FFDM. The technologists had a statistically significant effect on the radiologists’ recall rate, sensitivity, specificity and CDR for both SFM and FFDM (p-values<0.01). For PPV1, variability by technologist was observed for SFM (p-value<0.0001) but not for FFDM (p-value=0.088). Conclusion The interpretative performance of radiologists in screening mammography varies substantially by the technologist performing the examination. Additional studies should aim to identify technologist characteristics that may explain this variation. PMID:25435185

  19. Occult Primary Neuroendocrine Tumor Metastasis to the Breast Detected on Screening Mammogram.

    PubMed

    Policeni, Fabiana; Pakalniskis, Brittany; Yang, Limin

    2016-01-01

    Metastatic tumors are rare in the breast. Well-differentiated neuroendocrine tumors (WDNETs) are slow-growing neoplasms that arise from neuroendocrine cells, particularly in the gastrointestinal tract and bronchial tree. Metastatic WDNET to the breast is a rare entity. We present a case report of ileal WDNET metastatic to the breast which was initially identified as a small mass in the patient's left breast on screening mammography. Targeted ultrasound identified a suspicious mass, and ultrasound-guided percutaneous core biopsy was performed. Pathology revealed metastatic WDNET. Breast magnetic resonance imaging (MRI) was then performed and demonstrated left axillary Level 2 lymphadenopathy, and liver lesions were suspicious for metastasis. The patient underwent abdominal computed tomography (CT) to evaluate for distant metastatic disease. A spiculated mass was found near the ileocecal valve, suggestive of primary ileal WDNET. In addition, CT identified multiple liver lesions, most compatible with metastasis. Indium 111 OctreoScan confirmed radiotracer uptake in the ileum consistent with primary neuroendocrine tumor. In this report, we review the imaging characteristics of metastatic WDNET to the breast by different imaging modalities including mammogram, ultrasound, and breast MRI.

  20. Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme

    PubMed Central

    Posso, Margarita; Carles, Misericòrdia; Rué, Montserrat; Puig, Teresa; Bonfill, Xavier

    2016-01-01

    Objectives The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme. Methods Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1) double reading; 2) double reading for women in their first participation and single reading for women in their subsequent participations; and 3) single reading. We calculated the incremental cost-effectiveness ratio (ICER), which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER. Results The detection rate of double reading (5.17‰) was similar to that of single reading (4.78‰; P = .768). The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance. Conclusions From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs). PMID:27459663

  1. Mammogram screening in Chile: Using mixed methods to implement health policy planning at the primary care level

    PubMed Central

    Puschel, Klaus; Thompson, Beti

    2011-01-01

    Summary Breast cancer has the highest incidence of all cancers among women in Chile. In 2005, a national health program progressively introduced free mammography screening for women aged 50 and older; however, three years later the rates of compliance with mammographic screening was only 12% in Santiago, the capital city of Chile. This implementation article combines the findings of two previous studies that applied qualitative and quantitative methods to improve mammography screening in an area of Santiago. Socio-cultural and accessibility factors were identified as barriers and facilitators during the qualitative phase of the study and then applied to the design of a quantitative randomized clinical trial. After six months of intervention, 6% of women in the standard care group, 51.8% in the low intensity intervention group, and 70.1% in the high intensity intervention group had undergone a screening mammogram. This review discusses how the utilization of mixed methods research can contribute to the improvement of the implementation of health policies in local communities. PMID:21334897

  2. Audit feedback on reading performance of screening mammograms: An international comparison.

    PubMed

    Hofvind, S; Bennett, R L; Brisson, J; Lee, W; Pelletier, E; Flugelman, A; Geller, B

    2016-09-01

    Providing feedback to mammography radiologists and facilities may improve interpretive performance. We conducted a web-based survey to investigate how and why such feedback is undertaken and used in mammographic screening programmes. The survey was sent to representatives in 30 International Cancer Screening Network member countries where mammographic screening is offered. Seventeen programmes in 14 countries responded to the survey. Audit feedback was aimed at readers in 14 programmes, and facilities in 12 programmes. Monitoring quality assurance was the most common purpose of audit feedback. Screening volume, recall rate, and rate of screen-detected cancers were typically reported performance measures. Audit reports were commonly provided annually, but more frequently when target guidelines were not reached. The purpose, target audience, performance measures included, form and frequency of the audit feedback varied amongst mammographic screening programmes. These variations may provide a basis for those developing and improving such programmes. © The Author(s) 2016.

  3. More than just a mammogram: breast cancer screening perspectives of relatives of women with intellectual disability.

    PubMed

    Greenwood, Nechama W; Dreyfus, Deborah; Wilkinson, Joanne

    2014-12-01

    Women with intellectual disability (ID) have similar rates of breast cancer as the general public, but higher breast cancer mortality and lower rates of regular screening mammography. Screening rates are lowest among women who live with their families. Though women with ID often make decisions in partnership with their relatives, we lack research related to family member perspectives on mammography. We conducted a qualitative study of family members of women with ID, with an interview guide focused on health care decision making and experiences, and breast cancer screening barriers, facilitators, and beliefs as related to their loved ones. Sixteen family members underwent semistructured interviews. Important themes included mammography as a reference point for other social and cultural concerns, such as their loved one's sexuality or what it means to be an adult woman; fear of having to make hard decisions were cancer to be diagnosed acting as a barrier to screening; a focus on quality of life; and desire for quality health care for their loved one, though quality care did not always equate to regular cancer screening. Adults with ID are valued members of their families, and their relatives are invested in their well-being. However, families fear the potentially complicated decisions associated with a cancer diagnosis and may choose to forgo screening due to misinformation and a focus on quality of life. Effective interventions to address disparities in mammography should focus on adults with ID and their families together, and incorporate the family context.

  4. The Immediate Impact of the 2009 USPSTF Screening Guideline Change on Physician Recommendation of a Screening Mammogram: Findings from a National Ambulatory and Medical Care Survey-Based Study.

    PubMed

    Rajan, Suja S; Suryavanshi, Manasi S; Karanth, Siddharth; Lairson, David R

    2017-04-01

    Regular screening is considered the most effective method to reduce the mortality and morbidity associated with breast cancer. Nevertheless, contradictory evidence about screening mammograms has led to periodic changes and considerable variations among different screening guidelines. This study is the first to examine the immediate impact of the 2009 US Preventive Services Task Force (USPSTF) guideline modification on physician recommendation of mammograms. The study included visits by women aged 40 years and older without prior breast cancer from the National Ambulatory and Medical Care Survey 2008-2010. Bivariate and multiple logistic regressions were used to determine the factors associated with mammography recommendation. Approximately 29,395 visits were included and mammography was recommended during 1350 visits; 50-64-year-old women had 72% higher odds, and 65-74-year-old women had twice the odds of getting a mammogram recommendation compared with 40-49-year-old women in 2009. However, there was no difference in recommendation by age groups in 2008 and 2010. Obstetricians and gynecologists did not modify their recommendation behavior in 2009, unlike all other specialists who reduced their recommendation for 40-49-year-old women in 2009. Other characteristics associated with mammogram recommendations were certain patient comorbidities, physician specialty and primary care physician status, health maintenance organization status of the clinic, and certain visit characteristics. This study demonstrated a temporary effect of the USPSTF screening guideline change on mammogram recommendation. However, in light of conflicting recommendations by different guidelines, the physicians erred toward the more rigorous guidelines and did not permanently reduce their mammogram recommendation for women aged 40-49 years.

  5. High lifetime probability of screen-detected cervical abnormalities.

    PubMed

    Pankakoski, Maiju; Heinävaara, Sirpa; Sarkeala, Tytti; Anttila, Ahti

    2017-12-01

    Objective Regular screening and follow-up is an important key to cervical cancer prevention; however, screening inevitably detects mild or borderline abnormalities that would never progress to a more severe stage. We analysed the cumulative probability and recurrence of cervical abnormalities in the Finnish organized screening programme during a 22-year follow-up. Methods Screening histories were collected for 364,487 women born between 1950 and 1965. Data consisted of 1 207,017 routine screens and 88,143 follow-up screens between 1991 and 2012. Probabilities of cervical abnormalities by age were estimated using logistic regression and generalized estimating equations methodology. Results The probability of experiencing any abnormality at least once at ages 30-64 was 34.0% (95% confidence interval [CI]: 33.3-34.6%) . Probability was 5.4% (95% CI: 5.0-5.8%) for results warranting referral and 2.2% (95% CI: 2.0-2.4%) for results with histologically confirmed findings. Previous occurrences were associated with an increased risk of detecting new ones, specifically in older women. Conclusion A considerable proportion of women experience at least one abnormal screening result during their lifetime, and yet very few eventually develop an actual precancerous lesion. Re-evaluation of diagnostic criteria concerning mild abnormalities might improve the balance of harms and benefits of screening. Special monitoring of women with recurrent abnormalities especially at older ages may also be needed.

  6. Who should be screened for chromosomal abnormalities before ICSI treatment?

    PubMed

    Dul, E C; van Ravenswaaij-Arts, C M A; Groen, H; van Echten-Arends, J; Land, J A

    2010-11-01

    Guidelines on karyotyping infertile men before ICSI treatment are not consistent. Most guidelines recommend chromosomal screening in azoospermic and severe oligozoospermic men, because they are assumed to have the highest risk of abnormalities. We performed a retrospective cohort study in azoospermic men and men eligible for ICSI. We determined the prevalence of chromosomal abnormalities in relation to sperm concentration and compared our data to studies in the literature. A high prevalence of chromosomal abnormalities in azoospermic men was found, but no difference in the prevalence of abnormalities was seen between different sperm concentration categories in non-azoospermic men. This raises the question of who should be screened for chromosomal abnormalities before ICSI treatment. Considering the costs and benefits, we would propose limiting screening to infertile couples with non-obstructive azoospermia.

  7. Chorionic villus sampling for abnormal screening compared to historical indications: prevalence of abnormal karyotypes.

    PubMed

    Marshall, Nicole E; Fraley, Gwen; Feist, Cori; Burns, Michael J; Pereira, Leonardo

    2012-08-01

    To determine the prevalence of abnormal karyotype results in women undergoing chorionic villus sampling (CVS) for abnormal first trimester screening compared to CVS for historical indications (advanced maternal age (AMA) or prior aneuploidy). Retrospective cohort of all patients undergoing CVS at Oregon Health & Science University from January 2006 to June 2010. Patients were separated based on CVS indication: (1) positive ultrasound (U/S) or serum screening; or (2) AMA or prior aneuploidy with normal or no screening. Prevalence of abnormal karyotype results were compared between groups. Fetal karyotyping was successful in 500 of 506 CVS procedures performed. 203 CVS were performed for positive screening with 69 abnormal karyotypes (34.0%). 264 CVS were performed for historical indications with 11 abnormal karyotypes (4.2%). This difference was statistically significant (χ(2) 71.9, p < 0.001; OR 11.8 [95% CI 5.8, 24.6]). There were two age-related aneuplodies in AMA women without positive screening. 42 out of 44 AMA women diagnosed with aneuploidy (95.5%) had abnormal U/S and/or serum screening (35 U/S, 4 serum, 3 U/S and serum). Combined ultrasound and serum screening should be recommended to all women, including AMA women, prior to undergoing invasive testing to improve risk-based counseling and minimize morbidity.

  8. Computer-aided detection (CAD) of breast cancer on full field digital and screening film mammograms

    NASA Astrophysics Data System (ADS)

    Sun, Xuejun; Qian, Wei; Song, Xiaoshan; Qian, Yuyan; Song, Dansheng; Clark, Robert A.

    2003-05-01

    Full-field digital mammography (FFDM) as a new breast imaging modality has potential to detect more breast cancers or to detect them at smaller sizes and earlier stages compared with screening film mammography (SFM). However, its performance needs verification, and it would pose new problems for the development of CAD methods for breast cancer detection and diagnosis. Performance evaluation of CAD systems on FFDM and SFM has been conducted in this study, respectively. First, an adaptive CAD system employing a series of advanced modules has been developed on FFDM. Second, a standardization approach has been developed to make the CAD system independent of characteristics of digitizer or imaging modalities for mammography. CAD systems developed previously for SFM and developed in this study for FFDM have been evaluated on FFDM and SFM images without and with standardization, respectively, to examine the performance improvement of the CAD system developed in this study. Computerized free-response receiver operating characteristic (FROC) analysis has been adopted as performance evaluation method. Compared with previous one, the CAD system developed in this study demonstrated significantly performance improvements. However, the comparison results have shown that the performances of final CAD system in this study are not significantly different on FFDM and on SFM after standardization. It needs further study on the assessment of CAD system performance on FFDM and SFM modalities.

  9. Computer-aided diagnosis of malignant mammograms using Zernike moments and SVM.

    PubMed

    Sharma, Shubhi; Khanna, Pritee

    2015-02-01

    This work is directed toward the development of a computer-aided diagnosis (CAD) system to detect abnormalities or suspicious areas in digital mammograms and classify them as malignant or nonmalignant. Original mammogram is preprocessed to separate the breast region from its background. To work on the suspicious area of the breast, region of interest (ROI) patches of a fixed size of 128×128 are extracted from the original large-sized digital mammograms. For training, patches are extracted manually from a preprocessed mammogram. For testing, patches are extracted from a highly dense area identified by clustering technique. For all extracted patches corresponding to a mammogram, Zernike moments of different orders are computed and stored as a feature vector. A support vector machine (SVM) is used to classify extracted ROI patches. The experimental study shows that the use of Zernike moments with order 20 and SVM classifier gives better results among other studies. The proposed system is tested on Image Retrieval In Medical Application (IRMA) reference dataset and Digital Database for Screening Mammography (DDSM) mammogram database. On IRMA reference dataset, it attains 99% sensitivity and 99% specificity, and on DDSM mammogram database, it obtained 97% sensitivity and 96% specificity. To verify the applicability of Zernike moments as a fitting texture descriptor, the performance of the proposed CAD system is compared with the other well-known texture descriptors namely gray-level co-occurrence matrix (GLCM) and discrete cosine transform (DCT).

  10. Breast Cancers Between Mammograms Have Aggressive Features

    Cancer.gov

    Breast cancers that are discovered in the period between regular screening mammograms—known as interval cancers—are more likely to have features associated with aggressive behavior and a poor prognosis than cancers found via screening mammograms.

  11. "Thanks for Letting Us All Share Your Mammogram Experience Virtually": Developing a Web-Based Hub for Breast Cancer Screening.

    PubMed

    Galpin, Adam; Meredith, Joanne; Ure, Cathy; Robinson, Leslie

    2017-10-27

    The decision around whether to attend breast cancer screening can often involve making sense of confusing and contradictory information on its risks and benefits. The Word of Mouth Mammogram e-Network (WoMMeN) project was established to create a Web-based resource to support decision making regarding breast cancer screening. This paper presents data from our user-centered approach in engaging stakeholders (both health professionals and service users) in the design of this Web-based resource. Our novel approach involved creating a user design group within Facebook to allow them access to ongoing discussion between researchers, radiographers, and existing and potential service users. This study had two objectives. The first was to examine the utility of an online user design group for generating insight for the creation of Web-based health resources. We sought to explore the advantages and limitations of this approach. The second objective was to analyze what women want from a Web-based resource for breast cancer screening. We recruited a user design group on Facebook and conducted a survey within the group, asking questions about design considerations for a Web-based breast cancer screening hub. Although the membership of the Facebook group varied over time, there were 71 members in the Facebook group at the end point of analysis. We next conducted a framework analysis on 70 threads from Facebook and a thematic analysis on the 23 survey responses. We focused additionally on how the themes were discussed by the different stakeholders within the context of the design group. Two major themes were found across both the Facebook discussion and the survey data: (1) the power of information and (2) the hub as a place for communication and support. Information was considered as empowering but also recognized as threatening. Communication and the sharing of experiences were deemed important, but there was also recognition of potential miscommunication within online

  12. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    PubMed Central

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A <1st%ile has a good predictive value for subsequent fetal growth restriction. Women with PAPP-A<5th%ile should undergo subsequent risk assessment with routine MSAFP screening with the possible addition of uterine artery PI assessment in the midtrimester. PMID:20638576

  13. Timeliness of abnormal screening and diagnostic mammography follow-up at facilities serving vulnerable women.

    PubMed

    Goldman, L Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla

    2013-04-01

    Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations, such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. We examined receipt of diagnostic evaluation after abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4%-5% difference, P<0.05), and women at facilities serving more rural and low-income populations had lower rates of biopsy (4%-5% difference, P<0.05). Women undergoing biopsy at facilities serving vulnerable populations had longer times until biopsy than those at facilities serving nonvulnerable populations (21.6 vs. 15.6 d; 95% confidence interval for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range, 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations.

  14. Timeliness of abnormal screening and diagnostic mammography follow-up at facilities serving vulnerable women

    PubMed Central

    Goldman, L. Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla

    2013-01-01

    Background Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. Methods We examined receipt of diagnostic evaluation following abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. Results We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4-5% difference, p<0.05), and women at facilities serving more rural and low income populations had lower rates of biopsy (4-5% difference, p<0.05). Women undergoing biopsy at facilities serving vulnerable populations had longer times until biopsy than those at facilities serving non-vulnerable populations (21.6 days vs. 15.6 days; 95% CI for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Conclusions Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities

  15. Toward the breast screening balance sheet: cumulative risk of false positives for annual versus biennial mammograms commencing at age 40 or 50.

    PubMed

    Winch, Caleb J; Sherman, Kerry A; Boyages, John

    2015-01-01

    This study aimed to: (1) Estimate cumulative risk of recall from breast screening where no cancer is detected (a harm) in Australia; (2) Compare women screened annually versus biennially, commencing age 40 versus 50; and (3) Compare with international findings. At the no-cost metropolitan program studied, women attended biennial screening, but were offered annual screening if regarded at elevated risk for breast cancer. The cumulative risk of at least one recall was estimated using discrete-time survival analysis. Cancer detection statistics were computed. In total, 801,636 mammograms were undertaken in 231,824 women. Over 10 years, cumulative risk of recall was 13.3 % (95 % CI 12.7-13.8) for those screened biennially, and 19.9 % (CI 16.6-23.2) for those screened annually from age 50-51. Cumulative risk of complex false positive involving a biopsy was 3.1 % (CI 2.9-3.4) and 5.0 % (CI 3.4-6.6), respectively. From age 40-41, the risk of recall was 15.1 % (CI 14.3-16.0) and 22.5 % (CI 17.9-27.1) for biennial and annual screening, respectively. Corresponding rates of complex false positive were 3.3 % (CI 2.9-3.8) and 6.3 % (CI 3.4-9.1). Over 10 mammograms, invasive cancer was detected in 3.4 % (CI 3.3-3.5) and ductal carcinoma in situ in 0.7 % (CI 0.6-0.7) of women, with a non-significant trend toward a larger proportion of Tis and T1N0 cancers in women screened annually (74.5 %) versus biennially (70.1 %), χ (2) = 2.77, p = 0.10. Cancer detection was comparable to international findings. Recall risk was equal to European estimates for women screening from 50 and lower for screening from 40. Recall risk was half of United States' rates across start age and rescreening interval categories. Future benefit/harm balance sheets may be useful for communicating these findings to women.

  16. Ant-cuckoo colony optimization for feature selection in digital mammogram.

    PubMed

    Jona, J B; Nagaveni, N

    2014-01-15

    Digital mammogram is the only effective screening method to detect the breast cancer. Gray Level Co-occurrence Matrix (GLCM) textural features are extracted from the mammogram. All the features are not essential to detect the mammogram. Therefore identifying the relevant feature is the aim of this work. Feature selection improves the classification rate and accuracy of any classifier. In this study, a new hybrid metaheuristic named Ant-Cuckoo Colony Optimization a hybrid of Ant Colony Optimization (ACO) and Cuckoo Search (CS) is proposed for feature selection in Digital Mammogram. ACO is a good metaheuristic optimization technique but the drawback of this algorithm is that the ant will walk through the path where the pheromone density is high which makes the whole process slow hence CS is employed to carry out the local search of ACO. Support Vector Machine (SVM) classifier with Radial Basis Kernal Function (RBF) is done along with the ACO to classify the normal mammogram from the abnormal mammogram. Experiments are conducted in miniMIAS database. The performance of the new hybrid algorithm is compared with the ACO and PSO algorithm. The results show that the hybrid Ant-Cuckoo Colony Optimization algorithm is more accurate than the other techniques.

  17. Follow-up and timeliness after an abnormal cancer screening among underserved, urban women in a patient navigation program

    PubMed Central

    Markossian, Talar W.; Darnell, Julie S.; Calhoun, Elizabeth A.

    2012-01-01

    Background We evaluated the efficacy of a Chicago-based cancer patient navigation program developed to increase the proportion of patients reaching diagnostic resolution and reduce the time from abnormal screening test to definitive diagnostic resolution. Methods Women with an abnormal breast (n=352) or cervical (n=545) cancer screening test were recruited for the quasi-experimental study. Navigation subjects originated from five federally qualified health center sites and one safety net hospital. Records-based concurrent control subjects were selected from 20 sites. Control sites had similar characteristics to the navigated sites in terms of patient volume, racial/ethnic composition, and payor mix. Mixed-effects logistic regression and Cox proportional hazard regression analyses were conducted to compare navigation and control patients reaching diagnostic resolution by 60 days and time to resolution, adjusting for demographic covariates and site. Results Compared to controls, the breast navigation group had shorter time to diagnostic resolution (aHR=1.65, CI=1.20–2.28) and the cervical navigation group had shorter time to diagnostic resolution for those who resolved after 30 days (aHR= 2.31, CI=1.75–3.06), with no difference before 30 days (aHR= 1.42, CI=0.83–2.43). Variables significantly associated with longer time to resolution for breast cancer screening abnormalities were being older, never partnered, abnormal mammogram and BI-RADS 3, and being younger and Black for cervical abnormalities. Conclusions Patient navigation reduces time from abnormal cancer finding to definitive diagnosis in underserved women. Impact Results support efforts to use patient navigation as a strategy to reduce cancer disparities among socioeconomically disadvantaged women. PMID:23045544

  18. Follow-up and timeliness after an abnormal cancer screening among underserved, urban women in a patient navigation program.

    PubMed

    Markossian, Talar W; Darnell, Julie S; Calhoun, Elizabeth A

    2012-10-01

    We evaluated the efficacy of a Chicago-based cancer patient navigation program developed to increase the proportion of patients reaching diagnostic resolution and reduce the time from abnormal screening test to definitive diagnostic resolution. Women with an abnormal breast (n = 352) or cervical (n = 545) cancer screening test were recruited for the quasi-experimental study. Navigation subjects originated from five federally qualified health center sites and one safety net hospital. Records-based concurrent control subjects were selected from 20 sites. Control sites had similar characteristics to the navigated sites in terms of patient volume, racial/ethnic composition, and payor mix. Mixed-effects logistic regression and Cox proportional hazard regression analyses were conducted to compare navigation and control patients reaching diagnostic resolution by 60 days and time to resolution, adjusting for demographic covariates and site. Compared with controls, the breast navigation group had shorter time to diagnostic resolution (aHR = 1.65, CI = 1.20-2.28) and the cervical navigation group had shorter time to diagnostic resolution for those who resolved after 30 days (aHR = 2.31, CI = 1.75-3.06), with no difference before 30 days (aHR = 1.42, CI = 0.83-2.43). Variables significantly associated with longer time to resolution for breast cancer screening abnormalities were being older, never partnered, abnormal mammogram and BI-RADS 3, and being younger and Black for cervical abnormalities. Patient navigation reduces time from abnormal cancer finding to definitive diagnosis in underserved women. Results support efforts to use patient navigation as a strategy to reduce cancer disparities among socioeconomically disadvantaged women. 2012 AACR

  19. US Navy Women's Experience of an Abnormal Cervical Cancer Screening.

    PubMed

    Braun, Lisa A; Kennedy, Holly Powell; Sadler, Lois S; Dixon, Jane; Womack, Julie; Wilson, Candy

    2016-01-01

    Recent policy revisions allow greater inclusion of military women in operational and/or deployable positions (ie, shipboard, overseas, and war zone duty assignments), but these positions can create unique health care challenges. Military members are often transient due to deployments and change of duty stations, impacting timely follow-up care for treatable health conditions. There has been minimal research on challenges or strategies in preventive health screening and follow-up for US military women. The purpose of this qualitative research study was to describe US Navy women's experiences with abnormal cervical cancer screenings requiring colposcopic follow-up care. Ship- and shored-based women receiving care at a military colposcopy clinic completed interviews about their experience. Two forms of narrative analysis, Labov's sociolinguistic structural analysis and Braun and Clarke's thematic analysis, were employed to gain a more robust understanding of the women's experiences. The sample was comprised of 26 women (16 ship-based, 10 shore-based). Five themes were identified: 1) It's like this bombshell (initial abnormal results notification); 2) I didn't understand (self-discovery process); 3) Freaked (emotional toll); 4) It's kind of like this back and forth (scheduling and navigating care); and 5) It really opened my eyes (lessons learned). The women's stories highlighted some issues unique to military health care, such as operational demands and follow-up care; other issues are likely common for most women learning about an abnormal cervical cancer screening result. Areas important for practice and future research include improving notification practices, providing information, understanding women's fear, and continuity of care. Research exploring educational initiatives and self-management practices are critical within military populations. © 2016 by the American College of Nurse-Midwives.

  20. Using a Tracking System to Improve Prostate Cancer Screening and Follow-up in a Small Urban Community

    DTIC Science & Technology

    2001-05-01

    clinical practice, attention is directed toward informing the general public about them. In the late 1980 ’s, the Prostate Cancer Education Council...impact of abnormal mammograms on psychosocial outcomes and subsequent screening. PsychoOncology, 9, 402-410. Myers, R.E., Hyslop T., Jennings-Dozier, K...impact of abnormal mammograms on psychosocial outcomes and subsequent screening. PsychoOncology, 9, 402- 410. Myers, R.E., Hyslop T., Jennings-Dozier, K

  1. “Thanks for Letting Us All Share Your Mammogram Experience Virtually”: Developing a Web-Based Hub for Breast Cancer Screening

    PubMed Central

    2017-01-01

    Background The decision around whether to attend breast cancer screening can often involve making sense of confusing and contradictory information on its risks and benefits. The Word of Mouth Mammogram e-Network (WoMMeN) project was established to create a Web-based resource to support decision making regarding breast cancer screening. This paper presents data from our user-centered approach in engaging stakeholders (both health professionals and service users) in the design of this Web-based resource. Our novel approach involved creating a user design group within Facebook to allow them access to ongoing discussion between researchers, radiographers, and existing and potential service users. Objective This study had two objectives. The first was to examine the utility of an online user design group for generating insight for the creation of Web-based health resources. We sought to explore the advantages and limitations of this approach. The second objective was to analyze what women want from a Web-based resource for breast cancer screening. Methods We recruited a user design group on Facebook and conducted a survey within the group, asking questions about design considerations for a Web-based breast cancer screening hub. Although the membership of the Facebook group varied over time, there were 71 members in the Facebook group at the end point of analysis. We next conducted a framework analysis on 70 threads from Facebook and a thematic analysis on the 23 survey responses. We focused additionally on how the themes were discussed by the different stakeholders within the context of the design group. Results Two major themes were found across both the Facebook discussion and the survey data: (1) the power of information and (2) the hub as a place for communication and support. Information was considered as empowering but also recognized as threatening. Communication and the sharing of experiences were deemed important, but there was also recognition of potential

  2. Cervical cytology screening and management of abnormal cytology in adolescents.

    PubMed

    Burgis, Judith T; Brown, Jaime; Menon, Seema; Bacon, Janice L

    2009-02-01

    The consensus guidelines recognize adolescents as a special group and allow for more conservative follow- up of abnormal cytology and histology. The guidelines recognize the role of high rates of HPV infection and reinfection in teens, along with high rates of clearance of HPV and low rates of invasive cervical cancer. Risks of treatment are balanced with risk for disease progression. The cervical cancer vaccine is now recommended for teens. The approved vaccine protects against HPV related disease caused by four subtypes of HPV 6, 11, 16, and 18. The Food and Drug Administration has approved the vaccine as routine for 11- and 12-year-old girls. The vaccine is most effective prior to HPV exposure or before the sexual debut. In South Carolina only 4.8% of high school girls indicate having sexual intercourse before age 13. Vaccination provides an opportunity to review risky behaviors with adolescent patients and to encourage healthy, safe lifestyles. Vaccination is not protective for sexually transmitted infections and this can be emphasized at vaccination visits as well. The importance of cancer screening can also be reviewed with patients at vaccination visits.

  3. Abnormal ovarian cancer screening test result: women's informational, psychological and practical needs.

    PubMed

    Ryan, Patricia Y; Graves, Kristi D; Pavlik, Edward J; Andrykowski, Michael A

    2007-01-01

    Considerable effort has been devoted to the identification of cost-effective approaches to screening for ovarian cancer (OC). Transvaginal ultrasound (TVS) is one such screening approach. Approximately 5-7% of routine TVS screening tests yield abnormal results. Some women experience significant distress after receipt of an abnormal TVS screening test. Four focus groups provided in-depth, qualitative data regarding the informational, psychological, and practical needs of women after the receipt of an abnormal TVS result. Through question and content analytic procedures, we identified four themes: anticipation, emotional response, role of the screening technician, and impact of prior cancer experiences. Results provide initial guidance toward development of interventions to promote adaptive responses after receipt of an abnormal cancer screening test result.

  4. Variation in Screening Abnormality Rates and Follow-Up of Breast, Cervical and Colorectal Cancer Screening within the PROSPR Consortium.

    PubMed

    Tosteson, Anna N A; Beaber, Elisabeth F; Tiro, Jasmin; Kim, Jane; McCarthy, Anne Marie; Quinn, Virginia P; Doria-Rose, V Paul; Wheeler, Cosette M; Barlow, William E; Bronson, Mackenzie; Garcia, Michael; Corley, Douglas A; Haas, Jennifer S; Halm, Ethan A; Kamineni, Aruna; Rutter, Carolyn M; Tosteson, Tor D; Trentham-Dietz, Amy; Weaver, Donald L

    2016-04-01

    Primary care providers and health systems have prominent roles in guiding effective cancer screening. To characterize variation in screening abnormality rates and timely initial follow-up for common cancer screening tests. Population-based cohort undergoing screening in 2011, 2012, or 2013 at seven research centers comprising the National Cancer Institute-sponsored Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. Adults undergoing mammography with or without digital breast tomosynthesis (n = 97,683 ages 40-75 years), fecal occult blood or fecal immunochemical tests (n = 759,553 ages 50-75 years), or Papanicolaou with or without human papillomavirus tests (n = 167,330 ages 21-65 years). Breast, colorectal, or cervical cancer screening. Abnormality rates per 1000 screens; percentage with timely initial follow-up (within 90 days, except 9-month window for BI-RADS 3). Primary care clinic-level variation in percentage with screening abnormality and percentage with timely initial follow-up. There were 10,248/97,683 (104.9 per 1000) abnormal breast cancer screens, 35,847/759,553 (47.2 per 1000) FOBT/FIT-positive colorectal cancer screens, and 13,266/167,330 (79.3 per 1000) abnormal cervical cancer screens. The percentage with timely follow-up was 93.2 to 96.7 % for breast centers, 46.8 to 68.7  % for colorectal centers, and 46.6 % for the cervical cancer screening center (low-grade squamous intraepithelial lesions or higher). The primary care clinic variation (25th to 75th percentile) was smaller for the percentage with an abnormal screen (breast, 8.5-10.3 %; colorectal, 3.0-4.8 %; cervical, 6.3-9.9 %) than for the percentage with follow-up within 90 days (breast, 90.2-95.8 %; colorectal, 43.4-52.0 %; cervical, 29.6-61.4 %). Variation in both the rate of screening abnormalities and their initial follow-up was evident across organ sites and primary care clinics. This highlights an opportunity for improving the delivery of

  5. Wavelet Compression of Satellite-Transmitted Digital Mammograms

    NASA Technical Reports Server (NTRS)

    Zheng, Yuan F.

    2001-01-01

    Breast cancer is one of the major causes of cancer death in women in the United States. The most effective way to treat breast cancer is to detect it at an early stage by screening patients periodically. Conventional film-screening mammography uses X-ray films which are effective in detecting early abnormalities of the breast. Direct digital mammography has the potential to improve the image quality and to take advantages of convenient storage, efficient transmission, and powerful computer-aided diagnosis, etc. One effective alternative to direct digital imaging is secondary digitization of X-ray films. This technique may not provide as high an image quality as the direct digital approach, but definitely have other advantages inherent to digital images. One of them is the usage of satellite-transmission technique for transferring digital mammograms between a remote image-acquisition site and a central image-reading site. This technique can benefit a large population of women who reside in remote areas where major screening and diagnosing facilities are not available. The NASA-Lewis Research Center (LeRC), in collaboration with the Cleveland Clinic Foundation (CCF), has begun a pilot study to investigate the application of the Advanced Communications Technology Satellite (ACTS) network to telemammography. The bandwidth of the T1 transmission is limited (1.544 Mbps) while the size of a mammographic image is huge. It takes a long time to transmit a single mammogram. For example, a mammogram of 4k by 4k pixels with 16 bits per pixel needs more than 4 minutes to transmit. Four images for a typical screening exam would take more than 16 minutes. This is too long a time period for a convenient screening. Consequently, compression is necessary for making satellite-transmission of mammographic images practically possible. The Wavelet Research Group of the Department of Electrical Engineering at The Ohio State University (OSU) participated in the LeRC-CCF collaboration by

  6. Use of prior mammograms in the transition to digital mammography: a performance and cost analysis.

    PubMed

    Taylor-Phillips, S; Wallis, M G; Duncan, A; Gale, A G

    2012-01-01

    Breast screening in Europe is gradually changing from film to digital imaging and reporting of cases. In the transition period prior mammograms (from the preceding screening round) are films thereby potentially causing difficulties in comparison to current digital mammograms. To examine this breast screening performance was measured at a digital mammography workstation with prior mammograms displayed in different formats, and the associated costs calculated. 160 selected difficult cases (41% malignant) were read by eight UK qualified mammography readers in three conditions: with film prior mammograms; with digitised prior mammograms; or without prior mammograms. Lesion location and probability of malignancy were recorded, alongside a decision of whether to recall each case for further tests. JAFROC analysis showed a difference between conditions (p=.006); performance with prior mammograms in either film or digitised formats was superior to that without prior mammograms (p<.05). There was no difference in the performance when the prior mammograms were presented in film or digitised form. The number of benign or normal cases recalled was 26% higher without prior mammograms than with digitised or film prior mammograms (p<.05). This would correspond to an increase in recall rate at the study hospital from 4.3% to 5.5% with no associated increase in cancer detection rate. The cost of this increase was estimated to be £11,581 (€13,666) per 10,000 women screened, which is higher than the cost of digitised (£11,114/€13,115), or film display (£6451/€7612) of the prior mammograms. It is recommended that, where available, prior mammograms are used in the transition to digital breast screening. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. The agreement between self-reported cervical smear abnormalities and screening programme records.

    PubMed

    Canfell, Karen; Beral, Valerie; Green, Jane; Cameron, Rebecca; Baker, Krys; Brown, Anna

    2006-01-01

    The Million Women Study is a cohort study of women aged 50-64 years in England and Scotland. As a component of the follow-up questionnaire, participants were asked to indicate if they had an abnormal cervical smear in the previous five years. This study compared self-reported cervical abnormalities with screening records obtained from the National Health Service Cervical Screening Programme. For 1944 randomly selected Million Women Study participants in Oxfordshire, screening records were assessed over a six-year period prior to the date of self-reporting. The six-year period was chosen to allow for errors in the recall of timing of abnormal smears. A total of 68 women (3.5%) had a record of at least one equivocal or abnormal smear within the last six years, whereas 49 women (2.5%) self-reported an abnormality. There was a strong trend for an increased probability of self-reporting a history of an abnormal smear as the severity of the recorded abnormality increased (P <0.001). For women with an NHS record of borderline dyskaryosis, mild dyskaryosis, or moderate dyskaryosis/severe dyskaryosis/invasive cancer, the proportions reporting an abnormality were 40%, 58% and 77%, respectively. For women with negative and inadequate smears, the proportion self-reporting an abnormality were 0.6% and 0.7%, respectively. These results indicate that among women whose screening programme records show an abnormal smear, the proportion self-reporting an abnormality increases with the severity of the recorded lesion. Almost all women with a record of negative or inadequate smear(s) correctly interpret the result and do not self-report an abnormality.

  8. Electrocardiogram Screening in Children with Congenital Sensorineural Hearing Loss: Prevalence and Follow-up of Abnormalities.

    PubMed

    Farzal, Zainab; Walsh, Jonathan; Ahmad, Faisal I; Roberts, Jason; Ferns, Sunita J; Zdanski, Carlton J

    2018-03-01

    Objective The purpose is to determine the prevalence of electrocardiogram (ECG) abnormalities, including borderline and prolonged QT, among screened children with sensorineural hearing loss (SNHL) and to analyze their subsequent medical workup. Study Design Institutional Review Board-approved case series with chart review. Setting Tertiary academic center. Subjects and Methods Cases from 1996 to 2014 involving pediatric patients (N = 1994) with SNHL were analyzed. Abnormal ECGs were categorized as borderline/prolonged QT or other. A board-certified pediatric cardiologist retrospectively determined the clinical significance of ECG changes. For follow-up analysis, children with heart disease, known syndromes, or inaccessible records were excluded. Results Among 772 children who had ECGs, 215 (27.8%) had abnormal results: 35 (4.5%) with QT abnormalities and 180 (23.3%) with other abnormalities. For children with QT abnormalities meeting inclusion criteria (n = 30), follow-up measures included cardiology referral (46.6%), repeat ECG by ear, nose, and throat (ENT) specialist (20%), clearance by ENT specialist with clinical correlation and/or comparison with old ECGs (20%), and pediatrician follow-up (6.7%). Documentation of further workup by ENT or referral was absent for 6.7%. For children with other ECG changes meeting inclusion criteria (n = 136), abnormalities were documented for 57 (41.9%); normal QT without other abnormality was documented for 18 (13.2%). The most common follow-up referrals were to pediatricians (16.9%) and cardiologists (10.3%). Among patients with clinically significant non-QT abnormalities mandating further evaluation (n = 122), 38 (31.1%) had documented follow-up in medical records. Conclusion There is a high prevalence of ECG abnormalities among children with congenital SNHL. If findings are confirmed by future studies, screening should be considered for congenital unilateral or bilateral SNHL, regardless of severity. We describe a

  9. Clustering microcalcifications techniques in digital mammograms

    NASA Astrophysics Data System (ADS)

    Díaz, Claudia. C.; Bosco, Paolo; Cerello, Piergiorgio

    2008-11-01

    Breast cancer has become a serious public health problem around the world. However, this pathology can be treated if it is detected in early stages. This task is achieved by a radiologist, who should read a large amount of mammograms per day, either for a screening or diagnostic purpose in mammography. However human factors could affect the diagnosis. Computer Aided Detection is an automatic system, which can help to specialists in the detection of possible signs of malignancy in mammograms. Microcalcifications play an important role in early detection, so we focused on their study. The two mammographic features that indicate the microcalcifications could be probably malignant are small size and clustered distribution. We worked with density techniques for automatic clustering, and we applied them on a mammography CAD prototype developed at INFN-Turin, Italy. An improvement of performance is achieved analyzing images from a Perugia-Assisi Hospital, in Italy.

  10. Validation of a condition-specific measure for women having an abnormal screening mammography.

    PubMed

    Brodersen, John; Thorsen, Hanne; Kreiner, Svend

    2007-01-01

    The aim of this study is to assess the validity of a new condition-specific instrument measuring psychosocial consequences of abnormal screening mammography (PCQ-DK33). The draft version of the PCQ-DK33 was completed on two occasions by 184 women who had received an abnormal screening mammography and on one occasion by 240 women who had received a normal screening result. Item Response Theories and Classical Test Theories were used to analyze data. Construct validity, concurrent validity, known group validity, objectivity and reliability were established by item analysis examining the fit between item responses and Rasch models. Six dimensions covering anxiety, behavioral impact, sense of dejection, impact on sleep, breast examination, and sexuality were identified. One item belonging to the dejection dimension had uniform differential item functioning. Two items not fitting the Rasch models were retained because of high face validity. A sick leave item added useful information when measuring side effects and socioeconomic consequences of breast cancer screening. Five "poor items" were identified and should be deleted from the final instrument. Preliminary evidence for a valid and reliable condition-specific measure for women having an abnormal screening mammography was established. The measure includes 27 "good" items measuring different attributes of the same overall latent structure-the psychosocial consequences of abnormal screening mammography.

  11. Early Pregnancy Diabetes Screening and Diagnosis: Prevalence, Rates of Abnormal Test Results, and Associated Factors.

    PubMed

    Mission, John F; Catov, Janet; Deihl, Tiffany E; Feghali, Maisa; Scifres, Christina

    2017-11-01

    To evaluate the prevalence of early diabetes screening in pregnancy, rates of abnormal diabetes test results before 24 weeks of gestation, and factors associated with early diabetes screening. This was a retrospective cohort study of all singleton deliveries from 2012 to 2014 among diverse clinical practices at a large academic medical center. We assessed rates of early (less than 24 weeks of gestation) and routine (at or beyond 24 weeks of gestation) diabetes screening, with abnormal test results defined using the Carpenter-Coustan criteria, a 50-g glucose challenge test result greater than 200 mg/dL, or a hemoglobin A1C level greater than 6.5%. Univariate and multivariate analyses were used to evaluate clinical and demographic determinants of screening and diagnosis. Overall, 1,420 of 11,331 (12.5%) women underwent early screening. Increasing body mass index (BMI) category, race, public insurance, history of gestational diabetes mellitus, a family history of diabetes, and chronic hypertension were associated with early screening. Early screening rates rose with increasing BMI category, but only 268 of 551 (48.6%) of women with class III obesity underwent early screening. Among those screened early, 2.0% of normal-weight women, 4.0% of overweight women, 4.2% of class I obese women, 3.8% of class II obese women, and 9.0% of class III obese women had abnormal early test results (P<.001). Early diabetes screening is used inconsistently, and many women with risk factors do not undergo early screening. A significant proportion of women with class III obesity will test positive for gestational diabetes mellitus before 24 weeks of gestation, and studies are urgently needed to assess the effect of early diabetes screening and diagnosis on perinatal outcomes in high-risk women.

  12. Probability of an Abnormal Screening PSA Result Based on Age, Race, and PSA Threshold

    PubMed Central

    Espaldon, Roxanne; Kirby, Katharine A.; Fung, Kathy Z.; Hoffman, Richard M.; Powell, Adam A.; Freedland, Stephen J.; Walter, Louise C.

    2014-01-01

    Objective To determine the distribution of screening PSA values in older men and how different PSA thresholds affect the proportion of white, black, and Latino men who would have an abnormal screening result across advancing age groups. Methods We used linked national VA and Medicare data to determine the value of the first screening PSA test (ng/mL) of 327,284 men age 65+ who underwent PSA screening in the VA healthcare system in 2003. We calculated the proportion of men with an abnormal PSA result based on age, race, and common PSA thresholds. Results Among men age 65+, 8.4% had a PSA >4.0ng/mL. The percentage of men with a PSA >4.0ng/mL increased with age and was highest in black men (13.8%) versus white (8.0%) or Latino men (10.0%) (P<0.001). Combining age and race, the probability of having a PSA >4.0ng/mL ranged from 5.1% of Latino men age 65–69 to 27.4% of black men age 85+. Raising the PSA threshold from >4.0ng/mL to >10.0ng/mL, reclassified the greatest percentage of black men age 85+ (18.3% absolute change) and the lowest percentage of Latino men age 65–69 (4.8% absolute change) as being under the biopsy threshold (P<0.001). Conclusions Age, race, and PSA threshold together affect the pre-test probability of an abnormal screening PSA result. Based on screening PSA distributions, stopping screening among men whose PSA < 3ng/ml means over 80% of white and Latino men age 70+ would stop further screening, and increasing the biopsy threshold to >10ng/ml has the greatest effect on reducing the number of older black men who will face biopsy decisions after screening. PMID:24439009

  13. [Genetic diagnostics of pathogenic splicing abnormalities in the clinical laboratory--pitfalls and screening approaches].

    PubMed

    Niimi, Hideki; Ogawa, Tomomi; Note, Rhougou; Hayashi, Shirou; Ueno, Tomohiro; Harada, Kenu; Uji, Yoshinori; Kitajima, Isao

    2010-12-01

    In recent years, genetic diagnostics of pathogenic splicing abnormalities are increasingly recognized as critically important in the clinical genetic diagnostics. It is reported that approximately 10% of pathogenic mutations causing human inherited diseases are splicing mutations. Nonetheless, it is still difficult to identify splicing abnormalities in routine genetic diagnostic settings. Here, we studied two different kinds of cases with splicing abnormalities. The first case is a protein S deficiency. Nucleotide analyses revealed that the proband had a previously reported G to C substitution in the invariant AG dinucleotide at the splicing acceptor site of intronl/exon2, which produces multiple splicing abnormalities resulting in protein S deficiency. The second case is an antithrombin (AT) deficiency. This proband had a previously reported G to A substitution, at nucleotide position 9788 in intron 4, 14 bp in front of exon 5, which created a de novo exon 5 splice site and resulted in AT deficiency. From a practical standpoint, we discussed the pitfalls, attentions, and screening approaches in genetic diagnostics of pathogenic splicing abnormalities. Due to the difficulty with full-length sequence analysis of introns, and the lack of RNA samples, splicing mutations may escape identification. Although current genetic testing remains to be improved, to screen for splicing abnormalities more efficiently, it is significant to use an appropriate combination of various approaches such as DNA and/or RNA samples, splicing mutation databases, bioinformatic tools to detect splice sites and cis-regulatory elements, and in vitro and/or in vivo experimentally methods as needed.

  14. Edge map analysis in chest X-rays for automatic pulmonary abnormality screening.

    PubMed

    Santosh, K C; Vajda, Szilárd; Antani, Sameer; Thoma, George R

    2016-09-01

    Our particular motivator is the need for screening HIV+ populations in resource-constrained regions for the evidence of tuberculosis, using posteroanterior chest radiographs (CXRs). The proposed method is motivated by the observation that abnormal CXRs tend to exhibit corrupted and/or deformed thoracic edge maps. We study histograms of thoracic edges for all possible orientations of gradients in the range [Formula: see text] at different numbers of bins and different pyramid levels, using five different regions-of-interest selection. We have used two CXR benchmark collections made available by the U.S. National Library of Medicine and have achieved a maximum abnormality detection accuracy (ACC) of 86.36 % and area under the ROC curve (AUC) of 0.93 at 1 s per image, on average. We have presented an automatic method for screening pulmonary abnormalities using thoracic edge map in CXR images. The proposed method outperforms previously reported state-of-the-art results.

  15. Age Specific Cytological Abnormalities in Women Screened for Cervical Cancer in the Emirate of Abu Dhabi.

    PubMed

    Al Zaabi, Muna; Al Muqbali, Shaikha; Al Sayadi, Thekra; Al Ameeri, Suhaila; Coetsee, Karin; Balayah, Zuhur; Ortashi, Osman

    2015-01-01

    Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 270,000 deaths each year. Globally, it is estimated that over one million women currently have cervical cancer, most of whom have not been diagnosed, or have no access to treatment that could cure them or prolong their lives. In the United Arab Emirates (UAE) cervical cancer is the third most common cancer in women. A population-based cross-sectional retrospective survey of cervical smear abnormalities was conducted in the Emirate of Abu Dhabi, UAE, from January 2013 to December 2013 by collecting consecutive liquid-based cytology samples from the Department of Pathology at the SKMC Hospital in Abu Dhabi city. The total number of women screened for cervical cancer for the year 2013 at SKMC was 4,593, with 225 (4.89%) abnormal smears. The majority of the abnormal smear results were atypical squamous cells of undetermined significance (ASCUS) 114 (2.48%). This study showed 60% increase in the rate of abnormal cervical smears in the UAE over the last 10 years. In this study the highest incidence of high grade abnormalities were seen in women above the age of 61 years (1.73%), this might be due to the fact that this group of women missed the chance of screening of cervical cancer earlier in their lives or could be explained by the well-known second peak of HPV infection seen in many prevalence studies. We conclude that the rate of abnormal cervical smear in the screened Abu Dhabi women is not different from the rate in developed countries. A notable increase in both low and high grade abnormalities has occurred within the last decade.

  16. First-trimester screening for chromosomal abnormalities: advantages of an instant results approach.

    PubMed

    Norton, Mary E

    2010-09-01

    Protocols that include first trimester screening for fetal chromosome abnormalities have become standard of care throughout the United States. Earlier screening allows for first trimester diagnostic testing in cases found to be at increased risk. However, first trimester screening requires coordination of the nuchal translucency ultrasound screening (NT) and biochemical screening, during early, specific, narrow, but slightly different gestational age ranges. Instant results can often be provided at the time of the NT ultrasound if preceded by the programs that perform the biochemical analyses; this optimizes the benefits of the first trimester approach while improving efficiency and communication with the patient. This article discusses the benefits and logistics of such an approach. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Segmentation and detection of breast cancer in mammograms combining wavelet analysis and genetic algorithm.

    PubMed

    Pereira, Danilo Cesar; Ramos, Rodrigo Pereira; do Nascimento, Marcelo Zanchetta

    2014-04-01

    In Brazil, the National Cancer Institute (INCA) reports more than 50,000 new cases of the disease, with risk of 51 cases per 100,000 women. Radiographic images obtained from mammography equipments are one of the most frequently used techniques for helping in early diagnosis. Due to factors related to cost and professional experience, in the last two decades computer systems to support detection (Computer-Aided Detection - CADe) and diagnosis (Computer-Aided Diagnosis - CADx) have been developed in order to assist experts in detection of abnormalities in their initial stages. Despite the large number of researches on CADe and CADx systems, there is still a need for improved computerized methods. Nowadays, there is a growing concern with the sensitivity and reliability of abnormalities diagnosis in both views of breast mammographic images, namely cranio-caudal (CC) and medio-lateral oblique (MLO). This paper presents a set of computational tools to aid segmentation and detection of mammograms that contained mass or masses in CC and MLO views. An artifact removal algorithm is first implemented followed by an image denoising and gray-level enhancement method based on wavelet transform and Wiener filter. Finally, a method for detection and segmentation of masses using multiple thresholding, wavelet transform and genetic algorithm is employed in mammograms which were randomly selected from the Digital Database for Screening Mammography (DDSM). The developed computer method was quantitatively evaluated using the area overlap metric (AOM). The mean ± standard deviation value of AOM for the proposed method was 79.2 ± 8%. The experiments demonstrate that the proposed method has a strong potential to be used as the basis for mammogram mass segmentation in CC and MLO views. Another important aspect is that the method overcomes the limitation of analyzing only CC and MLO views. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. The frequent shift to intermediate flora in preterm delivery cases after abnormal vaginal flora screening

    PubMed Central

    Honda, Hiroshi; Yokoyama, Takanori; Akimoto, Yumiko; Tanimoto, Hirotoshi; Teramoto, Mitsue; Teramoto, Hideki

    2014-01-01

    The effect of screening and treatment for abnormal vaginal flora on the reduction of preterm deliveries remains controversial. We evaluated whether this screening and treatment reduces the preterm delivery rate for general-population pregnant women. Pregnant women of the Intervention group (n = 574) underwent the screening test and the treatment of vaginal metronidazole during the early second trimester, and those of the Control group (n = 1,161) did not. We compared the preterm delivery rate between these two groups. We also compared the profiles of vaginal flora of the preterm delivery cases with those of the pregnant women with a normal course. There was no significant difference in the preterm delivery rate between these two groups. However, in the preterm delivery cases, a frequent shift to intermediate flora was observed not before but after the screening in the Intervention group. This shift may explain why most of the previous studies failed in regard to the prevention of preterm deliveries. PMID:24762852

  19. Impact of depression on the intensity of patient navigation for women with abnormal cancer screenings.

    PubMed

    De La Cruz, Ignacio I; Freund, Karen M; Battaglia, Tracy A; Chen, Clara A; Bak, Sharon; Kalish, Richard; Lottero, Barbara; Egan, Patrick; Heeren, Tim; Kronman, Andrea C

    2014-02-01

    Patient navigation is increasingly being used to support vulnerable patients to receive timely and quality medical care. We sought to understand whether patients with depression utilize additional patient navigation services after abnormal cancer screening. We compared depressed and non-depressed women using three different measures of intensity of patient navigation: number of patient-navigator encounters, encounter time, and number of unique barriers to care. The study population consisted of 1,455 women who received navigation after abnormal screening for breast or cervical cancer at one of six community health centers in Boston. Navigators spent a median of 60-75 minutes over one or two encounters per participant, with 49% of participants having one or more documented barrier to care. Depressed women did not differ in total numbers of encounters, encounter time, or unique barriers compared with non-depressed women. Our findings suggest that pre-existing depression does not predict which women will utilize additional navigation services.

  20. Automated System for Early Breast Cancer Detection in Mammograms

    NASA Technical Reports Server (NTRS)

    Bankman, Isaac N.; Kim, Dong W.; Christens-Barry, William A.; Weinberg, Irving N.; Gatewood, Olga B.; Brody, William R.

    1993-01-01

    The increasing demand on mammographic screening for early breast cancer detection, and the subtlety of early breast cancer signs on mammograms, suggest an automated image processing system that can serve as a diagnostic aid in radiology clinics. We present a fully automated algorithm for detecting clusters of microcalcifications that are the most common signs of early, potentially curable breast cancer. By using the contour map of the mammogram, the algorithm circumvents some of the difficulties encountered with standard image processing methods. The clinical implementation of an automated instrument based on this algorithm is also discussed.

  1. Interventions to Improve Follow-Up of Abnormal Findings in Cancer Screening

    PubMed Central

    Bastani, Roshan; Yabroff, K. Robin; Myers, Ronald E.; Glenn, Beth

    2006-01-01

    The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care. Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and policy-level correlates. The majority of intervention studies to increase follow-up receipt have focused on patient-level factors and have targeted follow-up of abnormal Papanicolaou smears. Insufficient information is available regarding the effectiveness of provider, practice, or policy-level interventions. Standard definitions of what constitutes appropriate follow-up are lacking, which severely limit comparability of findings across studies. The validity of various methods of obtaining outcome data has not been clearly established. More research is needed on interventions targeting provider, system, and policy-level factors, particularly interventions focusing on follow-up of colorectal and breast abnormalities. Standardization of definitions and measures is needed to facilitate comparisons across studies. PMID:15316914

  2. Management of low-grade cervical abnormalities detected at screening: which method do women prefer?

    PubMed

    Whynes, D K; Woolley, C; Philips, Z

    2008-12-01

    To establish whether women with low-grade abnormalities detected during screening for cervical cancer prefer to be managed by cytological surveillance or by immediate colposcopy. TOMBOLA (Trial of Management of Borderline and Other Low-grade Abnormal smears) is a randomized controlled trial comparing alternative management strategies following the screen-detection of low-grade cytological abnormalities. At exit, a sample of TOMBOLA women completed a questionnaire eliciting opinions on their management, contingent valuations (CV) of the management methods and preferences. Within-trial quality of life (EQ-5D) data collected for a sample of TOMBOLA women throughout their follow-up enabled the comparison of self-reported health at various time points, by management method. Once management had been initiated, self-reported health in the colposcopy arm rose relative to that in the surveillance arm, although the effect was short-term only. For the majority of women, the satisfaction ratings and the CV indicated approval of the management method to which they had been randomized. Of the minority manifesting a preference for the method which they had not experienced, relatively more would have preferred colposcopy than would have preferred surveillance. The findings must be interpreted in the light of sample bias with respect to preferences, whereby enthusiasm for colposcopy was probably over-represented amongst trial participants. The study suggests that neither of the management methods is preferred unequivocally; rather, individual women have individual preferences, although many would be indifferent between methods.

  3. Using Natural Language Processing to Extract Abnormal Results From Cancer Screening Reports.

    PubMed

    Moore, Carlton R; Farrag, Ashraf; Ashkin, Evan

    2017-09-01

    Numerous studies show that follow-up of abnormal cancer screening results, such as mammography and Papanicolaou (Pap) smears, is frequently not performed in a timely manner. A contributing factor is that abnormal results may go unrecognized because they are buried in free-text documents in electronic medical records (EMRs), and, as a result, patients are lost to follow-up. By identifying abnormal results from free-text reports in EMRs and generating alerts to clinicians, natural language processing (NLP) technology has the potential for improving patient care. The goal of the current study was to evaluate the performance of NLP software for extracting abnormal results from free-text mammography and Pap smear reports stored in an EMR. A sample of 421 and 500 free-text mammography and Pap reports, respectively, were manually reviewed by a physician, and the results were categorized for each report. We tested the performance of NLP to extract results from the reports. The 2 assessments (criterion standard versus NLP) were compared to determine the precision, recall, and accuracy of NLP. When NLP was compared with manual review for mammography reports, the results were as follows: precision, 98% (96%-99%); recall, 100% (98%-100%); and accuracy, 98% (96%-99%). For Pap smear reports, the precision, recall, and accuracy of NLP were all 100%. Our study developed NLP models that accurately extract abnormal results from mammography and Pap smear reports. Plans include using NLP technology to generate real-time alerts and reminders for providers to facilitate timely follow-up of abnormal results.

  4. Current controversies in prenatal diagnosis 2: Cell-free DNA prenatal screening should be used to identify all chromosome abnormalities.

    PubMed

    Chitty, Lyn S; Hudgins, Louanne; Norton, Mary E

    2018-02-01

    Noninvasive prenatal testing (NIPT) using cell-free DNA (cfDNA) from maternal serum has been clinically available since 2011. This technology has revolutionized our ability to screen for the common aneuploidies trisomy 21 (Down syndrome), trisomy 18, and trisomy 13. More recently, clinical laboratories have offered screening for other chromosome abnormalities including sex chromosome abnormalities and copy number variants (CNV) without little published data on the sensitivity, specificity, and positive predictive value. In this debate, the pros and cons of performing prenatal screening via cfDNA for all chromosome abnormalities is discussed. At the time of the debate in 2017, the general consensus was that the literature does not yet support using this technology to screen for all chromosome abnormalities and that education is key for both providers and the patients so that the decision-making process is as informed as possible. © 2018 John Wiley & Sons, Ltd.

  5. Cell-free DNA screening in clinical practice: abnormal autosomal aneuploidy and microdeletion results.

    PubMed

    Valderramos, Stephanie G; Rao, Rashmi R; Scibetta, Emily W; Silverman, Neil S; Han, Christina S; Platt, Lawrence D

    2016-11-01

    Since its commercial release in 2011 cell-free DNA screening has been rapidly adopted as a routine prenatal genetic test. However, little is known about its performance in actual clinical practice. We sought to investigate factors associated with the accuracy of abnormal autosomal cell-free DNA results. We conducted a retrospective cohort study of 121 patients with abnormal cell-free DNA results from a referral maternal-fetal medicine practice from March 2013 through July 2015. Patients were included if cell-free DNA results for trisomy 21, trisomy 18, trisomy 13, or microdeletions (if reported by the laboratory) were positive or nonreportable. The primary outcome was confirmed aneuploidy or microarray abnormality on either prenatal or postnatal karyotype or microarray. Secondary outcomes were identifiable associations with in vitro fertilization, twins, ultrasound findings, testing platform, and testing laboratory. Kruskal-Wallis or Fisher exact tests were used as appropriate. A total of 121 patients had abnormal cell-free DNA results for trisomy 21, trisomy 18, trisomy 13, and/or microdeletions. In all, 105 patients had abnormal cell-free DNA results for trisomy 21, trisomy 18, and trisomy 13. Of these, 92 (87.6%) were positive and 13 (12.4%) were nonreportable. The results of the 92 positive cell-free DNA were for trisomy 21 (48, 52.2%), trisomy 18 (22, 23.9%), trisomy 13 (17, 18.5%), triploidy (2, 2.2%), and positive for >1 parameter (3, 3.3%). Overall, the positive predictive value of cell-free DNA was 73.5% (61/83; 95% confidence interval, 63-82%) for all trisomies (by chromosome: trisomy 21, 83.0% [39/47; 95% confidence interval, 69-92%], trisomy 18, 65.0% [13/20; 95% confidence interval, 41-84%], and trisomy 13, 43.8% [7/16; 95% confidence interval, 21-70%]). Abnormal cell-free DNA results were associated with positive serum screening (by group: trisomy 21 [17/48, 70.8%]; trisomy 18 [7/22, 77.8%]; trisomy 13 [3/17, 37.5%]; nonreportable [2/13, 16.7%]; P

  6. Breast cancer screening

    MedlinePlus

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  7. Cellphone based mobile colposcope for the evaluation of women with abnormal cervical cancer screening

    NASA Astrophysics Data System (ADS)

    Kahn, Bruce S.; Kass, Alex J.; Waalen, Jill; Levitz, David

    2015-03-01

    Objective: Compare an inexpensive cell-phone based Mobile Colposcope, with a standard colposcope in the evaluation of women with abnormal Pap smear screening. Methodology: The study was a prospective, parallel noninferiority trial. Thirty women underwent colposcopy for the evaluation of an abnormal Pap smear. After application of acetic acid, images of the cervix were obtained with both a standard colposcope and the Mobile Colposcope. An additional set of images using both devices were obtained using the red-free (green filter) mode. Eight experienced gynecologists then evaluated 100 paired images (plain and green filter) from two different sites in random order using a web based assessment program. After reviewing each set of paired images, the expert would make an assessment of: 1) normal (no biopsy/ random biopsy), or 2) abnormal. For abnormal images, the expert then electronically marked the site(s) on the image where a biopsy was recommended. In image analysis, the cervical image was divided into 12 radial sectors and the marked sites for biopsy on the matched pairs were compared. Matched pairs that were considered normal, or those where biopsy site recommendations were within +/- 30° were considered equivalent; unmatched biopsy sites were considered non-equivalent. Results were compared using Wilcoxon Matched Pairs Signed Ranks Test. Expert assessment of Mobile Colposcope images compared with assessment by standard colposcope is currently onging. Conclusions: if the Mobile Colposcope demonstrates non-inferiority to imaging obtained with a standard colposcope and due to its low cost, it has the potential help improve cervical cancer screening in low resource settings.

  8. Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening.

    PubMed

    Whitley, Elizabeth M; Raich, Peter C; Dudley, Donald J; Freund, Karen M; Paskett, Electra D; Patierno, Steven R; Simon, Melissa; Warren-Mears, Victoria; Snyder, Frederick R

    2017-01-01

    Whether patient navigation improves outcomes for patients with comorbidities is unknown. The aims of this study were to determine the effect of comorbidities on the time to diagnostic resolution after an abnormal cancer screening test and to examine whether patient navigation improves the timeliness and likelihood of diagnostic resolution for patients with comorbidities in comparison with no navigation. A secondary analysis of comorbidity data collected by Patient Navigation Research Program sites using the Charlson Comorbidity Index (CCI) was conducted. The participants were 6,349 patients with abnormal breast, cervical, colon, or prostate cancer screening tests between 2007 and 2011. The intervention was patient navigation or usual care. The CCI data were highly skewed across projects and cancer sites, and the CCI scores were categorized as 0 (CCI score of 0 or no comorbidities identified; 76% of cases); 1 (CCI score of 1; 16% of cases), or 2 (CCI score ≥ 2; 8% of cases). Separate adjusted hazard ratios for each site and cancer type were obtained, and then they were pooled with a meta-analysis random effects methodology. Patients with a CCI score ≥ 2 had delayed diagnostic resolution after an abnormal cancer screening test in comparison with those with no comorbidities. Patient navigation reduced delays in diagnostic resolution, with the greatest benefits seen for those with a CCI score ≥ 2. Persons with a CCI score ≥ 2 experienced significant delays in timely diagnostic care in comparison with patients without comorbidities. Patient navigation was effective in reducing delays in diagnostic resolution among those with CCI scores > 1. Cancer 2017;123:312-318. © 2016 American Cancer Society. © 2016 American Cancer Society.

  9. The Relationship of Comorbidities and Patient Navigation to Time to Diagnostic Resolution after Abnormal Cancer Screening

    PubMed Central

    Whitley, Elizabeth M; Raich, Peter C; Dudley, Donald J; Freund, Karen M; Paskett, Electra D; Patierno, Steven R; Simon, Melissa; Warren-Mears, Victoria; Snyder, Frederick R

    2016-01-01

    Background Whether patient navigation improves outcomes in patients with comorbidities is unknown. Study aims were to determine the effect of comorbidities on time to diagnostic resolution following an abnormal cancer screening test, and to examine for patients with comorbidities, if patient navigation improves timeliness and likelihood of diagnostic resolution compared to patients without navigation. Methods A secondary analysis from the Patient Navigation Research Program sites that collected comorbidity data using the Charlson Comorbidity Index (CCI) was conducted. Participants were 6,349 patients with abnormal breast, cervical, colon or prostate cancer screening tests between 2007 and 2011. The intervention was patient navigation or usual care. CCI data were highly skewed across projects and cancer sites and were categorized as 0, no comorbidities identified, CCI score of 0 (76% of cases); 1, CCI score of 1 (16% of cases); or 2, CCI score of ≥2 (8% of cases). A separate adjusted hazards ratio for each site and cancer type was obtained, and then pooled using meta-analysis random effects methodology. Results Having a CCI score of ≥2 delayed the time to diagnostic resolution following an abnormal cancer screening test compared with those with fewer than one comorbidity. Patient Navigation reduced delays in diagnostic resolution with the greatest benefit seen in those with a CCI score of ≥2. Conclusions Persons with a CCI score of ≥2 experienced significant delays in timely diagnostic care compared to patients without comorbidities. Patient navigation was effective in reducing delays in diagnostic resolution among those with CCI scores > 1. PMID:27648520

  10. The importance of sensitive screening for abnormal glucose metabolism in patients with IgA nephropathy.

    PubMed

    Jia, Xiaoyuan; Pan, Xiaoxia; Xie, Jingyuan; Shen, Pingyan; Wang, Zhaohui; Li, Ya; Wang, Weiming; Chen, Nan

    2016-01-01

    To investigate the prevalence of abnormal glucose metabolism, insulin resistance (IR) and the related risk factors in IgA nephropathy (IgAN) patients. We analyzed oral glucose tolerance test (OGTT) and clinical data of 107 IgAN patients and 106 healthy controls. Glucose metabolism, homeostasis model assessment of insulin resistance (HOMA-IR) and the insulin sensitivity index (ISI) of both groups were evaluated. The prevalence of abnormal glucose metabolism was significantly higher in the IgAN group than in the control group (41.12% vs. 9.43%, p < 0.001), while the prevalence of IR between the two groups was not significantly different. IgAN patients have significantly higher fasting blood glucose, fasting insulin, OGTT 2-hour blood glucose, OGTT 2-hour insulin, HOMA-IR, and lower ISI than healthy controls. Triglyceride (OR = 2.55), 24-hour urine protein excretion (OR = 1.39), and age (OR = 1.06) were independent risk factors for abnormal glucose metabolism in IgAN patients. BMI, eGFR, 24-hour urine protein excretion, triglyceride, fasting blood glucose, fasting insulin, OGTT 2-hour blood glucose, and OGTT 2-hour insulin were significantly higher in IgAN patients with IR than in IgAN patients without IR, while HDL and ISI were significantly lower. BMI, serum albumin, and 24-hour urine protein excretion were correlated factors of IR in IgAN patients. Our study highlighted that abnormal glucose metabolism was common in IgAN patients. Triglyceride and 24-hour urine protein excretion were significant risk factors for abnormal glucose metabolism. Therefore, sensitive screening for glucose metabolism status and timely intervention should be carried out in clinical work.

  11. Ultrasound screening of periarticular soft tissue abnormality around metal-on-metal bearings.

    PubMed

    Nishii, Takashi; Sakai, Takashi; Takao, Masaki; Yoshikawa, Hideki; Sugano, Nobuhiko

    2012-06-01

    Although metal hypersensitivity or pseudotumors are concerns for metal-on-metal (MoM) bearings, detailed pathologies of patterns, severity, and incidence of periprosthetic soft tissue lesions are incompletely understood. We examined the potential of ultrasound for screening of periarticular soft tissue lesions around MoM bearings. Ultrasound examinations were conducted in 88 hips (79 patients) with MoM hip resurfacings or MoM total hip arthroplasties with a large femoral head. Four qualitative ultrasound patterns were shown, including normal pattern in 69 hips, joint-expansion pattern in 11 hips, cystic pattern in 5 hips, and mass pattern in 3 hips. Hips with the latter 3 abnormal patterns showed significantly higher frequency of clinical symptoms, without significant differences of sex, duration of implantation, head sizes, and cup abduction/anteversion angles, compared with hips with normal pattern. Ultrasound examination provides sensitive screening of soft tissue reactions around MoM bearings and may be useful in monitoring progression and defining treatment for periarticular soft tissue abnormalities. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Automatic segmentation of mammogram and tomosynthesis images

    NASA Astrophysics Data System (ADS)

    Sargent, Dusty; Park, Sun Young

    2016-03-01

    Breast cancer is a one of the most common forms of cancer in terms of new cases and deaths both in the United States and worldwide. However, the survival rate with breast cancer is high if it is detected and treated before it spreads to other parts of the body. The most common screening methods for breast cancer are mammography and digital tomosynthesis, which involve acquiring X-ray images of the breasts that are interpreted by radiologists. The work described in this paper is aimed at optimizing the presentation of mammography and tomosynthesis images to the radiologist, thereby improving the early detection rate of breast cancer and the resulting patient outcomes. Breast cancer tissue has greater density than normal breast tissue, and appears as dense white image regions that are asymmetrical between the breasts. These irregularities are easily seen if the breast images are aligned and viewed side-by-side. However, since the breasts are imaged separately during mammography, the images may be poorly centered and aligned relative to each other, and may not properly focus on the tissue area. Similarly, although a full three dimensional reconstruction can be created from digital tomosynthesis images, the same centering and alignment issues can occur for digital tomosynthesis. Thus, a preprocessing algorithm that aligns the breasts for easy side-by-side comparison has the potential to greatly increase the speed and accuracy of mammogram reading. Likewise, the same preprocessing can improve the results of automatic tissue classification algorithms for mammography. In this paper, we present an automated segmentation algorithm for mammogram and tomosynthesis images that aims to improve the speed and accuracy of breast cancer screening by mitigating the above mentioned problems. Our algorithm uses information in the DICOM header to facilitate preprocessing, and incorporates anatomical region segmentation and contour analysis, along with a hidden Markov model (HMM) for

  13. Women with Disabilities and Breast Cancer Screening

    MedlinePlus

    ... Likely to Have Received a Mammogram During the Past Two Years 1 Breast Cancer Screening Recommendations 2 If you ... of Age Who Received a Mammogram During the Past 2 Years, By Disability Status – 2010 National Household Interview Survey( ...

  14. Multiple barriers delay care among women with abnormal cancer screening despite patient navigation.

    PubMed

    Ramachandran, Ambili; Freund, Karen M; Bak, Sharon M; Heeren, Timothy C; Chen, Clara A; Battaglia, Tracy A

    2015-01-01

    While there is widespread dissemination of patient navigation programs in an effort to reduce delays in cancer care, little is known about the impact of barriers to care on timely outcomes. We conducted a secondary analysis of the Boston Patient Navigation Research Program (PNRP) to examine the effect that the presence of barriers had on time to diagnostic resolution of abnormal breast or cervical cancer screening tests. We used multivariable Cox proportional hazards regression with time to diagnostic resolution as the outcome to examine the effect of the number of barriers, controlling for demographic covariates and clustered by patients' primary navigator. There were 1481 women who received navigation; mean age was 39 years; 32% were White, 27% Black, and 31% Hispanic; 28% had private health insurance; and 38% did not speak English. Overall, half (n=745, 50%) had documentation of one or more barriers to care. Women with barriers were more likely to be older, non-White, non-English language speakers, and on public or no health insurance compared with women without barriers. In multivariable analyses, we found less timely diagnostic resolution as the number of barriers increased (one barrier, adjusted hazard ratio [aHR] 0.81 [95% CI 0.56-1.17], p=0.26; two barriers, aHR 0.55 [95% CI 0.37-0.81], p=0.0025; three or more barriers, aHR 0.31 [95% CI 0.21-0.46], p<0.0001)]. Within a patient navigation program proven to reduce delays in care, we found that navigated patients with documented barriers to care experience less timely resolution of abnormal cancer screening tests.

  15. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review.

    PubMed

    Frederiksen, M E; Lynge, E; Rebolj, M

    2012-01-01

    If human papillomavirus (HPV) testing will replace cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management decisions. To determine women's preferences for the follow-up of low-grade cervical screening abnormalities. Using Medical Subject Headings (MeSH) terms, PubMed was searched for articles published up to December 2010. The reference lists of the retrieved studies were consulted. Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests. Information on study design, participants and outcomes was retrieved using a prespecified form. Studies were sorted by design. Thirteen studies were included in the review. In all five studies that surveyed women with abnormal tests before any management had started, two-thirds preferred active follow-up, predominantly as immediate colposcopy, to observation, predominantly as repeated Pap smears. In all but two studies testing other situations, women more often expressed a preference for active follow-up than for observation; however, women appeared to be somewhat more willing to accept observation if reassured of the low risk of cervical cancer. Even for low-grade abnormal cervical tests, women tend to prefer active management strategies. It may be a challenge to meet their expectations of optimal follow-up when HPV testing is used in primary screening. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  16. Role of endometrial cancer abnormal MMR protein in screening Lynch-syndrome families.

    PubMed

    Long, Qiongxian; Peng, Yong; Tang, Zhirong; Wu, Cailiang

    2014-01-01

    To identify patients with endometrial cancer with potential Lynch-related DNA mismatch repair (MMR) protein expression defects and to explore the role of these defects in screening for LS. Endometrial cancers from 173 patients recruited to the Nanchong Central Hospital were tested for MMR (MLH1, MSH2, PMS2, and MSH6) protein expression using immunohistochemistry (IHC). In the 173 tumor tissue samples, the expression loss rates of MSH6, MSH2, PMS2 and MLH1 protein were 16.18% (28/173), 12.14% (21/173), 7.51% (13/173) and 5.78% (10/173), respectively. The total loss rate of MMR protein was 29.89% (27/87). There were 19 patients with a family history of cancer, of which 18 patients demonstrated loss of expression of MMR protein. In the 22 abnormal MMR patients without family history, five families were found to have Lynch-associated cancer (colorectal cancer, endometrial cancer, ovarian cancer, stomach cancer) after follow-up for two years. MMR proteins play an important role in the progress of endometrial cancer. The routine testing of MMR proteins in endometrial cancer can contribute to the screening of LS families, especially small families.

  17. Chromosomal abnormalities in azoospermic and non-azoospermic infertile men: numbers needed to be screened to prevent adverse pregnancy outcomes.

    PubMed

    Dul, E C; van Echten-Arends, J; Groen, H; Dijkhuizen, T; Land, J A; van Ravenswaaij-Arts, C M A

    2012-09-01

    How many infertile men who wish to conceive need to be screened for chromosomal abnormalities to prevent one miscarriage or the birth of one child with congenital anomalies (CAs)? In azoospermic men, the prevalence of chromosomal abnormalities is 15.2% and the number needed to be screened (NNS; minimum-maximum estimate) for a miscarriage is 80-88 and for a child with CAs is 790-3951. The prevalence of chromosomal abnormalities in non-azoospermic men is 2.3% and the NNS are 315-347 and 2543-12 723, respectively. Guidelines advise the screening of infertile men for chromosomal abnormalities to prevent miscarriages and children with congenital abnormalities, but no studies have been published on the effectiveness of this screening strategy. Retrospective cohort study of 1223 infertile men between 1994 and 2007. Men with azoospermia and men eligible for ICSI treatment visiting a university hospital fertility clinic in The Netherlands who underwent chromosomal analysis between 1994 and 2007 were identified retrospectively in a registry. Only cases of which at least one sperm analysis was available were included. Data were collected by chart review, with a follow-up of pregnancies and their outcomes until 2010. The chromosomal abnormalities were categorized according to their risk of unbalanced offspring, i.e. miscarriage and/or child with CAs. Multi-level analysis was used to estimate the impact of chromosomal abnormalities on the outcome of pregnancies in the different subgroups of our cohort. NNS for miscarriages and children with CAs were calculated based on data from our cohort and data published in the literature. A chromosomal abnormality was found in 12 of 79 men with azoospermia (15.2%) and in 26 of 1144 non-azoospermic men (2.3%). The chromosomal abnormalities were categorized based on the literature, into abnormalities with and abnormalities without increased risk for miscarriage and/or child with CAs. In our study group, there was no statistically significant

  18. Frequency-Domain Optical Mammogram

    DTIC Science & Technology

    2002-10-01

    have performed the proposed analysis of frequency-domain optical mammograms for a clinical population of about 150 patients. This analysis has led to...model the propagation of light in tissue14-20 have led to new approaches to optical mammography. As The authors are with the Department of Electrical...Modulation Methods, and Signal Detection /406 7.2.1 Lasers and arc lamps / 407’ 7.2.2 Pulsed sources / 407 7.2.3 Laser diodes and light-emitting diodes ( LEDs

  19. Nonrigid mammogram registration using mutual information

    NASA Astrophysics Data System (ADS)

    Wirth, Michael A.; Narhan, Jay; Gray, Derek W. S.

    2002-05-01

    Of the papers dealing with the task of mammogram registration, the majority deal with the task by matching corresponding control-points derived from anatomical landmark points. One of the caveats encountered when using pure point-matching techniques is their reliance on accurately extracted anatomical features-points. This paper proposes an innovative approach to matching mammograms which combines the use of a similarity-measure and a point-based spatial transformation. Mutual information is a cost-function used to determine the degree of similarity between the two mammograms. An initial rigid registration is performed to remove global differences and bring the mammograms into approximate alignment. The mammograms are then subdivided into smaller regions and each of the corresponding subimages is matched independently using mutual information. The centroids of each of the matched subimages are then used as corresponding control-point pairs in association with the Thin-Plate Spline radial basis function. The resulting spatial transformation generates a nonrigid match of the mammograms. The technique is illustrated by matching mammograms from the MIAS mammogram database. An experimental comparison is made between mutual information incorporating purely rigid behavior, and that incorporating a more nonrigid behavior. The effectiveness of the registration process is evaluated using image differences.

  20. Mammograms

    MedlinePlus

    ... gov/widgets/fahc.html" width="243" height="179" title="Find a Health Center Widget" ... M.D., Community Oncology and Prevention Trials Research Group, Division of Cancer Prevention, National Cancer Institute, ...

  1. Options for managing low grade cervical abnormalities detected at screening: cost effectiveness study.

    PubMed

    2009-07-28

    To estimate the cost effectiveness of alternative methods of managing low grade cervical cytological abnormalities detected at routine screening. Design Cost analysis within multicentre individually randomised controlled trial. Grampian, Tayside, and Nottingham. 4201 women with low grade abnormalities. Cytological surveillance or referral to colposcopy for biopsy and recall if necessary or referral to colposcopy with immediate treatment based on colposcopic appearance. Data on resource use collected from participants throughout the duration of the trial (36 months), enabling the estimation of both the direct (health care) and indirect (time and travel) costs of management. Quality of life assessed at recruitment and at 12, 18, 24, and 30 months, using the EQ-5D instrument. Economic outcomes expressed as costs per case of cervical intraepithelial neoplasia (grade II or worse) detected, by trial arm, as confirmed at exit, and cost utility ratios (cost per quality adjusted life year (QALY) gained) for the three pairwise comparisons of trial arms. The mean three year discounted costs of surveillance, immediate treatment, and biopsy and recall were pound150.20 (euro177, $249), pound240.30 (euro283, $415), and pound241.10 (euro284, $4000), respectively, viewed from the health service perspective. From the social perspective, mean discounted costs were pound204.40 (euro241, $339), pound339.90 (euro440, $563), and pound327.50 (euro386, $543), respectively. Estimated at the means, the incremental cost effectiveness ratios indicated that immediate treatment was dominated by the other two management methods, although it did offer the lowest cost per case of cervical intraepithelial neoplasia detected and treated. The pronounced skews in the distributions indicated that probabilistic uncertainty analysis would offer more meaningful estimates of cost effectiveness. The observed differences in the cost effectiveness ratios between trial arms were not significant. Judged within

  2. Abnormal screening for gestational diabetes, maternal mood disorder, and preterm birth

    PubMed Central

    Sit, Dorothy; Luther, James; Dills, Jesse; Eng, Heather; Wisniewski, Stephen; Wisner, Katherine L

    2013-01-01

    Objective Gestational diabetes (GDM) affects 7% of pregnant mothers and those with GDM have increased rates of perinatal complications. Major depressive disorder (MDD) and its pharmacologic treatments are associated with obesity and adverse pregnancy outcomes. In this prospective study, we investigated the relationship between abnormal GDM screens, maternal mood disorders, and adverse outcomes. Methods We examined mothers with MDD, bipolar disorder (BD), and healthy controls (HC) at 20, 30, and 36 weeks gestation and delivery. We obtained demographic data and pre-pregnancy body mass index (BMI), and confirmed diagnoses with the Structured Clinical Interview for DSM-IV. We evaluated smoking, alcohol, substance use, and medication treatments with the Longitudinal Interval Follow-up Evaluation interview. Mothers received the one-hour 50 g glucose challenge test (GCT) at 26–28 weeks gestation. Outcome variables were preterm birth, birth weight (BW) and peripartum events. Results We enrolled 62 HC, 50 BD, 41 past MDD, and 39 current MDD mother–infant pairs. Mean GCT levels and the frequency of abnormal GCT (> 140 mg/dL) did not differ across groups. Rates of smoking (χ2 = 20.68, df = 3, p < 0.001), substance use (χ2 = 21.76, df = 3, p < 0.001), and pre-pregnancy obesity [BMI ≥ 30 (χ2 = 9.97, df = 3, p = 0.019)] differed significantly across groups. Mothers with BD received medications associated with weight gain significantly more often than others [13/45 (29%), p < 0.001). After adjusting for group differences, GCT levels were associated significantly with increased odds for preterm birth (odds ratio = 1.29, 95% confidence interval: 1.0–1.7; p = 0.05) and increased perinatal events (beta = 0.11, p = 0.04) but not associated with BW. Conclusions In mothers with or without mood disorders, having increased GCT levels contributes to a higher likelihood for adverse pregnancy outcomes. Mothers with BD or current MDD can have additional risks for adverse outcomes

  3. An Assessment of the Likelihood, Frequency, and Content of Verbal Communication Between Radiologists and Women Receiving Screening and Diagnostic Mammography

    PubMed Central

    Carney, Patricia A.; Kettler, Mark; Cook, Andrea J.; Geller, Berta M.; Karliner, Leah; Miglioretti, Diana L.; Bowles, Erin Aiello; Buist, Diana S.; Gallagher, Thomas H.; Elmore, Joann G.

    2009-01-01

    Rationale & Objective Research on communication between radiologists and women undergoing screening and diagnostic mammography is limited. We describe community radiologists’ communication practices with patients regarding screening and diagnostic mammogram results and factors associated with frequency of communication. Materials & Methods We received surveys from 257 radiologists (70% of those eligible) about the extent to which they talk to women as part of their healthcare visit for either screening or diagnostic mammograms, whether this occurs if the exam assessment is positive or negative, and how they use estimates of patient risk to convey information about an abnormal exam where the specific finding of cancer is not yet known. We also assessed characteristics of the radiologists to identify associations with more or less frequent communication at the time of the mammogram. Results Two hundred and forty-three radiologists provided complete data (95%). Very few (<6%) reported routinely communicating with women when screening mammograms were either normal or abnormal. Less than half (47%) routinely communicated with women when their diagnostic mammograms were normal, while 77% often or always communicated with women when their diagnostic exams were abnormal. For positive diagnostic exams, female radiologists were more likely to be frequent communicators compared to males (87.1% to 72.8%; p-value = 0.02) and those who spend 40-79% of their time in breast imaging (94.6%) were more likely to be frequent communicators compared to those who spend less time (67.2%-78.9%; p-value = 0.02). Most radiologists convey risk information using general rather than numeric statements (57.7% vs. 28.5%). Conclusions Radiologists are most likely to convey information about diagnostic mammographic findings when results are abnormal. Most radiologists convey risk information using general rather than numeric statements. PMID:19442539

  4. HPV genotyping for triage of women with abnormal cervical cancer screening results: a multicenter prospective study.

    PubMed

    Nakamura, Yuko; Matsumoto, Koji; Satoh, Toyomi; Nishide, Ken; Nozue, Akiko; Shimabukuro, Koji; Endo, Seiichi; Nagai, Kimihiro; Oki, Akinori; Ochi, Hiroyuki; Morishita, Yukio; Noguchi, Masayuki; Yoshikawa, Hiroyuki

    2015-10-01

    In cervical cancer screening programs, women with abnormal cytology are referred for colposcopy for histological evaluation. We examined whether a human papillomavirus (HPV) genotyping assay could be used to identify women who do not need immediate colposcopy and biopsy because of low risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+). We prospectively evaluated test performance for 2 carcinogenic HPV genotypes (HPV16/18), for 8 types (HPV16/18/31/33/35/45/52/58), and for 13 types (HPV16/18/31/33/35/45/51/52/56/58/59/68) for prediction of histological CIN3+ results among 427 screen-positive women referred for colposcopy. The study subjects consisted of 214 women with low-grade squamous intraepithelial lesion (LSIL), 184 with high-grade squamous intraepithelial lesion (HSIL), and 29 with atypical squamous cells, cannot exclude HSIL (ASC-H). Among women with LSIL cytology, HPV16/18 positivity was 29.4 % and increased to 58.9 % for 8 types and to 74.8 % for 13 types (P < 0.001). The risk of CIN3+ biopsy results was still 7.9 % for women testing negative for HPV16/18, but decreased to 0.0 % for those testing negative for at least eight types of HPV (HPV16/18/31/33/35/45/52/58). Although HPV genotyping results enabled additional risk stratification among women with HSIL/ASC-H cytology, the risk of histological CIN3+ diagnosis among women testing negative for eight types or more was still sufficiently high (>35 %) to warrant immediate colposcopy referral. Of women with LSIL cytology, those testing negative for at least eight of the highest-risk types of HPV (HPV16/18/31/33/35/45/52/58) may not need immediate colposcopy and biopsy. This would reduce the number of colposcopy referrals by approximately 40 %. However, the HPV genotyping assay is not likely to alter the clinical management of women with HSIL/ASC-H.

  5. Fetal karyotyping for chromosome abnormalities after an unexplained elevated maternal serum alpha-fetoprotein screening.

    PubMed

    Feuchtbaum, L B; Cunningham, G; Waller, D K; Lustig, L S; Tompkinson, D G; Hook, E B

    1995-08-01

    To study the chromosome abnormality rate among women with elevated levels of maternal serum alpha-fetoprotein (MSAFP) and the types of chromosome abnormalities in this population, and to compare this rate with reports in the literature and the rate observed in the general population. We studied 8097 women who chose to undergo amniocentesis and fetal karyotyping after having an elevated MSAFP test of 2.5 multiples of the median (MOM) or higher. All abnormal karyotypes were reviewed and grouped according to whether the elevated MSAFP value could be explained by a ventral wall or neural tube defect. The overall chromosome abnormality rate was 13.83 per 1000 amniocenteses. The rate in the "unexplained" group was 10.92 per 1000 amniocenteses. Just over half (53%) of the abnormal karyotypes were autosomal anomalies, and 47% were sex chromosome abnormalities. The autosomal aneuploidies observed most frequently were triploidy and trisomy 13. The sex chromosome abnormalities observed most frequently were the XXY and XYY karyotypes. Women who have unexplained elevated MSAFP values of 2.5 MOM or greater have a twofold increase in the rate of chromosome abnormalities in their fetuses compared with the general population (P < or = .001). This rate is consistent with other studies that used a 2.5 MOM cutoff. Studies that used a 2.0 MOM cutoff have reported chromosome abnormality rates that do not vary from general population estimates.

  6. Boston Patient Navigation Research Program: the impact of navigation on time to diagnostic resolution after abnormal cancer screening.

    PubMed

    Battaglia, Tracy A; Bak, Sharon M; Heeren, Timothy; Chen, Clara A; Kalish, Richard; Tringale, Stephen; Taylor, James O; Lottero, Barbara; Egan, A Patrick; Thakrar, Nisha; Freund, Karen M

    2012-10-01

    There is a need for controlled studies to assess the impact of patient navigation in vulnerable cancer populations. Boston Patient Navigation Research Program conducted a quasi-experimental patient navigation intervention across six federally qualified inner-city community health centers, three assigned to a breast cancer navigation intervention and three assigned to a cervical cancer navigation intervention; each group then served as the control for the other. Eligible women had an abnormal breast or cervical cancer screening test conducted at one of the participating health centers during a baseline (2004-2005) or intervention period (2007-2008). Kaplan-Meier survival curves and proportional hazards regression examined the effect of patient navigation on time to definitive diagnosis, adjusting for covariates, clustering by clinic and differences between the baseline and intervention period. We enrolled 997 subjects in the baseline period and 3,041 subjects during the intervention period, of whom 1,497 were in the navigated arm, and 1,544 in the control arm. There was a significant decrease in time to diagnosis for subjects in the navigated group compared with controls among those with a cervical screening abnormality [aHR 1.46; 95% confidence interval (CI), 1.1-1.9]; and among those with a breast cancer screening abnormality that resolved after 60 days (aHR 1.40; 95% CI, 1.1-1.9), with no differences before 60 days. This study documents a benefit of patient navigation on time to diagnosis among a racially/ethnically diverse inner city population. Patient navigation may address cancer health disparities by reducing time to diagnosis following an abnormal cancer-screening event. 2012 AACR

  7. Sex chromosomal abnormalities associated with equine infertility: validation of a simple molecular screening tool in the Purebred Spanish Horse.

    PubMed

    Anaya, G; Molina, A; Valera, M; Moreno-Millán, M; Azor, P; Peral-García, P; Demyda-Peyrás, S

    2017-08-01

    Chromosomal abnormalities in the sex chromosome pair (ECAX and ECAY) are widely associated with reproductive problems in horses. However, a large proportion of these abnormalities remains undiagnosed due to the lack of an affordable diagnostic tool that allows for avoiding karyotyping tests. Hereby, we developed an STR (single-tandem-repeat)-based molecular method to determine the presence of the main sex chromosomal abnormalities in horses in a fast, cheap and reliable way. The frequency of five ECAX-linked (LEX026, LEX003, TKY38, TKY270 and UCDEQ502) and two ECAY-linked (EcaYH12 and SRY) markers was characterized in 261 Purebred Spanish Horses to determine the efficiency of the methodology developed to be used as a chromosomal diagnostic tool. All the microsatellites analyzed were highly polymorphic, with a sizeable number of alleles (polymorphic information content > 0.5). Based on this variability, the methodology showed 100% sensitivity and 99.82% specificity to detect the most important sex chromosomal abnormalities reported in horses (chimerism, Turner's syndrome and sex reversal syndromes). The method was also validated with 100% efficiency in 10 individuals previously diagnosed as chromosomally aberrant. This STR screening panel is an efficient and reliable molecular-cytogenetic tool for the early detection of sex chromosomal abnormalities in equines that could be included in breeding programs to save money, effort and time of veterinary practitioners and breeders. © 2017 Stichting International Foundation for Animal Genetics.

  8. Mammogram registration using the Cauchy-Navier spline

    NASA Astrophysics Data System (ADS)

    Wirth, Michael A.; Choi, Christopher

    2001-07-01

    The process of comparative analysis involves inspecting mammograms for characteristic signs of potential cancer by comparing various analogous mammograms. Factors such as the deformable behavior of the breast, changes in breast positioning, and the amount/geometry of compression may contribute to spatial differences between corresponding structures in corresponding mammograms, thereby significantly complicating comparative analysis. Mammogram registration is a process whereby spatial differences between mammograms can be reduced. Presented in this paper is a nonrigid approach to matching corresponding mammograms based on a physical registration model. Many of the earliest approaches to mammogram registration used spatial transformations which were innately rigid or affine in nature. More recently algorithms have incorporated radial basis functions such as the Thin-Plate Spline to match mammograms. The approach presented here focuses on the use of the Cauchy-Navier Spline, a deformable registration model which offers approximate nonrigid registration. The utility of the Cauchy-Navier Spline is illustrated by matching both temporal and bilateral mammograms.

  9. Rate of Opportunistic Pap Smear Screening and Patterns of Epithelial Cell Abnormalities in Pap Smears in Ajman, United Arab Emirates

    PubMed Central

    Al Eyd, Ghaith J.; Shaik, Rizwana B.

    2012-01-01

    Objectives: The aim of this study was to estimate the proportion of women undergoing Papanicolaou (Pap) smear examinations, and the frequency of epithelial cell abnormalities in a teaching hospital in one emirate of the United Arab Emirates (UAE) during a three-year period. Methods: A retrospective study of 602 patient records from July 2007 to July 2010 was done in a teaching hospital in Ajman, UAE. The variables studied were age, ethnicity, menopausal status, and abnormalities in the Pap smear. Data were analysed using the Statistical Package for the Social Sciences and presented mainly as percentages; to assess associations, the chi-square test was used. Results: The total number of outpatients who attended the Obstetrics & Gynaecology Department from July 2007 to July 2010 was 150,111 patients, of which 602 (0.4% of the total) had a Pap smear test. The sample was 50.1% Arabs and 49.9% other nationalities. While 73% of the outpatients had specific complaints, 27% came for a routine screening. Epithelial cell abnormalities were seen in 3.3% of the sample, with atypical squamous cells of undetermined significance (ASCUS) found in 1.8%, low-grade squamous intraepithelial lesions (LSILs) found in 1.2%, and high-grade squamous intraepithelial lesions (HSILs) found in 0.3%. There were no cases of squamous cell carcinoma. Conclusion: Voluntary routine Pap smear screening was remarkably low in the study group. ASCUS was the most common epithelial cell abnormality. Community health education and opportunistic screening for cervical cancer are recommended for both national and expatriate women in the region. PMID:23275844

  10. Factors associated with screening for glucose abnormalities after gestational diabetes mellitus: baseline cohort of the interventional IMPACT study.

    PubMed

    Bihan, H; Cosson, E; Khiter, C; Vittaz, L; Faghfouri, F; Leboeuf, D; Carbillon, L; Dauphin, H; Reach, G; Valensi, P

    2014-04-01

    Although it is important to screen women who have had gestational diabetes mellitus (GDM) for abnormal post-partum glucose levels, such testing is rarely performed. The aim of this study was to use data from the first observational phase of the IMPACT study to determine rates of screening within 6 months of delivery in a multiethnic cohort, focusing in particular on the effects of social deprivation and the risk of future diabetes. To investigate the frequency of post-partum screening, charts were analyzed, and all women attending four centres located in a deprived area who had had GDM between January 2009 and December 2010 were contacted by phone. The Evaluation of Precarity and Inequalities in Health Examination Centres (EPICES) deprivation index and Finnish Diabetes Risk Score (FINDRISK) questionnaire were also evaluated. Data were evaluable for 589 of the 719 women contacted (mean age: 33.4 ± 5.2 years; mean body mass index: 27.6 ± 5.4 kg/m(2)), and 196 (33.3%) reported having been screened. On multivariate analysis, factors associated with a lack of screening were smoking [odds ratio (OR): 0.42 (0.20-0.90), P<0.05], low consumption of fruit and vegetables [OR: 0.58 (0.39-0.82), P<0.01] and heavier offspring birth weight (P<0.05), although there were no differences in FINDRISK and EPICES scores between screened and unscreened women. One-third of women who had had GDM reported having been screened for dysglycaemia at 6 months post-partum. However, it is expected that the interventional phase of the IMPACT study will increase screening rates, especially in women with the risk factors associated with lower screening rates during this observational phase. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Medical radiologic technologist review: effects on a population-based breast cancer screening program.

    PubMed

    Tonita, J M; Hillis, J P; Lim, C H

    1999-05-01

    To evaluate the effects of medical radiologic technologist review of mammograms in a population-based breast cancer screening program. A technologist review pilot project was incorporated into the Regina, Saskatchewan, Canada, reading center. Technologists received special training in mammographic interpretation. They reviewed all 27,863 mammograms obtained at the center from July 1995 to September 1996 that were reviewed by a radiologist and selected cases for second blind reading by another radiologist. When the two radiologists' readings were in agreement, the report was sent. When the readings differed, a third opinion was obtained from the program's consulting radiologist. Changes in the number of mammograms interpreted as abnormal and the number of cancers detected were assessed. The technologist review was responsible for the detection of nine cancers missed at the first radiologist's interpretation. Technologists were very discriminating; only 391 cases (1.4%) were sent for double reading. The positive predictive value of screening did not change significantly (7.5% without review, 8.1% with review; P > .20). A substantial number of cancers were found with the technologist review. The number of mammograms interpreted as abnormal was reduced slightly. The technologist review proved to be a cost-effective alternative to double reading by two radiologists.

  12. Presenting and discussing nuchal translucency screening for fetal abnormality in the UK.

    PubMed

    Pilnick, Alison M; Fraser, Diane M; James, David K

    2004-03-01

    to investigate the relationship between information giving by midwives and decision-making by women offered nuchal translucency (NT) screening. To establish how risk figures are discussed in practice, with the intention of relating this to the existing, and often critical, literature on women's accounts of antenatal screening. a qualitative study following women through the process of being offered and deciding to undergo NT screening. Tape recording of consultations, analysed in their entirety, was combined with post-screening interviews. a large teaching hospital in the UK. fourteen pregnant women eligible for NT screening at the time of recruitment. (i) tape recordings of consultations between community midwives and pregnant women where nuchal translucency screening was offered; (ii) tape recordings of consultations between hospital midwives and pregnant women immediately post-screening; (iii) individual face-to-face interviews with pregnant women between two and six weeks after the screening, carried out by the first author. NT screening was in general well received, particularly by those women who had undergone serum screening with previous pregnancies. However, communicating the nature of a risk figure is an interactionally complex process. A large amount of interactional work is required by midwives both before and after screening to ensure that women comprehend this information. Despite the emphasis placed in these consultations on understanding the purpose of NT screening and the status of the results, women often framed their decision to undergo NT screening in terms of it being a formality, or of presuming that all was well. This sometimes created practical and personal difficulties in terms of decision-making. previous sociological and psychological research has tended to be critical of midwives in terms of ensuring informed choice in screening, but this research is often based on post hoc accounts. Examining actual consultations with these accounts

  13. Sensitivity and specificity of a urinary screening test used in an emergency setting to detect abnormal first trimester pregnancies.

    PubMed

    Teixeira, João L G; Rabaioli, Paola; Savaris, Ricardo F

    2015-01-01

    To evaluate the performance of a commercial urinary test to screen for abnormal first trimester pregnancies in women presenting to an emergency room. In this prospective observational cohort, women with a confirmed first trimester pregnancy (gestational age <12 weeks) provided a urine sample for diagnosing the viability of their gestation. Pregnancy viability and location testing were confirmed by ultrasound and/or laparoscopy. From 815 eligible patients for the study, 12 were excluded for not having a confirmed pregnancy (n = 6) or were lost to follow-up (n = 6). A total of 803 patients underwent testing and completed follow-up. The pretest probability of an abnormal pregnancy was 44% (9% for ectopic pregnancy and 35% for miscarriage). The test had the following parameters to identify an abnormal first-trimester pregnancy (sensitivity, 13%; 95% confidence interval [CI], 10-17; specificity, 82%; 95% CI, 78-86; positive predictive value, 36; 95% CI, 28-46; negative predictive value, 54; 95% CI, 50-58; accuracy, 47%; positive likelihood ratio, 0.74; 95% CI, 0.53-1.03; negative likelihood ratio, 1.06; 95% CI, 1-1.12). The reproducibility of the test in our study was high (kappa index between readers, 0.89; 95% CI, 0.77-1). In our emergency setting, we were not able to confirm that the commercial test is adequate to detect or exclude an abnormal first-trimester pregnancy. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Automated detection of microcalcification clusters in mammograms

    NASA Astrophysics Data System (ADS)

    Karale, Vikrant A.; Mukhopadhyay, Sudipta; Singh, Tulika; Khandelwal, Niranjan; Sadhu, Anup

    2017-03-01

    Mammography is the most efficient modality for detection of breast cancer at early stage. Microcalcifications are tiny bright spots in mammograms and can often get missed by the radiologist during diagnosis. The presence of microcalcification clusters in mammograms can act as an early sign of breast cancer. This paper presents a completely automated computer-aided detection (CAD) system for detection of microcalcification clusters in mammograms. Unsharp masking is used as a preprocessing step which enhances the contrast between microcalcifications and the background. The preprocessed image is thresholded and various shape and intensity based features are extracted. Support vector machine (SVM) classifier is used to reduce the false positives while preserving the true microcalcification clusters. The proposed technique is applied on two different databases i.e DDSM and private database. The proposed technique shows good sensitivity with moderate false positives (FPs) per image on both databases.

  15. The Effect of Breast Implants on Mammogram Outcomes.

    PubMed

    Kam, Kelli; Lee, Esther; Pairawan, Seyed; Anderson, Kendra; Cora, Cherie; Bae, Won; Senthil, Maheswari; Solomon, Naveenraj; Lum, Sharon

    2015-10-01

    Breast cancer detection in women with implants has been questioned. We sought to evaluate the impact of breast implants on mammographic outcomes. A retrospective review of women undergoing mammography between March 1 and October 30, 2013 was performed. Demographic characteristics and mammogram results were compared between women with and without breast implants. Overall, 4.8 per cent of 1863 women identified during the study period had breast implants. Median age was 59 years (26-93). Women with implants were younger (53.9 vs 59.2 years, P < 0.0001), had lower body mass index (25.4 vs 28.9, P < 0.0001), and were more likely to have dense breast tissue (72.1% vs 56.4%, P = 0.004) than those without. There were no statistically significant differences with regards to Breast Imaging Recording and Data System 0 score (13.3% with implants vs 21.4% without), call back exam (18.9% with vs 24.1% without), time to resolution of abnormal imaging (58.6 days with vs 43.3 without), or cancer detection rate (0% with implants vs 1.0% without). Because implants did not significantly affect mammogram results, women with implants should be reassured that mammography remains useful in detecting cancer. However, future research is required to determine whether lower call back rates and longer time to resolution of imaging findings contribute to delays in diagnosis in patients with implants.

  16. Assessing the patient's mammogram experience.

    PubMed

    Dodendorf, Diane M; Deogun, Gurvinder K; Rodie, Amy Risch; Pol, Louis G

    2004-01-01

    This study overviews an operational blueprint that diagrams the activities and interactions of all participants in a typical screening mammography appointment in a large medical center. The blueprint is constructed from multiple sources of data collected from mammography patients, service providers in the radiology department, and medical records. The benefits from using patient perspectives, the insights gained from the blueprint development process, and the value of the resulting screening mammography appointment blueprint are included.

  17. Replacing the combined test by cell-free DNA testing in screening for trisomies 21, 18 and 13: impact on the diagnosis of other chromosomal abnormalities.

    PubMed

    Syngelaki, Argyro; Pergament, Eugene; Homfray, Tessa; Akolekar, Ranjit; Nicolaides, Kypros H

    2014-01-01

    To estimate the proportion of other chromosomal abnormalities that could be missed if combined testing was replaced by cell-free (cf) DNA testing as the method of screening for trisomies 21, 18 and 13. The prevalence of trisomies 21, 18 or 13, sex chromosome aneuploidies, triploidy and other chromosomal abnormalities was examined in pregnancies undergoing first-trimester combined screening and chorionic villus sampling (CVS). In 1,831 clinically significant chromosomal abnormalities in pregnancies with combined risk for trisomies 21, 18 and 13≥1:100, the contribution of trisomies 21, 18 or 13, sex chromosome aneuploidies, triploidy and other chromosomal abnormalities at high risk of adverse outcome was 82.9, 8.2, 3.9 and 5.0%, respectively. Combined screening followed by CVS for risk≥1:10 and cfDNA testing for risk 1:11-1:2,500 could detect 97% of trisomy 21 and 98% of trisomies 18 and 13. Additionally, 86% of monosomy X, half of 47,XXY, 47,XYY or 47,XXX, half of other chromosomal abnormalities and one third of triploidies, which are currently detected by combined screening and CVS for risk≥1:100, could be detected. Screening by cfDNA testing, contingent on results of combined testing, improves detection of trisomies, but misses a few of the other chromosomal abnormalities detected by screening with the combined test. © 2014 S. Karger AG, Basel.

  18. Fasting glucose measurement as a potential first step screening for glucose metabolism abnormalities in women with anovulatory polycystic ovary syndrome.

    PubMed

    Veltman-Verhulst, Susanne M; Goverde, Angelique J; van Haeften, Timon W; Fauser, Bart C J M

    2013-08-01

    Is routine screening by oral glucose tolerance test (OGTT) needed for all women with polycystic ovary syndrome (PCOS)? Screening for glucose metabolism abnormalities of PCOS patients by an OGTT could potentially be limited to patients who present with a fasting glucose concentration between 6.1 and 7.0 mmol/l only. Women with PCOS are at increased risk of developing diabetes. This study proposes a stepwise screening strategy for (pre)diabetes for PCOS patients based on risk stratification by fasting plasma glucose. A cross-sectional study of 226 women diagnosed with anovulatory PCOS. A consecutive series of 226 patients, diagnosed with PCOS at the University Medical Centre Utrecht, the Netherlands, were screened for glucose metabolism abnormalities by OGTT (75 g glucose load). The majority of the 226 women (mean age: 29.6 ± 4.3 years; BMI: 27.3 ± 6.7 kg/m(2); 81% Caucasian) presented with a normal OGTT (169 women (75%)). Of the 57 (25%) women presenting with mild to moderate glucose abnormalities, 53 (93%) could be identified by fasting glucose concentrations only. Diabetes was diagnosed in a total of eight women (3.5%). In six women, the diagnosis was based on fasting glucose >7.0 mmol/l. The other two cases of diabetes initially presented with fasting glucose between 6.1 and 7.0 mmol/l and were diagnosed by OGTT assessment. No women diagnosed with diabetes presented with fasting glucose levels below 6.1 mmol/l. We therefore conclude that all diabetes patients could potentially be found by initial fasting glucose assessment followed by OGTT only in patients with fasting glucose between 6.1 and 7.0 mmol/l. Before general implementation can be advised, this screening algorithm should be validated in a prospective study of a similar or greater number of PCOS women. Our study comprised of a mostly Caucasian (81%) population, therefore generalization to other ethnic populations should be done with caution. No external finance was involved in this study. B

  19. Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening.

    PubMed

    Paskett, Electra D; Dudley, Donald; Young, Gregory S; Bernardo, Brittany M; Wells, Kristen J; Calhoun, Elizabeth A; Fiscella, Kevin; Patierno, Steven R; Warren-Mears, Victoria; Battaglia, Tracy A

    2016-01-01

    As part of the Patient Navigation Research Program, we examined the effect of patient navigation versus usual care on timely diagnostic follow-up, defined as clinical management for women with cervical abnormalities within accepted time frames. Participants from four Patient Navigation Research Program centers were divided into low- and high-risk abnormality groups and analyzed separately. Low-risk participants (n = 2088) were those who enrolled with an initial Pap test finding of atypical squamous cells of undetermined significance (ASCUS) with a positive high-risk human papillomavirus (HPV) serotype, atypical glandular cells, or low-grade squamous intraepithelial lesion (LGSIL). High-risk participants were those with an initial finding of high-grade squamous intraepithelial lesion (HGSIL) (n = 229). A dichotomous outcome of timely diagnostic follow-up within 180 days was used for the low-risk abnormality group and timely diagnostic follow-up within 60 days for the high-risk group, consistent with treatment guidelines. A logistic mixed-effects regression model was used to evaluate the intervention effect using a random effect for study arm within an institution. A backward selection process was used for multivariable model building, considering the impact of each predictor on the intervention effect. Low-risk women in the patient navigation arm showed an improvement in the odds of timely diagnostic follow-up across all racial groups, but statistically significant effects were only observed in non-English-speaking Hispanics (OR 5.88, 95% CI 2.81-12.29). No effect was observed among high-risk women. These results suggest that patient navigation can improve timely diagnostic follow-up among women with low-risk cervical abnormalities, particularly in non-English-speaking Hispanic women.

  20. Risk of abnormal triple screen for Down syndrome is significantly higher in patients with female fetuses.

    PubMed

    Spong, C Y; Ghidini, A; Stanley-Christian, H; Meck, J M; Seydel, F D; Pezzullo, J C

    1999-04-01

    Previous studies have shown that mid-trimester maternal serum alpha-fetoprotein (AFP) levels are significantly higher and human chorionic gonadotrophin (hCG) levels significantly lower in women with male compared with female fetuses. We have evaluated whether triple-screen criteria are more likely to identify women with female fetuses as at risk for Down syndrome. From the Georgetown University genetics database we obtained the absolute values and corresponding multiples of the median (MoM) for AFP, hCG and unconjugated oestriol (uE3) in singleton gestations for the period database November 1992 July 1996. A Down syndrome risk of 1/270 or greater at mid-trimester was considered as high risk. A total of 977 patients with triple screen and outcome information were identified, including 502 female and 475 male fetuses. Patients with female fetuses were significantly more likely to have lower serum AFP (p=0.003) and a positive triple screen for Down syndrome (72 (14 per cent) versus 45 (9 per cent), p<0.02) than those with male fetuses. The gestational age at triple screen, maternal serum hCG and uE3, race and diabetes were not significantly different between the two groups. Since Down syndrome is less common in female than male fetuses, and the rates of female and male Down syndrome fetuses detected by triple screen and subsequent amniocentesis are not significantly different, the excess of positive mid-trimester maternal serum triple screen in women with female fetuses is likely due to false-positive results.

  1. Evidence-Based Assessment in Case Management to Improve Abnormal Cancer Screen Follow-Up

    ERIC Educational Resources Information Center

    Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah

    2005-01-01

    The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented…

  2. Global detection approach for clustered microcalcifications in mammograms using a deep learning network.

    PubMed

    Wang, Juan; Nishikawa, Robert M; Yang, Yongyi

    2017-04-01

    In computerized detection of clustered microcalcifications (MCs) from mammograms, the traditional approach is to apply a pattern detector to locate the presence of individual MCs, which are subsequently grouped into clusters. Such an approach is often susceptible to the occurrence of false positives (FPs) caused by local image patterns that resemble MCs. We investigate the feasibility of a direct detection approach to determining whether an image region contains clustered MCs or not. Toward this goal, we develop a deep convolutional neural network (CNN) as the classifier model to which the input consists of a large image window ([Formula: see text] in size). The multiple layers in the CNN classifier are trained to automatically extract image features relevant to MCs at different spatial scales. In the experiments, we demonstrated this approach on a dataset consisting of both screen-film mammograms and full-field digital mammograms. We evaluated the detection performance both on classifying image regions of clustered MCs using a receiver operating characteristic (ROC) analysis and on detecting clustered MCs from full mammograms by a free-response receiver operating characteristic analysis. For comparison, we also considered a recently developed MC detector with FP suppression. In classifying image regions of clustered MCs, the CNN classifier achieved 0.971 in the area under the ROC curve, compared to 0.944 for the MC detector. In detecting clustered MCs from full mammograms, at 90% sensitivity, the CNN classifier obtained an FP rate of 0.69 clusters/image, compared to 1.17 clusters/image by the MC detector. These results indicate that using global image features can be more effective in discriminating clustered MCs from FPs caused by various sources, such as linear structures, thereby providing a more accurate detection of clustered MCs on mammograms.

  3. Sampling probability distributions of lesions in mammograms

    NASA Astrophysics Data System (ADS)

    Looney, P.; Warren, L. M.; Dance, D. R.; Young, K. C.

    2015-03-01

    One approach to image perception studies in mammography using virtual clinical trials involves the insertion of simulated lesions into normal mammograms. To facilitate this, a method has been developed that allows for sampling of lesion positions across the cranio-caudal and medio-lateral radiographic projections in accordance with measured distributions of real lesion locations. 6825 mammograms from our mammography image database were segmented to find the breast outline. The outlines were averaged and smoothed to produce an average outline for each laterality and radiographic projection. Lesions in 3304 mammograms with malignant findings were mapped on to a standardised breast image corresponding to the average breast outline using piecewise affine transforms. A four dimensional probability distribution function was found from the lesion locations in the cranio-caudal and medio-lateral radiographic projections for calcification and noncalcification lesions. Lesion locations sampled from this probability distribution function were mapped on to individual mammograms using a piecewise affine transform which transforms the average outline to the outline of the breast in the mammogram. The four dimensional probability distribution function was validated by comparing it to the two dimensional distributions found by considering each radiographic projection and laterality independently. The correlation of the location of the lesions sampled from the four dimensional probability distribution function across radiographic projections was shown to match the correlation of the locations of the original mapped lesion locations. The current system has been implemented as a web-service on a server using the Python Django framework. The server performs the sampling, performs the mapping and returns the results in a javascript object notation format.

  4. Is screening for abnormal ECG patterns justified in long-term follow-up of childhood cancer survivors treated with anthracyclines?

    PubMed

    Pourier, Milanthy S; Mavinkurve-Groothuis, Annelies M C; Loonen, Jacqueline; Bökkerink, Jos P M; Roeleveld, Nel; Beer, Gil; Bellersen, Louise; Kapusta, Livia

    2017-03-01

    ECG and echocardiography are noninvasive screening tools to detect subclinical cardiotoxicity in childhood cancer survivors (CCSs). Our aims were as follows: (1) assess the prevalence of abnormal ECG patterns, (2) determine the agreement between abnormal ECG patterns and echocardiographic abnormalities; and (3) determine whether ECG screening for subclinical cardiotoxicity in CCSs is justified. We retrospectively studied ECG and echocardiography in asymptomatic CCSs more than 5 years after anthracycline treatment. Exclusion criteria were abnormal ECG and/or echocardiogram at the start of therapy, incomplete follow-up data, clinical heart failure, cardiac medication, and congenital heart disease. ECG abnormalities were classified using the Minnesota Code. Level of agreement between ECG and echocardiography was calculated with Cohen kappa. We included 340 survivors with a mean follow-up of 14.5 years (range 5-32). ECG was abnormal in 73 survivors (21.5%), with ventricular conduction disorders, sinus bradycardia, and high-amplitude R waves being most common. Prolonged QTc (>0.45 msec) was found in two survivors, both with a cumulative anthracycline dose of 300 mg/m 2 or higher. Echocardiography showed abnormalities in 44 survivors (12.9%), mostly mild valvular abnormalities. The level of agreement between ECG and echocardiography was low (kappa 0.09). Male survivors more often had an abnormal ECG (corrected odds ratio: 3.00, 95% confidence interval: 1.68-5.37). Abnormal ECG patterns were present in 21% of asymptomatic long-term CCSs. Lack of agreement between abnormal ECG patterns and echocardiographic abnormalities may suggest that ECG is valuable in long-term follow-up of CCSs. However, it is not clear whether these abnormal ECG patterns will be clinically relevant. © 2016 Wiley Periodicals, Inc.

  5. Screening for Electrophysiological Abnormalities in Chronic Hepatitis C Infection: Peripheral Neuropathy and Optic Neuropathy

    PubMed Central

    KÖŞKDERELİOĞLU, Aslı; ORTAN, Pınar; ARI, Alpay; GEDİZLİOĞLU, Muhteşem

    2016-01-01

    Introduction To investigate the existence of peripheral and optic neuropathies in asymptomatic individuals with hepatitis C infection. Methods Thirty consecutive patients who were followed in a hepatitis C outpatient clinic were recruited for electrophysiological evaluation together with 30 age- and gender-compatible healthy controls. All patients had a detailed neurological examination. The information regarding the disease duration and management with interferons were collected. Nerve conduction studies and visual evoked potentials (VEP) were recorded in all subjects. The results of the patient and control groups were statistically compared. Results Of the patients with hepatitis C infection, 16 were females and 14 males. The mean age was 57.5 years, and the average disease duration was 6.43 years. The P100 latencies in the patient group were within normal limits, while the amplitudes were meaningfully small by comparison with the controls. There were some abnormalities in the nerve conduction studies of 15 patients. Sensorial neuropathy was detected in two patients, sensorimotor polyneuropathy in four, carpal tunnel syndrome in seven, and carpal tunnel syndrome and sensorimotor polyneuropathy as comorbid states in another two patients. The nerve conduction studies and VEP parameters were entirely normal in the control group. Conclusion Hepatitis C-related neurological abnormalities may occur both in the central and peripheral nervous system. Mononeuritis multiplex, sensorial axonal neuropathy, and multiple mononeuropathies are some of the presentations of the peripheral nervous system involvement. The mode of infection is considered to be via vasculitic mechanisms. In addition, optic neuropathy is a known complication of interferon treatment. Autoantibodies, cytokines, chemokines, and cryoglobulins are accused to play roles in the pathogenesis. In this study, we investigated the involvement of the peripheral nervous system and optic nerves in a group of patients

  6. Screening for Electrophysiological Abnormalities in Chronic Hepatitis C Infection: Peripheral Neuropathy and Optic Neuropathy.

    PubMed

    Köşkderelioğlu, Aslı; Ortan, Pınar; Ari, Alpay; Gedizlioğlu, Muhteşem

    2016-03-01

    To investigate the existence of peripheral and optic neuropathies in asymptomatic individuals with hepatitis C infection. Thirty consecutive patients who were followed in a hepatitis C outpatient clinic were recruited for electrophysiological evaluation together with 30 age- and gender-compatible healthy controls. All patients had a detailed neurological examination. The information regarding the disease duration and management with interferons were collected. Nerve conduction studies and visual evoked potentials (VEP) were recorded in all subjects. The results of the patient and control groups were statistically compared. Of the patients with hepatitis C infection, 16 were females and 14 males. The mean age was 57.5 years, and the average disease duration was 6.43 years. The P100 latencies in the patient group were within normal limits, while the amplitudes were meaningfully small by comparison with the controls. There were some abnormalities in the nerve conduction studies of 15 patients. Sensorial neuropathy was detected in two patients, sensorimotor polyneuropathy in four, carpal tunnel syndrome in seven, and carpal tunnel syndrome and sensorimotor polyneuropathy as comorbid states in another two patients. The nerve conduction studies and VEP parameters were entirely normal in the control group. Hepatitis C-related neurological abnormalities may occur both in the central and peripheral nervous system. Mononeuritis multiplex, sensorial axonal neuropathy, and multiple mononeuropathies are some of the presentations of the peripheral nervous system involvement. The mode of infection is considered to be via vasculitic mechanisms. In addition, optic neuropathy is a known complication of interferon treatment. Autoantibodies, cytokines, chemokines, and cryoglobulins are accused to play roles in the pathogenesis. In this study, we investigated the involvement of the peripheral nervous system and optic nerves in a group of patients with hepatitis C. The results were in

  7. Costs and outcomes evaluation of patient navigation after abnormal cancer screening: evidence from the Patient Navigation Research Program.

    PubMed

    Bensink, Mark E; Ramsey, Scott D; Battaglia, Tracy; Fiscella, Kevin; Hurd, Thelma C; McKoy, June M; Patierno, Steven R; Raich, Peter C; Seiber, Eric E; Warren-Mears, Victoria; Whitley, Elizabeth; Paskett, Electra D; Mandelblatt, S

    2014-02-15

    Navigators can facilitate timely access to cancer services, but to the authors' knowledge there are little data available regarding their economic impact. The authors conducted a cost-consequence analysis of navigation versus usual care among 10,521 individuals with abnormal breast, cervical, colorectal, or prostate cancer screening results who enrolled in the Patient Navigation Research Program study from January 1, 2006 to March 31, 2010. Navigation costs included diagnostic evaluation, patient and staff time, materials, and overhead. Consequences or outcomes were time to diagnostic resolution and probability of resolution. Differences in costs and outcomes were evaluated using multilevel, mixed-effects regression modeling adjusting for age, race/ethnicity, language, marital status, insurance status, cancer, and site clustering. The majority of individuals were members of a minority (70.7%) and uninsured or publically insured (72.7%). Diagnostic resolution was higher for navigation versus usual care at 180 days (56.2% vs 53.8%; P = .008) and 270 days (70.0% vs 68.2%; P < .001). Although there were no differences in the average number of days to resolution between the 2 groups (110 days vs 109 days; P = .63), the probability of ever having diagnostic resolution was higher for the navigation group versus the usual-care group (84.5% vs 79.6%; P < .001). The added cost of navigation versus usual care was $275 per patient (95% confidence interval, $260-$290; P < .001). There was no significant difference in stage distribution among the 12.4% of patients in the navigation group vs 11% of the usual-care patients diagnosed with cancer. Navigation adds costs and modestly increases the probability of diagnostic resolution among patients with abnormal screening test results. Navigation is only likely to be cost-effective if improved resolution translates into an earlier cancer stage at the time of diagnosis. © 2013 American Cancer Society.

  8. Costs and Outcomes Evaluation of Patient Navigation Following Abnormal Cancer Screening: Evidence from the Patient Navigation Research Program

    PubMed Central

    Bensink, Mark E.; Ramsey, Scott D.; Battaglia, Tracy; Fiscella, Kevin; Hurd, Thelma C.; McKoy, June M.; Patierno, Steven R.; Raich, Peter C.; Seiber, Eric E.; Mears, Victoria Warren; Whitley, Elizabeth; Paskett, Electra D.; Mandelblatt, Jeanne S.

    2013-01-01

    Background Navigators can facilitate timely access to cancer services but there are little data on their economic impact. Methods We conduct a cost-consequence analysis of navigation vs. usual care among 10,521 individuals with abnormal breast, cervix, colorectal or prostate cancer screening results who enrolled in the Patient Navigation Research Program study from January 1 2006 to March 31 2010. Navigation costs included diagnostic evaluation, patient and staff time, materials, and overhead. Consequences or outcomes were time to diagnostic resolution and probability of resolution. Differences in costs and outcomes were evaluated using multi-level, mixed-effects regression adjusting for age, race/ethnicity, language, marital status, insurance, cancer, and site clustering. Results Most individuals were minority (70.7%) and un- or publically-insured (72.7%). Diagnostic resolution was higher for navigation vs. usual care at 180 (56.2% vs. 53.8%, p=0.008) and 270 days: 70.0% vs. 68.2%, p<0.001). While there were no differences in average days to resolution (110 vs. 109 days, p=.63), the probability of ever having diagnostic resolution was higher for navigation vs. usual care (84.5% vs. 79.6%, p <0.001). The added cost of navigation vs. usual care was $275 per patient (95% CI $260 – $290, p <0.001). There was no significant difference in stage distribution among the 12.4% of navigated vs. 11% of usual care patients diagnosed with cancer. Conclusions Navigation adds costs and modestly increases the probability of diagnostic resolution among patients with abnormal screening tests. Navigation is only likely to be cost-effective if improved resolution translates into earlier cancer stage at diagnosis. PMID:24166217

  9. Multi-scales region segmentation for ROI separation in digital mammograms

    NASA Astrophysics Data System (ADS)

    Zhang, Dapeng; Zhang, Di; Li, Yue; Wang, Wei

    2017-02-01

    Mammography is currently the most effective imaging modality used by radiologists for the screening of breast cancer. Segmentation is one of the key steps in the process of developing anatomical models for calculation of safe medical dose of radiation. This paper explores the potential of the statistical region merging segmentation technique for Breast segmentation in digital mammograms. First, the mammograms are pre-processing for regions enhancement, then the enhanced images are segmented using SRM with multi scales, finally these segmentations are combined for region of interest (ROI) separation and edge detection. The proposed algorithm uses multi-scales region segmentation in order to: separate breast region from background region, region edge detection and ROIs separation. The experiments are performed using a data set of mammograms from different patients, demonstrating the validity of the proposed criterion. Results show that, the statistical region merging segmentation algorithm actually can work on the segmentation of medical image and more accurate than another methods. And the outcome shows that the technique has a great potential to become a method of choice for segmentation of mammograms.

  10. Breast screening: What can the interval cancer review teach us? Are we perhaps being a bit too hard on ourselves?

    PubMed

    Lekanidi, Katerina; Dilks, Phil; Suaris, Tamara; Kennett, Steffan; Purushothaman, Hema

    2017-09-01

    The aim of this study was to determine the features that make interval cancers apparent on the preceding screening mammogram and determine whether changes in the ways of performing the interval cancer review will affect the true interval cancer rate. This study was approved by the clinical governance committee. Mammograms of women diagnosed with an interval cancer were included in the study if they had been allocated to either the "suspicious signs" group or "subtle signs" group, during the historic interval cancer review. Three radiologists, individually and blinded to the site of interval cancer, reviewed the mammograms and documented the presence, site, characteristics and classification of any abnormality. Findings were compared with the appearances of the abnormality at the site of subsequent cancer development by a different breast radiologist. The chi-squared test was used in the analysis of the results, seeking associations between recall concordance and cancer mammographic or histological characteristics. 111/590 interval cancers fulfilled the study inclusion criteria. In 17% of the cases none of the readers identified the relevant abnormality on the screening mammogram. 1/3 readers identified the relevant lesion in 22% of the cases, 2/3 readers in 28% of cases and all 3 readers in 33% of cases. The commonest unanimously recalled abnormality was microcalcification and the most challenging mammographic abnormality to detect was asymmetric density. We did not find any statistically significant association between recall concordance and time to interval cancer, position of lesion in the breast, breast density or cancer grade. Even the simple step of performing an independent blinded review of interval cancers reduces the rate of interval cancers classified as missed by up to 39%. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Detection of congenital heart defects throughout pregnancy; impact of first trimester ultrasound screening for cardiac abnormalities.

    PubMed

    Eleftheriades, Makarios; Tsapakis, Elsa; Sotiriadis, Alexandros; Manolakos, Emmanouil; Hassiakos, Demetrios; Botsis, Demetrios

    2012-12-01

    To evaluate prospectively the efficacy to screen for congenital heart defects (CHD) during the first trimester nuchal translucency (NT) ultrasound examination by assessing the four chambers' view of fetal heart. Pregnancies that were examined prospectively by ultrasound in the first trimester (11th-14th week), the second (19th-24th week) and third trimester were included in the study. 3774 fetuses were examined and fetal heart was assessed during the NT scan by examining the four chambers view. Detailed echocardiography was performed during the anomaly and growth scans. Diagnosis of congenital heart defects (CHD) was further confirmed by a fetal cardiologist. The four chambers view was obtained in 99.52% of the cases. CHD were diagnosed in 29 fetuses (0.77%). Thirteen cases (44.8%) were detected during the 11-13 weeks' scan, 14 cases (48.3%) during the anomaly scan, 1 CHD (3.5%) during the third trimester scan and 1 case (3.5%) postpartum. Assessment of the four chambers of fetal heart early in pregnancy was feasible and allowed the detection of 45% of CHD. Additional parameters of fetal cardiac anatomy during the NT scan may further improve the detection rate providing pregnancy management information early in the first trimester.

  12. Only a minority of sex chromosome abnormalities are detected by a national prenatal screening program for Down syndrome.

    PubMed

    Viuff, Mette Hansen; Stochholm, Kirstine; Uldbjerg, Niels; Nielsen, Birgitte Bruun; Gravholt, Claus Højbjerg

    2015-10-01

    How does a national prenatal screening program for Down syndrome (DS) perform in detecting sex chromosome abnormalities (SCAs)-Turner syndrome (TS), Klinefelter syndrome, 47,XXX and 47,XYY syndromes. The SCA detection rate resulting from DS screening was below 50% for all four groups of SCAs. The detection rates of SCAs are higher in countries with DS screening. TS is associated with greater nuchal translucency (NT) and lower pregnancy-associated plasma protein-A (PAPP-A). However, specific detection rates of SCAs using prenatal DS screening have not been determined. No clear trend in PAPP-A, free beta human chorionic gonadotropin (β-hCG) and NT has been found in the remaining SCAs. Several lines of inquiry suggest that it would be advantageous for individuals with SCA to be detected early in life, leading to prevention or treatment of accompanying conditions. There is limited information about pre- and perinatal status that distinguishes SCA embryogenesis from normal fetal development. A register-based case-control study from the Danish Central Cytogenetic Register (DCCR), cross-linked with the Danish Fetal Medicine Database (DFMD), was performed from 2008 to 2012. Groups of SCAs were compared with DS and then matched with non-SCA controls to assess differences between these groups in prenatal markers and birth outcomes. We included cases with prenatal and post-natal SCA karyotypes (n = 213), DS (n = 802) and 168 056 controls. We screened 275 037 individuals examined prenatally. We retrieved information regarding maternal age, NT, β-hCG and PAPP-A, as well as details regarding maternal and newborn characteristics. The DS screening procedure detected 87 per 100 000 TS (42% of expected), 19 per 100 000 Klinefelter syndrome (13% of expected), 16 per 100 000 47,XXX (16% of cases) and 5 per 100 000 47,XYY (5% of expected) SCAs, with an overall detection rate of 27%. Compared with controls, all four SCA groups showed significantly higher NT and lower PAPP-A compared

  13. Pattern Recognition and Size Prediction of Microcalcification Based on Physical Characteristics by Using Digital Mammogram Images.

    PubMed

    Jothilakshmi, G R; Raaza, Arun; Rajendran, V; Sreenivasa Varma, Y; Guru Nirmal Raj, R

    2018-06-05

    Breast cancer is one of the life-threatening cancers occurring in women. In recent years, from the surveys provided by various medical organizations, it has become clear that the mortality rate of females is increasing owing to the late detection of breast cancer. Therefore, an automated algorithm is needed to identify the early occurrence of microcalcification, which would assist radiologists and physicians in reducing the false predictions via image processing techniques. In this work, we propose a new algorithm to detect the pattern of a microcalcification by calculating its physical characteristics. The considered physical characteristics are the reflection coefficient and mass density of the binned digital mammogram image. The calculation of physical characteristics doubly confirms the presence of malignant microcalcification. Subsequently, by interpolating the physical characteristics via thresholding and mapping techniques, a three-dimensional (3D) projection of the region of interest (RoI) is obtained in terms of the distance in millimeter. The size of a microcalcification is determined using this 3D-projected view. This algorithm is verified with 100 abnormal mammogram images showing microcalcification and 10 normal mammogram images. In addition to the size calculation, the proposed algorithm acts as a good classifier that is used to classify the considered input image as normal or abnormal with the help of only two physical characteristics. This proposed algorithm exhibits a classification accuracy of 99%.

  14. Can HbA1c be Used to Screen for Glucose Abnormalities Among Adults with Severe Mental Illness?

    PubMed

    Romain, A J; Letendre, E; Akrass, Z; Avignon, A; Karelis, A D; Sultan, A; Abdel-Baki, A

    2017-04-01

    Aim: Prediabetes and type 2 diabetes are highly prevalent among individuals with serious mental illness and increased by antipsychotic medication. Although widely recommended, many obstacles prevent these patients from obtaining a proper screening for dysglycemia. Currently, glycated hemoglobin (HbA1c), fasting glucose, and 2-hour glucose levels from the oral glucose tolerance test are used for screening prediabetes and type 2 diabetes. The objective of this study was to investigate if HbA1c could be used as the only screening test among individuals with serious mental illness. Methods: Cross sectional study comparing the sensitivity of HbA1c, fasting glucose, and 2-h oral glucose tolerance test to detect dysglycemias in serious mental illness participants referred for metabolic complications. Results: A total of 84 participants (43 female; aged: 38.5±12.8 years; BMI: 35.0±6.8 kg/m²) was included. Regarding prediabetes, 44, 44 and 76% were identified by HbA1c, fasting glucose, and 2 h- oral glucose tolerance test respectively and for type 2 diabetes, 60, 53 and 66% were identified by HbA1c, fasting glucose and 2 h-oral glucose tolerance test. The overlap between the 3 markers was low (8% of participants for prediabetes and 26% for Type 2 diabetes). Sensitivity of HbA1c were moderate (range 40-62.5%), while its specificity was excellent (92-93%). Conclusion: The present study indicates a low agreement between HbA1c, fasting glucose and 2-h oral glucose tolerance test. It appears that these markers do not identify the same participants. Thus, HbA1c may not be used alone to detect all glucose abnormalities among individuals with serious mental illness. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Response to an Abnormal Ovarian Cancer Screening Test Result: Test of the Social Cognitive Processing and Cognitive Social Health Information Processing Models

    PubMed Central

    Andrykowski, Michael A.; Pavlik, Edward J.

    2009-01-01

    All cancer screening tests produce a proportion of abnormal results requiring follow-up. Consequently, the cancer screening setting is a natural laboratory for examining psychological and behavioral response to a threatening health-related event. This study tested hypotheses derived from the Social Cognitive Processing and Cognitive-Social Health Information Processing models in trying to understand response to an abnormal ovarian cancer (OC) screening test result. Women (n=278) receiving an abnormal screening test result a mean of 7 weeks earlier were assessed prior to a repeat screening test intended to clarify their previous abnormal result. Measures of disposition (optimism, informational coping style), social environment (social support and constraint), emotional processing, distress, and benefit finding were obtained. Regression analyses indicated greater distress was associated with greater social constraint and emotional processing and a monitoring coping style in women with a family history of OC. Distress was unrelated to social support. Greater benefit finding was associated with both greater social constraint and support and greater distress. The primacy of social constraint in accounting for both benefit-finding and distress was noteworthy and warrants further research on the role of social constraint in adaptation to stressful events. PMID:20419561

  16. Psychological distress in U.S. women who have experienced false-positive mammograms.

    PubMed

    Jatoi, Ismail; Zhu, Kangmin; Shah, Mona; Lawrence, William

    2006-11-01

    In the United States, approximately 10.7% of all screening mammograms lead to a false-positive result, but the overall impact of false-positives on psychological well-being is poorly understood. Data were analyzed from the 2000 U.S. National Health Interview Survey (NHIS), the most recent national survey that included a cancer control module. Study subjects were 9,755 women who ever had a mammogram, of which 1,450 had experienced a false-positive result. Psychological distress was assessed using the validated K6 questionnaire and logistic regression was used to discern any association with previous false-positive mammograms. In a multivariate analysis, women who had indicated a previous false-positive mammogram were more likely to report feeling sad (OR = 1.18, 95% CI, 1.03-1.35), restless (OR = 1.23, 95% CI, 1.08-1.40), worthless (OR = 1.27, 95% CI, 1.04-1.54), and finding that everything was an effort (OR = 1.27, 95% CI, 1.10-1.47). These women were also more likely to have seen a mental health professional in the 12 months preceding the survey (OR = 1.28, 95% CI, 1.03-1.58) and had a higher composite score on all items of the K6 scale (P < 0.0001), a reflection of increased psychological distress. Analyses by age and race revealed that, among women who had experienced false-positives, younger women were more likely to feel that everything was an effort, and blacks were more likely to feel restless. In a random sampling of the U.S. population, women who had previously experienced false-positive mammograms were more likely to report symptoms of anxiety and depression.

  17. The Ohio Patient Navigation Research Program: does the American Cancer Society patient navigation model improve time to resolution in patients with abnormal screening tests?

    PubMed

    Paskett, Electra D; Katz, Mira L; Post, Douglas M; Pennell, Michael L; Young, Gregory S; Seiber, Eric E; Harrop, J Phil; DeGraffinreid, Cecilia R; Tatum, Cathy M; Dean, Julie A; Murray, David M

    2012-10-01

    Patient navigation (PN) has been suggested as a way to reduce cancer health disparities; however, many models of PN exist and most have not been carefully evaluated. The goal of this study was to test the Ohio American Cancer Society model of PN as it relates to reducing time to diagnostic resolution among persons with abnormal breast, cervical, or colorectal cancer screening tests or symptoms. A total of 862 patients from 18 clinics participated in this group-randomized trial. Chart review documented the date of the abnormality and the date of resolution. The primary analysis used shared frailty models to test for the effect of PN on time to resolution. Crude HR were reported as there was no evidence of confounding. HRs became significant at 6 months; conditional on the random clinic effect, the resolution rate at 15 months was 65% higher in the PN arm (P = 0.012 for difference in resolution rate across arms; P = 0.009 for an increase in the HR over time). Participants with abnormal cancer screening tests or symptoms resolved faster if assigned to PN compared with those not assigned to PN. The effect of PN became apparent beginning six months after detection of the abnormality. PN may help address health disparities by reducing time to resolution after an abnormal cancer screening test. 2012 AACR

  18. Positive predictive values by mammographic density and screening mode in the Norwegian Breast Cancer Screening Program.

    PubMed

    Moshina, Nataliia; Ursin, Giske; Roman, Marta; Sebuødegård, Sofie; Hofvind, Solveig

    2016-01-01

    To investigate the probability of breast cancer among women recalled due to abnormal findings on the screening mammograms (PPV-1) and among women who underwent an invasive procedure (PPV-2) by mammographic density (MD), screening mode and age. We used information about 28,826 recall examinations from 26,951 subsequently screened women in the Norwegian Breast Cancer Screening Program, 1996-2010. The radiologists who performed the recall examinations subjectively classified MD on the mammograms into three categories: fatty (<30% fibroglandular tissue); medium dense (30-70%) and dense (>70%). Screening mode was defined as screen-film mammography (SFM) and full-field digital mammography (FFDM). We examined trends of PPVs by MD, screening mode and age. We used logistic regression to estimate odds ratio (OR) of screen-detected breast cancer associated with MD among women recalled, adjusting for screening mode and age. PPV-1 and PPV-2 decreased by increasing MD, regardless of screening mode (p for trend <0.05 for both PPVs). PPV-1 and PPV-2 were statistically significantly higher for FFDM compared with SFM for women with fatty breasts. Among women recalled, the adjusted OR of breast cancer decreased with increasing MD. Compared with women with fatty breasts, the OR was 0.90 (95% CI: 0.84-0.96) for those with medium dense breasts and 0.85 (95% CI: 0.76-0.95) for those with dense breasts. PPVs decreased by increasing MD. Fewer women needed to be recalled or undergo an invasive procedure to detect one breast cancer among those with fatty versus dense breasts in the screening program in Norway, 1996-2010. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. The potential impact of NIPT as a second-tier screen on the outcomes of high-risk pregnancies with rare chromosomal abnormalities.

    PubMed

    Maxwell, Susannah; Dickinson, Jan E; Murch, Ashleigh; O'Leary, Peter

    2015-10-01

    To describe the potential impact of using noninvasive prenatal testing (NIPT) as a second-tier test, on the diagnosis and outcomes of pregnancies identified as high risk through first trimester screening (FTS) in a cohort of real pregnancies. Western Australian FTS and diagnostic data (2007-2009) were linked to pregnancy outcomes. Karyotype results from invasive prenatal testing in high-risk women were analysed. The outcomes of abnormal results that would not be detected by NIPT, assuming a panel of trisomy 21/18/13 and sex chromosome aneuploidies, and the likelihood of diagnosis in a screening model using NIPT as a second-tier test are described. Abnormal karyotype results were reported in 224 of 1488 (15%) women with high-risk pregnancies having invasive diagnostic testing. NIPT potentially would have identified 85%. The 33 abnormalities unidentifiable by NIPT were triploidies (n = 7, 21%), balanced (n = 8, 24%) and unbalanced rearrangements (n = 10, 30%) and level III mosaicisms (n = 8, 24%). For conditions not identifiable by NIPT, fetal sonographic appearance was likely to have led to invasive testing for 10 of 17 (59%) pathogenic abnormalities. If a policy was adopted recommending invasive testing for FTS risk >1:50 and/or ultrasound detected abnormality, the residual risk of an unidentified pathogenic chromosomal abnormality in those without a diagnosis would have been 0.33% (95% CI 0.01-0.65%). A screening model with NIPT as a second-tier for high-risk pregnancies would be unlikely to have changed the outcome for the majority of pregnancies. Optimising the diagnosis of rare pathogenic abnormalities requires clear indicators for invasive testing over NIPT. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  20. Abnormal plasma DNA profiles in early ovarian cancer using a non-invasive prenatal testing platform: implications for cancer screening.

    PubMed

    Cohen, Paul A; Flowers, Nicola; Tong, Stephen; Hannan, Natalie; Pertile, Mark D; Hui, Lisa

    2016-08-24

    Non-invasive prenatal testing (NIPT) identifies fetal aneuploidy by sequencing cell-free DNA in the maternal plasma. Pre-symptomatic maternal malignancies have been incidentally detected during NIPT based on abnormal genomic profiles. This low coverage sequencing approach could have potential for ovarian cancer screening in the non-pregnant population. Our objective was to investigate whether plasma DNA sequencing with a clinical whole genome NIPT platform can detect early- and late-stage high-grade serous ovarian carcinomas (HGSOC). This is a case control study of prospectively-collected biobank samples comprising preoperative plasma from 32 women with HGSOC (16 'early cancer' (FIGO I-II) and 16 'advanced cancer' (FIGO III-IV)) and 32 benign controls. Plasma DNA from cases and controls were sequenced using a commercial NIPT platform and chromosome dosage measured. Sequencing data were blindly analyzed with two methods: (1) Subchromosomal changes were called using an open source algorithm WISECONDOR (WIthin-SamplE COpy Number aberration DetectOR). Genomic gains or losses ≥ 15 Mb were prespecified as "screen positive" calls, and mapped to recurrent copy number variations reported in an ovarian cancer genome atlas. (2) Selected whole chromosome gains or losses were reported using the routine NIPT pipeline for fetal aneuploidy. We detected 13/32 cancer cases using the subchromosomal analysis (sensitivity 40.6 %, 95 % CI, 23.7-59.4 %), including 6/16 early and 7/16 advanced HGSOC cases. Two of 32 benign controls had subchromosomal gains ≥ 15 Mb (specificity 93.8 %, 95 % CI, 79.2-99.2 %). Twelve of the 13 true positive cancer cases exhibited specific recurrent changes reported in HGSOC tumors. The NIPT pipeline resulted in one "monosomy 18" call from the cancer group, and two "monosomy X" calls in the controls. Low coverage plasma DNA sequencing used for prenatal testing detected 40.6 % of all HGSOC, including 38 % of early stage cases. Our

  1. Barriers to health care contribute to delays in follow-up among women with abnormal cancer screening: Data from the Patient Navigation Research Program.

    PubMed

    Ramachandran, Ambili; Snyder, Frederick R; Katz, Mira L; Darnell, Julie S; Dudley, Donald J; Patierno, Steven R; Sanders, Mechelle R; Valverde, Patricia A; Simon, Melissa A; Warren-Mears, Victoria; Battaglia, Tracy A

    2015-11-15

    There is limited understanding of the association between barriers to care and clinical outcomes within patient navigation programs. Secondary analyses of data from the intervention arms of the Patient Navigation Research Program were performed, which included navigated participants with abnormal breast and cervical cancer screening tests from 2007 to 2010. Independent variables were: 1) the number of unique barriers to care (0, 1, 2, or ≥3) documented during patient navigation encounters; and 2) the presence of socio-legal barriers originating from social policy (yes/no). The median time to diagnostic resolution of index screening abnormalities was estimated using Kaplan-Meier cumulative incidence curves. Multivariable Cox proportional hazards regression examined the impact of barriers on time to resolution, controlling for sociodemographics and stratifying by study center. Among 2600 breast screening participants, approximately 75% had barriers to care documented (25% had 1 barrier, 16% had 2 barriers, and 34% had ≥3 barriers). Among 1387 cervical screening participants, greater than one-half had barriers documented (31% had 1 barrier, 11% had 2 barriers, and 13% had ≥3 barriers). Among breast screening participants, the presence of barriers was associated with less timely resolution for any number of barriers compared with no barriers. Among cervical screening participants, only the presence of ≥2 barriers was found to be associated with less timely resolution. Both types of barriers, socio-legal and other barriers, were found to be associated with delay among breast and cervical screening participants. Navigated women with barriers resolved cancer screening abnormalities at a slower rate compared with navigated women with no barriers. Further innovations in navigation care are necessary to maximize the impact of patient navigation programs nationwide. © 2015 American Cancer Society.

  2. Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients.

    PubMed

    Thangarajah, Fabinshy; Einzmann, Thomas; Bergauer, Florian; Patzke, Jan; Schmidt-Petruschkat, Silke; Theune, Monika; Engel, Katja; Puppe, Julian; Richters, Lisa; Mallmann, Peter; Kirn, Verena

    2016-02-01

    Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort. Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers. Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management. Cancer screening itself and abnormal test results have an impact on patient's feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician-patient relationship in that matter.

  3. Breast Mass Detection in Digital Mammogram Based on Gestalt Psychology

    PubMed Central

    Bu, Qirong; Liu, Feihong; Zhang, Min; Ren, Yu; Lv, Yi

    2018-01-01

    Inspired by gestalt psychology, we combine human cognitive characteristics with knowledge of radiologists in medical image analysis. In this paper, a novel framework is proposed to detect breast masses in digitized mammograms. It can be divided into three modules: sensation integration, semantic integration, and verification. After analyzing the progress of radiologist's mammography screening, a series of visual rules based on the morphological characteristics of breast masses are presented and quantified by mathematical methods. The framework can be seen as an effective trade-off between bottom-up sensation and top-down recognition methods. This is a new exploratory method for the automatic detection of lesions. The experiments are performed on Mammographic Image Analysis Society (MIAS) and Digital Database for Screening Mammography (DDSM) data sets. The sensitivity reached to 92% at 1.94 false positive per image (FPI) on MIAS and 93.84% at 2.21 FPI on DDSM. Our framework has achieved a better performance compared with other algorithms. PMID:29854359

  4. Automatic detection of the breast border and nipple position on digital mammograms using genetic algorithm for asymmetry approach to detection of microcalcifications.

    PubMed

    Karnan, M; Thangavel, K

    2007-07-01

    The presence of microcalcifications in breast tissue is one of the most incident signs considered by radiologist for an early diagnosis of breast cancer, which is one of the most common forms of cancer among women. In this paper, the Genetic Algorithm (GA) is proposed for automatic look at commonly prone area the breast border and nipple position to discover the suspicious regions on digital mammograms based on asymmetries between left and right breast image. The basic idea of the asymmetry approach is to scan left and right images are subtracted to extract the suspicious region. The proposed system consists of two steps: First, the mammogram images are enhanced using median filter, normalize the image, at the pectoral muscle region is excluding the border of the mammogram and comparing for both left and right images from the binary image. Further GA is applied to magnify the detected border. The figure of merit is calculated to evaluate whether the detected border is exact or not. And the nipple position is identified using GA. The some comparisons method is adopted for detection of suspected area. Second, using the border points and nipple position as the reference the mammogram images are aligned and subtracted to extract the suspicious region. The algorithms are tested on 114 abnormal digitized mammograms from Mammogram Image Analysis Society database.

  5. Patient Navigation and Time to Diagnostic Resolution: Results for a Cluster Randomized Trial Evaluating the Efficacy of Patient Navigation among Patients with Breast Cancer Screening Abnormalities, Tampa, FL

    PubMed Central

    Lee, Ji-Hyun; Fulp, William; Wells, Kristen J.; Meade, Cathy D.; Calcano, Ercilia; Roetzheim, Richard

    2013-01-01

    Objectives The objective of this study was to evaluate a patient navigation (PN) program that attempts to reduce the time between a breast cancer screening abnormality and definitive diagnosis among medically underserved populations of Tampa Bay, Florida. Methods The Moffitt Patient Navigation Research Program conducted a cluster randomized design with 10 primary care clinics. Patients were navigated from time of a breast screening abnormality to diagnostic resolution. This paper examined the length of time between breast abnormality and definitive diagnosis, using a shared frailty Cox proportional hazard model to assess PN program effect. Results 1,039 patients were eligible for the study because of an abnormal breast cancer screening/clinical abnormality (494 navigated; 545 control). Analysis of PN effect by two time periods of resolution (0-3 months and > 3 months) showed a lagged effect of PN. For patients resolving in the first three months, the adjusted Hazard Ratio (aHR) was 0.85 (95% Confidence Interval [CI]: 0.64-1.13) suggesting that PN had no effect on resolution time during this period. Beyond three months, however, navigated patients resolved more quickly to diagnostic resolution compared with the control group (aHR 2.8, 95%CI: 1.30-6.13). The predicted aHR at 3 months was 1.2, which was not statistically significant, while PN had a significant positive effect beyond 4.7 months. Conclusions PN programs may increase the timeliness of diagnostic resolution for patients with a breast cancer-related abnormality. PN did not speed diagnostic resolution during the initial three months of follow up but started to reduce time to diagnostic resolution after three months and showed a significant effect after 4.7 months. Trial Registration ClinicalTrials.gov NCT00375024 PMID:24066145

  6. Patient navigation and time to diagnostic resolution: results for a cluster randomized trial evaluating the efficacy of patient navigation among patients with breast cancer screening abnormalities, Tampa, FL.

    PubMed

    Lee, Ji-Hyun; Fulp, William; Wells, Kristen J; Meade, Cathy D; Calcano, Ercilia; Roetzheim, Richard

    2013-01-01

    The objective of this study was to evaluate a patient navigation (PN) program that attempts to reduce the time between a breast cancer screening abnormality and definitive diagnosis among medically underserved populations of Tampa Bay, Florida. The Moffitt Patient Navigation Research Program conducted a cluster randomized design with 10 primary care clinics. Patients were navigated from time of a breast screening abnormality to diagnostic resolution. This paper examined the length of time between breast abnormality and definitive diagnosis, using a shared frailty Cox proportional hazard model to assess PN program effect. 1,039 patients were eligible for the study because of an abnormal breast cancer screening/clinical abnormality (494 navigated; 545 control). Analysis of PN effect by two time periods of resolution (0-3 months and > 3 months) showed a lagged effect of PN. For patients resolving in the first three months, the adjusted Hazard Ratio (aHR) was 0.85 (95% Confidence Interval [CI]: 0.64-1.13) suggesting that PN had no effect on resolution time during this period. Beyond three months, however, navigated patients resolved more quickly to diagnostic resolution compared with the control group (aHR 2.8, 95%CI: 1.30-6.13). The predicted aHR at 3 months was 1.2, which was not statistically significant, while PN had a significant positive effect beyond 4.7 months. PN programs may increase the timeliness of diagnostic resolution for patients with a breast cancer-related abnormality. PN did not speed diagnostic resolution during the initial three months of follow up but started to reduce time to diagnostic resolution after three months and showed a significant effect after 4.7 months. ClinicalTrials.gov NCT00375024.

  7. Screening for cognitive and behavioural impairment in amyotrophic lateral sclerosis: Frequency of abnormality and effect on survival.

    PubMed

    Xu, Zhouwei; Alruwaili, Ashwag Rafea S; Henderson, Robert David; McCombe, Pamela Ann

    2017-05-15

    To screen for cognitive and behavioural impairment in people with amyotrophic lateral sclerosis (ALS) and controls with neuromuscular disease and to correlate these with clinical features. 108 people with ALS and 60 controls with other neuromuscular diseases were recruited and assessed with the Addenbrooke's cognitive examination-III (ACE-III), the frontal assessment battery (FAB), and the executive function component of the Edinburgh cognitive and behavioural ALS screen (ECAS). The Amyotrophic lateral sclerosis-Frontotemporal dementia questionnaire (ALS-FTD-Q) and the Motor Neuron Disease Behavioural instrument (MiND-B) were administered to the caregivers of people with ALS. The prevalence of abnormalities was determined and correlated with clinical features and survival. In 37 people with ALS, serial studies were performed. The frequencies of cognitive impairment based on the ACE-III and FAB were 30.0% and 14.0%, in ALS and 11.7% and 3.3% in controls, respectively. Age and years of education influence the results of the ACE-III and ECAS executive function. In ALS, the frequencies of behavioural impairment based on ALS-FTD-Q and MiND-B were 32.1% and 39.4%, respectively. There is significant correlation of ALS-FTD-Q and MiND-B with the ALSFRS-R score. ALS participants with cognitive impairment measured with ACE-III had significantly shorter survival time than those without. ALS participants with behavioural impairment measured with ALS-FTD-Q had worse prognosis than those without. No significant difference was found between the first two serial cognitive tests based on ACE-III and FAB by using generalized estimating equation. There is a greater frequency of cognitive impairment in people with ALS than in patients with other neuromuscular diseases. The cognitive and behavioural tests are potential biomarkers of the prognosis of ALS. The results of cognitive tests are stable over 6months and possibly longer. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Evaluation of hybrids algorithms for mass detection in digitalized mammograms

    NASA Astrophysics Data System (ADS)

    Cordero, José; Garzón Reyes, Johnson

    2011-01-01

    The breast cancer remains being a significant public health problem, the early detection of the lesions can increase the success possibilities of the medical treatments. The mammography is an image modality effective to early diagnosis of abnormalities, where the medical image is obtained of the mammary gland with X-rays of low radiation, this allows detect a tumor or circumscribed mass between two to three years before that it was clinically palpable, and is the only method that until now achieved reducing the mortality by breast cancer. In this paper three hybrids algorithms for circumscribed mass detection on digitalized mammograms are evaluated. In the first stage correspond to a review of the enhancement and segmentation techniques used in the processing of the mammographic images. After a shape filtering was applied to the resulting regions. By mean of a Bayesian filter the survivors regions were processed, where the characteristics vector for the classifier was constructed with few measurements. Later, the implemented algorithms were evaluated by ROC curves, where 40 images were taken for the test, 20 normal images and 20 images with circumscribed lesions. Finally, the advantages and disadvantages in the correct detection of a lesion of every algorithm are discussed.

  9. A new breast cancer risk analysis approach using features extracted from multiple sub-regions on bilateral mammograms

    NASA Astrophysics Data System (ADS)

    Sun, Wenqing; Tseng, Tzu-Liang B.; Zheng, Bin; Zhang, Jianying; Qian, Wei

    2015-03-01

    A novel breast cancer risk analysis approach is proposed for enhancing performance of computerized breast cancer risk analysis using bilateral mammograms. Based on the intensity of breast area, five different sub-regions were acquired from one mammogram, and bilateral features were extracted from every sub-region. Our dataset includes 180 bilateral mammograms from 180 women who underwent routine screening examinations, all interpreted as negative and not recalled by the radiologists during the original screening procedures. A computerized breast cancer risk analysis scheme using four image processing modules, including sub-region segmentation, bilateral feature extraction, feature selection, and classification was designed to detect and compute image feature asymmetry between the left and right breasts imaged on the mammograms. The highest computed area under the curve (AUC) is 0.763 ± 0.021 when applying the multiple sub-region features to our testing dataset. The positive predictive value and the negative predictive value were 0.60 and 0.73, respectively. The study demonstrates that (1) features extracted from multiple sub-regions can improve the performance of our scheme compared to using features from whole breast area only; (2) a classifier using asymmetry bilateral features can effectively predict breast cancer risk; (3) incorporating texture and morphological features with density features can boost the classification accuracy.

  10. Improved Classification of Mammograms Following Idealized Training

    PubMed Central

    Hornsby, Adam N.; Love, Bradley C.

    2014-01-01

    People often make decisions by stochastically retrieving a small set of relevant memories. This limited retrieval implies that human performance can be improved by training on idealized category distributions (Giguère & Love, 2013). Here, we evaluate whether the benefits of idealized training extend to categorization of real-world stimuli, namely classifying mammograms as normal or tumorous. Participants in the idealized condition were trained exclusively on items that, according to a norming study, were relatively unambiguous. Participants in the actual condition were trained on a representative range of items. Despite being exclusively trained on easy items, idealized-condition participants were more accurate than those in the actual condition when tested on a range of item types. However, idealized participants experienced difficulties when test items were very dissimilar from training cases. The benefits of idealization, attributable to reducing noise arising from cognitive limitations in memory retrieval, suggest ways to improve real-world decision making. PMID:24955325

  11. Improved Classification of Mammograms Following Idealized Training.

    PubMed

    Hornsby, Adam N; Love, Bradley C

    2014-06-01

    People often make decisions by stochastically retrieving a small set of relevant memories. This limited retrieval implies that human performance can be improved by training on idealized category distributions (Giguère & Love, 2013). Here, we evaluate whether the benefits of idealized training extend to categorization of real-world stimuli, namely classifying mammograms as normal or tumorous. Participants in the idealized condition were trained exclusively on items that, according to a norming study, were relatively unambiguous. Participants in the actual condition were trained on a representative range of items. Despite being exclusively trained on easy items, idealized-condition participants were more accurate than those in the actual condition when tested on a range of item types. However, idealized participants experienced difficulties when test items were very dissimilar from training cases. The benefits of idealization, attributable to reducing noise arising from cognitive limitations in memory retrieval, suggest ways to improve real-world decision making.

  12. Characterizing Time to Diagnostic Resolution After an Abnormal Cancer Screening Exam in Older Adult Participants in the Ohio Patient Navigation Research Program.

    PubMed

    DeSalvo, Jennifer M; Young, Gregory S; Krok-Schoen, Jessica L; Paskett, Electra D

    2017-06-01

    This study aims to test the effectiveness of a patient navigation (PN) intervention to reduce time to diagnostic resolution among older adults age ≥65 years versus those <65 years with abnormal breast, cervical, or colorectal cancer screening exams participating in the Ohio Patient Navigation Research Program (OPNRP). The OPNRP utilized a nested cohort group-randomized trial design to randomize 862 participants ( n = 67 for ≥65 years; n = 795 for <65 years) to PN or usual care conditions. A shared frailty Cox model tested the effect of PN on time to resolution. Older adult participants randomized to PN achieved a 6-month resolution rate that was 127% higher than those randomized to usual care ( p = .001). This effect was not significantly different from participants <65 years. PN significantly reduced time to diagnostic resolution among older adults beginning 6 months after an abnormal cancer screening exam. Health care systems should include this population in PN programs to reduce cancer disparities.

  13. Epidemiology and Prevalence of Abnormal Results for Anal Cytology Screening in HIV-Infected Young Men Who Have Sex with Men.

    PubMed

    Coromilas, Alexandra; Brozovich, Ava; Nelson, John; Neu, Natalie

    2014-03-01

    To determine the prevalence and risk factors for dysplasia in an urban population of HIV-infected young men who have sex with men (YMSM) and to determine the adherence to guidelines for anal cytology screening. The electronic medical record was utilized to collect pre-existing demographic information, medical history, laboratory data, and anal cytology results. Among 60 subjects (mean age 21.2 years) at their first diagnostic anal cytology, 32 (53.3%) had an anal cytological abnormality and 28 (46.7%) had normal anal cytology. The abnormal results were as follows: 21 (65.6%) had atypical squamous cells of undetermined significance (ASCUS), one (3.1%) had atypical squamous cells and high-grade squamous intraepithelial lesion could not be excluded, nine (28.1%) had low-grade squamous intraepithelial lesion, and one (3.1%) had high-grade squamous intraepithelial lesion. In univariate analysis, abnormal anal cytology was not associated with any of the identified risk factors. The proportion of YMSM at the HIV Specialized Care Center who had an anal cytology screen rose from 32.3% (10/31) in 2008, the first full year of anal cytology screening at this clinic, to 81.4% (35/43) in 2012. The prevalence of abnormal anal cytology in this YMSM population is similar to the prevalence in other, primarily adult men who have sex with men, HIV-infected populations. Further studies are necessary to determine risk factors and outcomes of abnormal test results in HIV-infected YMSM populations.

  14. Increasing cancer detection yield of breast MRI using a new CAD scheme of mammograms

    NASA Astrophysics Data System (ADS)

    Tan, Maxine; Aghaei, Faranak; Hollingsworth, Alan B.; Stough, Rebecca G.; Liu, Hong; Zheng, Bin

    2016-03-01

    Although breast MRI is the most sensitive imaging modality to detect early breast cancer, its cancer detection yield in breast cancer screening is quite low (< 3 to 4% even for the small group of high-risk women) to date. The purpose of this preliminary study is to test the potential of developing and applying a new computer-aided detection (CAD) scheme of digital mammograms to identify women at high risk of harboring mammography-occult breast cancers, which can be detected by breast MRI. For this purpose, we retrospectively assembled a dataset involving 30 women who had both mammography and breast MRI screening examinations. All mammograms were interpreted as negative, while 5 cancers were detected using breast MRI. We developed a CAD scheme of mammograms, which include a new quantitative mammographic image feature analysis based risk model, to stratify women into two groups with high and low risk of harboring mammography-occult cancer. Among 30 women, 9 were classified into the high risk group by CAD scheme, which included all 5 women who had cancer detected by breast MRI. All 21 low risk women remained negative on the breast MRI examinations. The cancer detection yield of breast MRI applying to this dataset substantially increased from 16.7% (5/30) to 55.6% (5/9), while eliminating 84% (21/25) unnecessary breast MRI screenings. The study demonstrated the potential of applying a new CAD scheme to significantly increase cancer detection yield of breast MRI, while simultaneously reducing the number of negative MRIs in breast cancer screening.

  15. What Is a Mammogram and When Should I Get One?

    MedlinePlus

    ... Statistics What CDC Is Doing Research African American Women and Mass Media Campaign Public Service Announcements Print Materials Buttons and Badges Stay Informed Cancer Home What Is a Mammogram? Language: English (US) Español ( ...

  16. Simultaneous detection and classification of breast masses in digital mammograms via a deep learning YOLO-based CAD system.

    PubMed

    Al-Masni, Mohammed A; Al-Antari, Mugahed A; Park, Jeong-Min; Gi, Geon; Kim, Tae-Yeon; Rivera, Patricio; Valarezo, Edwin; Choi, Mun-Taek; Han, Seung-Moo; Kim, Tae-Seong

    2018-04-01

    Automatic detection and classification of the masses in mammograms are still a big challenge and play a crucial role to assist radiologists for accurate diagnosis. In this paper, we propose a novel Computer-Aided Diagnosis (CAD) system based on one of the regional deep learning techniques, a ROI-based Convolutional Neural Network (CNN) which is called You Only Look Once (YOLO). Although most previous studies only deal with classification of masses, our proposed YOLO-based CAD system can handle detection and classification simultaneously in one framework. The proposed CAD system contains four main stages: preprocessing of mammograms, feature extraction utilizing deep convolutional networks, mass detection with confidence, and finally mass classification using Fully Connected Neural Networks (FC-NNs). In this study, we utilized original 600 mammograms from Digital Database for Screening Mammography (DDSM) and their augmented mammograms of 2,400 with the information of the masses and their types in training and testing our CAD. The trained YOLO-based CAD system detects the masses and then classifies their types into benign or malignant. Our results with five-fold cross validation tests show that the proposed CAD system detects the mass location with an overall accuracy of 99.7%. The system also distinguishes between benign and malignant lesions with an overall accuracy of 97%. Our proposed system even works on some challenging breast cancer cases where the masses exist over the pectoral muscles or dense regions. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Urinary tract abnormalities in Chinese rural children who consumed melamine-contaminated dairy products: a population-based screening and follow-up study

    PubMed Central

    Liu, Jian-meng; Ren, Aiguo; Yang, Lei; Gao, Jinji; Pei, Lijun; Ye, Rongwei; Qu, Quangang; Zheng, Xiaoying

    2010-01-01

    Background Kidney damage related to consumption of melamine-contaminated dairy products by young children in China has been described. However, no studies have reported on the population-based prevalence of kidney damage among exposed children or on the condition of affected children after follow-up. Methods We conducted an ultrasound-based screening in September 2008 of 7933 children younger than 36 months of age who lived in a rural area in China where the dairy products most highly contaminated with melamine were sold. We monitored children who had evidence of nephrolithiasis or hydronephrosis at screening using renal ultrasonography after one, three and six months. We also collected information from the mothers of affected children about consumption of melamine-contaminated products between June and August 2008. Results The overall prevalence of urinary tract abnormalities among screened children was 0.61% (95% confidence interval [CI] 0.45%–0.80%). The mean exposure dose of melamine was estimated to be 116 (range 36–220) mg per day. Of the 48 affected children, 43 (89.6%) were asymptomatic, 2 had symptoms and were hospitalized, and 3 had symptoms but treatment had been not sought for them. Of the 46 children for whom six-month follow-up information was available, renal abnormalities persisted in 5 children and resolved in the remaining 41. Interpretation Among children who underwent screening, 0.61% showed ultrasonographic evidence of nephrolithiasis or hydronephrosis. Most of the affected children were asymptomatic. The majority of the affected children recovered from the toxic effects of melamine over time without specific treatment. Renal abnormalities remained in 12% of the affected children. PMID:20176755

  18. Influences of Radiology Trainees on Screening Mammography Interpretation.

    PubMed

    Hawley, Jeffrey R; Taylor, Clayton R; Cubbison, Alyssa M; Erdal, B Selnur; Yildiz, Vedat O; Carkaci, Selin

    2016-05-01

    Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes. Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded. A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P < .0001). Overall cancer detection rate for attending radiologists reading alone was 5.7 per 1,000 compared with 5.2 per 1,000 when reading with a trainee (P = .517). When reading with a trainee, dense breasts represented a greater portion of recalls (P = .0001), and more frequently, greater than one abnormality was described in the breast (P = .013). Detection of ductal carcinoma in situ versus invasive carcinoma or invasive cancer type was not significantly different. The mean size of cancers in patients recalled by attending radiologists alone was smaller, and nodal involvement was less frequent, though not statistically significantly. These results demonstrate a significant overall increase in recall rate when interpreting screening mammograms with radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All

  19. Study of the Effects of Total Modulation Transfer Function Changes on Observer Performance Using Clinical Mammograms.

    NASA Astrophysics Data System (ADS)

    Bencomo, Jose Antonio Fagundez

    The main goal of this study was to relate physical changes in image quality measured by Modulation Transfer Function (MTF) to diagnostic accuracy. One Hundred and Fifty Kodak Min-R screen/film combination conventional craniocaudal mammograms obtained with the Pfizer Microfocus Mammographic system were selected from the files of the Department of Radiology, at M.D. Anderson Hospital and Tumor Institute. The mammograms included 88 cases with a variety of benign diagnosis and 62 cases with a variety of malignant biopsy diagnosis. The average age of the patient population was 55 years old. 70 cases presented calcifications with 30 cases having calcifications smaller than 0.5mm. 46 cases presented irregular bordered masses larger than 1 cm. 30 cases presented smooth bordered masses with 20 larger than 1 cm. Four separated copies of the original images were made each having a different change in the MTF using a defocusing technique whereby copies of the original were obtained by light exposure through different thicknesses (spacing) of transparent film base. The mammograms were randomized, and evaluated by three experienced mammographers for the degree of visibility of various anatomical breast structures and pathological lesions (masses and calicifications), subjective image quality, and mammographic interpretation. 3,000 separate evaluations were anayzed by several statistical techniques including Receiver Operating Characteristic curve analysis, McNemar test for differences between proportions and the Landis et al. method of agreement weighted kappa for ordinal categorical data. Results from the statistical analysis show: (1) There were no statistical significant differences in the diagnostic accuracy of the observers when diagnosing from mammograms with the same MTF. (2) There were no statistically significant differences in diagnostic accuracy for each observer when diagnosing from mammograms with the different MTF's used in the study. (3) There statistical

  20. Mobile Versus Fixed Facility: Latinas' Attitudes and Preferences for Obtaining a Mammogram.

    PubMed

    Scheel, John R; Tillack, Allison A; Mercer, Lauren; Coronado, Gloria D; Beresford, Shirley A A; Molina, Yamile; Thompson, Beti

    2018-01-01

    Mobile mammographic services have been proposed as a way to reduce Latinas' disproportionate late-stage presentation compared with white women by increasing their access to mammography. The aims of this study were to assess why Latinas may not use mobile mammographic services and to explore their preferences after using these services. Using a mixed-methods approach, a secondary analysis was conducted of baseline survey data (n = 538) from a randomized controlled trial to improve screening mammography rates among Latinas in Washington. Descriptive statistics and bivariate regression were used to characterize mammography location preferences and to test for associations with sociodemographic indices, health care access, and perceived breast cancer risk and beliefs. On the basis of these findings, a qualitative study (n = 18) was used to explore changes in perceptions after using mobile mammographic services. More Latinas preferred obtaining a mammogram at a fixed facility (52.3% [n = 276]) compared with having no preference (46.3% [n = 249]) and preferring mobile mammographic services (1.7% [n = 9]). Concerns about privacy and comfort (15.6% [n = 84]) and about general quality (10.6% [n = 57]) were common reasons for preferring a fixed facility. Those with no history of mammography preferred a fixed facility (P < .05). In the qualitative study, Latinas expressed similar initial concerns but became positive toward the mobile mammographic services after obtaining a mammogram. Although most Latinas preferred obtaining a mammogram at a fixed facility, positive experiences with mobile mammography services changed their attitudes toward them. These findings highlight the need to include community education when using mobile mammographic service to increase screening mammography rates in underserved communities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. A comparison of face to face and group education on informed choice and decisional conflict of pregnant women about screening tests of fetal abnormalities.

    PubMed

    Kordi, Masoumeh; Riyazi, Sahar; Lotfalizade, Marziyeh; Shakeri, Mohammad Taghi; Suny, Hoseyn Jafari

    2018-01-01

    Screening of fetal anomalies is assumed as a necessary measurement in antenatal cares. The screening plans aim at empowerment of individuals to make the informed choice. This study was conducted in order to compare the effect of group and face-to-face education and decisional conflicts among the pregnant females regarding screening of fetal abnormalities. This study of the clinical trial was carried out on 240 pregnant women at <10-week pregnancy age in health care medical centers in Mashhad city in 2014. The form of individual-midwifery information and informed choice questionnaire and decisional conflict scale were used as tools for data collection. The face-to-face and group education course were held in two weekly sessions for intervention groups during two consecutive weeks, and the usual care was conducted for the control group. The rate of informed choice and decisional conflict was measured in pregnant women before education and also at weeks 20-22 of pregnancy in three groups. The data analysis was executed using SPSS statistical software (version 16), and statistical tests were implemented including Chi-square test, Kruskal-Wallis test, Wilcoxon test, Mann-Whitney U-test, one-way analysis of variance test, and Tukey's range test. The P < 0.05 was considered as a significant. The results showed that there was statically significant difference between three groups in terms of frequency of informed choice in screening of fetal abnormalities ( P = 0.001) in such a way that at next step of intervention, 62 participants (77.5%) in face-to-face education group, 64 members (80%) in group education class, and 20 persons (25%) in control group had the informed choice regarding screening tests, but there was no statistically significant difference between two individual and group education classes. Similarly, during the postintervention phase, there was a statistically significant difference in mean score of decisional conflict scale among pregnant women regarding

  2. A comparison of face to face and group education on informed choice and decisional conflict of pregnant women about screening tests of fetal abnormalities

    PubMed Central

    Kordi, Masoumeh; Riyazi, Sahar; Lotfalizade, Marziyeh; Shakeri, Mohammad Taghi; Suny, Hoseyn Jafari

    2018-01-01

    BACKGROUND AND GOAL: Screening of fetal anomalies is assumed as a necessary measurement in antenatal cares. The screening plans aim at empowerment of individuals to make the informed choice. This study was conducted in order to compare the effect of group and face-to-face education and decisional conflicts among the pregnant females regarding screening of fetal abnormalities. METHODS: This study of the clinical trial was carried out on 240 pregnant women at <10-week pregnancy age in health care medical centers in Mashhad city in 2014. The form of individual-midwifery information and informed choice questionnaire and decisional conflict scale were used as tools for data collection. The face-to-face and group education course were held in two weekly sessions for intervention groups during two consecutive weeks, and the usual care was conducted for the control group. The rate of informed choice and decisional conflict was measured in pregnant women before education and also at weeks 20–22 of pregnancy in three groups. The data analysis was executed using SPSS statistical software (version 16), and statistical tests were implemented including Chi-square test, Kruskal–Wallis test, Wilcoxon test, Mann–Whitney U-test, one-way analysis of variance test, and Tukey's range test. The P < 0.05 was considered as a significant. RESULTS: The results showed that there was statically significant difference between three groups in terms of frequency of informed choice in screening of fetal abnormalities (P = 0.001) in such a way that at next step of intervention, 62 participants (77.5%) in face-to-face education group, 64 members (80%) in group education class, and 20 persons (25%) in control group had the informed choice regarding screening tests, but there was no statistically significant difference between two individual and group education classes. Similarly, during the postintervention phase, there was a statistically significant difference in mean score of decisional

  3. Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country.

    PubMed

    Lee, Marianne; Mariapun, Shivaani; Rajaram, Nadia; Teo, Soo-Hwang; Yip, Cheng-Har

    2017-01-28

    The incidence of breast cancer in Asia is increasing because of urbanization and lifestyle changes. In the developing countries in Asia, women present at late stages, and mortality is high. Mammographic screening is the only evidence-based screening modality that reduces breast cancer mortality. To date, only opportunistic screening is offered in the majority of Asian countries because of the lack of justification and funding. Nevertheless, there have been few reports on the effectiveness of such programmes. In this study, we describe the cancer detection rate and challenges experienced in an opportunistic mammographic screening programme in Malaysia. From October 2011 to June 2015, 1,778 asymptomatic women, aged 40-74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined. The mean age for screening was 50.8 years and seven cancers (0.39%) were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist's experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities. The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2-4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening are likely premenopausal and hence have denser breasts. Radiologists who

  4. Barriers to healthcare contribute to delays in follow-up among women with abnormal cancer screening: data from the Patient Navigation Research Program

    PubMed Central

    Ramachandran, Ambili; Snyder, Frederick; Katz, Mira L.; Darnell, Julie; Dudley, Donald; Patierno, Steven R.; Sanders, Mechelle R; Valverde, Patricia A; Simon, Melissa A; Warren-Mears, Victoria; Battaglia, Tracy A.

    2015-01-01

    Background There is limited understanding of the association between barriers to care and clinical outcomes within patient navigation programs. Methods Secondary analyses of data from the intervention arms of the Patient Navigation Research Program (PNRP), including navigated participants with abnormal breast and cervical cancer screening tests from 2007 to 2010. Independent variables were (a) number of unique barriers to care (0, 1, 2, or 3+) documented during patient navigation encounters and (b) presence of socio-legal barriers originating from social policy (yes/no). Median time to diagnostic resolution of index screening abnormalities was estimated using Kaplan-Meier cumulative incidence curves. Multivariable Cox proportional hazards regression examined the impact of barriers on time to resolution, controlling for socio-demographics and stratifying by study center. Results Among 2600 breast participants, three-quarters had barriers to care (25% 1 barrier, 16% 2 barriers and 34% 3+ barriers). Among 1387 cervical participants, more than half had barriers (31% 1 barrier, 11% 2 barriers, and 13% 3+ barriers). Among breast participants, the presence of barriers was associated with less timely resolution for any number of barriers compared to no barriers. Among cervical participants, only the presence of 2 or more barriers was associated with less timely resolution. Both types of barriers, socio-legal and other barriers, were associated with delay among breast and cervical participants. Conclusions Navigated women with barriers resolve cancer screening abnormalities at a slower rate compared to navigated women with no barriers. Further innovations in navigation care are necessary to maximize the impact of patient navigation programs nationwide. PMID:26385420

  5. Towards an in-plane methodology to track breast lesions using mammograms and patient-specific finite-element simulations

    NASA Astrophysics Data System (ADS)

    Lapuebla-Ferri, Andrés; Cegoñino-Banzo, José; Jiménez-Mocholí, Antonio-José; Pérez del Palomar, Amaya

    2017-11-01

    In breast cancer screening or diagnosis, it is usual to combine different images in order to locate a lesion as accurately as possible. These images are generated using a single or several imaging techniques. As x-ray-based mammography is widely used, a breast lesion is located in the same plane of the image (mammogram), but tracking it across mammograms corresponding to different views is a challenging task for medical physicians. Accordingly, simulation tools and methodologies that use patient-specific numerical models can facilitate the task of fusing information from different images. Additionally, these tools need to be as straightforward as possible to facilitate their translation to the clinical area. This paper presents a patient-specific, finite-element-based and semi-automated simulation methodology to track breast lesions across mammograms. A realistic three-dimensional computer model of a patient’s breast was generated from magnetic resonance imaging to simulate mammographic compressions in cranio-caudal (CC, head-to-toe) and medio-lateral oblique (MLO, shoulder-to-opposite hip) directions. For each compression being simulated, a virtual mammogram was obtained and posteriorly superimposed to the corresponding real mammogram, by sharing the nipple as a common feature. Two-dimensional rigid-body transformations were applied, and the error distance measured between the centroids of the tumors previously located on each image was 3.84 mm and 2.41 mm for CC and MLO compression, respectively. Considering that the scope of this work is to conceive a methodology translatable to clinical practice, the results indicate that it could be helpful in supporting the tracking of breast lesions.

  6. Guidelines for breast cancer screening in Lebanon Public Health Communication.

    PubMed

    Adib, Salim M; El Saghir, Nagi S; Ammar, Walid

    2009-01-01

    The accumulation of national epidemiological data since the late 1990s has led to the adoption of evidence-based guidelines for breast cancer screening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is estimated at 69 new cases per 100,000 per year (2004). This official notification calls for breast self-examination (BSE) every month starting age 20, and a clinical breast examination (CBE) performed by a physician every three years between the ages of 20 and 40 years. Starting age 40, and for as long as a woman is in good health, an annual CBE and mammography are recommended. Women with known genetic family history of breast cancer should start screening 10 years earlier than the first young patient in the family, or earlier depending on medical advice. The Breast Cancer National Task Force (BCNTF) recommends certification of mammography centers and continued training of personnel to assure high quality mammograms, and to minimize unnecessary investigations and surgeries.It recommends that a national program should record call-backs of women for annual screening and follow-up data on abnormal mammograms. BCNTF encourages the adoption of these guidelines and monitoring of their results, as well as follow-up of breast cancer epidemiology and registry in Lebanon, and scientific progress in early breast cancer detection to determine needs for modifications in the future.

  7. Three-Class Mammogram Classification Based on Descriptive CNN Features.

    PubMed

    Jadoon, M Mohsin; Zhang, Qianni; Haq, Ihsan Ul; Butt, Sharjeel; Jadoon, Adeel

    2017-01-01

    In this paper, a novel classification technique for large data set of mammograms using a deep learning method is proposed. The proposed model targets a three-class classification study (normal, malignant, and benign cases). In our model we have presented two methods, namely, convolutional neural network-discrete wavelet (CNN-DW) and convolutional neural network-curvelet transform (CNN-CT). An augmented data set is generated by using mammogram patches. To enhance the contrast of mammogram images, the data set is filtered by contrast limited adaptive histogram equalization (CLAHE). In the CNN-DW method, enhanced mammogram images are decomposed as its four subbands by means of two-dimensional discrete wavelet transform (2D-DWT), while in the second method discrete curvelet transform (DCT) is used. In both methods, dense scale invariant feature (DSIFT) for all subbands is extracted. Input data matrix containing these subband features of all the mammogram patches is created that is processed as input to convolutional neural network (CNN). Softmax layer and support vector machine (SVM) layer are used to train CNN for classification. Proposed methods have been compared with existing methods in terms of accuracy rate, error rate, and various validation assessment measures. CNN-DW and CNN-CT have achieved accuracy rate of 81.83% and 83.74%, respectively. Simulation results clearly validate the significance and impact of our proposed model as compared to other well-known existing techniques.

  8. Three-Class Mammogram Classification Based on Descriptive CNN Features

    PubMed Central

    Zhang, Qianni; Jadoon, Adeel

    2017-01-01

    In this paper, a novel classification technique for large data set of mammograms using a deep learning method is proposed. The proposed model targets a three-class classification study (normal, malignant, and benign cases). In our model we have presented two methods, namely, convolutional neural network-discrete wavelet (CNN-DW) and convolutional neural network-curvelet transform (CNN-CT). An augmented data set is generated by using mammogram patches. To enhance the contrast of mammogram images, the data set is filtered by contrast limited adaptive histogram equalization (CLAHE). In the CNN-DW method, enhanced mammogram images are decomposed as its four subbands by means of two-dimensional discrete wavelet transform (2D-DWT), while in the second method discrete curvelet transform (DCT) is used. In both methods, dense scale invariant feature (DSIFT) for all subbands is extracted. Input data matrix containing these subband features of all the mammogram patches is created that is processed as input to convolutional neural network (CNN). Softmax layer and support vector machine (SVM) layer are used to train CNN for classification. Proposed methods have been compared with existing methods in terms of accuracy rate, error rate, and various validation assessment measures. CNN-DW and CNN-CT have achieved accuracy rate of 81.83% and 83.74%, respectively. Simulation results clearly validate the significance and impact of our proposed model as compared to other well-known existing techniques. PMID:28191461

  9. Mammogram segmentation using maximal cell strength updation in cellular automata.

    PubMed

    Anitha, J; Peter, J Dinesh

    2015-08-01

    Breast cancer is the most frequently diagnosed type of cancer among women. Mammogram is one of the most effective tools for early detection of the breast cancer. Various computer-aided systems have been introduced to detect the breast cancer from mammogram images. In a computer-aided diagnosis system, detection and segmentation of breast masses from the background tissues is an important issue. In this paper, an automatic segmentation method is proposed to identify and segment the suspicious mass regions of mammogram using a modified transition rule named maximal cell strength updation in cellular automata (CA). In coarse-level segmentation, the proposed method performs an adaptive global thresholding based on the histogram peak analysis to obtain the rough region of interest. An automatic seed point selection is proposed using gray-level co-occurrence matrix-based sum average feature in the coarse segmented image. Finally, the method utilizes CA with the identified initial seed point and the modified transition rule to segment the mass region. The proposed approach is evaluated over the dataset of 70 mammograms with mass from mini-MIAS database. Experimental results show that the proposed approach yields promising results to segment the mass region in the mammograms with the sensitivity of 92.25% and accuracy of 93.48%.

  10. [Estimated mammogram coverage in Goiás State, Brazil].

    PubMed

    Corrêa, Rosangela da Silveira; Freitas-Júnior, Ruffo; Peixoto, João Emílio; Rodrigues, Danielle Cristina Netto; Lemos, Maria Eugênia da Fonseca; Marins, Lucy Aparecida Parreira; Silveira, Erika Aparecida da

    2011-09-01

    This cross-sectional study aimed to estimate mammogram coverage in the State of Goiás, Brazil, describing the supply, demand, and variations in different age groups, evaluating 98 mammography services as observational units. We estimated the mammogram rates by age group and type of health service, as well as the number of tests required to cover 70% and 100% of the target population. We assessed the association between mammograms, geographical distribution of mammography machines, type of service, and age group. Full coverage estimates, considering 100% of women in the 40-69 and 50-69-year age brackets, were 61% and 66%, of which the Brazilian Unified National Health System provided 13% and 14%, respectively. To achieve 70% coverage, 43,424 additional mammograms would be needed. All the associations showed statistically significant differences (p < 0.001). We conclude that mammogram coverage is unevenly distributed in the State of Goiás and that fewer tests are performed than required.

  11. Evaluation of a New Ensemble Learning Framework for Mass Classification in Mammograms.

    PubMed

    Rahmani Seryasat, Omid; Haddadnia, Javad

    2018-06-01

    Mammography is the most common screening method for diagnosis of breast cancer. In this study, a computer-aided system for diagnosis of benignity and malignity of the masses was implemented in mammogram images. In the computer aided diagnosis system, we first reduce the noise in the mammograms using an effective noise removal technique. After the noise removal, the mass in the region of interest must be segmented and this segmentation is done using a deformable model. After the mass segmentation, a number of features are extracted from it. These features include: features of the mass shape and border, tissue properties, and the fractal dimension. After extracting a large number of features, a proper subset must be chosen from among them. In this study, we make use of a new method on the basis of a genetic algorithm for selection of a proper set of features. After determining the proper features, a classifier is trained. To classify the samples, a new architecture for combination of the classifiers is proposed. In this architecture, easy and difficult samples are identified and trained using different classifiers. Finally, the proposed mass diagnosis system was also tested on mini-Mammographic Image Analysis Society and digital database for screening mammography databases. The obtained results indicate that the proposed system can compete with the state-of-the-art methods in terms of accuracy. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Similarity estimation for reference image retrieval in mammograms using convolutional neural network

    NASA Astrophysics Data System (ADS)

    Muramatsu, Chisako; Higuchi, Shunichi; Morita, Takako; Oiwa, Mikinao; Fujita, Hiroshi

    2018-02-01

    Periodic breast cancer screening with mammography is considered effective in decreasing breast cancer mortality. For screening programs to be successful, an intelligent image analytic system may support radiologists' efficient image interpretation. In our previous studies, we have investigated image retrieval schemes for diagnostic references of breast lesions on mammograms and ultrasound images. Using a machine learning method, reliable similarity measures that agree with radiologists' similarity were determined and relevant images could be retrieved. However, our previous method includes a feature extraction step, in which hand crafted features were determined based on manual outlines of the masses. Obtaining the manual outlines of masses is not practical in clinical practice and such data would be operator-dependent. In this study, we investigated a similarity estimation scheme using a convolutional neural network (CNN) to skip such procedure and to determine data-driven similarity scores. By using CNN as feature extractor, in which extracted features were employed in determination of similarity measures with a conventional 3-layered neural network, the determined similarity measures were correlated well with the subjective ratings and the precision of retrieving diagnostically relevant images was comparable with that of the conventional method using handcrafted features. By using CNN for determination of similarity measure directly, the result was also comparable. By optimizing the network parameters, results may be further improved. The proposed method has a potential usefulness in determination of similarity measure without precise lesion outlines for retrieval of similar mass images on mammograms.

  13. Mutation screening of HOXA7 and HOXA9 genes in Chinese women with Müllerian duct abnormalities.

    PubMed

    Chen, Xinxia; Mu, Yulan; Li, Chunyan; Li, Guangyu; Zhao, Hui; Qin, Yingying; Chen, Zi-Jiang

    2014-11-01

    HOXA genes in groups 7-13 have been proven to play a role in determining positional identity along the genitalia axis. The aim of the present study was to explore the relationship between HOXA7 and HOXA9 mutations and Müllerian duct abnormalities (MDA). One hundred and ninety-two Chinese patients with MDA abnormalities and 192 healthy controls were recruited. All coding regions of HOXA7 and HOXA9 were amplified and sequenced directly. Rs2301721 and rs2301720 in HOXA7, rs35355140 and rs7810502 in HOXA9 were identified in patients with MDA and controls. One rare single nucleotide polymorphism rs189587233 in 3' UTR of HOXA9 gene was detected in one patient with didelphic uterus and absent in the 192 controls. This polymorphism, however, is known to exist in the normal Chinese population. Our results indicated that variants in the HOXA7 and HOXA9 genes were not common in Chinese women with Müllerian duct abnormalities. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  14. The Forsyth County Cervical Cancer Prevention Project--II. Compliance with screening follow-up of abnormal cervical smears.

    PubMed

    Michielutte, R; Dignan, M; Bahnson, J; Wells, H B

    1994-12-01

    The Forsyth County Cervical Cancer Prevention Project was a community-wide cancer education program to address the problem of cervical cancer incidence and mortality among minority women in Forsyth County, North Carolina. This paper reports program results with regard to increasing compliance with follow-up for abnormal cervical smears. An analysis of trends prior to and after implementation of the educational program was conducted in one private and two public health primary care clinics to provide an assessment of impact of the project in improving compliance with follow-up among black women. A similar analysis also was conducted for white women. The results of medical record reviews of follow-up procedures for 878 abnormal cervical smears suggested a modest program effect among black women. The percentage of black women who returned for follow-up and treatment of an abnormal cervical smear significantly increased during the time the program was in effect. The trend analysis further indicated that the decline did not begin prior to the intervention period and was maintained throughout the duration of the intervention. No significant change in the percentage who returned for follow-up was found for white women.

  15. Effectiveness of quadrivalent human papillomavirus vaccine for the prevention of cervical abnormalities: case-control study nested within a population based screening programme in Australia.

    PubMed

    Crowe, Elizabeth; Pandeya, Nirmala; Brotherton, Julia M L; Dobson, Annette J; Kisely, Stephen; Lambert, Stephen B; Whiteman, David C

    2014-03-04

    To measure the effectiveness of the quadrivalent human papillomavirus (HPV) vaccine against cervical abnormalities four years after implementation of a nationally funded vaccination programme in Queensland, Australia. Case-control analysis of linked administrative health datasets. Queensland, Australia. Women eligible for free vaccination (aged 12-26 years in 2007) and attending for their first cervical smear test between April 2007 and March 2011. High grade cases were women with histologically confirmed high grade cervical abnormalities (n = 1062) and "other cases" were women with any other abnormality at cytology or histology (n = 10,887). Controls were women with normal cytology (n = 96,404). Exposure odds ratio (ratio of odds of antecedent vaccination (one, two, or three vaccine doses compared with no doses) among cases compared with controls), vaccine effectiveness ((1-adjusted odds ratio) × 100), and number needed to vaccinate to prevent one cervical abnormality at first screening round. We stratified by four age groups adjusted for follow-up time, year of birth, and measures of socioeconomic status and remoteness. The primary analysis concerned women whose first ever smear test defined their status as a case or a control. The adjusted odds ratio for exposure to three doses of HPV vaccine compared with no vaccine was 0.54 (95% confidence interval 0.43 to 0.67) for high grade cases and 0.66 (0.62 to 0.70) for other cases compared with controls with normal cytology, equating to vaccine effectiveness of 46% and 34%, respectively. The adjusted numbers needed to vaccinate were 125 (95% confidence interval 97 to 174) and 22 (19 to 25), respectively. The adjusted exposure odds ratios for two vaccine doses were 0.79 (95% confidence interval 0.64 to 0.98) for high grade cases and 0.79 (0.74 to 0.85) for other cases, equating to vaccine effectiveness of 21%. The quadrivalent HPV vaccine conferred statistically significant protection against cervical abnormalities in

  16. Holistic component of image perception in mammogram interpretation: gaze-tracking study.

    PubMed

    Kundel, Harold L; Nodine, Calvin F; Conant, Emily F; Weinstein, Susan P

    2007-02-01

    To test the hypothesis that rapid and accurate performance of the proficient observer in mammogram interpretation involves a shift in the mechanism of image perception from a relatively slow search-to-find mode to a relatively fast holistic mode. This HIPAA-compliant study had institutional review board approval, and participant informed consent was obtained; patient informed consent was not required. The eye positions of three full-time mammographers, one attending radiologist, two mammography fellows, and three radiology residents were recorded during the interpretation of 20 normal and 20 subtly abnormal mammograms. The search time required to first locate a cancer, as well as the initial eye scan path, was determined and compared with diagnostic performance as measured with receiver operating characteristic (ROC) analysis. The median time for all observers to fixate a cancer, regardless of the decision outcome, was 1.13 seconds, with a range of 0.68 second to 3.06 seconds. Even though most of the lesions were fixated, recognition of them as cancerous ranged from 85% (17 of 20) to 10% (two of 20), with corresponding areas under the ROC curve of 0.87-0.40. The ROC index of detectability, d(a), was linearly related to the time to first fixate a cancer with a correlation (r(2)) of 0.81. The rapid initial fixation of a true abnormality is evidence for a global perceptual process capable of analyzing the visual input of the entire retinal image and pinpointing the spatial location of an abnormality. It appears to be more highly developed in the most proficient observers, replacing the less efficient initial search-to-find strategies. (c) RSNA, 2007.

  17. Effectiveness of the critical congenital heart disease screening program for early diagnosis of cardiac abnormalities in newborn infants.

    PubMed

    Almawazini, Abdulmajid M; Hanafi, Hamdi K; Madkhali, Hasan A; Majrashi, Noura B

    2017-10-01

    To evaluate the effectiveness of critical congenital heart disease (CCHD) screening program for early diagnosis of cardiac anomalies in newborn infants.  Methods: This is a hospital-based prospective cross-sectional study conducted in the Pediatric and Neonatology Department, King Fahad Hospital at  Albaha, Saudi Arabia, between February 2016 and February 2017. Results: We screened 2961 (95.4%) of 3103 patients in a nursery unit; 142 (4.6%) patients were not screened. The test was positive in 114 (3.9%) patients and negative in 2847 (96.1%). There were 94 (3.2%) false positives and 20 (0.7%) true positives. Critical cardiac defects were diagnosed in 7 (0.2%) patients of all screened infants, and severe pulmonary hypertension was diagnosed in 13 (0.4%) patients. True negative results were found in 2841(96%) patients, and no cardiac defect was diagnosed, whereas false negative results were seen in 6 (0.2%) patients diagnosed with ventricular septal defect. The sensitivity was 77%, and the specificity was very high at 97%, with a positive predictive value of 18%, and a negative predictive value of 99.8% (95% confidence interval 13.78-19.18, p=0.0001). Conclusion: Pulse oximetry was found to be easy, safe, sensitive, and highly specific for diagnosis of CCHD.

  18. Automatic correspondence detection in mammogram and breast tomosynthesis images

    NASA Astrophysics Data System (ADS)

    Ehrhardt, Jan; Krüger, Julia; Bischof, Arpad; Barkhausen, Jörg; Handels, Heinz

    2012-02-01

    Two-dimensional mammography is the major imaging modality in breast cancer detection. A disadvantage of mammography is the projective nature of this imaging technique. Tomosynthesis is an attractive modality with the potential to combine the high contrast and high resolution of digital mammography with the advantages of 3D imaging. In order to facilitate diagnostics and treatment in the current clinical work-flow, correspondences between tomosynthesis images and previous mammographic exams of the same women have to be determined. In this paper, we propose a method to detect correspondences in 2D mammograms and 3D tomosynthesis images automatically. In general, this 2D/3D correspondence problem is ill-posed, because a point in the 2D mammogram corresponds to a line in the 3D tomosynthesis image. The goal of our method is to detect the "most probable" 3D position in the tomosynthesis images corresponding to a selected point in the 2D mammogram. We present two alternative approaches to solve this 2D/3D correspondence problem: a 2D/3D registration method and a 2D/2D mapping between mammogram and tomosynthesis projection images with a following back projection. The advantages and limitations of both approaches are discussed and the performance of the methods is evaluated qualitatively and quantitatively using a software phantom and clinical breast image data. Although the proposed 2D/3D registration method can compensate for moderate breast deformations caused by different breast compressions, this approach is not suitable for clinical tomosynthesis data due to the limited resolution and blurring effects perpendicular to the direction of projection. The quantitative results show that the proposed 2D/2D mapping method is capable of detecting corresponding positions in mammograms and tomosynthesis images automatically for 61 out of 65 landmarks. The proposed method can facilitate diagnosis, visual inspection and comparison of 2D mammograms and 3D tomosynthesis images for

  19. Breast cancer screening practices among Asian Americans and Pacific Islanders.

    PubMed

    Oh, Kyeung Mi; Zhou, Qiuping Pearl; Kreps, Gary L; Ryu, Shin Kue

    2012-09-01

    To compare the breast cancer screening practices and related factors between Asian Americans and Pacific Islanders (PIs) and non-Hispanic whites. Using 2008 Behavioral Risk Factor Surveillance System data, reported mammogram usage among women aged 40+ were compared. Covariates included demographics, risk behaviors, health perception, care access, and general health practice behavior. PIs had higher rates of screening mammogram usage than did Asian Americans. Most covariates had different levels of influence on mammogram screening for the 2 groups, with a few in opposite directions. Understanding the magnitude and predictors of these disparities for racial/ethnic groups can help inform targeted interventions.

  20. Contrast enhanced dual energy spectral mammogram, an emerging addendum in breast imaging

    PubMed Central

    Gnanaprakasam, Francis; Anand, Subhapradha; Krishnaswami, Murali; Ramachandran, Madan

    2016-01-01

    Objective: To assess the role of contrast-enhanced dual-energy spectral mammogram (CEDM) as a problem-solving tool in equivocal cases. Methods: 44 consenting females with equivocal findings on full-field digital mammogram underwent CEDM. All the images were interpreted by two radiologists independently. Confidence of presence was plotted on a three-point Likert scale and probability of cancer was assigned on Breast Imaging Reporting and Data System scoring. Histopathology was taken as the gold standard. Statistical analyses of all variables were performed. Results: 44 breast lesions were included in the study, among which 77.3% lesions were malignant or precancerous and 22.7% lesions were benign or inconclusive. 20% of lesions were identified only on CEDM. True extent of the lesion was made out in 15.9% of cases, multifocality was established in 9.1% of cases and ductal extension was demonstrated in 6.8% of cases. Statistical significance for CEDM was p-value <0.05. Interobserver kappa value was 0.837. Conclusion: CEDM has a useful role in identifying occult lesions in dense breasts and in triaging lesions. In a mammographically visible lesion, CEDM characterizes the lesion, affirms the finding and better demonstrates response to treatment. Hence, we conclude that CEDM is a useful complementary tool to standard mammogram. Advances in knowledge: CEDM can detect and demonstrate lesions even in dense breasts with the advantage of feasibility of stereotactic biopsy in the same setting. Hence, it has the potential to be a screening modality with need for further studies and validation. PMID:27610475

  1. Contrast enhanced dual energy spectral mammogram, an emerging addendum in breast imaging.

    PubMed

    Kariyappa, Kalpana D; Gnanaprakasam, Francis; Anand, Subhapradha; Krishnaswami, Murali; Ramachandran, Madan

    2016-11-01

    To assess the role of contrast-enhanced dual-energy spectral mammogram (CEDM) as a problem-solving tool in equivocal cases. 44 consenting females with equivocal findings on full-field digital mammogram underwent CEDM. All the images were interpreted by two radiologists independently. Confidence of presence was plotted on a three-point Likert scale and probability of cancer was assigned on Breast Imaging Reporting and Data System scoring. Histopathology was taken as the gold standard. Statistical analyses of all variables were performed. 44 breast lesions were included in the study, among which 77.3% lesions were malignant or precancerous and 22.7% lesions were benign or inconclusive. 20% of lesions were identified only on CEDM. True extent of the lesion was made out in 15.9% of cases, multifocality was established in 9.1% of cases and ductal extension was demonstrated in 6.8% of cases. Statistical significance for CEDM was p-value <0.05. Interobserver kappa value was 0.837. CEDM has a useful role in identifying occult lesions in dense breasts and in triaging lesions. In a mammographically visible lesion, CEDM characterizes the lesion, affirms the finding and better demonstrates response to treatment. Hence, we conclude that CEDM is a useful complementary tool to standard mammogram. Advances in knowledge: CEDM can detect and demonstrate lesions even in dense breasts with the advantage of feasibility of stereotactic biopsy in the same setting. Hence, it has the potential to be a screening modality with need for further studies and validation.

  2. Evaluation of computer-aided detection of lesions in mammograms obtained with a digital phase-contrast mammography system.

    PubMed

    Tanaka, Toyohiko; Nitta, Norihisa; Ohta, Shinichi; Kobayashi, Tsuyoshi; Kano, Akiko; Tsuchiya, Keiko; Murakami, Yoko; Kitahara, Sawako; Wakamiya, Makoto; Furukawa, Akira; Takahashi, Masashi; Murata, Kiyoshi

    2009-12-01

    A computer-aided detection (CAD) system was evaluated for its ability to detect microcalcifications and masses on images obtained with a digital phase-contrast mammography (PCM) system, a system characterised by the sharp images provided by phase contrast and by the high resolution of 25-μm-pixel mammograms. Fifty abnormal and 50 normal mammograms were collected from about 3,500 mammograms and printed on film for reading on a light box. Seven qualified radiologists participated in an observer study based on receiver operating characteristic (ROC) analysis. The average of the areas under ROC curve (AUC) values for the ROC analysis with and without CAD were 0.927 and 0.897 respectively (P = 0.015). The AUC values improved from 0.840 to 0.888 for microcalcifications (P = 0.034) and from 0.947 to 0.962 for masses (P = 0.025) respectively. The application of CAD to the PCM system is a promising approach for the detection of breast cancer in its early stages.

  3. A new approach to develop computer-aided detection schemes of digital mammograms

    NASA Astrophysics Data System (ADS)

    Tan, Maxine; Qian, Wei; Pu, Jiantao; Liu, Hong; Zheng, Bin

    2015-06-01

    The purpose of this study is to develop a new global mammographic image feature analysis based computer-aided detection (CAD) scheme and evaluate its performance in detecting positive screening mammography examinations. A dataset that includes images acquired from 1896 full-field digital mammography (FFDM) screening examinations was used in this study. Among them, 812 cases were positive for cancer and 1084 were negative or benign. After segmenting the breast area, a computerized scheme was applied to compute 92 global mammographic tissue density based features on each of four mammograms of the craniocaudal (CC) and mediolateral oblique (MLO) views. After adding three existing popular risk factors (woman’s age, subjectively rated mammographic density, and family breast cancer history) into the initial feature pool, we applied a sequential forward floating selection feature selection algorithm to select relevant features from the bilateral CC and MLO view images separately. The selected CC and MLO view image features were used to train two artificial neural networks (ANNs). The results were then fused by a third ANN to build a two-stage classifier to predict the likelihood of the FFDM screening examination being positive. CAD performance was tested using a ten-fold cross-validation method. The computed area under the receiver operating characteristic curve was AUC = 0.779   ±   0.025 and the odds ratio monotonically increased from 1 to 31.55 as CAD-generated detection scores increased. The study demonstrated that this new global image feature based CAD scheme had a relatively higher discriminatory power to cue the FFDM examinations with high risk of being positive, which may provide a new CAD-cueing method to assist radiologists in reading and interpreting screening mammograms.

  4. A systematic screen for morphological abnormalities during fission yeast sexual reproduction identifies a mechanism of actin aster formation for cell fusion

    PubMed Central

    Groux, Raphaël; Vincenzetti, Vincent

    2017-01-01

    In non-motile fungi, sexual reproduction relies on strong morphogenetic changes in response to pheromone signaling. We report here on a systematic screen for morphological abnormalities of the mating process in fission yeast Schizosaccharomyces pombe. We derived a homothallic (self-fertile) collection of viable deletions, which, upon visual screening, revealed a plethora of phenotypes affecting all stages of the mating process, including cell polarization, cell fusion and sporulation. Cell fusion relies on the formation of the fusion focus, an aster-like F-actin structure that is marked by strong local accumulation of the myosin V Myo52, which concentrates secretion at the fusion site. A secondary screen for fusion-defective mutants identified the myosin V Myo51-associated coiled-coil proteins Rng8 and Rng9 as critical for the coalescence of the fusion focus. Indeed, rng8Δ and rng9Δ mutant cells exhibit multiple stable dots at the cell-cell contact site, instead of the single focus observed in wildtype. Rng8 and Rng9 accumulate on the fusion focus, dependent on Myo51 and tropomyosin Cdc8. A tropomyosin mutant allele, which compromises Rng8/9 localization but not actin binding, similarly leads to multiple stable dots instead of a single focus. By contrast, myo51 deletion does not strongly affect fusion focus coalescence. We propose that focusing of the actin filaments in the fusion aster primarily relies on Rng8/9-dependent cross-linking of tropomyosin-actin filaments. PMID:28410370

  5. Application of texture analysis method for mammogram density classification

    NASA Astrophysics Data System (ADS)

    Nithya, R.; Santhi, B.

    2017-07-01

    Mammographic density is considered a major risk factor for developing breast cancer. This paper proposes an automated approach to classify breast tissue types in digital mammogram. The main objective of the proposed Computer-Aided Diagnosis (CAD) system is to investigate various feature extraction methods and classifiers to improve the diagnostic accuracy in mammogram density classification. Texture analysis methods are used to extract the features from the mammogram. Texture features are extracted by using histogram, Gray Level Co-Occurrence Matrix (GLCM), Gray Level Run Length Matrix (GLRLM), Gray Level Difference Matrix (GLDM), Local Binary Pattern (LBP), Entropy, Discrete Wavelet Transform (DWT), Wavelet Packet Transform (WPT), Gabor transform and trace transform. These extracted features are selected using Analysis of Variance (ANOVA). The features selected by ANOVA are fed into the classifiers to characterize the mammogram into two-class (fatty/dense) and three-class (fatty/glandular/dense) breast density classification. This work has been carried out by using the mini-Mammographic Image Analysis Society (MIAS) database. Five classifiers are employed namely, Artificial Neural Network (ANN), Linear Discriminant Analysis (LDA), Naive Bayes (NB), K-Nearest Neighbor (KNN), and Support Vector Machine (SVM). Experimental results show that ANN provides better performance than LDA, NB, KNN and SVM classifiers. The proposed methodology has achieved 97.5% accuracy for three-class and 99.37% for two-class density classification.

  6. Segmentation for the enhancement of microcalcifications in digital mammograms.

    PubMed

    Milosevic, Marina; Jankovic, Dragan; Peulic, Aleksandar

    2014-01-01

    Microcalcification clusters appear as groups of small, bright particles with arbitrary shapes on mammographic images. They are the earliest sign of breast carcinomas and their detection is the key for improving breast cancer prognosis. But due to the low contrast of microcalcifications and same properties as noise, it is difficult to detect microcalcification. This work is devoted to developing a system for the detection of microcalcification in digital mammograms. After removing noise from mammogram using the Discrete Wavelet Transformation (DWT), we first selected the region of interest (ROI) in order to demarcate the breast region on a mammogram. Segmenting region of interest represents one of the most important stages of mammogram processing procedure. The proposed segmentation method is based on a filtering using the Sobel filter. This process will identify the significant pixels, that belong to edges of microcalcifications. Microcalcifications were detected by increasing the contrast of the images obtained by applying Sobel operator. In order to confirm the effectiveness of this microcalcification segmentation method, the Support Vector Machine (SVM) and k-Nearest Neighborhood (k-NN) algorithm are employed for the classification task using cross-validation technique.

  7. Diagnostic accuracy of fundal height and handheld ultrasound-measured abdominal circumference to screen for fetal growth abnormalities

    PubMed Central

    Haragan, Adriane F.; Hulsey, Thomas C.; Hawk, Angela F.; Newman, Roger B.; Chang, Eugene Y.

    2015-01-01

    OBJECTIVE We sought to compare fundal height and handheld ultrasound–measured fetal abdominal circumference (HHAC) for the prediction of fetal growth restriction (FGR) or large for gestational age. STUDY DESIGN This was a diagnostic accuracy study in nonanomalous singleton pregnancies between 24 and 40 weeks’ gestation. Patients underwent HHAC and fundal height measurement prior to formal growth ultrasound. FGR was defined as estimated fetal weight less than 10%, whereas large for gestational age was defined as estimated fetal weight greater than 90%. Sensitivity and specificity were calculated and compared using methods described elsewhere. RESULTS There were 251 patients included in this study. HHAC had superior sensitivity and specificity for the detection of FGR (sensitivity, 100% vs 42.86%) and (specificity, 92.62% vs 85.24%). HHAC had higher specificity but lower sensitivity when screening for LGA (specificity, 85.66% vs 66.39%) and (sensitivity, 57.14% vs 71.43%). CONCLUSION HHAC could prove to be a valuable screening tool in the detection of FGR. Further studies are needed in a larger population. PMID:25818672

  8. Automatic classification for mammogram backgrounds based on bi-rads complexity definition and on a multi content analysis framework

    NASA Astrophysics Data System (ADS)

    Wu, Jie; Besnehard, Quentin; Marchessoux, Cédric

    2011-03-01

    Clinical studies for the validation of new medical imaging devices require hundreds of images. An important step in creating and tuning the study protocol is the classification of images into "difficult" and "easy" cases. This consists of classifying the image based on features like the complexity of the background, the visibility of the disease (lesions). Therefore, an automatic medical background classification tool for mammograms would help for such clinical studies. This classification tool is based on a multi-content analysis framework (MCA) which was firstly developed to recognize image content of computer screen shots. With the implementation of new texture features and a defined breast density scale, the MCA framework is able to automatically classify digital mammograms with a satisfying accuracy. BI-RADS (Breast Imaging Reporting Data System) density scale is used for grouping the mammograms, which standardizes the mammography reporting terminology and assessment and recommendation categories. Selected features are input into a decision tree classification scheme in MCA framework, which is the so called "weak classifier" (any classifier with a global error rate below 50%). With the AdaBoost iteration algorithm, these "weak classifiers" are combined into a "strong classifier" (a classifier with a low global error rate) for classifying one category. The results of classification for one "strong classifier" show the good accuracy with the high true positive rates. For the four categories the results are: TP=90.38%, TN=67.88%, FP=32.12% and FN =9.62%.

  9. Evaluating a bilingual patient navigation program for uninsured women with abnormal screening tests for breast and cervical cancer: implications for future navigator research.

    PubMed

    Simon, Melissa A; Tom, Laura S; Nonzee, Narissa J; Murphy, Kara R; Endress, Richard; Dong, XinQi; Feinglass, Joe

    2015-05-01

    The DuPage Patient Navigation Collaborative evaluated the Patient Navigation Research Program (PNRP) model for uninsured women receiving free breast or cervical cancer screening through the Illinois Breast and Cervical Cancer Program in DuPage County, Illinois. We used medical records review and patient surveys of 477 women to compare median follow-up times with external Illinois Breast and Cervical Cancer Program and Chicago PNRP benchmarks of performance. We examined the extent to which we mitigated community-defined timeliness risk factors for delayed follow-up, with a focus on Spanish-speaking participants. Median follow-up time (29.0 days for breast and 56.5 days for cervical screening abnormalities) compared favorably to external benchmarks. Spanish-speaking patients had lower health literacy, lower patient activation, and more health care system distrust than did English-speaking patients, but despite the prevalence of timeliness risk factors, we observed no differences in likelihood of delayed (> 60 days) follow-up by language. Our successful replication and scaling of the PNRP navigation model to DuPage County illustrates a promising approach for future navigator research.

  10. Evaluating a Bilingual Patient Navigation Program for Uninsured Women With Abnormal Screening Tests for Breast and Cervical Cancer: Implications for Future Navigator Research

    PubMed Central

    Tom, Laura S.; Nonzee, Narissa J.; Murphy, Kara R.; Endress, Richard; Dong, XinQi; Feinglass, Joe

    2015-01-01

    Objectives. The DuPage Patient Navigation Collaborative evaluated the Patient Navigation Research Program (PNRP) model for uninsured women receiving free breast or cervical cancer screening through the Illinois Breast and Cervical Cancer Program in DuPage County, Illinois. Methods. We used medical records review and patient surveys of 477 women to compare median follow-up times with external Illinois Breast and Cervical Cancer Program and Chicago PNRP benchmarks of performance. We examined the extent to which we mitigated community-defined timeliness risk factors for delayed follow-up, with a focus on Spanish-speaking participants. Results. Median follow-up time (29.0 days for breast and 56.5 days for cervical screening abnormalities) compared favorably to external benchmarks. Spanish-speaking patients had lower health literacy, lower patient activation, and more health care system distrust than did English-speaking patients, but despite the prevalence of timeliness risk factors, we observed no differences in likelihood of delayed (> 60 days) follow-up by language. Conclusions. Our successful replication and scaling of the PNRP navigation model to DuPage County illustrates a promising approach for future navigator research. PMID:25713942

  11. Evaluating wait times from screening to breast cancer diagnosis among women undergoing organised assessment vs usual care

    PubMed Central

    Chiarelli, Anna M; Muradali, Derek; Blackmore, Kristina M; Smith, Courtney R; Mirea, Lucia; Majpruz, Vicky; O'Malley, Frances P; Quan, May Lynn; Holloway, Claire MB

    2017-01-01

    Background: Timely coordinated diagnostic assessment following an abnormal screening mammogram reduces patient anxiety and may optimise breast cancer prognosis. Since 1998, the Ontario Breast Screening Program (OBSP) has offered organised assessment through Breast Assessment Centres (BACs). For OBSP women seen at a BAC, an abnormal mammogram is followed by coordinated referrals through the use of navigators for further imaging, biopsy, and surgical consultation as indicated. For OBSP women seen through usual care (UC), further diagnostic imaging is arranged directly from the screening centre and/or through their physician; results must be communicated to the physician who is then responsible for arranging any necessary biopsy and/or surgical consultation. This study aims to evaluate factors associated with diagnostic wait times for women undergoing assessment through BAC and UC. Methods: Of the 2 147 257 women aged 50–69 years screened in the OBSP between 1 January 2002 and 31 December 2009, 155 866 (7.3%) had an abnormal mammogram. A retrospective design identified two concurrent cohorts of women diagnosed with screen-detected breast cancer at a BAC (n=4217; 47%) and UC (n=4827; 53%). Multivariable logistic regression analyses examined associations between wait times and assessment and prognostic characteristics by pathway. A two-sided 5% significance level was used. Results: Screened women with breast cancer were two times more likely to be diagnosed within 7 weeks when assessed through a BAC vs UC (OR=1.91, 95% CI=1.73–2.10). In addition, compared with UC, women assessed through a BAC were significantly more likely to have their first assessment procedure within 3 weeks of their abnormal mammogram (OR=1.25, 95% CI=1.12–1.39), ⩽3 assessment procedures (OR=1.54, 95% CI=1.41–1.69), ⩽2 assessment visits (OR=1.86, 95% CI=1.70–2.05), and ⩾2 procedures per visit (OR=1.41, 95% CI=1.28–1.55). Women diagnosed through a BAC were also more likely

  12. Evaluating wait times from screening to breast cancer diagnosis among women undergoing organised assessment vs usual care.

    PubMed

    Chiarelli, Anna M; Muradali, Derek; Blackmore, Kristina M; Smith, Courtney R; Mirea, Lucia; Majpruz, Vicky; O'Malley, Frances P; Quan, May Lynn; Holloway, Claire Mb

    2017-05-09

    Timely coordinated diagnostic assessment following an abnormal screening mammogram reduces patient anxiety and may optimise breast cancer prognosis. Since 1998, the Ontario Breast Screening Program (OBSP) has offered organised assessment through Breast Assessment Centres (BACs). For OBSP women seen at a BAC, an abnormal mammogram is followed by coordinated referrals through the use of navigators for further imaging, biopsy, and surgical consultation as indicated. For OBSP women seen through usual care (UC), further diagnostic imaging is arranged directly from the screening centre and/or through their physician; results must be communicated to the physician who is then responsible for arranging any necessary biopsy and/or surgical consultation. This study aims to evaluate factors associated with diagnostic wait times for women undergoing assessment through BAC and UC. Of the 2 147 257 women aged 50-69 years screened in the OBSP between 1 January 2002 and 31 December 2009, 155 866 (7.3%) had an abnormal mammogram. A retrospective design identified two concurrent cohorts of women diagnosed with screen-detected breast cancer at a BAC (n=4217; 47%) and UC (n=4827; 53%). Multivariable logistic regression analyses examined associations between wait times and assessment and prognostic characteristics by pathway. A two-sided 5% significance level was used. Screened women with breast cancer were two times more likely to be diagnosed within 7 weeks when assessed through a BAC vs UC (OR=1.91, 95% CI=1.73-2.10). In addition, compared with UC, women assessed through a BAC were significantly more likely to have their first assessment procedure within 3 weeks of their abnormal mammogram (OR=1.25, 95% CI=1.12-1.39), ⩽3 assessment procedures (OR=1.54, 95% CI=1.41-1.69), ⩽2 assessment visits (OR=1.86, 95% CI=1.70-2.05), and ⩾2 procedures per visit (OR=1.41, 95% CI=1.28-1.55). Women diagnosed through a BAC were also more likely than those in UC to have imaging (OR=1.99, 95

  13. Automated recognition of microcalcification clusters in mammograms

    NASA Astrophysics Data System (ADS)

    Bankman, Isaac N.; Christens-Barry, William A.; Kim, Dong W.; Weinberg, Irving N.; Gatewood, Olga B.; Brody, William R.

    1993-07-01

    The widespread and increasing use of mammographic screening for early breast cancer detection is placing a significant strain on clinical radiologists. Large numbers of radiographic films have to be visually interpreted in fine detail to determine the subtle hallmarks of cancer that may be present. We developed an algorithm for detecting microcalcification clusters, the most common and useful signs of early, potentially curable breast cancer. We describe this algorithm, which utilizes contour map representations of digitized mammographic films, and discuss its benefits in overcoming difficulties often encountered in algorithmic approaches to radiographic image processing. We present experimental analyses of mammographic films employing this contour-based algorithm and discuss practical issues relevant to its use in an automated film interpretation instrument.

  14. Automated analysis for microcalcifications in high resolution digital mammograms

    DOEpatents

    Mascio, Laura N.

    1996-01-01

    A method for automatically locating microcalcifications indicating breast cancer. The invention assists mammographers in finding very subtle microcalcifications and in recognizing the pattern formed by all the microcalcifications. It also draws attention to microcalcifications that might be overlooked because a more prominent feature draws attention away from an important object. A new filter has been designed to weed out false positives in one of the steps of the method. Previously, iterative selection threshold was used to separate microcalcifications from the spurious signals resulting from texture or other background. A Selective Erosion or Enhancement (SEE) Filter has been invented to improve this step. Since the algorithm detects areas containing potential calcifications on the mammogram, it can be used to determine which areas need be stored at the highest resolution available, while, in addition, the full mammogram can be reduced to an appropriate resolution for the remaining cancer signs.

  15. Automated analysis for microcalcifications in high resolution digital mammograms

    DOEpatents

    Mascio, L.N.

    1996-12-17

    A method is disclosed for automatically locating microcalcifications indicating breast cancer. The invention assists mammographers in finding very subtle microcalcifications and in recognizing the pattern formed by all the microcalcifications. It also draws attention to microcalcifications that might be overlooked because a more prominent feature draws attention away from an important object. A new filter has been designed to weed out false positives in one of the steps of the method. Previously, iterative selection threshold was used to separate microcalcifications from the spurious signals resulting from texture or other background. A Selective Erosion or Enhancement (SEE) Filter has been invented to improve this step. Since the algorithm detects areas containing potential calcifications on the mammogram, it can be used to determine which areas need be stored at the highest resolution available, while, in addition, the full mammogram can be reduced to an appropriate resolution for the remaining cancer signs. 8 figs.

  16. Region-growing approach to detect microcalcifications in digital mammograms

    NASA Astrophysics Data System (ADS)

    Shin, Jin-Wook; Chae, Soo-Ik; Sook, Yoon M.; Park, Dong-Sun

    2001-09-01

    Detecting early symptoms of breast cancer is very important to enhance the possibility of cure. There have been active researches to develop computer-aided diagnosis(CAD) systems detecting early symptoms of breast cancer in digital mammograms. An expert or a CAD system can recognize the early symptoms based on microcalcifications appeared in digital mammographic images. Microcalcifications have higher gray value than surrounding regions, so these can be detected by expanding a region from a local maximum. However the resultant image contains unnecessary elements such as noise, holes and valleys. Mathematical morphology is a good solution to delete regions that are affected by the unnecessary elements. In this paper, we present a method that effectively detects microcalcifications in digital mammograms using a combination of local maximum operation and the region-growing operation.

  17. Alignment of breast cancer screening guidelines, accountability metrics, and practice patterns.

    PubMed

    Onega, Tracy; Haas, Jennifer S; Bitton, Asaf; Brackett, Charles; Weiss, Julie; Goodrich, Martha; Harris, Kimberly; Pyle, Steve; Tosteson, Anna N A

    2017-01-01

    Breast cancer screening guidelines and metrics are inconsistent with each other and may differ from breast screening practice patterns in primary care. This study measured breast cancer screening practice patterns in relation to common evidence-based guidelines and accountability metrics. Cohort study using primary data collected from a regional breast cancer screening research network between 2011 and 2014. Using information on women aged 30 to 89 years within 21 primary care practices of 2 large integrated health systems in New England, we measured the proportion of women screened overall and by age using 2 screening definition categories: any mammogram and screening mammogram. Of the 81,352 women in our cohort, 54,903 (67.5%) had at least 1 mammogram during the time period, 48,314 (59.4%) had a screening mammogram. Women aged 50 to 69 years were the highest proportion screened (82.4% any mammogram, 75% screening indication); 72.6% of women at age 40 had a screening mammogram with a median of 70% (range = 54.3%-84.8%) among the practices. Of women aged at least 75 years, 63.3% had a screening mammogram, with the median of 63.9% (range = 37.2%-78.3%) among the practices. Of women who had 2 or more mammograms, 79.5% were screened annually. Primary care practice patterns for breast cancer screening are not well aligned with some evidence-based guidelines and accountability metrics. Metrics and incentives should be designed with more uniformity and should also include shared decision making when the evidence does not clearly support one single conclusion.

  18. Individualized correction for maternal weight in calculating the risk of chromosomal abnormalities with first-trimester screening data.

    PubMed

    Merz, E; Thode, C; Eiben, B; Faber, R; Hackelöer, B J; Huesgen, G; Pruggmaier, M; Wellek, S

    2011-02-01

    In the algorithm developed by the Fetal Medicine Foundation (FMF) Germany designed to evaluate the findings of routine first-trimester screening, the false-positive rate (FPR) was determined for the entire study group without stratification by maternal weight. Based on the data received from the continuous audit we were able to identify an increase in the FPR for the weight-related subgroups of patients, particularly for patients with extremely high body weights. The aim of this study was to demonstrate that the variability of the FPR can be reduced through adjusting the concentrations of free β-HCG and PAPP-A measured in the maternal serum by means of a nonlinear regression function modeling the dependence of these values on maternal weight. The database used to establish a version of the algorithm enabling control of the FPR over the whole range of maternal weight consisted of n = 123 546 pregnancies resulting in the birth of a child without chromosomal anomalies. The group with positive outcomes covered n = 500 cases of trisomy 21 and n = 159 trisomies 13 or 18. The dependency of the serum parameters free β-HCG and PAPP-A on maternal weight was analyzed in the sample of negative outcomes by means of nonlinear regression. The fitted regression curve was of exponential form with negative slope. Using this model, all individual measurements were corrected through multiplication with a factor obtained as the ratio of the concentration level predicted by the model to belong to the average maternal body weight of 68.2 kg, over the ordinate of that point on the regression curve which belongs to the weight actually measured. Subsequently, the totality of all values of free β-HCG and PAPP-A corrected for deviation from average weight were used as input data for carrying out the construction of diagnostic discrimination rules described in our recent paper for a database to which no corrections for over- or under-weight had been applied. This entailed in particular the

  19. Screening for abnormal vaginal microflora by self-assessed vaginal pH does not enable detection of sexually transmitted infections in Ugandan women.

    PubMed

    Donders, Gilbert G G; Donders, Francesca; Bellen, Gert; Depuydt, Christophe; Eggermont, Natalie; Michiels, Thirsa; Lule, John; Byamughisa, Jacobat

    2016-06-01

    Is self-assessed vaginal pH measurement to detect abnormal vaginal bacterial microflora (AVF) an adequate prescreening method for detection of genital sexually transmitted infections (STIs)? A total of 360 Ugandan women tested themselves with a gloved finger and a pH color strip. PCR for bacterial vaginosis (BV)-associated bacteria was tested by PCR for Mycoplasma hominis, Ureaplasma urealyticum, and/or Atopobium vaginae, while the STIs were diagnosed by positive PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and/or Trichomonas vaginalis. A strong correlation was found between self-assessed pH values and BV-associated bacteria (P<0.0001), but not with STIs, not as single infections, nor in general. Self-measured vaginal pH correlated well with markers of high-risk microflora types such as BV or aerobic vaginitis, but not with STIs. Hence, in a screening program addressing AVF in low-resource countries, extra specific tests are required to exclude STIs. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. [Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer--comparison with film-screen mammography].

    PubMed

    Kitahama, H

    1991-05-25

    The aim of this study is to present efficacy of storage phosphor-based digital mammography (CR-mammography) in diagnosis of breast cancer. Ninety-seven cases with breast cancer including 44 cases less than 2 cm in macroscopic size (t1 cases) were evaluated using storage phosphor-based digital mammography (2000 x 2510 pixels by 10 bits). Abnormal findings on CR-mammography were detected in 86 cases (88.7%) of 97 women with breast cancer. Sensitivity of CR-mammography was 88.7%. It was superior to that of film-screen mammography. On t1 breast cancer cases, sensitivity on CR-mammography was 88.6%. False negative rate in t1 breast cancer cases was reduced by image processing using CR-mammography. To evaluate microcalcifications, CR-mammograms and film-screen mammograms were investigated in 22 cases of breast cancer proven pathologically the existence of microcalcifications and 11 paraffin tissue blocks of breast cancer. CR-mammography was superior to film-screen mammography in recognizing of microcalcifications. As regards the detectability for the number and the shape of microcalcifications, CR-mammography was equivalent to film-screen mammography. Receiver operating characteristic (ROC) analysis by eight observers was performed for CR-mammography and film-screen mammography with 54 breast cancer patients and 54 normal cases. The detectability of abnormal findings of breast cancer on CR-mammography (ROC area = 0.91) was better than that on film-screen mammography (ROC area = 0.88) (p less than 0.05). Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer was discussed and demonstrated in this study.

  1. Hough transform for clustered microcalcifications detection in full-field digital mammograms

    NASA Astrophysics Data System (ADS)

    Fanizzi, A.; Basile, T. M. A.; Losurdo, L.; Amoroso, N.; Bellotti, R.; Bottigli, U.; Dentamaro, R.; Didonna, V.; Fausto, A.; Massafra, R.; Moschetta, M.; Tamborra, P.; Tangaro, S.; La Forgia, D.

    2017-09-01

    Many screening programs use mammography as principal diagnostic tool for detecting breast cancer at a very early stage. Despite the efficacy of the mammograms in highlighting breast diseases, the detection of some lesions is still doubtless for radiologists. In particular, the extremely minute and elongated salt-like particles of microcalcifications are sometimes no larger than 0.1 mm and represent approximately half of all cancer detected by means of mammograms. Hence the need for automatic tools able to support radiologists in their work. Here, we propose a computer assisted diagnostic tool to support radiologists in identifying microcalcifications in full (native) digital mammographic images. The proposed CAD system consists of a pre-processing step, that improves contrast and reduces noise by applying Sobel edge detection algorithm and Gaussian filter, followed by a microcalcification detection step performed by exploiting the circular Hough transform. The procedure performance was tested on 200 images coming from the Breast Cancer Digital Repository (BCDR), a publicly available database. The automatically detected clusters of microcalcifications were evaluated by skilled radiologists which asses the validity of the correctly identified regions of interest as well as the system error in case of missed clustered microcalcifications. The system performance was evaluated in terms of Sensitivity and False Positives per images (FPi) rate resulting comparable to the state-of-art approaches. The proposed model was able to accurately predict the microcalcification clusters obtaining performances (sensibility = 91.78% and FPi rate = 3.99) which favorably compare to other state-of-the-art approaches.

  2. A database for assessment of effect of lossy compression on digital mammograms

    NASA Astrophysics Data System (ADS)

    Wang, Jiheng; Sahiner, Berkman; Petrick, Nicholas; Pezeshk, Aria

    2018-03-01

    With widespread use of screening digital mammography, efficient storage of the vast amounts of data has become a challenge. While lossless image compression causes no risk to the interpretation of the data, it does not allow for high compression rates. Lossy compression and the associated higher compression ratios are therefore more desirable. The U.S. Food and Drug Administration (FDA) currently interprets the Mammography Quality Standards Act as prohibiting lossy compression of digital mammograms for primary image interpretation, image retention, or transfer to the patient or her designated recipient. Previous work has used reader studies to determine proper usage criteria for evaluating lossy image compression in mammography, and utilized different measures and metrics to characterize medical image quality. The drawback of such studies is that they rely on a threshold on compression ratio as the fundamental criterion for preserving the quality of images. However, compression ratio is not a useful indicator of image quality. On the other hand, many objective image quality metrics (IQMs) have shown excellent performance for natural image content for consumer electronic applications. In this paper, we create a new synthetic mammogram database with several unique features. We compare and characterize the impact of image compression on several clinically relevant image attributes such as perceived contrast and mass appearance for different kinds of masses. We plan to use this database to develop a new objective IQM for measuring the quality of compressed mammographic images to help determine the allowed maximum compression for different kinds of breasts and masses in terms of visual and diagnostic quality.

  3. Multi-task transfer learning deep convolutional neural network: application to computer-aided diagnosis of breast cancer on mammograms

    NASA Astrophysics Data System (ADS)

    Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.; Cha, Kenny H.; Richter, Caleb D.

    2017-12-01

    Transfer learning in deep convolutional neural networks (DCNNs) is an important step in its application to medical imaging tasks. We propose a multi-task transfer learning DCNN with the aim of translating the ‘knowledge’ learned from non-medical images to medical diagnostic tasks through supervised training and increasing the generalization capabilities of DCNNs by simultaneously learning auxiliary tasks. We studied this approach in an important application: classification of malignant and benign breast masses. With Institutional Review Board (IRB) approval, digitized screen-film mammograms (SFMs) and digital mammograms (DMs) were collected from our patient files and additional SFMs were obtained from the Digital Database for Screening Mammography. The data set consisted of 2242 views with 2454 masses (1057 malignant, 1397 benign). In single-task transfer learning, the DCNN was trained and tested on SFMs. In multi-task transfer learning, SFMs and DMs were used to train the DCNN, which was then tested on SFMs. N-fold cross-validation with the training set was used for training and parameter optimization. On the independent test set, the multi-task transfer learning DCNN was found to have significantly (p  =  0.007) higher performance compared to the single-task transfer learning DCNN. This study demonstrates that multi-task transfer learning may be an effective approach for training DCNN in medical imaging applications when training samples from a single modality are limited.

  4. A similarity measure method combining location feature for mammogram retrieval.

    PubMed

    Wang, Zhiqiong; Xin, Junchang; Huang, Yukun; Li, Chen; Xu, Ling; Li, Yang; Zhang, Hao; Gu, Huizi; Qian, Wei

    2018-05-28

    Breast cancer, the most common malignancy among women, has a high mortality rate in clinical practice. Early detection, diagnosis and treatment can reduce the mortalities of breast cancer greatly. The method of mammogram retrieval can help doctors to find the early breast lesions effectively and determine a reasonable feature set for image similarity measure. This will improve the accuracy effectively for mammogram retrieval. This paper proposes a similarity measure method combining location feature for mammogram retrieval. Firstly, the images are pre-processed, the regions of interest are detected and the lesions are segmented in order to get the center point and radius of the lesions. Then, the method, namely Coherent Point Drift, is used for image registration with the pre-defined standard image. The center point and radius of the lesions after registration are obtained and the standard location feature of the image is constructed. This standard location feature can help figure out the location similarity between the image pair from the query image to each dataset image in the database. Next, the content feature of the image is extracted, including the Histogram of Oriented Gradients, the Edge Direction Histogram, the Local Binary Pattern and the Gray Level Histogram, and the image pair content similarity can be calculated using the Earth Mover's Distance. Finally, the location similarity and content similarity are fused to form the image fusion similarity, and the specified number of the most similar images can be returned according to it. In the experiment, 440 mammograms, which are from Chinese women in Northeast China, are used as the database. When fusing 40% lesion location feature similarity and 60% content feature similarity, the results have obvious advantages. At this time, precision is 0.83, recall is 0.76, comprehensive indicator is 0.79, satisfaction is 96.0%, mean is 4.2 and variance is 17.7. The results show that the precision and recall of this

  5. Mammogram classification scheme using 2D-discrete wavelet and local binary pattern for detection of breast cancer

    NASA Astrophysics Data System (ADS)

    Adi Putra, Januar

    2018-04-01

    In this paper, we propose a new mammogram classification scheme to classify the breast tissues as normal or abnormal. Feature matrix is generated using Local Binary Pattern to all the detailed coefficients from 2D-DWT of the region of interest (ROI) of a mammogram. Feature selection is done by selecting the relevant features that affect the classification. Feature selection is used to reduce the dimensionality of data and features that are not relevant, in this paper the F-test and Ttest will be performed to the results of the feature extraction dataset to reduce and select the relevant feature. The best features are used in a Neural Network classifier for classification. In this research we use MIAS and DDSM database. In addition to the suggested scheme, the competent schemes are also simulated for comparative analysis. It is observed that the proposed scheme has a better say with respect to accuracy, specificity and sensitivity. Based on experiments, the performance of the proposed scheme can produce high accuracy that is 92.71%, while the lowest accuracy obtained is 77.08%.

  6. Mammogram registration: a phantom-based evaluation of compressed breast thickness variation effects.

    PubMed

    Richard, Frédéric J P; Bakić, Predrag R; Maidment, Andrew D A

    2006-02-01

    The temporal comparison of mammograms is complex; a wide variety of factors can cause changes in image appearance. Mammogram registration is proposed as a method to reduce the effects of these changes and potentially to emphasize genuine alterations in breast tissue. Evaluation of such registration techniques is difficult since ground truth regarding breast deformations is not available in clinical mammograms. In this paper, we propose a systematic approach to evaluate sensitivity of registration methods to various types of changes in mammograms using synthetic breast images with known deformations. As a first step, images of the same simulated breasts with various amounts of simulated physical compression have been used to evaluate a previously described nonrigid mammogram registration technique. Registration performance is measured by calculating the average displacement error over a set of evaluation points identified in mammogram pairs. Applying appropriate thickness compensation and using a preferred order of the registered images, we obtained an average displacement error of 1.6 mm for mammograms with compression differences of 1-3 cm. The proposed methodology is applicable to analysis of other sources of mammogram differences and can be extended to the registration of multimodality breast data.

  7. Generalized procrustean image deformation for subtraction of mammograms

    NASA Astrophysics Data System (ADS)

    Good, Walter F.; Zheng, Bin; Chang, Yuan-Hsiang; Wang, Xiao Hui; Maitz, Glenn S.

    1999-05-01

    This project is a preliminary evaluation of two simple fully automatic nonlinear transformations which can map any mammographic image onto a reference image while guaranteeing registration of specific features. The first method automatically identifies skin lines, after which each pixel is given coordinates in the range [0,1] X [0,1], where the actual value of a coordinate is the fractional distance of the pixel between tissue boundaries in either the horizontal or vertical direction. This insures that skin lines are put in registration. The second method, which is the method of primary interest, automatically detects pectoral muscles, skin lines and nipple locations. For each image, a polar coordinate system is established with its origin at the intersection of the nipple axes line (NAL) and a line indicating the pectoral muscle. Points within a mammogram are identified by the angle of their position vector, relative to the NAL, and by their fractional distance between the origin and the skin line. This deforms mammograms in such a way that their pectoral lines, NALs and skin lines are all in registration. After images are deformed, their grayscales are adjusted by applying linear regression to pixel value pairs for corresponding tissue pixels. In a comparison of these methods to a previously reported 'translation/rotation' technique, evaluation of difference images clearly indicates that the polar coordinates method results in the most accurate registration of the transformations considered.

  8. Classification of breast tissue in mammograms using efficient coding.

    PubMed

    Costa, Daniel D; Campos, Lúcio F; Barros, Allan K

    2011-06-24

    Female breast cancer is the major cause of death by cancer in western countries. Efforts in Computer Vision have been made in order to improve the diagnostic accuracy by radiologists. Some methods of lesion diagnosis in mammogram images were developed based in the technique of principal component analysis which has been used in efficient coding of signals and 2D Gabor wavelets used for computer vision applications and modeling biological vision. In this work, we present a methodology that uses efficient coding along with linear discriminant analysis to distinguish between mass and non-mass from 5090 region of interest from mammograms. The results show that the best rates of success reached with Gabor wavelets and principal component analysis were 85.28% and 87.28%, respectively. In comparison, the model of efficient coding presented here reached up to 90.07%. Altogether, the results presented demonstrate that independent component analysis performed successfully the efficient coding in order to discriminate mass from non-mass tissues. In addition, we have observed that LDA with ICA bases showed high predictive performance for some datasets and thus provide significant support for a more detailed clinical investigation.

  9. The effect of feature selection methods on computer-aided detection of masses in mammograms

    NASA Astrophysics Data System (ADS)

    Hupse, Rianne; Karssemeijer, Nico

    2010-05-01

    In computer-aided diagnosis (CAD) research, feature selection methods are often used to improve generalization performance of classifiers and shorten computation times. In an application that detects malignant masses in mammograms, we investigated the effect of using a selection criterion that is similar to the final performance measure we are optimizing, namely the mean sensitivity of the system in a predefined range of the free-response receiver operating characteristics (FROC). To obtain the generalization performance of the selected feature subsets, a cross validation procedure was performed on a dataset containing 351 abnormal and 7879 normal regions, each region providing a set of 71 mass features. The same number of noise features, not containing any information, were added to investigate the ability of the feature selection algorithms to distinguish between useful and non-useful features. It was found that significantly higher performances were obtained using feature sets selected by the general test statistic Wilks' lambda than using feature sets selected by the more specific FROC measure. Feature selection leads to better performance when compared to a system in which all features were used.

  10. Meiotic abnormalities

    SciTech Connect

    NONE

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  11. Opportunistic Breast Cancer Education and Screening in Rural Honduras

    PubMed Central

    Kennedy, Linda S.; Bejarano, Suyapa A.; Onega, Tracy L.; Stenquist, Derek S.

    2016-01-01

    Purpose In Honduras, the breast cancer burden is high, and access to women’s health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. Methods The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services. The cervical cancer screening event was held in Honduras in 2013; 476 women from 31 villages attended. Results Half of the women attending elected to receive a CBE; most had concerns about lactation. Clinicians referred 12 women with abnormal CBEs to La Liga Contra el Cancer for additional evaluation at no cost. All referred patients were compliant with the recommendation and received follow-up care. One abnormal follow-up mammogram/ultrasound result was negative on biopsy. One woman with an aggressive phyllodes tumor had a mastectomy within 60 days. Multimodal education about breast cancer screening maximized delivery of women’s health services in a low-tech rural setting. Conclusion The addition of opportunistic breast cancer education and screening to a cervical cancer screening event resulted in high uptake of services at low additional cost to program sponsors. Such novel strategies to maximize delivery of women’s health services in low-resource settings, where there is no access to mammography, may result in earlier detection of breast cancer. Close follow-up of positive results with referral to appropriate treatment is essential. PMID:28717699

  12. Locally adaptive decision in detection of clustered microcalcifications in mammograms.

    PubMed

    Sainz de Cea, María V; Nishikawa, Robert M; Yang, Yongyi

    2018-02-15

    In computer-aided detection or diagnosis of clustered microcalcifications (MCs) in mammograms, the performance often suffers from not only the presence of false positives (FPs) among the detected individual MCs but also large variability in detection accuracy among different cases. To address this issue, we investigate a locally adaptive decision scheme in MC detection by exploiting the noise characteristics in a lesion area. Instead of developing a new MC detector, we propose a decision scheme on how to best decide whether a detected object is an MC or not in the detector output. We formulate the individual MCs as statistical outliers compared to the many noisy detections in a lesion area so as to account for the local image characteristics. To identify the MCs, we first consider a parametric method for outlier detection, the Mahalanobis distance detector, which is based on a multi-dimensional Gaussian distribution on the noisy detections. We also consider a non-parametric method which is based on a stochastic neighbor graph model of the detected objects. We demonstrated the proposed decision approach with two existing MC detectors on a set of 188 full-field digital mammograms (95 cases). The results, evaluated using free response operating characteristic (FROC) analysis, showed a significant improvement in detection accuracy by the proposed outlier decision approach over traditional thresholding (the partial area under the FROC curve increased from 3.95 to 4.25, p-value  <10 -4 ). There was also a reduction in case-to-case variability in detected FPs at a given sensitivity level. The proposed adaptive decision approach could not only reduce the number of FPs in detected MCs but also improve case-to-case consistency in detection.

  13. Locally adaptive decision in detection of clustered microcalcifications in mammograms

    NASA Astrophysics Data System (ADS)

    Sainz de Cea, María V.; Nishikawa, Robert M.; Yang, Yongyi

    2018-02-01

    In computer-aided detection or diagnosis of clustered microcalcifications (MCs) in mammograms, the performance often suffers from not only the presence of false positives (FPs) among the detected individual MCs but also large variability in detection accuracy among different cases. To address this issue, we investigate a locally adaptive decision scheme in MC detection by exploiting the noise characteristics in a lesion area. Instead of developing a new MC detector, we propose a decision scheme on how to best decide whether a detected object is an MC or not in the detector output. We formulate the individual MCs as statistical outliers compared to the many noisy detections in a lesion area so as to account for the local image characteristics. To identify the MCs, we first consider a parametric method for outlier detection, the Mahalanobis distance detector, which is based on a multi-dimensional Gaussian distribution on the noisy detections. We also consider a non-parametric method which is based on a stochastic neighbor graph model of the detected objects. We demonstrated the proposed decision approach with two existing MC detectors on a set of 188 full-field digital mammograms (95 cases). The results, evaluated using free response operating characteristic (FROC) analysis, showed a significant improvement in detection accuracy by the proposed outlier decision approach over traditional thresholding (the partial area under the FROC curve increased from 3.95 to 4.25, p-value  <10-4). There was also a reduction in case-to-case variability in detected FPs at a given sensitivity level. The proposed adaptive decision approach could not only reduce the number of FPs in detected MCs but also improve case-to-case consistency in detection.

  14. A new idea for visualization of lesions distribution in mammogram based on CPD registration method.

    PubMed

    Pan, Xiaoguang; Qi, Buer; Yu, Hongfei; Wei, Haiping; Kang, Yan

    2017-07-20

    Mammography is currently the most effective technique for breast cancer. Lesions distribution can provide support for clinical diagnosis and epidemiological studies. We presented a new idea to help radiologists study breast lesions distribution conveniently. We also developed an automatic tool based on this idea which could show visualization of lesions distribution in a standard mammogram. Firstly, establishing a lesion database to study; then, extracting breast contours and match different women's mammograms to a standard mammogram; finally, showing the lesion distribution in the standard mammogram, and providing the distribution statistics. The crucial process of developing this tool was matching different women's mammograms correctly. We used a hybrid breast contour extraction method combined with coherent point drift method to match different women's mammograms. We tested our automatic tool by four mass datasets of 641 images. The distribution results shown by the tool were consistent with the results counted according to their reports and mammograms by manual. We also discussed the registration error that was less than 3.3 mm in average distance. The new idea is effective and the automatic tool can provide lesions distribution results which are consistent with radiologists simply and conveniently.

  15. Exploring potential use of internet, E-mail, and instant text messaging to promote breast health and mammogram use among immigrant Hispanic women in Los Angeles County.

    PubMed

    Dang, Catherine M; Estrada, Sylvia; Bresee, Catherine; Phillips, Edward H

    2013-10-01

    Breast cancer is now the leading cause of death in Hispanic women (HW). Internet, e-mail, and instant text messaging may be cost-effective in educating HW about breast health and in reducing breast cancer mortality. We surveyed 905 HW women attending a free health fair about their technology use, acculturation, insurance status, mammography use, and breast cancer knowledge. Data were analyzed by t test or χ(2) tests. Mean age was 51.9 ± 14.2 years (range, 18 to 88 years). Ninety-two per cent were foreign-born. Most had completed some high school (39%) or elementary (38%) education. Most (62%) were uninsured. The majority spoke (67%) and read (66%) only Spanish. Only 60 per cent of HW older than 40 years had a recent mammogram. HW older than 40 years who had not had a recent mammogram were younger (mean 54.9 ± 10.8 vs 58 ± 10.4 years) and less likely to have health insurance (25 vs 44%; P < 0.001). Most HW never use the Internet (58%) or e-mail (64%). However, 70 per cent have mobile phones (66% older than 40 years), and 65 per cent use text messaging daily (58% older than 40 years, P = 0.001). In fact, 45 per cent wish to receive a mammogram reminder by text. Text messaging may be an inexpensive way to promote breast health and screening mammography use among uninsured HW.

  16. Automated detection scheme of architectural distortion in mammograms using adaptive Gabor filter

    NASA Astrophysics Data System (ADS)

    Yoshikawa, Ruriha; Teramoto, Atsushi; Matsubara, Tomoko; Fujita, Hiroshi

    2013-03-01

    Breast cancer is a serious health concern for all women. Computer-aided detection for mammography has been used for detecting mass and micro-calcification. However, there are challenges regarding the automated detection of the architectural distortion about the sensitivity. In this study, we propose a novel automated method for detecting architectural distortion. Our method consists of the analysis of the mammary gland structure, detection of the distorted region, and reduction of false positive results. We developed the adaptive Gabor filter for analyzing the mammary gland structure that decides filter parameters depending on the thickness of the gland structure. As for post-processing, healthy mammary glands that run from the nipple to the chest wall are eliminated by angle analysis. Moreover, background mammary glands are removed based on the intensity output image obtained from adaptive Gabor filter. The distorted region of the mammary gland is then detected as an initial candidate using a concentration index followed by binarization and labeling. False positives in the initial candidate are eliminated using 23 types of characteristic features and a support vector machine. In the experiments, we compared the automated detection results with interpretations by a radiologist using 50 cases (200 images) from the Digital Database of Screening Mammography (DDSM). As a result, true positive rate was 82.72%, and the number of false positive per image was 1.39. There results indicate that the proposed method may be useful for detecting architectural distortion in mammograms.

  17. Mass type-specific sparse representation for mass classification in computer-aided detection on mammograms

    PubMed Central

    2013-01-01

    Background Breast cancer is the leading cause of both incidence and mortality in women population. For this reason, much research effort has been devoted to develop Computer-Aided Detection (CAD) systems for early detection of the breast cancers on mammograms. In this paper, we propose a new and novel dictionary configuration underpinning sparse representation based classification (SRC). The key idea of the proposed algorithm is to improve the sparsity in terms of mass margins for the purpose of improving classification performance in CAD systems. Methods The aim of the proposed SRC framework is to construct separate dictionaries according to the types of mass margins. The underlying idea behind our method is that the separated dictionaries can enhance the sparsity of mass class (true-positive), leading to an improved performance for differentiating mammographic masses from normal tissues (false-positive). When a mass sample is given for classification, the sparse solutions based on corresponding dictionaries are separately solved and combined at score level. Experiments have been performed on both database (DB) named as Digital Database for Screening Mammography (DDSM) and clinical Full Field Digital Mammogram (FFDM) DBs. In our experiments, sparsity concentration in the true class (SCTC) and area under the Receiver operating characteristic (ROC) curve (AUC) were measured for the comparison between the proposed method and a conventional single dictionary based approach. In addition, a support vector machine (SVM) was used for comparing our method with state-of-the-arts classifier extensively used for mass classification. Results Comparing with the conventional single dictionary configuration, the proposed approach is able to improve SCTC of up to 13.9% and 23.6% on DDSM and FFDM DBs, respectively. Moreover, the proposed method is able to improve AUC with 8.2% and 22.1% on DDSM and FFDM DBs, respectively. Comparing to SVM classifier, the proposed method improves

  18. Assessment of mammographic film processor performance in a hospital and mobile screening unit.

    PubMed

    Murray, J G; Dowsett, D J; Laird, O; Ennis, J T

    1992-12-01

    In contrast to the majority of mammographic breast screening programmes, film processing at this centre occurs on site in both hospital and mobile trailer units. Initial (1989) quality control (QC) sensitometric tests revealed a large variation in film processor performance in the mobile unit. The clinical significance of these variations was assessed and acceptance limits for processor performance determined. Abnormal mammograms were used as reference material and copied using high definition 35 mm film over a range of exposure settings. The copies were than matched with QC film density variation from the mobile unit. All films were subsequently ranked for spatial and contrast resolution. Optimal values for processing time of 2 min (equivalent to film transit time 3 min and developer time 46 s) and temperature of 36 degrees C were obtained. The widespread anomaly of reporting film transit time as processing time is highlighted. Use of mammogram copies as a means of measuring the influence of film processor variation is advocated. Careful monitoring of the mobile unit film processor performance has produced stable quality comparable with the hospital based unit. The advantages of on site film processing are outlined. The addition of a sensitometric step wedge to all mammography film stock as a means of assessing image quality is recommended.

  19. Incorporation of the technologist's opinion for arbitration of discrepant assessments among radiologists at screening mammography.

    PubMed

    Coolen, Angela M P; Lameijer, Joost R C; Voogd, Adri C; Strobbe, Luc J; Louwman, Marieke W J; Tjan-Heijnen, Vivianne C G; Duijm, Lucien E M

    2018-05-05

    We determined whether the addition of the technologist's opinion may be helpful in deciding if discordant readings at blinded double reading should be recalled. A consecutive series of 99,013 digital screening mammograms, obtained between July 2013 and January 2015, were included. All mammograms were first interpreted by a technologist and then double read in a blinded fashion by a team of 13 screening radiologists. All concordant and discordant positive readings among radiologists were recalled. Out of 3562 recalls, 998 women were recalled after a discordant reading. Of these women, 337 (33.8%) had a positive technologist assessment, of which 40 (11.9%) were diagnosed with breast cancer. Sixty women with a negative technologist assessment (60/661, 9.1%) were diagnosed with breast cancer (p = 0.16). Recall rate would have decreased with technologist arbitration (3.6% vs. 2.9%, p < 0.001). Cancer detection rate decreased with 8.5%, from 7.1/1000 screens to 6.5/1000 screens (p = 0.10). Among women with a positive technologist assessment, the probability of breast cancer was highest in case of suspicious microcalcifications and lowest for suspicious masses (30.4% (17/56) versus 7.0% (16/212), p < 0.001). Breast cancers were diagnosed in all groups of mammographic abnormalities, except in women with a suspicious asymmetry and a negative technologist assessment. Assessment by a technologist does not provide a significant discriminating ability in case of a discordant radiologist reading and, taking into account the decrease in cancer detection rate, does not appear to be a suitable arbitration strategy for discordant recalls at blinded double reading.

  20. Testing novel patient financial incentives to increase breast cancer screening.

    PubMed

    Merrick, Elizabeth Levy; Hodgkin, Dominic; Horgan, Constance M; Lorenz, Laura S; Panas, Lee; Ritter, Grant A; Kasuba, Paul; Poskanzer, Debra; Nefussy, Renee Altman

    2015-11-01

    To examine the effects of 3 types of low-cost financial incentives for patients, including a novel "person-centered" approach on breast cancer screening (mammogram) rates. Randomized controlled trial with 4 arms: 3 types of financial incentives ($15 gift card, entry into lottery for $250 gift card, and a person-centered incentive with choice of $15 gift card or lottery) and a control group. Sample included privately insured Tufts Health Plan members in Massachusetts who were women aged 42 to 69 years with no mammogram claim in ≥ 2.6 years. A sample of 4700 eligible members were randomized to 4 study arms. The control group received a standard reminder letter and the incentive groups received a reminder letter plus an incentive offer for obtaining a mammogram within the next 4 months. Bivariate tests and multivariate logistic regression were used to assess the incentives' impact on mammogram receipt. Data were analyzed for 4427 members (after exclusions such as undeliverable mail). The percent of members receiving a mammogram during the study was 11.7% (gift card), 12.1% (lottery), 13.4% (person-centered/choice), and 11.9% (controls). Differences were not statistically significant in bivariate or multivariate full-sample analyses. In exploratory subgroup analyses of members with a mammogram during the most recent year prior to the study-defined gap, person-centered incentives were associated with a higher likelihood of mammogram receipt. None of the low-cost incentives tested had a statistically significant effect on mammogram rates in the full sample. Exploratory findings for members who were more recently screened suggest that they may be more responsive to person-centered incentives.

  1. Deep learning and non-negative matrix factorization in recognition of mammograms

    NASA Astrophysics Data System (ADS)

    Swiderski, Bartosz; Kurek, Jaroslaw; Osowski, Stanislaw; Kruk, Michal; Barhoumi, Walid

    2017-02-01

    This paper presents novel approach to the recognition of mammograms. The analyzed mammograms represent the normal and breast cancer (benign and malignant) cases. The solution applies the deep learning technique in image recognition. To obtain increased accuracy of classification the nonnegative matrix factorization and statistical self-similarity of images are applied. The images reconstructed by using these two approaches enrich the data base and thanks to this improve of quality measures of mammogram recognition (increase of accuracy, sensitivity and specificity). The results of numerical experiments performed on large DDSM data base containing more than 10000 mammograms have confirmed good accuracy of class recognition, exceeding the best results reported in the actual publications for this data base.

  2. Breast Cancer Screening (PDQ®)—Patient Version

    Cancer.gov

    Breast cancer screening is performed using mammogram, clinical breast exam (CBE), and MRI (magnetic resonance imaging) tests. Learn about these and other tests that have been studied to detect or screen for breast cancer in this expert-reviewed and evidence-based summary.

  3. Comparison Between Digital and Synthetic 2D Mammograms in Breast Density Interpretation.

    PubMed

    Alshafeiy, Taghreed I; Wadih, Antoine; Nicholson, Brandi T; Rochman, Carrie M; Peppard, Heather R; Patrie, James T; Harvey, Jennifer A

    2017-07-01

    The purpose of this study was to compare assessments of breast density on synthetic 2D images as compared with digital 2D mammograms. This retrospective study included consecutive women undergoing screening with digital 2D mammography and tomosynthesis during May 2015 with a negative or benign outcome. In separate reading sessions, three radiologists with 5-25 years of clinical experience and 1 year of experience with synthetic 2D mammography read digital 2D and synthetic 2D images and assigned breast density categories according to the 5th edition of BI-RADS. Inter- and intrareader agreement was assessed for each BI-RADS density assessment and combined dense and nondense categories using percent agreement and Cohen kappa coefficient for consensus and all reads. A total of 309 patients met study inclusion criteria. Agreement between consensus BI-RADS density categories assigned for digital and synthetic 2D mammography was 80.3% (95% CI, 75.4-84.5%) with κ = 0.73 (95% CI, 0.66-0.79). For combined dense and nondense categories, agreement reached 91.9% (95% CI, 88.2-94.7%). For consensus readings, similar numbers of patients were shifted between nondense and dense categories (11 and 14, respectively) with the synthetic 2D compared with digital 2D mammography. Interreader differences were apparent; assignment to dense categories was greater with digital 2D mammography for reader 1 (odds ratio [OR], 1.26; p = 0.002), the same for reader 2 (OR, 0.91; p = 0.262), and greater with synthetic 2D mammography for reader 3 (OR, 0.86; p = 0.033). Overall, synthetic 2D mammography is comparable with digital 2D mammography in assessment of breast density, though there is some variability by reader. Practices can readily adopt synthetic 2D mammography without concern that it will affect density assessment and subsequent recommendations for supplemental screening.

  4. Staging of breast cancer and the advanced applications of digital mammogram: what the physician needs to know?

    PubMed

    Helal, Maha H; Mansour, Sahar M; Zaglol, Mai; Salaleldin, Lamia A; Nada, Omniya M; Haggag, Marwa A

    2017-03-01

    -enhanced spectral mammogram shows the extent of abnormal contrast uptake and detects multiplicity. Integrated analysis provides optimal findings for proper "T" staging of breast cancer.

  5. Staging of breast cancer and the advanced applications of digital mammogram: what the physician needs to know?

    PubMed Central

    Helal, Maha H; Zaglol, Mai; Salaleldin, Lamia A; Nada, Omniya M; Haggag, Marwa A

    2017-01-01

    tissue and spots microcalcifications. Contrast-enhanced spectral mammogram shows the extent of abnormal contrast uptake and detects multiplicity. Integrated analysis provides optimal findings for proper “T” staging of breast cancer. PMID:28055247

  6. Accuracy of Screening Mammography Interpretation by Characteristics of Radiologists

    PubMed Central

    Barlow, William E.; Chi, Chen; Carney, Patricia A.; Taplin, Stephen H.; D’Orsi, Carl; Cutter, Gary; Hendrick, R. Edward; Elmore, Joann G.

    2011-01-01

    Background Radiologists differ in their ability to interpret screening mammograms accurately. We investigated the relationship of radiologist characteristics to actual performance from 1996 to 2001. Methods Screening mammograms (n = 469 512) interpreted by 124 radiologists were linked to cancer outcome data. The radiologists completed a survey that included questions on demographics, malpractice concerns, years of experience interpreting mammograms, and the number of mammograms read annually. We used receiver operating characteristics (ROC) analysis to analyze variables associated with sensitivity, specificity, and the combination of the two, adjusting for patient variables that affect performance. All P values are two-sided. Results Within 1 year of the mammogram, 2402 breast cancers were identified. Relative to low annual interpretive volume (≤1000 mammograms), greater interpretive volume was associated with higher sensitivity (P = .001; odds ratio [OR] for moderate volume [1001–2000] = 1.68, 95% CI = 1.18 to 2.39; OR for high volume [>2000] = 1.89, 95% CI = 1.36 to 2.63). Specificity decreased with volume (OR for 1001–2000 = 0.65, 95% CI = 0.52 to 0.83; OR for more than 2000 = 0.76, 95% CI = 0.60 to 0.96), compared with 1000 or less (P = .002). Greater number of years of experience interpreting mammograms was associated with lower sensitivity (P = .001), but higher specificity (P = .003). ROC analysis using the ordinal BI-RADS interpretation showed an association between accuracy and both previous mammographic history (P = .012) and breast density (P<.001). No association was observed between accuracy and years interpreting mammograms (P = .34) or mammography volume (P = .94), after adjusting for variables that affect the threshold for calling a mammogram positive. Conclusions We found no evidence that greater volume or experience at interpreting mammograms is associated with better performance. However, they may affect sensitivity and specificity

  7. Congenital Abnormalities

    MedlinePlus

    ... tube defects. However, there is also a genetic influence to this type of congenital anomaly. Unknown Causes The vast majority of congenital abnormalities have no known cause. This is particularly troubling for parents who plan to have more children, because there is no way to predict if ...

  8. Quantifying the effect of colorization enhancement on mammogram images

    NASA Astrophysics Data System (ADS)

    Wojnicki, Paul J.; Uyeda, Elizabeth; Micheli-Tzanakou, Evangelia

    2002-04-01

    Current methods of radiological displays provide only grayscale images of mammograms. The limitation of the image space to grayscale provides only luminance differences and textures as cues for object recognition within the image. However, color can be an important and significant cue in the detection of shapes and objects. Increasing detection ability allows the radiologist to interpret the images in more detail, improving object recognition and diagnostic accuracy. Color detection experiments using our stimulus system, have demonstrated that an observer can only detect an average of 140 levels of grayscale. An optimally colorized image can allow a user to distinguish 250 - 1000 different levels, hence increasing potential image feature detection by 2-7 times. By implementing a colorization map, which follows the luminance map of the original grayscale images, the luminance profile is preserved and color is isolated as the enhancement mechanism. The effect of this enhancement mechanism on the shape, frequency composition and statistical characteristics of the Visual Evoked Potential (VEP) are analyzed and presented. Thus, the effectiveness of the image colorization is measured quantitatively using the Visual Evoked Potential (VEP).

  9. Identifying the optimal segmentors for mass classification in mammograms

    NASA Astrophysics Data System (ADS)

    Zhang, Yu; Tomuro, Noriko; Furst, Jacob; Raicu, Daniela S.

    2015-03-01

    In this paper, we present the results of our investigation on identifying the optimal segmentor(s) from an ensemble of weak segmentors, used in a Computer-Aided Diagnosis (CADx) system which classifies suspicious masses in mammograms as benign or malignant. This is an extension of our previous work, where we used various parameter settings of image enhancement techniques to each suspicious mass (region of interest (ROI)) to obtain several enhanced images, then applied segmentation to each image to obtain several contours of a given mass. Each segmentation in this ensemble is essentially a "weak segmentor" because no single segmentation can produce the optimal result for all images. Then after shape features are computed from the segmented contours, the final classification model was built using logistic regression. The work in this paper focuses on identifying the optimal segmentor(s) from an ensemble mix of weak segmentors. For our purpose, optimal segmentors are those in the ensemble mix which contribute the most to the overall classification rather than the ones that produced high precision segmentation. To measure the segmentors' contribution, we examined weights on the features in the derived logistic regression model and computed the average feature weight for each segmentor. The result showed that, while in general the segmentors with higher segmentation success rates had higher feature weights, some segmentors with lower segmentation rates had high classification feature weights as well.

  10. Remote vs. head-mounted eye-tracking: a comparison using radiologists reading mammograms

    NASA Astrophysics Data System (ADS)

    Mello-Thoms, Claudia; Gur, David

    2007-03-01

    Eye position monitoring has been used for decades in Radiology in order to determine how radiologists interpret medical images. Using these devices several discoveries about the perception/decision making process have been made, such as the importance of comparisons of perceived abnormalities with selected areas of the background, the likelihood that a true lesion will attract visual attention early in the reading process, and the finding that most misses attract prolonged visual dwell, often comparable to dwell in the location of reported lesions. However, eye position tracking is a cumbersome process, which often requires the observer to wear a helmet gear which contains the eye tracker per se and a magnetic head tracker, which allows for the computation of head position. Observers tend to complain of fatigue after wearing the gear for a prolonged time. Recently, with the advances made to remote eye-tracking, the use of head-mounted systems seemed destined to become a thing of the past. In this study we evaluated a remote eye tracking system, and compared it to a head-mounted system, as radiologists read a case set of one-view mammograms on a high-resolution display. We compared visual search parameters between the two systems, such as time to hit the location of the lesion for the first time, amount of dwell time in the location of the lesion, total time analyzing the image, etc. We also evaluated the observers' impressions of both systems, and what their perceptions were of the restrictions of each system.

  11. With the Advent of Tomosynthesis in the Workup of Mammographic Abnormality, is Spot Compression Mammography Now Obsolete? An Initial Clinical Experience.

    PubMed

    Ni Mhuircheartaigh, Neasa; Coffey, Louise; Fleming, Hannah; O' Doherty, Ann; McNally, Sorcha

    2017-09-01

    To determine if the routine use of spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and architectural distortion since the availability of digital breast tomosynthesis. We introduced breast tomosynthesis in the workup of screen detected abnormalities in our screening center in January 2015. During an initial learning period with tomosynthesis standard spot compression views were also performed. Three consultant breast radiologists retrospectively reviewed all screening mammograms recalled for assessment over the first 6-month period. We assessed retrospectively whether there was any additional diagnostic information obtained from spot compression views not already apparent on tomography. All cases were also reviewed for any additional lesions detected by tomosynthesis, not detected on routine 2-view screening mammography. 548 women screened with standard 2-view digital screening mammography were recalled for assessment in the selected period and a total of 565 lesions were assessed. 341 lesions were assessed by both tomosynthesis and routine spot compression mammography. The spot compression view was considered more helpful than tomosynthesis in only one patient. This was because the breast was inadequately positioned for tomosynthesis and the area in question was not adequately imaged. Apart from this technical error there was no asymmetry, distortion or mass where spot compression provided more diagnostic information than tomosynthesis alone. We detected three additional cancers on tomosynthesis, not detected by routine screening mammography. From our initial experience with tomosynthesis we conclude that spot compression mammography is now obsolete in the assessment of screen detected masses, asymmetries and distortions where tomosynthesis is available. © 2017 Wiley Periodicals, Inc.

  12. Use of volumetric features for temporal comparison of mass lesions in full field digital mammograms

    SciTech Connect

    Bozek, Jelena, E-mail: jelena.bozek@fer.hr; Grgic, Mislav; Kallenberg, Michiel

    2014-02-15

    Purpose: Temporal comparison of lesions might improve classification between benign and malignant lesions in full-field digital mammograms (FFDM). The authors compare the use of volumetric features for lesion classification, which are computed from dense tissue thickness maps, to the use of mammographic lesion area. Use of dense tissue thickness maps for lesion characterization is advantageous, since it results in lesion features that are invariant to acquisition parameters. Methods: The dataset used in the analysis consisted of 60 temporal mammogram pairs comprising 120 mediolateral oblique or craniocaudal views with a total of 65 lesions, of which 41 were benign and 24more » malignant. The authors analyzed the performance of four volumetric features, area, and four other commonly used features obtained from temporal mammogram pairs, current mammograms, and prior mammograms. The authors evaluated the individual performance of all features and of different feature sets. The authors used linear discriminant analysis with leave-one-out cross validation to classify different feature sets. Results: Volumetric features from temporal mammogram pairs achieved the best individual performance, as measured by the area under the receiver operating characteristic curve (A{sub z} value). Volume change (A{sub z} = 0.88) achieved higher A{sub z} value than projected lesion area change (A{sub z} = 0.78) in the temporal comparison of lesions. Best performance was achieved with a set that consisted of a set of features extracted from the current exam combined with four volumetric features representing changes with respect to the prior mammogram (A{sub z} = 0.90). This was significantly better (p = 0.005) than the performance obtained using features from the current exam only (A{sub z} = 0.77). Conclusions: Volumetric features from temporal mammogram pairs combined with features from the single exam significantly improve discrimination of benign and malignant lesions in FFDM

  13. Neonatal cystic fibrosis screening

    MedlinePlus

    ... also be used to screen for CF. Normal Results If the test result is negative, the child ... further testing will likely be done. What Abnormal Results Mean An abnormal (positive) result suggests that your ...

  14. Utilization of screening mammography in New Hampshire: a population-based assessment.

    PubMed

    Carney, Patricia A; Goodrich, Martha E; Mackenzie, Todd; Weiss, Julia E; Poplack, Steven P; Wells, Wendy S; Titus-Ernstoff, Linda

    2005-10-15

    The objective of screening mammography is to identify breast carcinoma early, which requires routine screening. Although self-report data indicate that screening utilization is high, the results of this population-based assessment indicated that utilization is lower than reported previously. The authors compared New Hampshire population data from the 2000 Census with clinical encounter data for the corresponding time obtained from the New Hampshire Mammography Network, a mammography registry that captures approximately 90% of the mammograms performed in participating New Hampshire facilities. The results showed that approximately 36% of New Hampshire women either never had a mammogram or had not had a mammogram in > 27 months (irregular screenees), and older women (80 yrs and older) were less likely to be screened (79% unscreened/underscreened) compared with younger women (ages 40-69 yrs; 28-32% unscreened/underscreened). Of the screened women, 44% were adhering to an interval of 14 months, and 21% were adhering within 15 months and 26 months. The remaining 35% of the women had 1 or 2 mammograms and did not return within 27 months. Routine mammography screening may be occurring less often than believed when survey data alone are used. An important, compelling concern is the reason women had one or two mammograms only and then did not return for additional screening. This area deserves additional research. Copyright 2005 American Cancer Society

  15. The mammography screening employee inreach program.

    PubMed

    Robinson, Joanne; Seltzer, Vicki; Lawrence, Loretta; Autz, George; Kostroff, Karen; Weiselberg, Lora; Colagiacomo, Maria

    2007-02-01

    To determine whether our health care employees were undergoing mammography screening according to American Cancer Society guidelines and to determine whether aggressive outreach, education and streamlining of mammography scheduling could improve compliance. All female employees at North Shore University Hospital (NSUH) and several other health system facilities (SF) were sent mailings to their homes that included breast health education and mammography screening guidelines, a questionnaire regarding their own mammography screening history and the opportunity to have their mammography screening scheduled by the Mammography Screening Employee Inreach Program (MSEIP) coordinator. Of the approximately 2,700 female employees aged 40 and over at NSUH and SF, 2,235 (82.7%) responded to the questionnaire, and 1,455 had a mammogram done via the MSEIP. Of the 1,455, 43% either were overdue for a mammogram or had never had one. During a second year of the MSEIP at NSUH and SF, an additional 1,706 mammograms were done. People employed in health care jobs do not necessarily avail themselves of appropriate health care screening. An aggressive program that utilized education, outreach and assistance with scheduling was effective in increasing compliance with mammography screening.

  16. Clinical outcomes and a high prevalence of abnormalities on comprehensive arterial and venous thrombophilia screening in TIA or ischaemic stroke patients with a patent foramen ovale, an inter-atrial septal aneurysm or both.

    PubMed

    Lim, Soon Tjin; Murphy, Stephen J X; Smith, Deirdre R; Williams, Jennifer; Navarro, Silvia Gil; McCabe, John; Moore, David P; McHugh, Johnny; McCabe, Dominick J H

    2017-06-15

    Data are limited on the optimal management of cryptogenic TIA/stroke patients with a patent foramen ovale (PFO)±inter-atrial septal aneurysm (IASA), especially with an inherited thrombophilia. Prospectively-collected data on TIA/ischaemic stroke patients with PFO, IASA or both who received 'goal-directed secondary-prevention medical treatment' were analysed. All patients had trans-oesophageal echocardiography, anti-nuclear, anti-cardiolipin, anti-beta 2 glycoprotein I antibodies, rheumatoid factor, lupus anticoagulant, protein C&S, anti-thrombin, factor VIII activity, activated protein C resistance, Factor V Leiden, prothrombin gene and MTHFR-c.677C>T mutation screening. ENA and homocysteine were assessed in the latter study period. Eighty-three patients were recruited. Mean follow-up: 48.1months. Forty-seven patients (56.6%) had an isolated PFO, 32 (38.6%) a PFO and an IASA, and 4 (4.8%) an IASA alone. Eighteen (21.7%) had ≥1 abnormality on thrombophilia screening. The most important abnormalities which lead to treatment changes in 11 patients (13.3%) were primary anti-phospholipid syndrome (N=3; 3.6%), protein S deficiency (N=2; 2.4%) hyper-homocysteinaemia (N=6/72 screened, 8.3%). Four patients (4.8%) opted for PFO closure: two with protein S deficiency, and two with no identified thrombophilia. Seven (8.4%) had recurrent TIA/ischaemic stroke during follow-up (overall annualised incidence: 2.1%), of whom five had a PFO alone and two a PFO and IASA. Comprehensive arterial and venous thrombophilia screening is warranted in TIA/ischaemic stroke patients with a PFO±IASA, is conclusively abnormal in over a fifth, and informed important decision-making regarding individualised therapy in 13.3% of patients. The incidence of recurrent vascular events in this population is low on optimal, personalised secondary-prevention treatment, even with an underlying thrombophilia. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Screening for human papillomavirus, cervical cytological abnormalities and associated risk factors in HIV-positive and HIV-negative women in Rwanda.

    PubMed

    Mukanyangezi, M F; Sengpiel, V; Manzi, O; Tobin, G; Rulisa, S; Bienvenu, E; Giglio, D

    2018-02-01

    Cervical cancer is the major cause of death from cancer in Africa. We wanted to assess the prevalence of human papillomavirus (HPV) infections and associated risk factors and to determine whether HPV testing could serve as a screening method for squamous intraepithelial lesions (SILs) in Rwanda. We also wanted to obtain a broader understanding of the underlying risk factors for the establishment of HPV infection in Rwanda. A total of 206 HIV-positive women, 172 HIV-negative women and 22 women with unknown HIV status were recruited at the University Teaching Hospitals of Kigali (UTHK) and of Butare (UTHB) in Rwanda. Participants underwent an interview, cervical sampling for a Thinprep Pap test and a screening test analysing 37 HPV strains. Only 27% of HIV-positive women and 7% of HIV-negative women had been screened for cervical cancer before. HPV16 and HPV52 were the most common HPV strains. HIV-positive women were more commonly infected with high-risk (HR) HPV and multitype HPV than HIV-negative women. The sensitivity was 78% and the specificity 87% to detect high-grade SIL (HSIL) with HPV screening. Among HIV-negative women, being divorced was positively associated with HR-HPV infection, while hepatitis B, Trichomonas vaginalis infection and HR-HPV infection were factors positively associated with SILs. Ever having had gonorrhoea was positively associated with HR-HPV infection among HIV-positive women. HR-HPV infection and the number of live births were positively associated with SILs. The currently used quadrivalent vaccine may be insufficient to give satisfactory HPV coverage in Rwanda. HPV Screening may be effective to identify women at risk of developing cervical cancer, particularly if provided to high-risk patients. © 2017 British HIV Association.

  18. Computerized image analysis: estimation of breast density on mammograms

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Petrick, Nicholas; Sahiner, Berkman; Helvie, Mark A.; Roubidoux, Marilyn A.; Hadjiiski, Lubomir M.; Goodsitt, Mitchell M.

    2000-06-01

    An automated image analysis tool is being developed for estimation of mammographic breast density, which may be useful for risk estimation or for monitoring breast density change in a prevention or intervention program. A mammogram is digitized using a laser scanner and the resolution is reduced to a pixel size of 0.8 mm X 0.8 mm. Breast density analysis is performed in three stages. First, the breast region is segmented from the surrounding background by an automated breast boundary-tracking algorithm. Second, an adaptive dynamic range compression technique is applied to the breast image to reduce the range of the gray level distribution in the low frequency background and to enhance the differences in the characteristic features of the gray level histogram for breasts of different densities. Third, rule-based classification is used to classify the breast images into several classes according to the characteristic features of their gray level histogram. For each image, a gray level threshold is automatically determined to segment the dense tissue from the breast region. The area of segmented dense tissue as a percentage of the breast area is then estimated. In this preliminary study, we analyzed the interobserver variation of breast density estimation by two experienced radiologists using BI-RADS lexicon. The radiologists' visually estimated percent breast densities were compared with the computer's calculation. The results demonstrate the feasibility of estimating mammographic breast density using computer vision techniques and its potential to improve the accuracy and reproducibility in comparison with the subjective visual assessment by radiologists.

  19. Contribution of patient, physician, and environmental factors to demographic and health variation in colonoscopy follow-up for abnormal colorectal cancer screening test results.

    PubMed

    Partin, Melissa R; Gravely, Amy A; Burgess, James F; Haggstrom, David A; Lillie, Sarah E; Nelson, David B; Nugent, Sean M; Shaukat, Aasma; Sultan, Shahnaz; Walter, Louise C; Burgess, Diana J

    2017-09-15

    Patient, physician, and environmental factors were identified, and the authors examined the contribution of these factors to demographic and health variation in colonoscopy follow-up after a positive fecal occult blood test/fecal immunochemical test (FOBT/FIT) screening. In total, 76,243 FOBT/FIT-positive patients were identified from 120 Veterans Health Administration (VHA) facilities between August 16, 2009 and March 20, 2011 and were followed for 6 months. Patient demographic (race/ethnicity, sex, age, marital status) and health characteristics (comorbidities), physician characteristics (training level, whether primary care provider) and behaviors (inappropriate FOBT/FIT screening), and environmental factors (geographic access, facility type) were identified from VHA administrative records. Patient behaviors (refusal, private sector colonoscopy use) were estimated with statistical text mining conducted on clinic notes, and follow-up predictors and adjusted rates were estimated using hierarchical logistic regression. Roughly 50% of individuals completed a colonoscopy at a VHA facility within 6 months. Age and comorbidity score were negatively associated with follow-up. Blacks were more likely to receive follow-up than whites. Environmental factors attenuated but did not fully account for these differences. Patient behaviors (refusal, private sector colonoscopy use) and physician behaviors (inappropriate screening) fully accounted for the small reverse race disparity and attenuated variation by age and comorbidity score. Patient behaviors (refusal and private sector colonoscopy use) contributed more to variation in follow-up rates than physician behaviors (inappropriate screening). In the VHA, blacks are more likely to receive colonoscopy follow-up for positive FOBT/FIT results than whites, and follow-up rates markedly decline with advancing age and comorbidity burden. Patient and physician behaviors explain race variation in follow-up rates and contribute to

  20. Computer-aided classification of breast masses using contrast-enhanced digital mammograms

    NASA Astrophysics Data System (ADS)

    Danala, Gopichandh; Aghaei, Faranak; Heidari, Morteza; Wu, Teresa; Patel, Bhavika; Zheng, Bin

    2018-02-01

    By taking advantages of both mammography and breast MRI, contrast-enhanced digital mammography (CEDM) has emerged as a new promising imaging modality to improve efficacy of breast cancer screening and diagnosis. The primary objective of study is to develop and evaluate a new computer-aided detection and diagnosis (CAD) scheme of CEDM images to classify between malignant and benign breast masses. A CEDM dataset consisting of 111 patients (33 benign and 78 malignant) was retrospectively assembled. Each case includes two types of images namely, low-energy (LE) and dual-energy subtracted (DES) images. First, CAD scheme applied a hybrid segmentation method to automatically segment masses depicting on LE and DES images separately. Optimal segmentation results from DES images were also mapped to LE images and vice versa. Next, a set of 109 quantitative image features related to mass shape and density heterogeneity was initially computed. Last, four multilayer perceptron-based machine learning classifiers integrated with correlationbased feature subset evaluator and leave-one-case-out cross-validation method was built to classify mass regions depicting on LE and DES images, respectively. Initially, when CAD scheme was applied to original segmentation of DES and LE images, the areas under ROC curves were 0.7585+/-0.0526 and 0.7534+/-0.0470, respectively. After optimal segmentation mapping from DES to LE images, AUC value of CAD scheme significantly increased to 0.8477+/-0.0376 (p<0.01). Since DES images eliminate overlapping effect of dense breast tissue on lesions, segmentation accuracy was significantly improved as compared to regular mammograms, the study demonstrated that computer-aided classification of breast masses using CEDM images yielded higher performance.

  1. INDIAM--an e-learning system for the interpretation of mammograms.

    PubMed

    Guliato, Denise; Bôaventura, Ricardo S; Maia, Marcelo A; Rangayyan, Rangaraj M; Simedo, Mariângela S; Macedo, Túlio A A

    2009-08-01

    We propose the design of a teaching system named Interpretation and Diagnosis of Mammograms (INDIAM) for training students in the interpretation of mammograms and diagnosis of breast cancer. The proposed system integrates an illustrated tutorial on radiology of the breast, that is, mammography, which uses education techniques to guide the user (doctors, students, or researchers) through various concepts related to the diagnosis of breast cancer. The user can obtain informative text about specific subjects, access a library of bibliographic references, and retrieve cases from a mammographic database that are similar to a query case on hand. The information of each case stored in the mammographic database includes the radiological findings, the clinical history, the lifestyle of the patient, and complementary exams. The breast cancer tutorial is linked to a module that simulates the analysis and diagnosis of a mammogram. The tutorial incorporates tools for helping the user to evaluate his or her knowledge about a specific subject by using the education system or by simulating a diagnosis with appropriate feedback in case of error. The system also makes available digital image processing tools that allow the user to draw the contour of a lesion, the contour of the breast, or identify a cluster of calcifications in a given mammogram. The contours provided by the user are submitted to the system for evaluation. The teaching system is integrated with AMDI-An Indexed Atlas of Digital Mammograms-that includes case studies, e-learning, and research systems. All the resources are accessible via the Web.

  2. Postpartum screening practices, progression to abnormal glucose tolerance and its related risk factors in Asian women with a known history of gestational diabetes: A systematic review and meta-analysis.

    PubMed

    Nouhjah, Sedigheh; Shahbazian, Hajieh; Amoori, Neda; Jahanfar, Shayesteh; Shahbazian, Nahid; Jahanshahi, Alireza; Cheraghian, Bahman

    2017-12-01

    Rate of postpartum screening and progression to glucose intolerance (diabetes and/or pre-diabetes) in Asian women with prior GDM and risk factors of diversion to abnormal glucose tolerance were reviewed. We searched Pub Med, Cochrane Library, Web of Science, EMBASE, and Ovid data base. About 1300 studies were screened and 27 articles were selected. Meta-analysis using Comprehensive Meta -Analysis software was conducted. All results were reported at the pooled ORs and 95% CI. Quantitative heterogeneity (I 2 ) was assessed. To estimate the variances between studies, the statistical method "tau-squared" was applied. Statistical models like fixed effect or Mantel-Haenszel, and random effect (REM) or Dersimonian-laird were used for the analysis and integration of results. Rate of glucose testing ranged from 13.1% to 81.9%. Prevalence of pre-diabetes was 3.9%-50.9%. Diabetes was reported in 2.8%-58% of women with history of gestational diabetes based on length of follow-up. Factor associated with postpartum diabetes mellitus included family History of diabetes mellitus, gestational age at diagnosis of GDM, insulin use during pregnancy and pre-pregnancy BMI. Rate of postpartum screening in most of the Asian countries population is sub-optimal, in spite of high rate of glucose intolerance in this high risk group of women. Risk factors of progression to pre-diabetes and diabetes are similar to previous reported in developed countries. Copyright © 2017 Diabetes India. All rights reserved.

  3. Abnormal placentation.

    PubMed

    Bauer, Samuel T; Bonanno, Clarissa

    2009-04-01

    Abnormal placentation poses a diagnostic and treatment challenge for all providers caring for pregnant women. As one of the leading causes of postpartum hemorrhage, abnormal placentation involves the attachment of placental villi directly to the myometrium with potentially deeper invasion into the uterine wall or surrounding organs. Surgical procedures that disrupt the integrity of uterus, including cesarean section, dilatation and curettage, and myomectomy, have been implicated as key risk factors for placenta accreta. The diagnosis is typically made by gray-scale ultrasound and confirmed with magnetic resonance imaging, which may better delineate the extent of placental invasion. It is critical to make the diagnosis before delivery because preoperative planning can significantly decrease blood loss and avoid substantial morbidity associated with placenta accreta. Aggressive management of hemorrhage through the use of uterotonics, fluid resuscitation, blood products, planned hysterectomy, and surgical hemostatic agents can be life-saving for these patients. Conservative management, including the use of uterine and placental preservation and subsequent methotrexate therapy or pelvic artery embolization, may be considered when a focal accreta is suspected; however, surgical management remains the current standard of care.

  4. Comparative effectiveness of mailed reminder letters on mammography screening compliance.

    PubMed

    Romaire, Melissa A; Bowles, Erin J Aiello; Anderson, Melissa L; Buist, Diana S M

    2012-08-01

    Reminder letters are effective at prompting women to schedule mammograms. Less well studied are reminders addressing multiple preventive service recommendations. We compared the effectiveness of a mammogram-specific reminder sent when a woman was due for a mammogram to a reminder letter addressing multiple preventive services and sent on a woman's birthday on mammography receipt. The study included 48,583 women 52-74 years enrolled in Group Health Cooperative, a health plan in Washington State. From 2005 to 2009, women were mailed 88,605 mammogram-specific or birthday letters. In this one group pretest-posttest study, we modeled the odds of obtaining a screening mammogram after receiving a letter by reminder type using logistic regression, controlling for demographic and healthcare use characteristics and stratifying by whether women were overdue or up-to-date with mammography at the mailing. Among women up-to-date with screening, birthday letters were negatively associated with mammography receipt compared to mammogram-specific letters (birthday letters with 1-2 recommendations: OR=0.73; 95% CI:0.68-0.79; 3 recommendations: OR=0.74; 95% CI:0.69-0.78; 4-8 recommendations: OR=0.62 95% CI:0.55-0.68) after. Among overdue women, birthday letters with 4-8 recommendations were negatively associated with mammography receipt. Transitioning from mammogram-specific reminder letters to multiple preventive service birthday letters was associated with decreased mammography receipt. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Consensus review of discordant findings maximizes cancer detection rate in double-reader screening mammography: Irish National Breast Screening Program experience.

    PubMed

    Shaw, Colette M; Flanagan, Fidema L; Fenlon, Helen M; McNicholas, Michelle M

    2009-02-01

    To assesses consensus review of discordant screening mammography findings in terms of its sensitivity, safety, and effect on overall performance in the first 6 years of operation of the Irish National Breast Screening Program (NBSP). Women who participated in the Irish NBSP gave written informed consent for use of their data for auditing purposes. Local ethics committee approval was obtained. The study population consisted of women who participated in the Irish NBSP and underwent initial screening mammography at one of the two screening centers serving the eastern part of Ireland between 2000 and 2005. Independent double reading of mammograms was performed. When the readers disagreed regarding referral, the case was reviewed by a consensus panel. Of the 128 569 screenings performed, 1335 (1%) were discussed by consensus. Of the 1335 cases discussed by consensus, 606 (45.39%) were recalled for further assessment. This resulted in an overall recall rate of 4.41%. In those recalled to assessment, 71 cases of malignant disease were diagnosed (ductal carcinoma in situ, n = 24; invasive cancer, n = 47). The remaining 729 patients were returned to biennial screening. Of these 729 patients, seven had false-negative findings that were identified in the subsequent screening round. Use of the highest reader recall method, in which a patient is recalled if her findings are deemed abnormal by either reader, could potentially increase the cancer detection rate by 0.6 per 1000 women screened but would increase the recall rate by 12.69% and the number of false-positive findings by 15.37%. The consensus panel identified 71 (7.33%) of 968 cancers diagnosed. Consensus review substantially reduced the number of cases recalled and was associated with a low false-negative rate.

  6. National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium.

    PubMed

    Lehman, Constance D; Arao, Robert F; Sprague, Brian L; Lee, Janie M; Buist, Diana S M; Kerlikowske, Karla; Henderson, Louise M; Onega, Tracy; Tosteson, Anna N A; Rauscher, Garth H; Miglioretti, Diana L

    2017-04-01

    Purpose To establish performance benchmarks for modern screening digital mammography and assess performance trends over time in U.S. community practice. Materials and Methods This HIPAA-compliant, institutional review board-approved study measured the performance of digital screening mammography interpreted by 359 radiologists across 95 facilities in six Breast Cancer Surveillance Consortium (BCSC) registries. The study included 1 682 504 digital screening mammograms performed between 2007 and 2013 in 792 808 women. Performance measures were calculated according to the American College of Radiology Breast Imaging Reporting and Data System, 5th edition, and were compared with published benchmarks by the BCSC, the National Mammography Database, and performance recommendations by expert opinion. Benchmarks were derived from the distribution of performance metrics across radiologists and were presented as 50th (median), 10th, 25th, 75th, and 90th percentiles, with graphic presentations using smoothed curves. Results Mean screening performance measures were as follows: abnormal interpretation rate (AIR), 11.6 (95% confidence interval [CI]: 11.5, 11.6); cancers detected per 1000 screens, or cancer detection rate (CDR), 5.1 (95% CI: 5.0, 5.2); sensitivity, 86.9% (95% CI: 86.3%, 87.6%); specificity, 88.9% (95% CI: 88.8%, 88.9%); false-negative rate per 1000 screens, 0.8 (95% CI: 0.7, 0.8); positive predictive value (PPV) 1, 4.4% (95% CI: 4.3%, 4.5%); PPV2, 25.6% (95% CI: 25.1%, 26.1%); PPV3, 28.6% (95% CI: 28.0%, 29.3%); cancers stage 0 or 1, 76.9%; minimal cancers, 57.7%; and node-negative invasive cancers, 79.4%. Recommended CDRs were achieved by 92.1% of radiologists in community practice, and 97.1% achieved recommended ranges for sensitivity. Only 59.0% of radiologists achieved recommended AIRs, and only 63.0% achieved recommended levels of specificity. Conclusion The majority of radiologists in the BCSC surpass cancer detection recommendations for screening

  7. Motivators and barriers to mammography screening uptake by female health-care workers in primary health-care centres: a cross-sectional study.

    PubMed

    Nazzal, Zaher; Sholi, Hisham; Sholi, Suha B; Sholi, Mohammad B; Lahaseh, Rawya

    2018-02-21

    Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at primary health-care centres and to identify the primary motivators and barriers that affect uptake. This cross-sectional study included all governmental primary health-care centres in the West Bank. Governorates were grouped into three regions as follows: north West Bank (Nablus, Jenin, Tulkarm, Tubas, Qalqiliya, and Salfit), middle West Bank (Jerusalem, Jericho, and Ramallah), and south West Bank (Hebron, and Bethlehem). The study population included all female health-care workers older than 40 years. Those who performed mammography for a suspected mass or other breast abnormalities were excluded. A self-administered questionnaire was used to collect data on demographic characteristics, knowledge about mammography screening, the extent and regularity of mammography screening, and motivators and barriers influencing their mammography screening uptake. The rate of mammography screening uptake was calculated. χ 2 test and t tests were used to assess screening motivators and barriers. The study was approved by the Institutional Review Board of the An-Najah National University. Participation was voluntary, and written consent was obtained from each participant. 299 female health-care workers completed a self-administered questionnaire. The mean age of the participants was 46 years (SD 4·7). 284 (95%) women had adequate knowledge about breast cancer and mammography screening, and 149 (50%) women reported having had at least one mammogram. 62 (21%) women had had regular scheduled mammograms. The most frequent reported motivators were the perceived benefit that early detection of breast cancer is important for its management (269 [90

  8. Computer aided system for segmentation and visualization of microcalcifications in digital mammograms.

    PubMed

    Reljin, Branimir; Milosević, Zorica; Stojić, Tomislav; Reljin, Irini

    2009-01-01

    Two methods for segmentation and visualization of microcalcifications in digital or digitized mammograms are described. First method is based on modern mathematical morphology, while the second one uses the multifractal approach. In the first method, by using an appropriate combination of some morphological operations, high local contrast enhancement, followed by significant suppression of background tissue, irrespective of its radiology density, is obtained. By iterative procedure, this method highly emphasizes only small bright details, possible microcalcifications. In a multifractal approach, from initial mammogram image, a corresponding multifractal "images" are created, from which a radiologist has a freedom to change the level of segmentation. An appropriate user friendly computer aided visualization (CAV) system with embedded two methods is realized. The interactive approach enables the physician to control the level and the quality of segmentation. Suggested methods were tested through mammograms from MIAS database as a gold standard, and from clinical praxis, using digitized films and digital images from full field digital mammograph.

  9. A Qualitative Secondary Evaluation of Statewide Follow-Up Interviews for Abnormal Newborn Screening Results for Cystic Fibrosis and Sickle Cell Hemoglobinopathy

    PubMed Central

    La Pean, Alison; Collins, Jenelle L.; Christopher, Stephanie A.; Eskra, Kerry L.; Roedl, Sara; Tluczek, Audrey; Farrell, Michael H.

    2011-01-01

    Purpose The purpose of this qualitative analysis was to assess parental acceptability of large-scale, telephone follow-up regarding their infants' newborn screening (NBS) results indicating carrier status for sickle cell hemoglobinopathy (SCH) and cystic fibrosis (CF). Methods Analysis of 195 interview transcripts focused on parents' responses to two open-ended questions “What was your reaction to being called by me?” and “What do you think of the state newborn screening program having follow-up people calling parents like you?” Responses were coded using conventional content analysis procedures and non-parametric tests were performed to analyze quantitative data. Results Most parents reported favorable opinions about the follow-up. Favorable opinions were associated with several emotional reactions to receiving follow-up (p<0.001), and three reasons why parents found the interview beneficial (p<0.05): it provided information, clarified NBS results, and answered questions. Seventeen parents of SCH carriers reportedly had not been told their infant's NBS results and received them for the first time during the follow-up interview. Conclusion Parents of CF and SCH carrier infants had favorable opinions and identified specific benefits to receiving follow-up contact. This analysis demonstrates an information deficit among carrier parents and illustrates the importance of NBS follow-up and need for comprehensive communication and counseling. PMID:22261754

  10. The personal costs and convenience of screening mammography.

    PubMed

    Suter, Lisa Gale; Nakano, Connie Y; Elmore, Joann G

    2002-09-01

    Few studies have examined the impact of women's personal costs on obtaining a screening mammogram in the United States. All women obtaining screening mammograms at nine Connecticut mammography facilities during a 2-week study period were asked to complete a questionnaire. Facilities included urban and rural fixed sites and mobile sites. The survey included questions about insurance coverage, mammogram payment, and personal costs in terms of transportation, family care, parking, and lost work time from the women's perspective. The response rate was 62% (731 of 1189). Thirty-two percent of respondents incurred some type of personal cost, including lost work time, family care, and parking. Women incurring personal costs were more likely than those without personal costs to attend an urban facility (46% vs. 23%, p < 0.01) and be under the age of 50 (40% vs. 26%, p < 0.01). Overall, 61% of women listed convenience and 17% listed cost as a reason for choosing a mammography facility; 23% reported that cost might prevent them from obtaining a future mammogram. One third of women obtaining mammograms may be incurring personal costs. These personal costs should be considered in future cost-effectiveness analyses.

  11. U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.

    PubMed

    Salloum, Ramzi G; Kohler, Racquel E; Jensen, Gail A; Sheridan, Stacey L; Carpenter, William R; Biddle, Andrea K

    2014-03-01

    Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. We identified female Medicare beneficiaries aged 66-80 years and used bivariate probit regression to examine the receipt of breast (mammogram) and cervical (Pap test) cancer screening reflecting changes in the Task Force recommendations. We analyzed 9,760 Medicare Current Beneficiary Survey responses from 2001 to 2007. More than two-thirds reported receiving a mammogram and more than one-third a Pap test in the previous 2 years. Lack of recommendation was given as a reason for not getting screened among the majority (51% for mammogram and 75% for Pap). After controlling for beneficiary-level socioeconomic characteristics and access to care factors, we did not observe a significant change in breast and cervical cancer screening patterns following the changes in Task Force recommendations. Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.

  12. TU-F-18C-09: Mammogram Surveillance Using Texture Analysis for Breast Cancer Patients After Radiation Therapy

    SciTech Connect

    Kuo, H; Tome, W; FOX, J

    2014-06-15

    Purpose: To study the feasibility of applying cancer risk model established from treated patients to predict the risk of recurrence on follow-up mammography after radiation therapy for both ipsilateral and contralateral breast. Methods: An extensive set of textural feature functions was applied to a set of 196 Mammograms from 50 patients. 56 Mammograms from 28 patients were used as training set, 44 mammograms from 22 patients were used as test set and the rest were used for prediction. Feature functions include Histogram, Gradient, Co-Occurrence Matrix, Run-Length Matrix and Wavelet Energy. An optimum subset of the feature functions was selected bymore » Fisher Coefficient (FO) or Mutual Information (MI) (up to top 10 features) or a method combined FO, MI and Principal Component (FMP) (up to top 30 features). One-Nearest Neighbor (1-NN), Linear Discriminant Analysis (LDA) and Nonlinear Discriminant Analysis (NDA) were utilized to build a risk model of breast cancer from the training set of mammograms at the time of diagnosis. The risk model was then used to predict the risk of recurrence from mammogram taken one year and three years after RT. Results: FPM with NDA has the best classification power in classifying the training set of the mammogram with lesions versus those without lesions. The model of FPM with NDA achieved a true positive (TP) rate of 82% compared to 45.5% of using FO with 1-NN. The best false positive (FP) rates were 0% and 3.6% in contra-lateral breast of 1-year and 3-years after RT, and 10.9% in ipsi-lateral breast of 3-years after RT. Conclusion: Texture analysis offers high dimension to differentiate breast tissue in mammogram. Using NDA to classify mammogram with lesion from mammogram without lesion, it can achieve rather high TP and low FP in the surveillance of mammogram for patient with conservative surgery combined RT.« less

  13. In silico screening of the impact of hERG channel kinetic abnormalities on channel block and susceptibility to acquired long QT syndrome

    PubMed Central

    Romero, Lucia; Trenor, Beatriz; Yang, Pei-Chi; Saiz, Javier; Clancy, Colleen E.

    2014-01-01

    Accurate diagnosis of predisposition to long QT syndrome is crucial for reducing the risk of cardiac arrhythmias. In recent years, drug-induced provocative tests have proved useful to unmask some latent mutations linked to cardiac arrhythmias. In this study we expanded this concept by developing a prototype for a computational provocative screening test to reveal genetic predisposition to acquired Long-QT Syndrome (aLTQS). We developed a computational approach to reveal the pharmacological properties of IKr blocking drugs that are most likely to cause aLQTS in the setting of subtle alterations in IKr channel gating that would be expected to result from benign genetic variants. We used the model to predict the most potentially lethal combinations of kinetic anomalies and drug properties. In doing so, we also implicitly predicted ideal inverse therapeutic properties of K channel openers that would be expected to remedy a specific defect. We systematically performed “in silico mutagenesis” by altering discrete kinetic transition rates of the Fink et al. Markov model of human IKr channels, corresponding to activation, inactivation, deactivation and recovery from inactivation of IKr channels. We then screened and identified the properties of IKr blockers that caused acquired Long QT and therefore unmasked mutant phenotypes for mild, moderate and severe variants. Mutant IKr channels were incorporated into the O’Hara et al. human ventricular action potential (AP) model and subjected to simulated application of a wide variety of IKr-drug interactions in order to identify the characteristics that selectively exacerbate the AP duration (APD) differences between wild-type and IKr mutated cells. Our results show that drugs with disparate affinities to conformation states of the IKr channel are key to amplify variants underlying susceptibility to acquired Long QT Syndrome, an effect that is especially pronounced at slow frequencies. Finally, we developed a mathematical

  14. New Embedded Denotes Fuzzy C-Mean Application for Breast Cancer Density Segmentation in Digital Mammograms

    NASA Astrophysics Data System (ADS)

    Othman, Khairulnizam; Ahmad, Afandi

    2016-11-01

    In this research we explore the application of normalize denoted new techniques in advance fast c-mean in to the problem of finding the segment of different breast tissue regions in mammograms. The goal of the segmentation algorithm is to see if new denotes fuzzy c- mean algorithm could separate different densities for the different breast patterns. The new density segmentation is applied with multi-selection of seeds label to provide the hard constraint, whereas the seeds labels are selected based on user defined. New denotes fuzzy c- mean have been explored on images of various imaging modalities but not on huge format digital mammograms just yet. Therefore, this project is mainly focused on using normalize denoted new techniques employed in fuzzy c-mean to perform segmentation to increase visibility of different breast densities in mammography images. Segmentation of the mammogram into different mammographic densities is useful for risk assessment and quantitative evaluation of density changes. Our proposed methodology for the segmentation of mammograms on the basis of their region into different densities based categories has been tested on MIAS database and Trueta Database.

  15. Does telephone scheduling assistance increase mammography screening adherence?

    PubMed

    Payton, Colleen A; Sarfaty, Mona; Beckett, Shirley; Campos, Carmen; Hilbert, Kathleen

    2015-11-01

    The 2 objectives were: 1) describe the use of a patient navigation process utilized to promote adherence to mammography screening within a primary care practice, and 2) determine the result of the navigation process and estimate the time required to increase mammography screening with this approach in a commercially insured patient population enrolled in a health maintenance organization. An evaluation of a nonrandomized practice improvement intervention. Women eligible for mammography (n = 298) who did not respond to 2 reminder letters were contacted via telephone by a navigator who offered scheduling assistance for mammography screening. The patient navigator scheduled appointments, documented the number of calls, and confirmed completed mammograms in the electronic health record, as well as estimated the time for calls and chart review. Of the 188 participants reached by phone, 112 (59%) scheduled appointments using the patient navigator, 35 (19%) scheduled their own appointments independently prior to the call, and 41 (22%) declined. As a result of the telephone intervention, 78 of the 188 women reached (41%) received a mammogram; also, all 35 women who had independently scheduled a mammogram received one. Chart documentation confirmed that 113 (38%) of the cohort of 298 women completed a mammogram. The estimated time burden for the entire project was 55 hours and 33 minutes, including calling patients, scheduling appointments, and chart review. A patient navigator can increase mammography adherence in a previously nonadherent population by making the screening appointment while the patient is on the phone.

  16. The Association of Social Support and Education with Breast and Cervical Cancer Screening

    ERIC Educational Resources Information Center

    Documet, Patricia; Bear, Todd M.; Flatt, Jason D.; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M.

    2015-01-01

    Background: Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose:…

  17. Screening Mammography Use Among Older Women Before and After the 2009 U.S. Preventive Services Task Force Recommendations.

    PubMed

    Chang, Chiang-Hua; Bynum, Julie P W; Onega, Tracy; Colla, Carrie H; Lurie, Jon D; Tosteson, Anna N A

    2016-10-01

    It is uncertain how changes in the U.S. Preventive Services Task Force breast cancer screening recommendations (from annual to biennial mammography screening in women aged 50-74 and grading the evidence as insufficient for screening in women aged 75 and older) have affected mammography use among Medicare beneficiaries. Cohort study of 12 million Medicare fee-for-service women aged 65-74 and 75 and older to measure changes in 3-year screening use, 2007-2009 (before) and 2010-2012 (after), defined by two measures-proportion screened and frequency of screening by age, race/ethnicity, and hospital referral region. Fewer women were screened, but with similar frequency after 2009 for both age groups (after vs. before: age 65-74: 60.1% vs. 60.8% screened, 2.1 vs. 2.1 mammograms per screened woman; age 75 and older: 31.7% vs. 33.6% screened, 1.9 vs. 1.9 mammograms per screened woman; all p < 0.05). Black women were the only subgroup with an increase in screening use, and for both age groups (after vs. before: age 65-74: 55.4% vs. 54.0% screened and 2.0 vs. 1.9 mammograms per screened woman; age 75 and older: 28.5% vs. 27.9% screened and 1.8 vs. 1.8 mammograms per screened woman; all p < 0.05). Regional change patterns in screening were more similar between age groups (Pearson correlation r = 0.781 for proportion screened; r = 0.840 for frequency of screening) than between black versus nonblack women (Pearson correlation r = 0.221 for proportion screened; r = 0.212 for frequency of screening). Changes in screening mammography use for Medicare women are not fully aligned with the 2009 recommendations.

  18. Classification of breast abnormalities using artificial neural network

    NASA Astrophysics Data System (ADS)

    Zaman, Nur Atiqah Kamarul; Rahman, Wan Eny Zarina Wan Abdul; Jumaat, Abdul Kadir; Yasiran, Siti Salmah

    2015-05-01

    Classification is the process of recognition, differentiation and categorizing objects into groups. Breast abnormalities are calcifications which are tumor markers that indicate the presence of cancer in the breast. The aims of this research are to classify the types of breast abnormalities using artificial neural network (ANN) classifier and to evaluate the accuracy performance using receiver operating characteristics (ROC) curve. The methods used in this research are ANN for breast abnormalities classifications and Canny edge detector as a feature extraction method. Previously the ANN classifier provides only the number of benign and malignant cases without providing information for specific cases. However in this research, the type of abnormality for each image can be obtained. The existing MIAS MiniMammographic database classified the mammogram images into three features only namely characteristic of background tissues, class of abnormality and radius of abnormality. However, in this research three other features are added-in. These three features are number of spots, area and shape of abnormalities. Lastly the performance of the ANN classifier is evaluated using ROC curve. It is found that ANN has an accuracy of 97.9% which is considered acceptable.

  19. Improving mass candidate detection in mammograms via feature maxima propagation and local feature selection.

    PubMed

    Melendez, Jaime; Sánchez, Clara I; van Ginneken, Bram; Karssemeijer, Nico

    2014-08-01

    Mass candidate detection is a crucial component of multistep computer-aided detection (CAD) systems. It is usually performed by combining several local features by means of a classifier. When these features are processed on a per-image-location basis (e.g., for each pixel), mismatching problems may arise while constructing feature vectors for classification, which is especially true when the behavior expected from the evaluated features is a peaked response due to the presence of a mass. In this study, two of these problems, consisting of maxima misalignment and differences of maxima spread, are identified and two solutions are proposed. The first proposed method, feature maxima propagation, reproduces feature maxima through their neighboring locations. The second method, local feature selection, combines different subsets of features for different feature vectors associated with image locations. Both methods are applied independently and together. The proposed methods are included in a mammogram-based CAD system intended for mass detection in screening. Experiments are carried out with a database of 382 digital cases. Sensitivity is assessed at two sets of operating points. The first one is the interval of 3.5-15 false positives per image (FPs/image), which is typical for mass candidate detection. The second one is 1 FP/image, which allows to estimate the quality of the mass candidate detector's output for use in subsequent steps of the CAD system. The best results are obtained when the proposed methods are applied together. In that case, the mean sensitivity in the interval of 3.5-15 FPs/image significantly increases from 0.926 to 0.958 (p < 0.0002). At the lower rate of 1 FP/image, the mean sensitivity improves from 0.628 to 0.734 (p < 0.0002). Given the improved detection performance, the authors believe that the strategies proposed in this paper can render mass candidate detection approaches based on image location classification more robust to feature

  20. Correlates of mammography screening among Hispanic women living in lower Rio Grande Valley farmworker communities.

    PubMed

    Palmer, Richard C; Fernandez, Maria E; Tortolero-Luna, Guillermo; Gonzales, Alicia; Mullen, Patricia Dolan

    2005-08-01

    Factors contributing to the underuse of mammography screening by female Hispanic farmworkers aged 50 years and older in the Lower Rio Grande Valley were determined through home-based, Spanish-language personal interviews (N = 200). Questions covered adherence to screening mammography guidelines (mammogram within 2 years), healthcare access, sociodemographic characteristics, and theoretical constructs related to breast cancer screening in the literature. Multivariate findings indicated that adherent women were 3.6 times more likely to have health insurance. Self-efficacy for obtaining a mammogram and decisional balance were also significantly related to adherence; age, income, and education variables were not associated, perhaps because of restricted variation. Results indicate continuing efforts are needed to ensure that medically underserved migrant farmworker women have access to health care services. In addition, efforts to increase their self-efficacy in obtaining a mammogram and to counter negative attitudes and opinions by stressing the positive prognosis associated with early detection are warranted.

  1. Breast Cancer Screening in Morocco: Performance Indicators During Two Years of an Organized Programme.

    PubMed

    El Fakir, Samira; Najdi, Adil; Khazraji, Youssef Chami; Bennani, Maria; Belakhel, Latifa; Abousselham, Loubna; Lyoussi, Badiaa; Bekkali, Rachid; Nejjari, Chakib

    2015-01-01

    Breast cancer is commonly diagnosed at late stages in countries with limited resources. In Morocco, breast cancer is ranked the first female cancer (36.1%) and screening methods could reduce the proportion presenting with a late diagnosis. Morocco is currently adopting a breast cancer screening program based on clinical examination at primary health facilities, diagnosis at secondary level and treatment at tertiary level. So far, there is no systematic information on the performance of the screening program for breast cancer in Morocco. The aim of this study was to analyze early performance indicators. A retrospective evaluative study conducted in Temara city. The target population was the entire female population aged between 45-70 years. The study was based on process and performance indicators collected at the individual level from the various health structures in Tamara between 2009 and 2011. A total of 2,350 women participated in the screening program; the participation rate was 35.7%. Of these, 76.8% (1,806) were married and 5.2% (106) of this group had a family history of breast cancer. Of the women who attended screening, 9.3% (190) were found to have an abnormal physical examination findings. A total of 260 (12.7%) were referred for a specialist consultation. The positive predictive value of clinical breast examination versus mammography was 23.0%. Forty four (35.5%) of the lesions found on the mammograms were classified as BI-RADs 3; 4 or 5 category. Cancer was found in 4 (1.95%) of the total number of screened women and benign cases represented 0.58%. These first results of the programme are very encouraging, but there is a need to closely monitor performance and to improve programme procedures with the aim of increasing both the participation rate and the proportion of women eligible to attend screening.

  2. Large Subpectoral Lipoma on Screening Mammography

    PubMed Central

    Su, Andres; Margolies, Laurie

    2017-01-01

    A 61 year-old woman presenting for bilateral screening mammogram was found to have an oval fat-density mass in the posterior right breast, partially visualized, with anterior displacement and thinning of the pectoralis major muscle. This mass was found on CT and MRI correlation to represent a large fat-containing mass, likely a lipoma, deep to the pectoralis major. On subsequent screening mammograms, the visualized portion of the mass remained stable. Subpectoral lipomas and intramuscular lipomas within the pectoralis major are rare, and their appearance on mammography may not be familiar to most radiologists. A review of the literature and a discussion of their appearance on multiple imaging modalities is provided. PMID:29299106

  3. Evaluation of information-theoretic similarity measures for content-based retrieval and detection of masses in mammograms

    SciTech Connect

    Tourassi, Georgia D.; Harrawood, Brian; Singh, Swatee

    The purpose of this study was to evaluate image similarity measures employed in an information-theoretic computer-assisted detection (IT-CAD) scheme. The scheme was developed for content-based retrieval and detection of masses in screening mammograms. The study is aimed toward an interactive clinical paradigm where physicians query the proposed IT-CAD scheme on mammographic locations that are either visually suspicious or indicated as suspicious by other cuing CAD systems. The IT-CAD scheme provides an evidence-based, second opinion for query mammographic locations using a knowledge database of mass and normal cases. In this study, eight entropy-based similarity measures were compared with respect to retrievalmore » precision and detection accuracy using a database of 1820 mammographic regions of interest. The IT-CAD scheme was then validated on a separate database for false positive reduction of progressively more challenging visual cues generated by an existing, in-house mass detection system. The study showed that the image similarity measures fall into one of two categories; one category is better suited to the retrieval of semantically similar cases while the second is more effective with knowledge-based decisions regarding the presence of a true mass in the query location. In addition, the IT-CAD scheme yielded a substantial reduction in false-positive detections while maintaining high detection rate for malignant masses.« less

  4. Evaluation of information-theoretic similarity measures for content-based retrieval and detection of masses in mammograms.

    PubMed

    Tourassi, Georgia D; Harrawood, Brian; Singh, Swatee; Lo, Joseph Y; Floyd, Carey E

    2007-01-01

    The purpose of this study was to evaluate image similarity measures employed in an information-theoretic computer-assisted detection (IT-CAD) scheme. The scheme was developed for content-based retrieval and detection of masses in screening mammograms. The study is aimed toward an interactive clinical paradigm where physicians query the proposed IT-CAD scheme on mammographic locations that are either visually suspicious or indicated as suspicious by other cuing CAD systems. The IT-CAD scheme provides an evidence-based, second opinion for query mammographic locations using a knowledge database of mass and normal cases. In this study, eight entropy-based similarity measures were compared with respect to retrieval precision and detection accuracy using a database of 1820 mammographic regions of interest. The IT-CAD scheme was then validated on a separate database for false positive reduction of progressively more challenging visual cues generated by an existing, in-house mass detection system. The study showed that the image similarity measures fall into one of two categories; one category is better suited to the retrieval of semantically similar cases while the second is more effective with knowledge-based decisions regarding the presence of a true mass in the query location. In addition, the IT-CAD scheme yielded a substantial reduction in false-positive detections while maintaining high detection rate for malignant masses.

  5. Inequalities in socioeconomic status and race and the odds of undergoing a mammogram in Brazil.

    PubMed

    Melo, Enirtes Caetano Prates; de Oliveira, Evangelina Xavier Gouveia; Chor, Dóra; Carvalho, Marilia Sá; Pinheiro, Rejane Sobrino

    2016-09-15

    Access to mammograms, in common with other diagnostic procedures, is strongly conditioned by socioeconomic disparities. Which aspects of inequality affect the odds of undergoing a mammogram, and whether they are the same in different localities, are relevant issues related to the success of health policies. This study analyzed data from the 2008 PNAD - Brazilian National Household Sample Survey (11.607 million women 40 years of age or older), on having had at least one mammogram over life for women 40 years of age or older in each of Brazil's nine Metropolitan Regions (MR), according to socioeconomic position. The effects of income, schooling, health insurance and race in the different regions were investigated using multivariate logistical regression for each region individually, and for all MRs combined. The age-adjusted odds of a woman having had a mammogram according to race and stratified by two income strata (and two schooling strata) were also analyzed. Having a higher income increases four to seven times a woman's odds of having had at least one mammogram in all MRs except Curitiba. For schooling, the gradient, though less steep, is favorable to women with more years of study. Having health insurance increases two to three times the odds in all MRs. Multivariate analysis did not show differences due to race (except for the Fortaleza MR), but the stratified analysis by income and schooling shows effects of race in most MRs, with greater differences for women with higher socioeconomic status. This study confirms that income and schooling, as well as having health insurance, are still important determinants of inequality in health service use in Brazil. Additionally, race also contributes to the odds of having had a mammogram. The point is not to isolate the effect of each factor, but to evaluate how their interrelations may exacerbate differences, generating patterns of cumulative adversity, a theme that is still little explored in Brazil. This is much more

  6. Analysis of utilization patterns and associated costs of the breast imaging and diagnostic procedures after screening mammography.

    PubMed

    Vlahiotis, Anna; Griffin, Brian; Stavros, A Thomas; Margolis, Jay

    2018-01-01

    Little data exist on real-world patterns and associated costs of downstream breast diagnostic procedures following an abnormal screening mammography or clinical exam. To analyze the utilization patterns in real-world clinical settings for breast imaging and diagnostic procedures, including the frequency and volume of patients and procedures, procedure sequencing, and associated health care expenditures. Using medical claims from 2011 to 2015 MarketScan Commercial and Medicare Databases, adult females with breast imaging/diagnostic procedures (diagnostic mammography, ultrasound, molecular breast imaging, tomosynthesis, magnetic resonance imaging, or biopsy) other than screening mammography were selected. Continuous health plan coverage without breast diagnostic procedures was required for ≥13 months before the first found breast diagnostic procedure (index event), with a 13-month post-index follow-up period. Key outcomes included diagnostic procedure volumes, sequences, and payments. Results reported descriptively were projected to provide US national patient and procedure volumes. The final sample of 875,526 patients was nationally projected to 12,394,432 patients annually receiving 8,732,909 diagnostic mammograms (53.3% of patients), 6,987,399 breast ultrasounds (42.4% of patients), and 1,585,856 biopsies (10.3% of patients). Following initial diagnostic procedures, 49.4% had second procedures, 20.1% followed with third procedures, and 10.0% had a fourth procedure. Mean (SD) costs for diagnostic mammograms of US$349 ($493), ultrasounds US$132 ($134), and biopsies US$1,938 ($2,343) contributed US$3.05 billion, US$0.92 billion, and US$3.07 billion, respectively, to annual diagnostic breast expenditures estimated at US$7.91 billion. The volume and expense of additional breast diagnostic testing, estimated at US$7.91 billion annually, underscores the need for technological improvements in the breast diagnostic landscape.

  7. Abnormal Uterine Bleeding FAQ

    MedlinePlus

    ... Abnormal Uterine Bleeding • What is a normal menstrual cycle? • When is bleeding abnormal? • At what ages is ... abnormal bleeding? •Glossary What is a normal menstrual cycle? The normal length of the menstrual cycle is ...

  8. Abnormal Uterine Bleeding

    MedlinePlus

    ... abnormal uterine bleeding? Abnormal uterine bleeding is any heavy or unusual bleeding from the uterus (through your ... one symptom of abnormal uterine bleeding. Having extremely heavy bleeding during your period can also be considered ...

  9. Breast mass segmentation in mammograms combining fuzzy c-means and active contours

    NASA Astrophysics Data System (ADS)

    Hmida, Marwa; Hamrouni, Kamel; Solaiman, Basel; Boussetta, Sana

    2018-04-01

    Segmentation of breast masses in mammograms is a challenging issue due to the nature of mammography and the characteristics of masses. In fact, mammographic images are poor in contrast and breast masses have various shapes and densities with fuzzy and ill-defined borders. In this paper, we propose a method based on a modified Chan-Vese active contour model for mass segmentation in mammograms. We conduct the experiment on mass Regions of Interest (ROI) extracted from the MIAS database. The proposed method consists of mainly three stages: Firstly, the ROI is preprocessed to enhance the contrast. Next, two fuzzy membership maps are generated from the preprocessed ROI based on fuzzy C-Means algorithm. These fuzzy membership maps are finally used to modify the energy of the Chan-Vese model and to perform the final segmentation. Experimental results indicate that the proposed method yields good mass segmentation results.

  10. Association between mammogram density and background parenchymal enhancement of breast MRI

    NASA Astrophysics Data System (ADS)

    Aghaei, Faranak; Danala, Gopichandh; Wang, Yunzhi; Zarafshani, Ali; Qian, Wei; Liu, Hong; Zheng, Bin

    2018-02-01

    Breast density has been widely considered as an important risk factor for breast cancer. The purpose of this study is to examine the association between mammogram density results and background parenchymal enhancement (BPE) of breast MRI. A dataset involving breast MR images was acquired from 65 high-risk women. Based on mammography density (BIRADS) results, the dataset was divided into two groups of low and high breast density cases. The Low-Density group has 15 cases with mammographic density (BIRADS 1 and 2), while the High-density group includes 50 cases, which were rated by radiologists as mammographic density BIRADS 3 and 4. A computer-aided detection (CAD) scheme was applied to segment and register breast regions depicted on sequential images of breast MRI scans. CAD scheme computed 20 global BPE features from the entire two breast regions, separately from the left and right breast region, as well as from the bilateral difference between left and right breast regions. An image feature selection method namely, CFS method, was applied to remove the most redundant features and select optimal features from the initial feature pool. Then, a logistic regression classifier was built using the optimal features to predict the mammogram density from the BPE features. Using a leave-one-case-out validation method, the classifier yields the accuracy of 82% and area under ROC curve, AUC=0.81+/-0.09. Also, the box-plot based analysis shows a negative association between mammogram density results and BPE features in the MRI images. This study demonstrated a negative association between mammogram density and BPE of breast MRI images.

  11. Accurate 3D Modeling of Breast Deformation for Temporal Mammogram Registration

    DTIC Science & Technology

    2009-09-01

    U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION...MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland...Towards Registration of Temporal Mammograms by Finite Element Simulation of MR Breast Volumes”, Proceedings of SPIE Medical Imaging 2008 2. Qiu Y

  12. Mammogram image quality as a potential contributor to disparities in breast cancer stage at diagnosis: an observational study

    PubMed Central

    2013-01-01

    Background In an ongoing study of racial/ethnic disparities in breast cancer stage at diagnosis, we consented patients to allow us to review their mammogram images, in order to examine the potential role of mammogram image quality on this disparity. Methods In a population-based study of urban breast cancer patients, a single breast imaging specialist (EC) performed a blinded review of the index mammogram that prompted diagnostic follow-up, as well as recent prior mammograms performed approximately one or two years prior to the index mammogram. Seven indicators of image quality were assessed on a five-point Likert scale, where 4 and 5 represented good and excellent quality. These included 3 technologist-associated image quality (TAIQ) indicators (positioning, compression, sharpness), and 4 machine associated image quality (MAIQ) indicators (contrast, exposure, noise and artifacts). Results are based on 494 images examined for 268 patients, including 225 prior images. Results Whereas MAIQ was generally high, TAIQ was more variable. In multivariable models of sociodemographic predictors of TAIQ, less income was associated with lower TAIQ (p < 0.05). Among prior mammograms, lower TAIQ was subsequently associated with later stage at diagnosis, even after adjusting for multiple patient and practice factors (OR = 0.80, 95% CI: 0.65, 0.99). Conclusions Considerable gains could be made in terms of increasing image quality through better positioning, compression and sharpness, gains that could impact subsequent stage at diagnosis. PMID:23621946

  13. Automatic localization of the nipple in mammograms using Gabor filters and the Radon transform

    NASA Astrophysics Data System (ADS)

    Chakraborty, Jayasree; Mukhopadhyay, Sudipta; Rangayyan, Rangaraj M.; Sadhu, Anup; Azevedo-Marques, P. M.

    2013-02-01

    The nipple is an important landmark in mammograms. Detection of the nipple is useful for alignment and registration of mammograms in computer-aided diagnosis of breast cancer. In this paper, a novel approach is proposed for automatic detection of the nipple based on the oriented patterns of the breast tissues present in mammograms. The Radon transform is applied to the oriented patterns obtained by a bank of Gabor filters to detect the linear structures related to the tissue patterns. The detected linear structures are then used to locate the nipple position using the characteristics of convergence of the tissue patterns towards the nipple. The performance of the method was evaluated with 200 scanned-film images from the mini-MIAS database and 150 digital radiography (DR) images from a local database. Average errors of 5:84 mm and 6:36 mm were obtained with respect to the reference nipple location marked by a radiologist for the mini-MIAS and the DR images, respectively.

  14. Using x-ray mammograms to assist in microwave breast image interpretation.

    PubMed

    Curtis, Charlotte; Frayne, Richard; Fear, Elise

    2012-01-01

    Current clinical breast imaging modalities include ultrasound, magnetic resonance (MR) imaging, and the ubiquitous X-ray mammography. Microwave imaging, which takes advantage of differing electromagnetic properties to obtain image contrast, shows potential as a complementary imaging technique. As an emerging modality, interpretation of 3D microwave images poses a significant challenge. MR images are often used to assist in this task, and X-ray mammograms are readily available. However, X-ray mammograms provide 2D images of a breast under compression, resulting in significant geometric distortion. This paper presents a method to estimate the 3D shape of the breast and locations of regions of interest from standard clinical mammograms. The technique was developed using MR images as the reference 3D shape with the future intention of using microwave images. Twelve breast shapes were estimated and compared to ground truth MR images, resulting in a skin surface estimation accurate to within an average Euclidean distance of 10 mm. The 3D locations of regions of interest were estimated to be within the same clinical area of the breast as corresponding regions seen on MR imaging. These results encourage investigation into the use of mammography as a source of information to assist with microwave image interpretation as well as validation of microwave imaging techniques.

  15. Engaging Patients in Decisions About Cancer Screening: Exploring the Decision Journey Through the Use of a Patient Portal.

    PubMed

    Woolf, Steven H; Krist, Alex H; Lafata, Jennifer Elston; Jones, Resa M; Lehman, Rebecca R; Hochheimer, Camille J; Sabo, Roy T; Frosch, Dominick L; Zikmund-Fisher, Brian J; Longo, Daniel R

    2018-02-01

    Engaging patients to make informed choices is paramount but difficult in busy practices. This study sought to engage patients outside the clinical setting to better understand how they approach cancer screening decisions, including their primary concerns and their preferences for finalizing their decision. Twelve primary care practices offering patients an online personal health record invited eligible patients to complete a 17-item online interactive module. Among 11,458 registered users, invitations to complete the module were sent to adults aged 50-74 years who were overdue for colorectal cancer screening and to women aged 40-49 years and men aged 55-69 who had not undergone a recent mammogram or prostate-specific antigen test, respectively. The module was started by 2,355 patients and completed by 903 patients. Most respondents (76.8%) knew they were eligible for screening. Preferred next steps were talking to the clinician (76.6%), reading/research (28.6%), and consulting trusted friends/family (16.4%). Priority topics included how much screening improves life expectancy, comparative test performance, and the prevalence/health risks of the cancer. Leading fears were getting cancer/delayed detection (79.2%), abnormal results (40.5%), and testing complications (39.1%), the last referring to false test results, medical complications, or unnecessary treatments. Men eligible for prostate-specific antigen screening were more likely than women eligible for mammography to express concerns about testing complications and to prioritize weighing pros and cons over gut feelings (p<0.05). Although this sample was predisposed to screening, most patients wanted help in finalizing their decision. Many wanted to weigh the pros and cons and expressed fears of potential harms from screening. Understanding how patients approach decisions may help design more effective engagement strategies. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All

  16. Mammographic screening practices among Chinese-Australian women.

    PubMed

    Kwok, Cannas; Fethney, Judith; White, Kate

    2012-03-01

    To report mammographic screening practice among Chinese-Australian women, and to examine the relationship between demographic characteristics, acculturation factors (English proficiency and length of stay in Australia), cultural beliefs, and having a mammogram as recommended. Cross-sectional and descriptive. The study was conducted in 2009 in Sydney, Australia. Of 988 Chinese-Australian women over 18 years of age invited to participate in the study, 785 (79%) completed and returned the questionnaire. Of these women, 320 (40.8%) were in the target age range of 50 to 69 years. The Chinese Breast Cancer Screening Beliefs Questionnaire (CBCSB) was used as a data collection instrument. Analysis included descriptive statistics, bivariate analysis using chi-square and t tests, and logistic regression. Of the 320 women in the targeted age range of 50 to 69 years, 238 (74.4%) had a mammogram as recommended biannually. Being married-de facto, in the 60 to 69 age group, and speaking Cantonese at home were positively associated with women's mammographic screening practice. However, no statistically significant differences in acculturation factors and having a mammogram as recommended were found. In terms of CBCSB score, women who had mammograms as recommended had more positive attitudes toward health checkups and perceived fewer barriers to mammographic screening. Effort should be focused on specific subgroups of Chinese-Australian women in order to fully understand the barriers involved in participating in mammographic screening. Nurses can use the findings from the present study to design culturally sensitive breast cancer screening programs to encourage women's participation in mammography. © 2011 Sigma Theta Tau International.

  17. Comparative Multifractal Analysis of Dynamic Infrared Thermograms and X-Ray Mammograms Enlightens Changes in the Environment of Malignant Tumors.

    PubMed

    Gerasimova-Chechkina, Evgeniya; Toner, Brian; Marin, Zach; Audit, Benjamin; Roux, Stephane G; Argoul, Francoise; Khalil, Andre; Gileva, Olga; Naimark, Oleg; Arneodo, Alain

    2016-01-01

    There is growing evidence that the microenvironment surrounding a tumor plays a special role in cancer development and cancer therapeutic resistance. Tumors arise from the dysregulation and alteration of both the malignant cells and their environment. By providing tumor-repressing signals, the microenvironment can impose and sustain normal tissue architecture. Once tissue homeostasis is lost, the altered microenvironment can create a niche favoring the tumorigenic transformation process. A major challenge in early breast cancer diagnosis is thus to show that these physiological and architectural alterations can be detected with currently used screening techniques. In a recent study, we used a 1D wavelet-based multi-scale method to analyze breast skin temperature temporal fluctuations collected with an IR thermography camera in patients with breast cancer. This study reveals that the multifractal complexity of temperature fluctuations superimposed on cardiogenic and vasomotor perfusion oscillations observed in healthy breasts is lost in malignant tumor foci in cancerous breasts. Here we use a 2D wavelet-based multifractal method to analyze the spatial fluctuations of breast density in the X-ray mammograms of the same panel of patients. As compared to the long-range correlations and anti-correlations in roughness fluctuations, respectively observed in dense and fatty breast areas, some significant change in the nature of breast density fluctuations with some clear loss of correlations is detected in the neighborhood of malignant tumors. This attests to some architectural disorganization that may deeply affect heat transfer and related thermomechanics in breast tissues, corroborating the change to homogeneous monofractal temperature fluctuations recorded in cancerous breasts with the IR camera. These results open new perspectives in computer-aided methods to assist in early breast cancer diagnosis.

  18. Comparative Multifractal Analysis of Dynamic Infrared Thermograms and X-Ray Mammograms Enlightens Changes in the Environment of Malignant Tumors

    PubMed Central

    Gerasimova-Chechkina, Evgeniya; Toner, Brian; Marin, Zach; Audit, Benjamin; Roux, Stephane G.; Argoul, Francoise; Khalil, Andre; Gileva, Olga; Naimark, Oleg; Arneodo, Alain

    2016-01-01

    There is growing evidence that the microenvironment surrounding a tumor plays a special role in cancer development and cancer therapeutic resistance. Tumors arise from the dysregulation and alteration of both the malignant cells and their environment. By providing tumor-repressing signals, the microenvironment can impose and sustain normal tissue architecture. Once tissue homeostasis is lost, the altered microenvironment can create a niche favoring the tumorigenic transformation process. A major challenge in early breast cancer diagnosis is thus to show that these physiological and architectural alterations can be detected with currently used screening techniques. In a recent study, we used a 1D wavelet-based multi-scale method to analyze breast skin temperature temporal fluctuations collected with an IR thermography camera in patients with breast cancer. This study reveals that the multifractal complexity of temperature fluctuations superimposed on cardiogenic and vasomotor perfusion oscillations observed in healthy breasts is lost in malignant tumor foci in cancerous breasts. Here we use a 2D wavelet-based multifractal method to analyze the spatial fluctuations of breast density in the X-ray mammograms of the same panel of patients. As compared to the long-range correlations and anti-correlations in roughness fluctuations, respectively observed in dense and fatty breast areas, some significant change in the nature of breast density fluctuations with some clear loss of correlations is detected in the neighborhood of malignant tumors. This attests to some architectural disorganization that may deeply affect heat transfer and related thermomechanics in breast tissues, corroborating the change to homogeneous monofractal temperature fluctuations recorded in cancerous breasts with the IR camera. These results open new perspectives in computer-aided methods to assist in early breast cancer diagnosis. PMID:27555823

  19. Women's views on reminder letters for screening mammography: Mixed methods study of women from 23 family health networks.

    PubMed

    Kaczorowski, Janusz; Karwalajtys, Tina; Lohfeld, Lynne; Laryea, Stephanie; Anderson, Kelly; Roder, Stefanie; Sebaldt, Rolf J

    2009-06-01

    To explore women's perspectives on the acceptability and content of reminder letters for screening mammography from their family physicians, as well as such letters' effect on screening intentions. Cross-sectional mailed survey followed by focus groups with a subgroup of respondents. Ontario. One family physician was randomly selected from each of 23 family health networks and primary care networks participating in a demonstration project to increase the delivery of preventive services. From the practice roster of each physician, up to 35 randomly selected women aged 50 to 69 years who were due or overdue for screening mammograms and who had received reminder letters from their family physicians within the past 6 months were surveyed. Recall of having received reminder letters and of their content, influence of the letters on decisions to have mammograms, and interest in receiving future reminder letters. Focus group interviews with survey respondents explored the survey findings in greater depth using a standardized interview guide. The response rate to the survey was 55.7% (384 of 689), and 45.1% (173 of 384) of responding women reported having mammograms in the past 6 months. Among women who recalled receiving letters and either making appointments for or having mammograms, 74.8% (122 of 163) indicated that the letters substantially influenced their decisions. Most respondents (77.1% [296 of 384]) indicated that they would like to continue to receive reminders, and 28.9% (111 of 384) indicated that they would like to receive additional information about mammograms. Participants in 2 focus groups (n = 3 and n = 5) indicated that they thought letters reflected a positive attitude of physicians toward mammography screening. They also commented that newly eligible women had different information needs than women who had had mammograms done in the past. Reminder letters were considered by participants to be useful and appeared to influence women's decisions to

  20. Urine - abnormal color

    MedlinePlus

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  1. Expert identification of visual primitives used by CNNs during mammogram classification

    NASA Astrophysics Data System (ADS)

    Wu, Jimmy; Peck, Diondra; Hsieh, Scott; Dialani, Vandana; Lehman, Constance D.; Zhou, Bolei; Syrgkanis, Vasilis; Mackey, Lester; Patterson, Genevieve

    2018-02-01

    This work interprets the internal representations of deep neural networks trained for classification of diseased tissue in 2D mammograms. We propose an expert-in-the-loop inter- pretation method to label the behavior of internal units in convolutional neural networks (CNNs). Expert radiologists identify that the visual patterns detected by the units are correlated with meaningful medical phenomena such as mass tissue and calcificated vessels. We demonstrate that several trained CNN models are able to produce explanatory descriptions to support the final classification decisions. We view this as an important first step toward interpreting the internal representations of medical classification CNNs and explaining their predictions.

  2. B-Spline Filtering for Automatic Detection of Calcification Lesions in Mammograms

    NASA Astrophysics Data System (ADS)

    Bueno, G.; Sánchez, S.; Ruiz, M.

    2006-10-01

    Breast cancer continues to be an important health problem between women population. Early detection is the only way to improve breast cancer prognosis and significantly reduce women mortality. It is by using CAD systems that radiologist can improve their ability to detect, and classify lesions in mammograms. In this study the usefulness of using B-spline based on a gradient scheme and compared to wavelet and adaptative filtering has been investigated for calcification lesion detection and as part of CAD systems. The technique has been applied to different density tissues. A qualitative validation shows the success of the method.

  3. Coverage and Preventive Screening

    PubMed Central

    Meeker, Daniella; Joyce, Geoffrey F; Malkin, Jesse; Teutsch, Steven M; Haddix, Anne C; Goldman, Dana P

    2011-01-01

    Context Preventive care has been shown as a high-value health care service. Many employers now offer expanded coverage of preventive care to encourage utilization. Objective To determine whether expanding coverage is an effective means to encourage utilization. Design Comparison of screening rates before and after introduction of deductible-free coverage. Setting People insured through large corporations between 2002 and 2006. Patients or Other Participants Preferred Provider Organization (PPO) enrollees from an employer introducing deductible-free coverage, and a control group enrolled in a PPO from a second employer with no policy change. Main Outcome Measures Adjusted probability of endoscopy, fecal occult blood test (FOBT), lipid screens, mammography, and Papanicolaou (pap) smears. Intervention Introduction of first-dollar coverage (FDC) of preventive services in 2003. Results After adjusting for demographics and secular trends, there were between 23 and 78 additional uses per 1,000 eligible patients of covered preventive screens (lipid screens, pap smears, mammograms, and FOBT), with no significant changes in the control group or in a service without FDC (endoscopy). Conclusions FDC improves utilization modestly among healthy individuals, particularly those in lower deductible plans. Compliance with guidelines can be encouraged by lowering out-of-pocket costs, but patients' predisposing characteristics merit attention. PMID:21029084

  4. American Indian Women and Screening Mammography: Findings from a Qualitative Study in Oklahoma

    ERIC Educational Resources Information Center

    Tolma, Eleni; Batterton, Chasity; Hamm, Robert M.; Thompson, David; Engelman, Kimberly K.

    2012-01-01

    Background: Breast cancer is an important public health issue within the American Indian (AI) community in Oklahoma; however, there is limited information to explain the low screening mammography rates among AI women. Purpose: To identify the motivational factors affecting an AI woman's decision to obtain a mammogram. Methods: Through the use of…

  5. Mammographic screening for breast cancer in a resource-restricted environment.

    PubMed

    Apffelstaedt, S P; Dalmayer, L; Baatjes, K

    2014-04-01

    Mammographic screening is carried out at public sector hospitals as part of clinical practice. We report the experience of such screening at Tygerberg Academic Hospital (TBAH), a tertiary referral hospital in the Western Cape Province, South Africa. All mammograms performed between 2003 and 2012 at TBAH were analysed regarding patient demographics, clinical data, indication and outcome according to the American College of Radiology Breast Imaging Reporting and Data System (BIRADS). Screening mammography was offered to patients > 40 years of age and mammograms were read by experienced breast surgeons. Patients with BIRADS 3 and 4 lesions were recalled for short-term follow-up, further imaging or tissue acquisition. Patients with BIRADS 5 lesions were recalled for tissue acquisition. Further imaging, method of tissue acquisition, histology results and use of neo-adjuvant therapy were also recorded. Of 16 105 mammograms, 3 774 (23.4%) were carried out for screening purposes. The median age of patients undergoing screening was 54 years. Of 407 women with mammograms that were reported as BIRADS 3 - 5 (10.8% of screening mammograms), 187 (46% of recalled women) went on to have further imaging only. Tissue was acquired in 175 patients (43% of recalled women), comprising a biopsy rate of 4.6% of the total series. The malignancy rate in cases in which tissue acquisition was done was 25%. Forty-three breast cancers were diagnosed (11.4/1 000 examinations). Of the cancers, nine (31%) were ductal carcinomas in situ. Of 20 invasive cancers, nine (45%) were < 10 mm in size. Of the invasive cancers, 40% were node-positive. The cancer diagnosis rate indicates a high breast cancer load in an urbanised population.

  6. The association of social support and education with breast and cervical cancer screening.

    PubMed

    Documet, Patricia; Bear, Todd M; Flatt, Jason D; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M

    2015-02-01

    Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. This study examines the association between social support and compliance with mammogram and Pap test screening guidelines, and whether social support provides added value for women of low education. Data were from a countywide 2009-2010 population-based survey, which included records of 2,588 women 40 years and older (mammogram) and 2,123 women 21 to 65 years old (Pap test). Compliance was determined using the guidelines in effect at the time of data collection. Social support was significantly related to mammogram (adjusted odds ratio = 1.43; 95% confidence interval [1.16, 1.77]) and Pap test (adjusted odds ratio = 1.71; 95% confidence interval [1.27, 2.29]) compliance after controlling for age, race, having a regular health care provider, and insurance status. The interaction between social support and education had a significant effect on Pap test compliance only among women younger than 40; the effect was not significant for mammogram compliance. Social support is associated with breast and cervical cancer screening compliance. The association between education and cancer screening behavior may be moderated by social support; however, results hold only for Pap tests among younger women. Practitioners and researchers should focus on interventions that activate social support networks as they may help increase both breast and cervical cancer screening compliance among women with low educational attainment. © 2014 Society for Public Health Education.

  7. Maintaining quality in the UK breast screening program

    NASA Astrophysics Data System (ADS)

    Gale, Alastair

    2010-02-01

    Breast screening in the UK has been implemented for over 20 years and annually nearly two million women are now screened with an estimated 1,400 lives saved. Nationally, some 700 individuals interpret screening mammograms in almost 110 screening centres. Currently, women aged 50 to 70 are invited for screening every three years and by 2012 this age range will increase to 47 - 73 years. There is a rapid ongoing transition from using film mammograms to full field digital mammography such that in 2010 every screening centre will be partly digital. An early, and long running, concern has been how to ensure the highest quality of imaging interpretation across the UK, an issue enhanced by the use of a three year screening interval. To partly address this question a self assessment scheme was developed in 1988 and subsequently implemented nationally in the UK as a virtually mandatory activity. The scheme is detailed from its beginnings, through its various developments to current incarnation and future plans. This encompasses both radiological (single view screening, two view screening, mammographic film and full field digital mammography) as well as design changes (cases reported by means of: form filling; PDA; tablet PC; iPhone, and the internet). The scheme provides a rich data source which is regularly studied to examine different aspects of radiological performance. Overall it aids screening radiologists by giving them regular access to a range of difficult exemplar cases together with feedback on their performance as compared to their peers.

  8. Promoting Breast Cancer Screening through Storytelling by Chamorro Cancer Survivors

    PubMed Central

    Manglona, Rosa Duenas; Robert, Suzanne; Isaacson, Lucy San Nicolas; Garrido, Marie; Henrich, Faye Babauta; Santos, Lola Sablan; Le, Daisy; Peters, Ruth

    2017-01-01

    The largest Chamorro population outside of Guam and the Mariana Islands reside in California. Cancer health disparities disproportionally affect Pacific Islander communities, including the Chamorro, and breast cancer is the most common cancer affecting women. To address health concerns such as cancer, Pacific Islander women frequently utilize storytelling to initiate conversations about health and to address sensitive topics such as breast health and cancer. One form of storytelling used in San Diego is a play that conveys the message of breast cancer screening to the community in a culturally and linguistically appropriate way. This play, Nan Nena’s Mammogram, tells the story of an older woman in the community who learns about breast cancer screening from her young niece. The story builds upon the underpinnings of Chamorro culture - family, community, support, and humor - to portray discussing breast health, getting support for breast screening, and visiting the doctor. The story of Nan Nena’s Mammogram reflects the willingness of a few pioneering Chamorro women to use their personal experiences of cancer survivorship to promote screening for others. Through the support of a Chamorro community-based organization, these Chamorro breast cancer survivors have used the success of Nan Nena’s Mammogram to expand their education activities and to form a new cancer survivor organization for Chamorro women in San Diego. PMID:29805328

  9. Mammography screening credit card and compliance.

    PubMed

    Schapira, D V; Kumar, N B; Clark, R A; Yag, C

    1992-07-15

    Screening for breast cancer using mammography has been shown to be effective in reducing mortality from breast cancer. The authors attempted to determine if use of a wallet-size plastic screening "credit" card would increase participants' compliance for subsequent mammograms when compared with traditional methods of increasing compliance. Two hundred and twenty consecutive women, ages 40-70 years, undergoing their first screening mammography were recruited and assigned randomly to four groups receiving (1) a reminder plastic credit card (2) reminder credit card with written reminder; (3) appointment card; and (4) verbal recommendation. Return rates of the four groups were determined after 15 months. The return rate for subsequent mammograms was significantly higher for participants (72.4%) using the credit card than for participants (39.8%) exposed to traditional encouragement/reminders (P less than 0.0001). The credit card was designed to show the participant's screening anniversary, and the durability of the card may have been a factor in increasing the return rate. The use of reminder credit cards may increase compliance for periodic screening examinations for other cancers and other chronic diseases.

  10. Mammography screening services: market segments and messages.

    PubMed

    Scammon, D L; Smith, J A; Beard, T

    1991-01-01

    Mammography has become a vital tool for the early detection of breast cancer. Although many organizations and health care facilities are working to educate and motivate women to take advantage of the life saving opportunity that is offered through screening mammography, only twenty percent of women who should be screened actually have the procedure performed. In order to reach women who have not been screened, it is important to learn which factors most strongly motivate those women who do choose to have a mammogram. Depth interviews with 18 women attending a mobile mammography unit were conducted to explore the decision making process of women obtaining mammography screening services and to develop a profile of prevalent emotions, attitudes, and feelings associated with receiving breast cancer screening services. Analysis of the interview transcripts revealed several important themes to which health care professionals can direct marketing and health promotion strategies.

  11. [Granulomatous lobular mastitis: a benign abnormality that mimics malignancy].

    PubMed

    Vingerhoedt, N M; Janssen, S; Mravunac, M; Wauters, C A P; Strobbe, L J A

    2008-05-03

    A palpable abnormality of the breast was found in three women, one aged 57 and two aged 41. The first two patients predominantly showed the characteristics of a purulent inflammation, and on mammogram the third patient appeared to have mastitis carcinomatosa. Histopathological investigation revealed a lobular, non-caseating granulomatous inflammation. They were treated with prednisone and the first and third patients also received azathioprine. After some time, the condition recurred in the contralateral breast in the second and third patients. Once again, medicinal treatment was given. When a palpable tumour of the breast is found the primary goal is to exclude malignancy. Granulomatous lobular mastitis is a rare and benign tumour of the breast that clinically mimics carcinoma. Often, conventional imaging does not lead to the diagnosis. A histological needle biopsy is the best way to reach a diagnosis. Immunosuppressive therapy is effective and is preferred over surgery.

  12. Detection of masses in mammogram images using CNN, geostatistic functions and SVM.

    PubMed

    Sampaio, Wener Borges; Diniz, Edgar Moraes; Silva, Aristófanes Corrêa; de Paiva, Anselmo Cardoso; Gattass, Marcelo

    2011-08-01

    Breast cancer occurs with high frequency among the world's population and its effects impact the patients' perception of their own sexuality and their very personal image. This work presents a computational methodology that helps specialists detect breast masses in mammogram images. The first stage of the methodology aims to improve the mammogram image. This stage consists in removing objects outside the breast, reducing noise and highlighting the internal structures of the breast. Next, cellular neural networks are used to segment the regions that might contain masses. These regions have their shapes analyzed through shape descriptors (eccentricity, circularity, density, circular disproportion and circular density) and their textures analyzed through geostatistic functions (Ripley's K function and Moran's and Geary's indexes). Support vector machines are used to classify the candidate regions as masses or non-masses, with sensitivity of 80%, rates of 0.84 false positives per image and 0.2 false negatives per image, and an area under the ROC curve of 0.87. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Modeling of digital mammograms using bicubic spline functions and additive noise

    NASA Astrophysics Data System (ADS)

    Graffigne, Christine; Maintournam, Aboubakar; Strauss, Anne

    1998-09-01

    The purpose of our work is the microcalcifications detection on digital mammograms. In order to do so, we model the grey levels of digital mammograms by the sum of a surface trend (bicubic spline function) and an additive noise or texture. We also introduce a robust estimation method in order to overcome the bias introduced by the microcalcifications. After the estimation we consider the subtraction image values as noise. If the noise is not correlated, we adjust its distribution probability by the Pearson's system of densities. It allows us to threshold accurately the images of subtraction and therefore to detect the microcalcifications. If the noise is correlated, a unilateral autoregressive process is used and its coefficients are again estimated by the least squares method. We then consider non overlapping windows on the residues image. In each window the texture residue is computed and compared with an a priori threshold. This provides correct localization of the microcalcifications clusters. However this technique is definitely more time consuming that then automatic threshold assuming uncorrelated noise and does not lead to significantly better results. As a conclusion, even if the assumption of uncorrelated noise is not correct, the automatic thresholding based on the Pearson's system performs quite well on most of our images.

  14. Computer-aided detection and diagnosis of masses and clustered microcalcifications from digital mammograms

    NASA Astrophysics Data System (ADS)

    Nishikawa, Robert M.; Giger, Maryellen L.; Doi, Kunio; Vyborny, Carl J.; Schmidt, Robert A.; Metz, Charles E.; Wu, Chris Y.; Yin, Fang-Fang; Jiang, Yulei; Huo, Zhimin; Lu, Ping; Zhang, Wei; Ema, Takahiro; Bick, Ulrich; Papaioannou, John; Nagel, Rufus H.

    1993-07-01

    We are developing an 'intelligent' workstation to assist radiologists in diagnosing breast cancer from mammograms. The hardware for the workstation will consist of a film digitizer, a high speed computer, a large volume storage device, a film printer, and 4 high resolution CRT monitors. The software for the workstation is a comprehensive package of automated detection and classification schemes. Two rule-based detection schemes have been developed, one for breast masses and the other for clustered microcalcifications. The sensitivity of both schemes is 85% with a false-positive rate of approximately 3.0 and 1.5 false detections per image, for the mass and cluster detection schemes, respectively. Computerized classification is performed by an artificial neural network (ANN). The ANN has a sensitivity of 100% with a specificity of 60%. Currently, the ANN, which is a three-layer, feed-forward network, requires as input ratings of 14 different radiographic features of the mammogram that were determined subjectively by a radiologist. We are in the process of developing automated techniques to objectively determine these 14 features. The workstation will be placed in the clinical reading area of the radiology department in the near future, where controlled clinical tests will be performed to measure its efficacy.

  15. Acceleration of Image Segmentation Algorithm for (Breast) Mammogram Images Using High-Performance Reconfigurable Dataflow Computers

    PubMed Central

    Filipovic, Nenad D.

    2017-01-01

    Image segmentation is one of the most common procedures in medical imaging applications. It is also a very important task in breast cancer detection. Breast cancer detection procedure based on mammography can be divided into several stages. The first stage is the extraction of the region of interest from a breast image, followed by the identification of suspicious mass regions, their classification, and comparison with the existing image database. It is often the case that already existing image databases have large sets of data whose processing requires a lot of time, and thus the acceleration of each of the processing stages in breast cancer detection is a very important issue. In this paper, the implementation of the already existing algorithm for region-of-interest based image segmentation for mammogram images on High-Performance Reconfigurable Dataflow Computers (HPRDCs) is proposed. As a dataflow engine (DFE) of such HPRDC, Maxeler's acceleration card is used. The experiments for examining the acceleration of that algorithm on the Reconfigurable Dataflow Computers (RDCs) are performed with two types of mammogram images with different resolutions. There were, also, several DFE configurations and each of them gave a different acceleration value of algorithm execution. Those acceleration values are presented and experimental results showed good acceleration. PMID:28611851

  16. Multiplexed wavelet transform technique for detection of microcalcification in digitized mammograms.

    PubMed

    Mini, M G; Devassia, V P; Thomas, Tessamma

    2004-12-01

    Wavelet transform (WT) is a potential tool for the detection of microcalcifications, an early sign of breast cancer. This article describes the implementation and evaluates the performance of two novel WT-based schemes for the automatic detection of clustered microcalcifications in digitized mammograms. Employing a one-dimensional WT technique that utilizes the pseudo-periodicity property of image sequences, the proposed algorithms achieve high detection efficiency and low processing memory requirements. The detection is achieved from the parent-child relationship between the zero-crossings [Marr-Hildreth (M-H) detector] /local extrema (Canny detector) of the WT coefficients at different levels of decomposition. The detected pixels are weighted before the inverse transform is computed, and they are segmented by simple global gray level thresholding. Both detectors produce 95% detection sensitivity, even though there are more false positives for the M-H detector. The M-H detector preserves the shape information and provides better detection sensitivity for mammograms containing widely distributed calcifications.

  17. Acceleration of Image Segmentation Algorithm for (Breast) Mammogram Images Using High-Performance Reconfigurable Dataflow Computers.

    PubMed

    Milankovic, Ivan L; Mijailovic, Nikola V; Filipovic, Nenad D; Peulic, Aleksandar S

    2017-01-01

    Image segmentation is one of the most common procedures in medical imaging applications. It is also a very important task in breast cancer detection. Breast cancer detection procedure based on mammography can be divided into several stages. The first stage is the extraction of the region of interest from a breast image, followed by the identification of suspicious mass regions, their classification, and comparison with the existing image database. It is often the case that already existing image databases have large sets of data whose processing requires a lot of time, and thus the acceleration of each of the processing stages in breast cancer detection is a very important issue. In this paper, the implementation of the already existing algorithm for region-of-interest based image segmentation for mammogram images on High-Performance Reconfigurable Dataflow Computers (HPRDCs) is proposed. As a dataflow engine (DFE) of such HPRDC, Maxeler's acceleration card is used. The experiments for examining the acceleration of that algorithm on the Reconfigurable Dataflow Computers (RDCs) are performed with two types of mammogram images with different resolutions. There were, also, several DFE configurations and each of them gave a different acceleration value of algorithm execution. Those acceleration values are presented and experimental results showed good acceleration.

  18. Urban women's preferences for learning of their mammogram result: a qualitative study.

    PubMed

    Marcus, Erin N; Drummond, Darlene; Dietz, Noella

    2012-03-01

    Research suggests that communication of mammogram results is flawed for many low-income ethnic minority women. This study conducted four focus groups with low-income inner-city minority women (n = 34). The goals of our project were: (1) to elucidate women's experiences learning of their result; (2) to elicit their preferences as to how this communication could be improved; and (3) to gather information to help inform the development of a new tool for communicating mammogram results. Salient themes included dissatisfaction with result communication; difficulty elucidating the meaning of a typical results notification letter; a preference for direct verbal communication of results and for print materials that included pictures, testimonials, and an action plan including a hotline to call with questions; and a strong interest in advance education about the likelihood of having to return for additional follow up. Video and other programs to inform patients before the test about what happens after may improve patient satisfaction and enhance women's understanding of their personal result and follow up plan.

  19. Effectiveness of breast cancer screening policies in countries with medium-low incidence rates.

    PubMed

    Kong, Qingxia; Mondschein, Susana; Pereira, Ana

    2018-02-05

    Chile has lower breast cancer incidence rates compared to those in developed countries. Our public health system aims to perform 10 biennial screening mammograms in the age group of 50 to 69 years by 2020. Using a dynamic programming model, we have found the optimal ages to perform 10 screening mammograms that lead to the lowest lifetime death rate and we have evaluated a set of fixed inter-screening interval policies. The optimal ages for the 10 mammograms are 43, 47, 51, 54, 57, 61, 65, 68, 72, and 76 years, and the most effective fixed inter-screening is every four years after the 40 years. Both policies respectively reduce lifetime death rate in 6.4% and 5.7% and the cost of saving one life in 17% and 9.3% compared to the 2020 Chilean policy. Our findings show that two-year inter-screening interval policies are less effective in countries with lower breast cancer incidence; thus we recommend screening policies with a wider age range and larger inter-screening intervals for Chile.

  20. Effectiveness of breast cancer screening policies in countries with medium-low incidence rates

    PubMed Central

    Kong, Qingxia; Mondschein, Susana; Pereira, Ana

    2018-01-01

    ABSTRACT Chile has lower breast cancer incidence rates compared to those in developed countries. Our public health system aims to perform 10 biennial screening mammograms in the age group of 50 to 69 years by 2020. Using a dynamic programming model, we have found the optimal ages to perform 10 screening mammograms that lead to the lowest lifetime death rate and we have evaluated a set of fixed inter-screening interval policies. The optimal ages for the 10 mammograms are 43, 47, 51, 54, 57, 61, 65, 68, 72, and 76 years, and the most effective fixed inter-screening is every four years after the 40 years. Both policies respectively reduce lifetime death rate in 6.4% and 5.7% and the cost of saving one life in 17% and 9.3% compared to the 2020 Chilean policy. Our findings show that two-year inter-screening interval policies are less effective in countries with lower breast cancer incidence; thus we recommend screening policies with a wider age range and larger inter-screening intervals for Chile. PMID:29412375

  1. Fixed-facility workplace screening mammography.

    PubMed

    Reynolds, H E; Larkin, G N; Jackson, V P; Hawes, D R

    1997-02-01

    Potential barriers to compliance with screening mammography guidelines include the cost and inconvenience involved with undergoing the procedure. Workplace screening with mobile mammography is one possible approach to the convenience barrier. However, fixed-facility workplace screening is a viable alternative for any company with a large workforce in one location. This paper describes our initial experience with one such fixed facility. The facility was a cooperative venture by a large pharmaceutical company and an academic radiology department to provide convenient, no-cost (to the patient) screening mammography to employees, dependents, and retirees more than 40 years old. The pharmaceutical company built the facility within its corporate headquarters and the academic radiology department provided the equipment and personnel. The company was billed a fixed cost per examination. In the first 22 months of operation, 4210 (of 4559 scheduled) screening mammograms were obtained. The mean age of the population was 53 years old. Ninety percent of the screening mammograms were interpreted as negative or benign; 10% required additional workup. Of the screened population, 62 biopsies were recommended and 60 were performed. Of these, 42 were benign and 18 malignant. The cancer detection rate was 4.3 per 1000 (0.43%). At the time of diagnosis, six patients were stage 0, 10 patients were stage I, one patient was stage II, and one patient was stage III. Eleven of the 18 patients had minimal cancers. Of the patients who completed a satisfaction survey, 97% percent expressed a high degree of satisfaction with the screening process and stated they would use the facility in the future. A fixed facility for workplace screening mammography is a viable way to provide nearly barrier-free access to high-quality mammography. Patient acceptance is high.

  2. Tooth - abnormal shape

    MedlinePlus

    Hutchinson incisors; Abnormal tooth shape; Peg teeth; Mulberry teeth; Conical teeth ... The appearance of normal teeth varies, especially the molars. ... conditions. Specific diseases can affect tooth shape, tooth ...

  3. Computer aided detection of clusters of microcalcifications on full field digital mammograms

    SciTech Connect

    Ge Jun; Sahiner, Berkman; Hadjiiski, Lubomir M.

    2006-08-15

    We are developing a computer-aided detection (CAD) system to identify microcalcification clusters (MCCs) automatically on full field digital mammograms (FFDMs). The CAD system includes six stages: preprocessing; image enhancement; segmentation of microcalcification candidates; false positive (FP) reduction for individual microcalcifications; regional clustering; and FP reduction for clustered microcalcifications. At the stage of FP reduction for individual microcalcifications, a truncated sum-of-squares error function was used to improve the efficiency and robustness of the training of an artificial neural network in our CAD system for FFDMs. At the stage of FP reduction for clustered microcalcifications, morphological features and features derived from themore » artificial neural network outputs were extracted from each cluster. Stepwise linear discriminant analysis (LDA) was used to select the features. An LDA classifier was then used to differentiate clustered microcalcifications from FPs. A data set of 96 cases with 192 images was collected at the University of Michigan. This data set contained 96 MCCs, of which 28 clusters were proven by biopsy to be malignant and 68 were proven to be benign. The data set was separated into two independent data sets for training and testing of the CAD system in a cross-validation scheme. When one data set was used to train and validate the convolution neural network (CNN) in our CAD system, the other data set was used to evaluate the detection performance. With the use of a truncated error metric, the training of CNN could be accelerated and the classification performance was improved. The CNN in combination with an LDA classifier could substantially reduce FPs with a small tradeoff in sensitivity. By using the free-response receiver operating characteristic methodology, it was found that our CAD system can achieve a cluster-based sensitivity of 70, 80, and 90 % at 0.21, 0.61, and 1.49 FPs/image, respectively. For case

  4. Impact of Immediate Interpretation of Screening Tomosynthesis Mammography on Performance Metrics.

    PubMed

    Winkler, Nicole S; Freer, Phoebe; Anzai, Yoshimi; Hu, Nan; Stein, Matthew

    2018-05-07

    This study aimed to compare performance metrics for immediate and delayed batch interpretation of screening tomosynthesis mammograms. This HIPAA compliant study was approved by institutional review board with a waiver of consent. A retrospective analysis of screening performance metrics for tomosynthesis mammograms interpreted in 2015 when mammograms were read immediately was compared to historical controls from 2013 to 2014 when mammograms were batch interpreted after the patient had departed. A total of 5518 screening tomosynthesis mammograms (n = 1212 for batch interpretation and n = 4306 for immediate interpretation) were evaluated. The larger sample size for the latter group reflects a group practice shift to performing tomosynthesis for the majority of patients. Age, breast density, comparison examinations, and high-risk status were compared. An asymptotic proportion test and multivariable analysis were used to compare performance metrics. There was no statistically significant difference in recall or cancer detection rates for the batch interpretation group compared to immediate interpretation group with respective recall rate of 6.5% vs 5.3% = +1.2% (95% confidence interval -0.3 to 2.7%; P = .101) and cancer detection rate of 6.6 vs 7.2 per thousand = -0.6 (95% confidence interval -5.9 to 4.6; P = .825). There was no statistically significant difference in positive predictive values (PPVs) including PPV1 (screening recall), PPV2 (biopsy recommendation), or PPV 3 (biopsy performed) with batch interpretation (10.1%, 42.1%, and 40.0%, respectively) and immediate interpretation (13.6%, 39.2%, and 39.7%, respectively). After adjusting for age, breast density, high-risk status, and comparison mammogram, there was no difference in the odds of being recalled or cancer detection between the two groups. There is no statistically significant difference in interpretation performance metrics for screening tomosynthesis mammograms interpreted

  5. The impact of breast cancer knowledge and attitudes on screening and early detection among an immigrant Iranian population in southern California

    PubMed Central

    Kobeissi, Loulou; Samari, Goleen; Telesca, Donatello; Esfandiari, Mahtash; Galal, Osman

    2014-01-01

    Background Few studies explore factors influencing breast cancer screening and early detection behaviors among immigrant Iranian women residing in the United States. Methods Using a cross-sectional survey, a convenience sample of 319 Iranian-American women was selected to explore the impact of breast cancer knowledge and attitude on screening. A self-administered questionnaire assessed: breast cancer screening knowledge, attitude, and mammography use (ever, previous year and future intention). Results 79 % of the women in the study reported ever-receiving at least one mammogram and 74 % received a mammogram in the past year. Personal attitude had an independent significant effect on: mammography use in the last year, ever use of mammography and future intention to screen. Knowledge and morality-induced attitude influenced screening behavior but not significantly. Conclusion Interventions targeting breast cancer screening among immigrant Iranian women in the US should focus on enhancing personal attitudes in order to influence actual screening behavior. PMID:24096382

  6. Toxicology screen

    MedlinePlus

    ... Analgesics - screen; Antidepressants - screen; Narcotics - screen; Phenothiazines - screen; Drug abuse screen; Blood alcohol test ... poisoning) Complicated alcohol abstinence (delirium tremens) Delirium ... Fetal alcohol syndrome Intentional overdose Seizures Stroke ...

  7. Mammographic enhancement with combining local statistical measures and sliding band filter for improved mass segmentation in mammograms

    NASA Astrophysics Data System (ADS)

    Kim, Dae Hoe; Choi, Jae Young; Choi, Seon Hyeong; Ro, Yong Man

    2012-03-01

    In this study, a novel mammogram enhancement solution is proposed, aiming to improve the quality of subsequent mass segmentation in mammograms. It has been widely accepted that characteristics of masses are usually hyper-dense or uniform density with respect to its background. Also, their core parts are likely to have high-intensity values while the values of intensity tend to be decreased as the distance to core parts increases. Based on the aforementioned observations, we develop a new and effective mammogram enhancement method by combining local statistical measurements and Sliding Band Filtering (SBF). By effectively combining local statistical measurements and SBF, we are able to improve the contrast of the bright and smooth regions (which represent potential mass regions), as well as, at the same time, the regions where their surrounding gradients are converging to the centers of regions of interest. In this study, 89 mammograms were collected from the public MAIS database (DB) to demonstrate the effectiveness of the proposed enhancement solution in terms of improving mass segmentation. As for a segmentation method, widely used contour-based segmentation approach was employed. The contour-based method in conjunction with the proposed enhancement solution achieved overall detection accuracy of 92.4% with a total of 85 correct cases. On the other hand, without using our enhancement solution, overall detection accuracy of the contour-based method was only 78.3%. In addition, experimental results demonstrated the feasibility of our enhancement solution for the purpose of improving detection accuracy on mammograms containing dense parenchymal patterns.

  8. A controlled phantom study of a noise equalization algorithm for detecting microcalcifications in digital mammograms.

    PubMed

    Gürün, O O; Fatouros, P P; Kuhn, G M; de Paredes, E S

    2001-04-01

    We report on some extensions and further developments of a well-known microcalcification detection algorithm based on adaptive noise equalization. Tissue equivalent phantom images with and without labeled microcalcifications were subjected to this algorithm, and analyses of results revealed some shortcomings in the approach. Particularly, it was observed that the method of estimating the width of distributions in the feature space was based on assumptions which resulted in the loss of similarity preservation characteristics. A modification involving a change of estimator statistic was made, and the modified approach was tested on the same phantom images. Other modifications for improving detectability such as downsampling and use of alternate local contrast filters were also tested. The results indicate that these modifications yield improvements in detectability, while extending the generality of the approach. Extensions to real mammograms and further directions of research are discussed.

  9. Case base classification on digital mammograms: improving the performance of case base classifier

    NASA Astrophysics Data System (ADS)

    Raman, Valliappan; Then, H. H.; Sumari, Putra; Venkatesa Mohan, N.

    2011-10-01

    Breast cancer continues to be a significant public health problem in the world. Early detection is the key for improving breast cancer prognosis. The aim of the research presented here is in twofold. First stage of research involves machine learning techniques, which segments and extracts features from the mass of digital mammograms. Second level is on problem solving approach which includes classification of mass by performance based case base classifier. In this paper we build a case-based Classifier in order to diagnose mammographic images. We explain different methods and behaviors that have been added to the classifier to improve the performance of the classifier. Currently the initial Performance base Classifier with Bagging is proposed in the paper and it's been implemented and it shows an improvement in specificity and sensitivity.

  10. Automated selection of BI-RADS lesion descriptors for reporting calcifications in mammograms

    NASA Astrophysics Data System (ADS)

    Paquerault, Sophie; Jiang, Yulei; Nishikawa, Robert M.; Schmidt, Robert A.; D'Orsi, Carl J.; Vyborny, Carl J.; Newstead, Gillian M.

    2003-05-01

    We are developing an automated computer technique to describe calcifications in mammograms according to the BI-RADS lexicon. We evaluated this technique by its agreement with radiologists' description of the same lesions. Three expert mammographers reviewed our database of 90 cases of digitized mammograms containing clustered microcalcifications and described the calcifications according to BI-RADS. In our study, the radiologists used only 4 of the 5 calcification distribution descriptors and 5 of the 14 calcification morphology descriptors contained in BI-RADS. Our computer technique was therefore designed specifically for these 4 calcification distribution descriptors and 5 calcification morphology descriptors. For calcification distribution, 4 linear discriminant analysis (LDA) classifiers were developed using 5 computer-extracted features to produce scores of how well each descriptor describes a cluster. Similarly, for calcification morphology, 5 LDAs were designed using 10 computer-extracted features. We trained the LDAs using only the BI-RADS data reported by the first radiologist and compared the computer output to the descriptor data reported by all 3 radiologists (for the first radiologist, the leave-one-out method was used). The computer output consisted of the best calcification distribution descriptor and the best 2 calcification morphology descriptors. The results of the comparison with the data from each radiologist, respectively, were: for calcification distribution, percent agreement, 74%, 66%, and 73%, kappa value, 0.44, 0.36, and 0.46; for calcification morphology, percent agreement, 83%, 77%, and 57%, kappa value, 0.78, 0.70, and 0.44. These results indicate that the proposed computer technique can select BI-RADS descriptors in good agreement with radiologists.

  11. Utility of adaptive control processing for the interpretation of digital mammograms.

    PubMed

    Jinnouchi, Mikako; Yabuuchi, Hidetake; Kubo, Makoto; Tokunaga, Eriko; Yamamoto, Hidetaka; Honda, Hiroshi

    2016-11-01

    Background Adaptive control processing for mammography (ACM) is a novel program that automatically sets up appropriate image-processing parameters for individual mammograms (MMGs) by analyzing the focal and whole breast histogram. Purpose To investigate whether ACM improves the image contrast of digital MMGs and whether it improves radiologists' diagnostic performance in reading of MMGs. Material and Methods One hundred normal cases for image quality assessment and another 100 cases (50 normal and 50 cancers) for observer performance assessment were enrolled. All mammograms were examined with and without ACM. Five radiologists assessed the intra- and extra-mammary contrast of 100 normal MMGs, and the mean scores of the intra- and extra-mammary contrast were compared between MMGs with and without ACM in both the dense and non-dense group. They classified 100 MMGs into BI-RADS categories 1-5, and were asked to rate the images on a scale of 0 to 100 for the likelihood of the presence of category 3-5 lesions in each breast. Detectability of breast cancer, reading time, and frequency of window adjustment were compared between MMGs with and without ACM. Results ACM improved the intra-mammary contrast in both the dense and non-dense group but degraded extra-mammary contrast in the dense group. There was no significant difference in detectability of breast cancer between MMGs with and without ACM. Frequency of window adjustment without ACM was significantly higher than that with ACM. Reading time without ACM was significantly longer than that with ACM. Conclusion ACM improves the image contrast of MMGs and shortens reading time.

  12. [Organized breast cancer screening].

    PubMed

    Rouëssé, Jacques; Sancho-Garnier, Hélèn

    2014-02-01

    increase its efficiency, by targeting populations at a higher risk than the women currently included, and to reduce the number of mammograms done outside the program, as they are not subject to the same quality controls. Risks could be reduced by increasing the sensitivity of mammography and the specificity of the readings. Moreover, it is mandatory to inform women of both the benefits and risks of screening, in compliance with the principle of enabling patients to make a free and informed choice.

  13. Breast cancer screening in older women.

    PubMed

    Caplan, L S; Haynes, S G

    1996-01-01

    There is currently an epidemic of breast cancer in women 65 years of age and older. The purposes of this paper are to explore the breast cancer screening behaviors of older women and to identify some of the determinants of screening in these women. Data were analyzed from the 1987 National Health Interview Survey, a continuous nationwide household interview survey of the U.S. civilian, noninstitutionalized population. As in other studies, the utilization of breast cancer screening by older women was less in older women than in younger women. This was true for both mammography and clinical breast examination. A number of determinants of screening in older women were identified here. Women with a usual source of care and/or no activity limitation, as well as high school graduates, were the ones most likely to have received a screening mammogram and/or a screening clinical breast exam during the past year. The failure of older women to receive adequate breast cancer screening is an important concern which should be reevaluated, given the breast cancer epidemic in this population. This study identified a number of determinants of breast cancer screening in older women. For the most part, these determinants point to the primary care physician as the key to breast cancer screening in these women. Therefore, the primary care physician must be informed of, and encouraged to follow, the recommendations for periodic breast cancer screening in older women.

  14. A novel image toggle tool for comparison of serial mammograms: automatic density normalization and alignment-development of the tool and initial experience.

    PubMed

    Honda, Satoshi; Tsunoda, Hiroko; Fukuda, Wataru; Saida, Yukihisa

    2014-12-01

    The purpose is to develop a new image toggle tool with automatic density normalization (ADN) and automatic alignment (AA) for comparing serial digital mammograms (DMGs). We developed an ADN and AA process to compare the images of serial DMGs. In image density normalization, a linear interpolation was applied by taking two points of high- and low-brightness areas. The alignment was calculated by determining the point of the greatest correlation while shifting the alignment between the current and prior images. These processes were performed on a PC with a 3.20-GHz Xeon processor and 8 GB of main memory. We selected 12 suspected breast cancer patients who had undergone screening DMGs in the past. Automatic processing was retrospectively performed on these images. Two radiologists subjectively evaluated them. The process of the developed algorithm took approximately 1 s per image. In our preliminary experience, two images could not be aligned approximately. When they were aligned, image toggling allowed detection of differences between examinations easily. We developed a new tool to facilitate comparative reading of DMGs on a mammography viewing system. Using this tool for toggling comparisons might improve the interpretation efficiency of serial DMGs.

  15. "Jeopardy" in Abnormal Psychology.

    ERIC Educational Resources Information Center

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  16. Shapelet analysis of pupil dilation for modeling visuo-cognitive behavior in screening mammography

    NASA Astrophysics Data System (ADS)

    Alamudun, Folami; Yoon, Hong-Jun; Hammond, Tracy; Hudson, Kathy; Morin-Ducote, Garnetta; Tourassi, Georgia

    2016-03-01

    Our objective is to improve understanding of visuo-cognitive behavior in screening mammography under clinically equivalent experimental conditions. To this end, we examined pupillometric data, acquired using a head-mounted eye-tracking device, from 10 image readers (three breast-imaging radiologists and seven Radiology residents), and their corresponding diagnostic decisions for 100 screening mammograms. The corpus of mammograms comprised cases of varied pathology and breast parenchymal density. We investigated the relationship between pupillometric fluctuations, experienced by an image reader during mammographic screening, indicative of changes in mental workload, the pathological characteristics of a mammographic case, and the image readers' diagnostic decision and overall task performance. To answer these questions, we extract features from pupillometric data, and additionally applied time series shapelet analysis to extract discriminative patterns in changes in pupil dilation. Our results show that pupillometric measures are adequate predictors of mammographic case pathology, and image readers' diagnostic decision and performance with an average accuracy of 80%.

  17. Cancer screening among Vietnamese in Hawaii.

    PubMed

    Nguyen, Ly T; Withy, Kelley; Nguyen, Michelle M; Yamada, Seiji

    2003-07-01

    To determine the extent of utilization of cancer screening services by Vietnamese in Hawaii, who had sought medical care from 1996 through 2000. A chart review of 952 adult Vietnamese patients was performed. Of all eligible women, 52% and 26% had Papanicolaou test and mammogram, respectively. Among men age 45 and over, 8.4% had prostate-specific antigen test and 3.4% had digital rectal exam. Flexible sigmoidoscopy and colonoscopy were not utilized by patients. This is the first study to examine the use of cancer screening tests by Vietnamese immigrants in Hawaii. Our findings of lower utilization rates in cancer screening by both male and female strongly support efforts to educate and promote preventive health for this population.

  18. Benefits of the quality assured double and arbitration reading of mammograms in the early diagnosis of breast cancer in symptomatic women.

    PubMed

    Waldmann, Annika; Kapsimalakou, Smaragda; Katalinic, Alexander; Grande-Nagel, Isabell; Stoeckelhuber, Beate M; Fischer, Dorothea; Barkhausen, Joerg; Vogt, Florian M

    2012-05-01

    To address the benefits of double and arbitration reading regarding tumour detection rates, percentage of in situ tumours, and number (of patients) needed to send for expert reading (number needed to treat; NNT) for one additional tumour finding. QuaMaDi is a quality assured breast cancer diagnosis programme; with two-view mammography (craniocaudal, mediolateral oblique) and, in case of breast density ACR 3 or 4, routine ultrasound imaging; and with independent double reading of all images. A consecutive sample of symptomatic women, i.e. women at risk for breast cancer, women aged 70 and above, and/or women with preceding BI-RADS III findings, was analysed. 28,558 mammograms were performed (mean age of women: 57.3 [standard deviation: 12.3] years). Discordant findings were present in 3,837 double readings and were sent for arbitration reading. After histopathological assessment, 52 carcinomas were found (thereof 32% in situ). These carcinomas accounted for 1.8 tumours per 1,000 examinations in the total cohort and increased the tumour detection rate up to 16.4/1,000. The NNT in discordant cases was 74. Double and arbitration reading appears to be a useful tool to ensure the quality of early detection of breast lesions in symptomatic women during indication-based, standardised mammography. • Quality assured breast cancer diagnosis is feasible outside organised screening structures. • Double and arbitration reading is beneficial for populations ineligible for screening. • Double and arbitration reading increases the tumour detection rate. • Double and arbitration reading increases the percentage of in situ cancers.

  19. Development of a Computer-aided Diagnosis System for Early Detection of Masses Using Retrospectively Detected Cancers on Prior Mammograms

    DTIC Science & Technology

    2009-06-01

    131 cases with 131 biopsy proven masses, of which 27 were malignant and 104 benign. The true locations of the masses were identified by an experi- enced ...two acquisitions would cause differ- ences in the subtlety of the masses on the FFDMs and SFMs. However, assuming that the differences are ran- dom... Lado , M. Souto, and J. J. Vidal, “Computer-aided diagnosis: Automatic detection of malignant masses in digitized mammograms,” Med. Phys. 25, 957–964

  20. Two-view information fusion for improvement of computer-aided detection (CAD) of breast masses on mammograms

    NASA Astrophysics Data System (ADS)

    Wei, Jun; Sahiner, Berkman; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Helvie, Mark A.; Roubidoux, Marilyn A.; Zhou, Chuan; Ge, Jun; Zhang, Yiheng

    2006-03-01

    We are developing a two-view information fusion method to improve the performance of our CAD system for mass detection. Mass candidates on each mammogram were first detected with our single-view CAD system. Potential object pairs on the two-view mammograms were then identified by using the distance between the object and the nipple. Morphological features, Hessian feature, correlation coefficients between the two paired objects and texture features were used as input to train a similarity classifier that estimated a similarity scores for each pair. Finally, a linear discriminant analysis (LDA) classifier was used to fuse the score from the single-view CAD system and the similarity score. A data set of 475 patients containing 972 mammograms with 475 biopsy-proven masses was used to train and test the CAD system. All cases contained the CC view and the MLO or LM view. We randomly divided the data set into two independent sets of 243 cases and 232 cases. The training and testing were performed using the 2-fold cross validation method. The detection performance of the CAD system was assessed by free response receiver operating characteristic (FROC) analysis. The average test FROC curve was obtained from averaging the FP rates at the same sensitivity along the two corresponding test FROC curves from the 2-fold cross validation. At the case-based sensitivities of 90%, 85% and 80% on the test set, the single-view CAD system achieved an FP rate of 2.0, 1.5, and 1.2 FPs/image, respectively. With the two-view fusion system, the FP rates were reduced to 1.7, 1.3, and 1.0 FPs/image, respectively, at the corresponding sensitivities. The improvement was found to be statistically significant (p<0.05) by the AFROC method. Our results indicate that the two-view fusion scheme can improve the performance of mass detection on mammograms.

  1. Development of a Computer-Aided Diagnosis System for Early Detection of Masses Using Retrospectively Detected Cancers on Prior Mammograms

    DTIC Science & Technology

    2006-06-01

    Hadjiiski, and N. Petrick, "Computerized nipple identification for multiple image analysis in computer-aided diagnosis," Medical Physics 31, 2871...candidates, 3 identification of suspicious objects, 4 feature extraction and analysis, and 5 FP reduc- tion by classification of normal tissue...detection of microcalcifi- cations on digitized mammograms.41 An illustration of a La- placian decomposition tree is shown on the left-hand side of Fig. 4

  2. Comparative visualization of digital mammograms on clinical 2K monitor workstations and hardcopy: a contrast detail analysis

    NASA Astrophysics Data System (ADS)

    Torbica, Pavle; Buchberger, Wolfgang; Bernathova, M.; Mallouhi, Ammar; Peer, Siegfried; Bosmans, Hilde; Faulkner, Keith

    2003-05-01

    The purpose of this study was to compare the radiologist`s performance in detecting small low-contrast objects with hardcopy and softcopy reading of digital mammograms. 12 images of a contrast-detail (CD) phantom without and with 25.4 mm, 50.8 mm, and 76.2 mm additional polymethylmetacrylate (PMMA) attenuation were acquired with a caesium iodid/amorphous silicon flat panel detector under standard exposure conditions. The phantom images were read by three independent observers, by conducting a four-alternative forced-choice experiment. Reading of the hardcopy was done on a mammography viewbox under standardized reading conditions. For soft copy reading, a dedicated workstation with two 2K monitors was used. CD-curves and image quality figure (IQF) values were calculated from the correct detection rates of randomly located gold disks in the phantom. The figures were compared for both reading conditions and for different PMMA layers. For all types of exposures, soft copy reading resulted in significantly better contrast-detail characteristics and IQF values, as compared to hard copy reading of laser printouts. (p< 0.01). The authors conclude that the threshold contrast characteristics of digital mammograms displayed on high-resolution monitors are sufficient to make soft copy reading of digital mammograms feasible.

  3. Contrast limited adaptive histogram equalization image processing to improve the detection of simulated spiculations in dense mammograms.

    PubMed

    Pisano, E D; Zong, S; Hemminger, B M; DeLuca, M; Johnston, R E; Muller, K; Braeuning, M P; Pizer, S M

    1998-11-01

    The purpose of this project was to determine whether Contrast Limited Adaptive Histogram Equalization (CLAHE) improves detection of simulated spiculations in dense mammograms. Lines simulating the appearance of spiculations, a common marker of malignancy when visualized with masses, were embedded in dense mammograms digitized at 50 micron pixels, 12 bits deep. Film images with no CLAHE applied were compared to film images with nine different combinations of clip levels and region sizes applied. A simulated spiculation was embedded in a background of dense breast tissue, with the orientation of the spiculation varied. The key variables involved in each trial included the orientation of the spiculation, contrast level of the spiculation and the CLAHE settings applied to the image. Combining the 10 CLAHE conditions, 4 contrast levels and 4 orientations gave 160 combinations. The trials were constructed by pairing 160 combinations of key variables with 40 backgrounds. Twenty student observers were asked to detect the orientation of the spiculation in the image. There was a statistically significant improvement in detection performance for spiculations with CLAHE over unenhanced images when the region size was set at 32 with a clip level of 2, and when the region size was set at 32 with a clip level of 4. The selected CLAHE settings should be tested in the clinic with digital mammograms to determine whether detection of spiculations associated with masses detected at mammography can be improved.

  4. Cervical and Breast Cancer Screening Among Mexican Migrant Women, 2013

    PubMed Central

    Guerrero, Natalie; Zhang, Xiao; Rangel, Gudelia; Gonzalez-Fagoaga, J. Eduardo

    2016-01-01

    Introduction Information on cervical and breast cancer screening among Latinas in the United States is limited. Even less information is available on screening practices of migrant women who engage in circular migration. We examined rates of cervical and breast cancer screening and the extent to which sociodemographics and other characteristics explain screening practices of Mexican migrant women who return to Mexico from the United States. Methods We used data from a cross-sectional probability survey of Mexico-born migrant women who returned, through Tijuana, to Mexico from the United States in 2013. The sample consisted of women who returned involuntarily (via deportation) or voluntarily; 177 reported authorized documentation status, and 36 reported unauthorized documentation status in the previous 12 months. Descriptive statistics were calculated and logistic regressions were estimated. Results Of 36 undocumented migrant women, 8 (22.2%) had a Papanicolaou test and 11 (30.6%) had a mammogram in the previous year; of 177 documented migrants, 83 (46.9%) had a Papanicolaou test and 68 (38.4%) had a mammogram. Undocumented migrants were less likely than documented migrants to receive a Papanicolaou test (odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.12–0.67); the likelihood was similar after adjustment for sociodemographic, migration, and acculturation factors (adjusted OR = 0.33; 95% CI, 0.12–0.90). Having health insurance (adjusted OR = 4.17; 95% CI, 1.80–9.65) and a regular source of health care (adjusted OR = 2.83; 95% CI, 1.05–7.65) were significant predictors of receiving a mammogram but not a Papanicolaou test. Conclusion Public health programs are needed to improve access to cervical and breast cancer screenings for Latina migrant women in general and undocumented circular migrants in particular. PMID:27513995

  5. Cervical and Breast Cancer Screening Among Mexican Migrant Women, 2013.

    PubMed

    Guerrero, Natalie; Zhang, Xiao; Rangel, Gudelia; Gonzalez-Fagoaga, J Eduardo; Martinez-Donate, Ana

    2016-08-11

    Information on cervical and breast cancer screening among Latinas in the United States is limited. Even less information is available on screening practices of migrant women who engage in circular migration. We examined rates of cervical and breast cancer screening and the extent to which sociodemographics and other characteristics explain screening practices of Mexican migrant women who return to Mexico from the United States. We used data from a cross-sectional probability survey of Mexico-born migrant women who returned, through Tijuana, to Mexico from the United States in 2013. The sample consisted of women who returned involuntarily (via deportation) or voluntarily; 177 reported authorized documentation status, and 36 reported unauthorized documentation status in the previous 12 months. Descriptive statistics were calculated and logistic regressions were estimated. Of 36 undocumented migrant women, 8 (22.2%) had a Papanicolaou test and 11 (30.6%) had a mammogram in the previous year; of 177 documented migrants, 83 (46.9%) had a Papanicolaou test and 68 (38.4%) had a mammogram. Undocumented migrants were less likely than documented migrants to receive a Papanicolaou test (odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.12-0.67); the likelihood was similar after adjustment for sociodemographic, migration, and acculturation factors (adjusted OR = 0.33; 95% CI, 0.12-0.90). Having health insurance (adjusted OR = 4.17; 95% CI, 1.80-9.65) and a regular source of health care (adjusted OR = 2.83; 95% CI, 1.05-7.65) were significant predictors of receiving a mammogram but not a Papanicolaou test. Public health programs are needed to improve access to cervical and breast cancer screenings for Latina migrant women in general and undocumented circular migrants in particular.

  6. A deep learning approach for the analysis of masses in mammograms with minimal user intervention.

    PubMed

    Dhungel, Neeraj; Carneiro, Gustavo; Bradley, Andrew P

    2017-04-01

    We present an integrated methodology for detecting, segmenting and classifying breast masses from mammograms with minimal user intervention. This is a long standing problem due to low signal-to-noise ratio in the visualisation of breast masses, combined with their large variability in terms of shape, size, appearance and location. We break the problem down into three stages: mass detection, mass segmentation, and mass classification. For the detection, we propose a cascade of deep learning methods to select hypotheses that are refined based on Bayesian optimisation. For the segmentation, we propose the use of deep structured output learning that is subsequently refined by a level set method. Finally, for the classification, we propose the use of a deep learning classifier, which is pre-trained with a regression to hand-crafted feature values and fine-tuned based on the annotations of the breast mass classification dataset. We test our proposed system on the publicly available INbreast dataset and compare the results with the current state-of-the-art methodologies. This evaluation shows that our system detects 90% of masses at 1 false positive per image, has a segmentation accuracy of around 0.85 (Dice index) on the correctly detected masses, and overall classifies masses as malignant or benign with sensitivity (Se) of 0.98 and specificity (Sp) of 0.7. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Neural and Decision Theoretic Approaches for the Automated Segmentation of Radiodense Tissue in Digitized Mammograms

    NASA Astrophysics Data System (ADS)

    Eckert, R.; Neyhart, J. T.; Burd, L.; Polikar, R.; Mandayam, S. A.; Tseng, M.

    2003-03-01

    Mammography is the best method available as a non-invasive technique for the early detection of breast cancer. The radiographic appearance of the female breast consists of radiolucent (dark) regions due to fat and radiodense (light) regions due to connective and epithelial tissue. The amount of radiodense tissue can be used as a marker for predicting breast cancer risk. Previously, we have shown that the use of statistical models is a reliable technique for segmenting radiodense tissue. This paper presents improvements in the model that allow for further development of an automated system for segmentation of radiodense tissue. The segmentation algorithm employs a two-step process. In the first step, segmentation of tissue and non-tissue regions of a digitized X-ray mammogram image are identified using a radial basis function neural network. The second step uses a constrained Neyman-Pearson algorithm, developed especially for this research work, to determine the amount of radiodense tissue. Results obtained using the algorithm have been validated by comparing with estimates provided by a radiologist employing previously established methods.

  8. Three-dimensional reconstruction of clustered microcalcifications from two digitized mammograms

    NASA Astrophysics Data System (ADS)

    Stotzka, Rainer; Mueller, Tim O.; Epper, Wolfgang; Gemmeke, Hartmut

    1998-06-01

    X-ray mammography is one of the most significant diagnosis methods in early detection of breast cancer. Usually two X- ray images from different angles are taken from each mamma to make even overlapping structures visible. X-ray mammography has a very high spatial resolution and can show microcalcifications of 50 - 200 micron in size. Clusters of microcalcifications are one of the most important and often the only indicator for malignant tumors. These calcifications are in some cases extremely difficult to detect. Computer assisted diagnosis of digitized mammograms may improve detection and interpretation of microcalcifications and cause more reliable diagnostic findings. We build a low-cost mammography workstation to detect and classify clusters of microcalcifications and tissue densities automatically. New in this approach is the estimation of the 3D formation of segmented microcalcifications and its visualization which will put additional diagnostic information at the radiologists disposal. The real problem using only two or three projections for reconstruction is the big loss of volume information. Therefore the arrangement of a cluster is estimated using only the positions of segmented microcalcifications. The arrangement of microcalcifications is visualized to the physician by rotating.

  9. Lenticular abnormalities in children.

    PubMed

    Khokhar, Sudarshan; Agarwal, Tushar; Kumar, Gaurav; Kushmesh, Rakhi; Tejwani, Lalit Kumar

    2012-01-01

    To study the lenticular problems in children presenting at an apex institute. Retrospective analysis of records (< 14 years) of new lens clinic cases was done. Of 1,047 children, 687 were males. Mean age at presentation was 6.35 ± 4.13 years. Developmental cataract was seen in 45.6% and posttraumatic cataract in 29.7% of patients. Other abnormalities were cataract with retinal detachment, persistent hyperplastic primary vitreous, subluxated lens, micro/spherophakia, cataract secondary to uveitis, intraocular lens complications, cataract with choroidal coloboma, and visual axis opacification. Developmental and posttraumatic cataracts were the most common abnormalities. Delayed presentation is of concern. Copyright 2012, SLACK Incorporated.

  10. Screening for Lung Cancer

    PubMed Central

    Mazzone, Peter J.; Naidich, David P.; Bach, Peter B.

    2013-01-01

    Background: Lung cancer is by far the major cause of cancer deaths largely because in the majority of patients it is at an advanced stage at the time it is discovered, when curative treatment is no longer feasible. This article examines the data regarding the ability of screening to decrease the number of lung cancer deaths. Methods: A systematic review was conducted of controlled studies that address the effectiveness of methods of screening for lung cancer. Results: Several large randomized controlled trials (RCTs), including a recent one, have demonstrated that screening for lung cancer using a chest radiograph does not reduce the number of deaths from lung cancer. One large RCT involving low-dose CT (LDCT) screening demonstrated a significant reduction in lung cancer deaths, with few harms to individuals at elevated risk when done in the context of a structured program of selection, screening, evaluation, and management of the relatively high number of benign abnormalities. Whether other RCTs involving LDCT screening are consistent is unclear because data are limited or not yet mature. Conclusions: Screening is a complex interplay of selection (a population with sufficient risk and few serious comorbidities), the value of the screening test, the interval between screening tests, the availability of effective treatment, the risk of complications or harms as a result of screening, and the degree with which the screened individuals comply with screening and treatment recommendations. Screening with LDCT of appropriate individuals in the context of a structured process is associated with a significant reduction in the number of lung cancer deaths in the screened population. Given the complex interplay of factors inherent in screening, many questions remain on how to effectively implement screening on a broader scale. PMID:23649455

  11. Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study

    PubMed Central

    Kim, Theresa W; Alford, Daniel P; Cabral, Howard; Saitz, Richard; Samet, Jeffrey H

    2011-01-01

    Objective To compare cancer screening and flu vaccination among persons with and without unhealthy substance use. Design The authors analysed data from 4804 women eligible for mammograms, 4414 eligible for Papanicolou (Pap) smears, 7008 persons eligible for colorectal cancer (CRC) screening and 7017 persons eligible for flu vaccination. All patients were screened for unhealthy substance use. The main outcome was completion of cancer screening and flu vaccination. Results Among the 9995 patients eligible for one or more of the preventive services of interest, 10% screened positive for unhealthy substance use. Compared with women without unhealthy substance use, women with unhealthy substance use received mammograms less frequently (75.4% vs 83.8%; p<0.0001), but Pap smears no less frequently (77.9% vs 78.1%). Persons with unhealthy substance use received CRC screening no less frequently (61.7% vs 63.4%), yet received flu vaccination less frequently (44.7% vs 50.4%; p=0.01). In multivariable analyses, women with unhealthy substance use were less likely to receive mammograms (adjusted odds ratio 0.68; 95% CI 0.52 to 0.89), and persons with unhealthy substance use were less likely to receive flu vaccination (adjusted odds ratio 0.81; 95% CI 0.67 to 0.97). Conclusions Unhealthy substance use is a risk factor for not receiving all appropriate preventive health services. PMID:22021737

  12. Self-Report Versus Medical Record for Mammography Screening Among Minority Women.

    PubMed

    Nandy, Karabi; Menon, Usha; Szalacha, Laura A; Park, HanJong; Lee, Jongwon; Lee, Eunice E

    2016-12-01

    Self-report is the most common means of obtaining mammography screening data. The purpose of this study was to assess the accuracy of minority women's self-reported mammography by comparing their self-reported dates of mammograms with those in their medical records from a community-based randomized control trial. We found that out of 192 women, 116 signed the Health Information Portability and Accountability Act form and, among these, 97 had medical records that could be verified (97 / 116 = 83.6%). Ninety-two records matched where both sources confirmed a mammogram; 48 of 92 (52.2%) matched perfectly on self-reported date of mammogram. Complexities in the verification process warrant caution when verifying self-reported mammography screening in minority populations. In spite of some limitations, our findings support the usage of self-reported data on mammography as a validated tool for other researchers investigating mammography screening among minority women who continue to have low screening rates. © The Author(s) 2016.

  13. Mammography screening among Arab American women in metropolitan Detroit.

    PubMed

    Schwartz, Kendra; Fakhouri, Monty; Bartoces, Monina; Monsur, Joseph; Younis, Amani

    2008-12-01

    Mammography screening behavior has not been well studied among Middle Eastern immigrant women. We conducted a telephone survey of 365 Arab American women residing in metropolitan Detroit, home to one of the largest populations of Middle Eastern immigrants in the US, to determine prevalence of factors associated with mammography, and attitudes and beliefs regarding mammography screening. Of 365 participants, only five were born in the US. Mean age was 53.2 years (SD 10.8). Two hundred twelve (58.1%) reported having mammogram every 1-2 years; 70% ever had mammogram. Age 50-64 years, having health insurance, married status, being in the US over 10 years, and being Lebanese were associated with mammography every 1-2 years. After adjusting for demographic factors, perceived seriousness of disease, general health motivation, and having fewer barriers were associated with more frequent screening. Appropriate mammography screening is decreased in this group. Targeted outreach regarding screening is appropriate for this population; however, lack of insurance may prevent adequate follow-up.

  14. Depression Screening

    MedlinePlus

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  15. Neurologic abnormalities in murderers.

    PubMed

    Blake, P Y; Pincus, J H; Buckner, C

    1995-09-01

    Thirty-one individuals awaiting trial or sentencing for murder or undergoing an appeal process requested a neurologic examination through legal counsel. We attempted in each instance to obtain EEG, MRI or CT, and neuropsychological testing. Neurologic examination revealed evidence of "frontal" dysfunction in 20 (64.5%). There were symptoms or some other evidence of temporal lobe abnormality in nine (29%). We made a specific neurologic diagnosis in 20 individuals (64.5%), including borderline or full mental retardation (9) and cerebral palsy (2), among others. Neuropsychological testing revealed abnormalities in all subjects tested. There were EEG abnormalities in eight of the 20 subjects tested, consisting mainly of bilateral sharp waves with slowing. There were MRI or CT abnormalities in nine of the 19 subjects tested, consisting primarily of atrophy and white matter changes. Psychiatric diagnoses included paranoid schizophrenia (8), dissociative disorder (4), and depression (9). Virtually all subjects had paranoid ideas and misunderstood social situations. There was a documented history of profound, protracted physical abuse in 26 (83.8%) and of sexual abuse in 10 (32.3%). It is likely that prolonged, severe physical abuse, paranoia, and neurologic brain dysfunction interact to form the matrix of violent behavior.

  16. Mammography screening using independent double reading with consensus: is there a potential benefit for computer-aided detection?

    PubMed

    Skaane, Per; Kshirsagar, Ashwini; Hofvind, Solveig; Jahr, Gunnar; Castellino, Ronald A

    2012-04-01

    Double reading improves the cancer detection rate in mammography screening. Single reading with computer-aided detection (CAD) has been considered to be an alternative to double reading. Little is known about the potential benefit of CAD in breast cancer screening with double reading. To compare prospective independent double reading of screen-film (SFM) and full-field digital (FFDM) mammography in population-based screening with retrospective standalone CAD performance on the baseline mammograms of the screen-detected cancers and subsequent cancers diagnosed during the follow-up period. The study had ethics committee approval. A 5-point rating scale for probability of cancer was used for 23,923 (SFM = 16,983; FFDM = 6940) screening mammograms. Of 208 evaluable cancers, 104 were screen-detected and 104 were subsequent (44 interval and 60 next screening round) cancers. Baseline mammograms of subsequent cancers were retrospectively classified in consensus without information about cancer location, histology, or CAD prompting as normal, non-specific minimal signs, significant minimal signs, and false-negatives. The baseline mammograms of the screen-detected cancers and subsequent cancers were evaluated by CAD. Significant minimal signs and false-negatives were considered 'actionable' and potentially diagnosable if correctly prompted by CAD. CAD correctly marked 94% (98/104) of the baseline mammograms of the screen-detected cancers (SFM = 95% [61/64]; FFDM = 93% [37/40]), including 96% (23/24) of those with discordant interpretations. Considering only those baseline examinations of subsequent cancers prospectively interpreted as normal and retrospectively categorized as 'actionable', CAD input at baseline screening had the potential to increase the cancer detection rate from 0.43% to 0.51% (P = 0.13); and to increase cancer detection by 16% ([104 + 17]/104) and decrease interval cancers by 20% (from 44 to 35). CAD may have the potential to increase cancer detection by

  17. Potential impact of legislation mandating breast density notification: benefits, harms, and cost effectiveness of supplemental ultrasound screening

    PubMed Central

    Sprague, Brian L.; Stout, Natasha K.; Schechter, Clyde; van Ravesteyn, Nicolien T.; Cevik, Mucahit; Alagoz, Oguzhan; Lee, Christoph I.; van den Broek, Jeroen J.; Miglioretti, Diana L.; Mandelblatt, Jeanne S.; de Koning, Harry J.; Kerlikowske, Karla; Lehman, Constance D.; Tosteson, Anna N. A.

    2014-01-01

    Background At least nineteen states have laws that require telling women with dense breasts and a negative screening mammogram to consider supplemental screening. The most readily available supplemental screening modality is ultrasound, yet little is known about its effectiveness. Objective To evaluate the benefits, harms, and cost-effectiveness of supplemental ultrasound screening for women with dense breasts. Design Comparative modeling with 3 validated simulation models. Data Sources Surveillance, Epidemiology, and End Results Program; Breast Cancer Surveillance Consortium; the medical literature. Target Population A contemporary cohort of women eligible for routine screening. Time Horizon Lifetime. Perspective Payer. Interventions Supplemental ultrasound screening for women with dense breasts following a negative screening mammogram. Outcome Measures Breast cancer deaths averted, quality-adjusted life years (QALYs) gained, false positive ultrasound biopsy recommendations, costs, costs per QALY gained. Results of Base-Case Analysis Supplemental ultrasound screening after a negative mammogram for women aged 50–74 with heterogeneously or extremely dense breasts averted 0.36 additional breast cancer deaths (range across models: 0.14–0.75), gained 1.7 QALYs (0.9–4.7), and resulted in 354 false-positive ultrasound biopsy recommendations (345–421) per 1000 women with dense breasts compared with biennial screening by mammography alone. The cost-effectiveness ratio was $325,000 per QALY gained ($112,000-$766,000). Restricting supplemental ultrasound screening to women with extremely dense breasts cost $246,000 per QALY gained ($74,000-$535,000). Results of Sensitivity Analysis The conclusions were not sensitive to ultrasound performance characteristics, screening frequency, or starting age. Limitations Provider costs for coordinating supplemental ultrasound were not considered. Conclusions Supplemental ultrasound screening for women with dense breasts undergoing

  18. Breast Cancer Screening in Patients With Newly Diagnosed Lung and Colorectal Cancer: A Population-Based Study of Utilization

    PubMed Central

    Sadigh, Gelareh; Carlos, Ruth C.; Ward, Kevin C.; Switchenko, Jeffrey M.; Jiang, Renjian; Applegate, Kimberly E.; Duszak, Richard

    2017-01-01

    Purpose To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls. Methods Female fee-for-service Medicare beneficiaries who were ≥67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as the percentage of women with ≥1 screening mammogram during follow-up. Results Overall, 104,164 cases (48% colorectal, 52% lung; 30% advanced cancer) and 104,164 controls were included. Among women with lung or colorectal cancer, 22% underwent ≥1 screening mammogram versus 26% of controls (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.78–0.82). Stratified by cancer type, 28% of colorectal cancer cases versus 29% of controls (OR 0.98; 95% CI 0.95–1.01) and 17% of lung cancer cases versus 23% of controls (OR 0.63; 95% CI 0.60–0.65) received ≥1 mammogram. When stratified by stage, 8% with advanced cancer versus 18% of controls (OR 0.33; 95% CI 0.31–0.35) and 30% with early-stage cancer versus 30% of controls (OR 1; 95% CI 0.97–1.02) underwent ≥1 mammogram. Conclusion Screening mammography utilization rates are similar between Medicare beneficiaries with early-stage cancer versus controls. Although the majority of patients with advanced-stage cancer appropriately do not pursue screening mammography, a small number (8%) continue with screening. PMID:28325489

  19. Estimation of stress relaxation time for normal and abnormal breast phantoms using optical technique

    NASA Astrophysics Data System (ADS)

    Udayakumar, K.; Sujatha, N.

    2015-03-01

    Many of the early occurring micro-anomalies in breast may transform into a deadliest cancer tumor in future. Probability of curing early occurring abnormalities in breast is more if rightly identified. Even in mammogram, considered as a golden standard technique for breast imaging, it is hard to pick up early occurring changes in the breast tissue due to the difference in mechanical behavior of the normal and abnormal tissue when subjected to compression prior to x-ray or laser exposure. In this paper, an attempt has been made to estimate the stress relaxation time of normal and abnormal breast mimicking phantom using laser speckle image correlation. Phantoms mimicking normal breast is prepared and subjected to precise mechanical compression. The phantom is illuminated by a Helium Neon laser and by using a CCD camera, a sequence of strained phantom speckle images are captured and correlated by the image mean intensity value at specific time intervals. From the relation between mean intensity versus time, tissue stress relaxation time is quantified. Experiments were repeated for phantoms with increased stiffness mimicking abnormal tissue for similar ranges of applied loading. Results shows that phantom with more stiffness representing abnormal tissue shows uniform relaxation for varying load of the selected range, whereas phantom with less stiffness representing normal tissue shows irregular behavior for varying loadings in the given range.

  20. Electrocardiographic abnormalities in amateur male marathon runners.

    PubMed

    Kaleta, Anna M; Lewicka, Ewa; Dąbrowska-Kugacka, Alicja; Lewicka-Potocka, Zuzanna; Wabich, Elżbieta; Szerszyńska, Anna; Dyda, Julia; Sobolewski, Jakub; Koenner, Jakub; Raczak, Grzegorz

    2018-06-18

    Sports activity has become extremely popular among amateurs. Electrocardiography is a useful tool in screening for cardiac pathologies in athletes; however, there is little data on electrocardiographic abnormalities in the group of amateur athletes. The aim of this study was to analyze the abnormalities in resting and exercise electrocardiograms (ECGs) in a group of amateur athletes, and try to determine whether the criteria applied for the general population or for athletes' ECGs should be implemented in this group. In 40 amateur male marathon runners, 3 consecutive 12-lead ECGs were performed: 2-3 weeks before (stage 1), just after the run (stage 2) and 2-3 weeks after the marathon (stage 3). Resting (stage 1) and exercise (stage 2) ECGs were analyzed following the refined criteria for the assessment of athlete's ECG (changes classified as training-related, borderline or training-unrelated). In resting ECGs, at least 1 abnormality was found in 92.5% of the subjects and the most common was sinus bradycardia (62.5%). In post-exercise ECGs, at least 1 abnormality was present in 77.5% of the subjects and the most common was right atrium enlargement (RAE) (42.5%). Training-related ECG variants were more frequent at rest (82.5% vs 42.5%; p = 0.0008), while borderline variants - after the run (22.5% vs 57.5%; p = 0.0004). Training-unrelated abnormalities were found in 15% and 10% of the subjects, respectively (p-value - nonsignificant), and the most common was T-wave inversion. Even if the refined criteria rather than the criteria used for normal sedentary population were applied, the vast majority of amateur runners showed at least 1 abnormality in resting ECGs, which were mainly training-related variants. However, at rest, in 15% of the subjects, pathologic training-unrelated abnormalities were found. The most frequent post-exercise abnormality was right atrial enlargement. General electrocardiographic screening in amateur athletes should be taken into consideration.

  1. Mammography screening in six diverse communities in Chicago--a population study.

    PubMed

    Whitman, Steve; Shah, Ami M; Silva, Abigail; Ansell, David

    2007-01-01

    Despite the fact that recent studies suggest a narrowing in access to mammography, Black women are much more likely to die from breast cancer than White women. Data at the community level regarding mammography screening can help explain health disparities and inform plans for improved screening efforts. In 2002-2003, a comprehensive household health survey in English or Spanish was conducted in six community areas with 1700 households. The module on mammography was based on a state-based nationwide health survey and included questions on frequency of mammography, repeat screenings, and several demographic variables. The proportion of women >or=40 years (n=482) who received a mammogram in the past 2 years ranged from 74% to 90% across the six communities. The community with the highest screening proportion was predominantly Mexican and included recent immigrants. The screening proportion in the poorest community area, which was all Black, was 77%. Women with health insurance, higher income, and more education were more likely to receive a mammogram. Proportions for women >or=50 years (n=286) were slightly higher but similar. Repeat screening, which is recommended, occurred at lower levels. Access to and utilization of mammography have grown in recent years so that even these vulnerable communities had screening proportions at or even higher than the national average and the Healthy People Year 2010 objective. Nonetheless, repeat screening sequences were lower and may require attention if mammography screening efforts are to have a greater impact on female breast cancer mortality.

  2. Hemostatic Abnormalities in Multiple Myeloma Patients

    PubMed Central

    Gogia, Aarti; Sikka, Meera; Sharma, Satender; Rusia, Usha

    2018-01-01

    Background: Multiple myeloma (MM) is a neoplastic plasma cell disorder characterized by clonal proliferation of plasma cells in the bone marrow. Diverse hemostatic abnormalities have been reported in patients with myeloma which predispose to bleeding and also thrombosis. Methods: Complete blood count, biochemical parameters and parameters of hemostasis i.e. platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), factor VIII assay results, plasma fibrinogen, D-dimer and lupus anticoagulant, were assessed in 29 MM patients and 30 age matched controls. Results: The most frequent abnormal screening parameter was APTT. Of the six indicative of a bleeding tendency i.e. thrombocytopenia, prolonged PT, APTT, TT, reduced plasma fibrinogen and factor VIII, at least one was abnormal in 8 (27.6%) patients. Of the four prothrombotic markers, lupus anticoagulant, D-dimer, elevated factor VIII and plasma fibrinogen, one or more marker was present in 24 (82.7%). D-dimer was the most common prothrombotic marker, being elevated in 22 (75.9%) patients. One or more laboratory parameter of hemostasis was abnormal in all 29 (100%) patients. Though thrombotic complications are reported to be less frequent as compared to hemorrhagic manifestations, one or more marker of thrombosis was present in 24 (82.7%) patients. Conclusion: This study provided laboratory evidence of hemostatic dysfunction which may be associated with thrombotic or bleeding complications at diagnosis in all MM patients. Hence, screening for these abnormalities at the time of diagnosis should help improved prognosis in such cases. PMID:29373903

  3. A qualitative study on Singaporean women's views towards breast cancer screening and Single Nucleotide Polymorphisms (SNPs) gene testing to guide personalised screening strategies.

    PubMed

    Wong, Xin Yi; Chong, Kok Joon; van Til, Janine A; Wee, Hwee Lin

    2017-11-21

    Breast cancer is the top cancer by incidence and mortality in Singaporean women. Mammography is by far its best screening tool, but current recommended age and interval may not yield the most benefit. Recent studies have demonstrated the potential of single nucleotide polymorphisms (SNPs) to improve discriminatory accuracy of breast cancer risk assessment models. This study was conducted to understand Singaporean women's views towards breast cancer screening and SNPs gene testing to guide personalised screening strategies. Focus group discussions were conducted among English-speaking women (n = 27) between 40 to 65 years old, both current and lapsed mammogram users. Women were divided into four groups based on age and mammogram usage. Discussions about breast cancer and screening experience, as well as perception and attitude towards SNPs gene testing were conducted by an experienced moderator. Women were also asked for factors that will influence their uptake of the test. Transcripts were analysed using thematic analysis to captured similarities and differences in views expressed. Barriers to repeat mammogram attendance include laziness to make appointment and painful and uncomfortable screening process. However, the underlying reason may be low perceived susceptibility to breast cancer. Facilitators to repeat mammogram attendance include ease of making appointment and timely reminders. Women were generally receptive towards SNPs gene testing, but required information on accuracy, cost, invasiveness, and side effects before they decide whether to go for it. Other factors include waiting time for results and frequency interval. On average, women gave a rating of 7.5 (range 5 to 10) when asked how likely they will go for the test. Addressing concerns such as pain and discomfort during mammogram, providing timely reminders and debunking breast cancer myths can help to improve screening uptake. Women demonstrated a spectrum of responses towards a novel test like

  4. A hybrid deep learning approach to predict malignancy of breast lesions using mammograms

    NASA Astrophysics Data System (ADS)

    Wang, Yunzhi; Heidari, Morteza; Mirniaharikandehei, Seyedehnafiseh; Gong, Jing; Qian, Wei; Qiu, Yuchen; Zheng, Bin

    2018-03-01

    Applying deep learning technology to medical imaging informatics field has been recently attracting extensive research interest. However, the limited medical image dataset size often reduces performance and robustness of the deep learning based computer-aided detection and/or diagnosis (CAD) schemes. In attempt to address this technical challenge, this study aims to develop and evaluate a new hybrid deep learning based CAD approach to predict likelihood of a breast lesion detected on mammogram being malignant. In this approach, a deep Convolutional Neural Network (CNN) was firstly pre-trained using the ImageNet dataset and serve as a feature extractor. A pseudo-color Region of Interest (ROI) method was used to generate ROIs with RGB channels from the mammographic images as the input to the pre-trained deep network. The transferred CNN features from different layers of the CNN were then obtained and a linear support vector machine (SVM) was trained for the prediction task. By applying to a dataset involving 301 suspicious breast lesions and using a leave-one-case-out validation method, the areas under the ROC curves (AUC) = 0.762 and 0.792 using the traditional CAD scheme and the proposed deep learning based CAD scheme, respectively. An ensemble classifier that combines the classification scores generated by the two schemes yielded an improved AUC value of 0.813. The study results demonstrated feasibility and potentially improved performance of applying a new hybrid deep learning approach to develop CAD scheme using a relatively small dataset of medical images.

  5. Race/ethnicity and the socioeconomic status gradient in women's cancer screening utilization: a case of diminishing returns?

    PubMed

    Monnat, Shannon M

    2014-02-01

    Using three years (2006, 2008, 2010) of nationally representative data from the Behavioral Risk Factor Surveillance System, I assessed the socioeconomic status (SES) gradient for odds of receiving a mammogram in the past two years and a Pap test in the past three years among White, Black, Hispanic, and Asian women living in the U.S. Mammogram and Pap test utilization were less likely among low-SES women. However, women of color experience less benefit than Whites from increasing SES for both screenings; as income and education increased, White women experienced more pronounced increases in the likelihood of being screened than did women of color. In what might be referred to as paradoxical returns, Asian women actually experienced a decline in the likelihood of obtaining a recent Pap test at higher levels of education. My findings suggest that women of color differ from Whites in the extent to which increasing socioeconomic resources is associated with increasing cancer screening utilization.

  6. Abnormality, rationality, and sanity.

    PubMed

    Hertwig, Ralph; Volz, Kirsten G

    2013-11-01

    A growing body of studies suggests that neurological and mental abnormalities foster conformity to norms of rationality that are widely endorsed in economics and psychology, whereas normality stands in the way of rationality thus defined. Here, we outline the main findings of these studies, discuss their implications for experimental design, and consider how 'sane' some benchmarks of rationality really are. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Design and evaluation of a theory-based, culturally relevant outreach model for breast and cervical cancer screening for Latina immigrants.

    PubMed

    White, Kari; Garces, Isabel C; Bandura, Lisa; McGuire, Allison A; Scarinci, Isabel C

    2012-01-01

    Breast and cervical cancer are common among Latinas, but screening rates among foreign-born Latinas are relatively low. In this article we describe the design and implementation of a theory-based (PEN-3) outreach program to promote breast and cervical cancer screening to Latina immigrants, and evaluate the program's effectiveness. We used data from self-administered questionnaires completed at six annual outreach events to examine the sociodemographic characteristics of attendees and evaluate whether the program reached the priority population - foreign-born Latina immigrants with limited access to health care and screening services. To evaluate the program's effectiveness in connecting women to screening, we examined the proportion and characteristics of women who scheduled and attended Pap smear and mammography appointments. Among the 782 Latinas who attended the outreach program, 60% and 83% had not had a Pap smear or mammogram, respectively, in at least a year. Overall, 80% scheduled a Pap smear and 78% scheduled a mammogram. Women without insurance, who did not know where to get screening and had not been screened in the last year were more likely to schedule appointments (P < .05). Among women who scheduled appointments, 65% attended their Pap smear and 79% attended the mammogram. We did not identify significant differences in sociodemographic characteristics associated with appointment attendance. Using a theoretical approach to outreach design and implementation, it is possible to reach a substantial number of Latina immigrants and connect them to cancer screening services.

  8. Design and evaluation of a theory-based, culturally relevant outreach model for breast and cervical cancer screening for Latina immigrants

    PubMed Central

    White, Kari; Garces, Isabel C.; Bandura, Lisa; McGuire, Allison A.; Scarinci, Isabel C.

    2013-01-01

    Objectives Breast and cervical cancer are common among Latinas, but screening rates among foreign-born Latinas are relatively low. In this article we describe the design and implementation of a theory-based (PEN-3) outreach program to promote breast and cervical cancer screening to Latina immigrants, and evaluate the program’s effectiveness. Methods We used data from self-administered questionnaires completed at six annual outreach events to examine the sociodemographic characteristics of attendees and evaluate whether the program reached the priority population – foreign-born Latina immigrants with limited access to health care and screening services. To evaluate the program’s effectiveness in connecting women to screening, we examined the proportion and characteristics of women who scheduled and attended Pap smear and mammography appointments. Results Among the 782 Latinas who attended the outreach program, 60% and 83% had not had a Pap smear or mammogram, respectively, in at least a year. Overall, 80% scheduled a Pap smear and 78% scheduled a mammogram. Women without insurance, who did not know where to get screening and had not been screened in the last year were more likely to schedule appointments (p < 0.05). Among women who scheduled appointments, 65% attended their Pap smear and 79% attended the mammogram. We did not identify significant differences in sociodemographic characteristics associated with appointment attendance. Conclusions Using a theoretical approach to outreach design and implementation, it is possible to reach a substantial number of Latina immigrants and connect them to cancer screening services. PMID:22870569

  9. Perceptions of One's Neighborhood and Mammogram Use among a Sample of Low-Income Women at Risk for Human Immunodeficiency Virus and Sexually Transmitted Infections.

    PubMed

    Davey-Rothwell, Melissa A; Bowie, Janice; Murray, Laura; Latkin, Carl A

    2016-01-01

    Neighborhood disorder, signs of physical and social disorganization, has been related to a range of poor mental and physical health outcomes. Although individual factors have been widely associated with getting a mammogram, little is known about the impact of the neighborhood environment on a woman's decision to get a mammogram. In a sample of women at risk for human immunodeficiency virus and sexually transmitted infections, we explored the role of perceptions of one's neighborhood on getting a mammogram. The study included two samples: women 40 to 49 years (n = 233) and women 50 years and older (n = 83). Data were collected from May 2006 through June 2008. Women age 50 years and older who lived in a neighborhood with disorder were 72% less likely to get a mammogram compared with women who lived in neighborhoods without disorder. There was no relationship for women age 40 to 49 years. Interventions are needed to increase awareness and encourage women living in neighborhoods with disorder to get a mammogram. In addition to interventions to increase mammography, programs are needed to decrease neighborhood disorder. Increasing neighborhood cohesion, social control, and empowerment could integrate health promotion programs to both reduce disorder and increase health behaviors. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  10. Priming cases disturb visual search patterns in screening mammography

    NASA Astrophysics Data System (ADS)

    Lewis, Sarah J.; Reed, Warren M.; Tan, Alvin N. K.; Brennan, Patrick C.; Lee, Warwick; Mello-Thoms, Claudia

    2015-03-01

    Rationale and Objectives: To investigate the effect of inserting obvious cancers into a screening set of mammograms on the visual search of radiologists. Previous research presents conflicting evidence as to the impact of priming in scenarios where prevalence is naturally low, such as in screening mammography. Materials and Methods: An observer performance and eye position analysis study was performed. Four expert breast radiologists were asked to interpret two sets of 40 screening mammograms. The Control Set contained 36 normal and 4 malignant cases (located at case # 9, 14, 25 and 37). The Primed Set contained the same 34 normal and 4 malignant cases (in the same location) plus 2 "primer" malignant cases replacing 2 normal cases (located at positions #20 and 34). Primer cases were defined as lower difficulty cases containing salient malignant features inserted before cases of greater difficulty. Results: Wilcoxon Signed Rank Test indicated no significant differences in sensitivity or specificity between the two sets (P > 0.05). The fixation count in the malignant cases (#25, 37) in the Primed Set after viewing the primer cases (#20, 34) decreased significantly (Z = -2.330, P = 0.020). False-Negatives errors were mostly due to sampling in the Primed Set (75%) in contrast to in the Control Set (25%). Conclusion: The overall performance of radiologists is not affected by the inclusion of obvious cancer cases. However, changes in visual search behavior, as measured by eye-position recording, suggests visual disturbance by the inclusion of priming cases in screening mammography.

  11. Abnormal pressures as hydrodynamic phenomena

    USGS Publications Warehouse

    Neuzil, C.E.

    1995-01-01

    So-called abnormal pressures, subsurface fluid pressures significantly higher or lower than hydrostatic, have excited speculation about their origin since subsurface exploration first encountered them. Two distinct conceptual models for abnormal pressures have gained currency among earth scientists. The static model sees abnormal pressures generally as relict features preserved by a virtual absence of fluid flow over geologic time. The hydrodynamic model instead envisions abnormal pressures as phenomena in which flow usually plays an important role. This paper develops the theoretical framework for abnormal pressures as hydrodynamic phenomena, shows that it explains the manifold occurrences of abnormal pressures, and examines the implications of this approach. -from Author

  12. Ocular screening tests of elementary school children

    NASA Technical Reports Server (NTRS)

    Richardson, J.

    1983-01-01

    This report presents an analysis of 507 abnormal retinal reflex images taken of Huntsville kindergarten and first grade students. The retinal reflex images were obtained by using an MSFC-developed Generated Retinal Reflex Image System (GRRIS) photorefractor. The system uses a 35 mm camera with a telephoto lens with an electronic flash attachment. Slide images of the eyes were examined for abnormalities. Of a total of 1835 students screened for ocular abnormalities, 507 were found to have abnormal retinal reflexes. The types of ocular abnormalities detected were hyperopia, myopia, astigmatism, esotropia, exotropia, strabismus, and lens obstuctions. The report shows that the use of the photorefractor screening system is an effective low-cost means of screening school children for abnormalities.

  13. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    ERIC Educational Resources Information Center

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  14. Pre-reading mammograms by specialised breast technologists: legal implications for technologist and radiologist in The Netherlands.

    PubMed

    van den Biggelaar, F J H M; Flobbe, K; van Engelshoven, J M A; de Bijl, N P Y M

    2009-09-01

    This paper focuses on the legal implications in terms of duties and responsibilities for radiologists and radiologic technologists of independent pre-reading of mammograms by radiologic technologists, so patients could be discharged without being seen by a radiologist. Pre-reading could be effectuated when preconditions are met to perform reserved procedures by unauthorised professionals as stated in the Individual Health Care Professions (IHCP) Act. Furthermore, compliance with a protocol or code of conduct in combination with adequate training and supervision should be sufficient to disprove potential claims. For a wide implementation, pre-reading should be well-embedded in legal rules and should answer the professional standard of care.

  15. Newborn Screening

    MedlinePlus

    ... Laboratory Sciences Office of Public Health Genomics Publications & Articles Newborn Screening Lab Bulletin Laboratory Partners Multimedia Tools Newborn Screening Program – Role of Laboratories Meet the Scientist Newborn Screening: Family Stories Newborn Screening: Public Health ...

  16. Abnormal Uterine Bleeding.

    PubMed

    Benetti-Pinto, Cristina Laguna; Rosa-E-Silva, Ana Carolina Japur de Sá; Yela, Daniela Angerame; Soares Júnior, José Maria

    2017-07-01

    Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evidence on the treatment of women with abnormal uterine bleeding, both acute and chronic. Didactically, the treatment options were based on the current International Federation of Gynecology and Obstetrics (FIGO) classification system (PALM-COEIN). The etiologies of PALM-COEIN are: uterine Polyp (P), Adenomyosis (A), Leiomyoma (L), precursor and Malignant lesions of the uterine body (M), Coagulopathies (C), Ovulatory dysfunction (O), Endometrial dysfunction (E), Iatrogenic (I), and Not yet classified (N). The articles were selected according to the recommendation grades of the PubMed, Cochrane and Embase databases, and those in which the main objective was the reduction of uterine menstrual bleeding were included. Only studies written in English were included. All editorial or complete papers that were not consistent with abnormal uterine bleeding, or studies in animal models, were excluded. The main objective of the treatment is the reduction of menstrual flow and morbidity and the improvement of quality of life. It is important to emphasize that the treatment in the acute phase aims to hemodynamically stabilize the patient and stop excessive bleeding, while the treatment in the chronic phase is based on correcting menstrual dysfunction according to its etiology and clinical manifestations. The treatment may be surgical or pharmacological, and the latter is based mainly on hormonal therapy, anti-inflammatory drugs and antifibrinolytics. Thieme Revinter Publicações Ltda Rio de Janeiro

  17. Mammography screening in single older African-American women: a study of related factors.

    PubMed

    Zhu, K; Hunter, S; Bernard, L J; Payne-Wilks, K; Roland, C L; Levine, R S

    2000-01-01

    Using baseline data from an intervention study, we examined cognitive, psychological, social and medical care factors in relation to the use of a mammogram in the preceding year among single African-American women aged 65 and older. Study subjects were 325 African-American women aged 65 and older who were divorced, widowed, separated or never-married, and lived in ten public housing complexes in Nashville, Tennessee. In-person interviews were conducted to collect information on breast screening behavior, knowledge and attitude, social network and activities, emotional and psychological symptoms and signs, and medical care use. Compared with those who had not had a mammogram in the preceding year, women who had had a mammogram in the preceding year were three times more likely to have a regular doctor (95% confidence interval [CI] 1.4-5.0) and about six times more likely to have a doctor's recommendation for a mammogram (95%CI 3.4-11.1). In addition, they were more likely to: (a) have attended a meeting on breast health or received educational materials on breast cancer; (b) agree that a woman needs a mammogram even though she has no breast problem; (c) agree that a woman can have breast cancer without having symptoms; (d) have living children and grandchildren; and (e) attend social activities more frequently. While access to regular medical care and receiving a physician's recommendation are strongly associated with mammography among these older, single African-American women, education on breast health and social networks also appear to be influential.

  18. Data based abnormality detection

    NASA Astrophysics Data System (ADS)

    Purwar, Yashasvi

    Data based abnormality detection is a growing research field focussed on extracting information from feature rich data. They are considered to be non-intrusive and non-destructive in nature which gives them a clear advantage over conventional methods. In this study, we explore different streams of data based anomalies detection. We propose extension and revisions to existing valve stiction detection algorithm supported with industrial case study. We also explored the area of image analysis and proposed a complete solution for Malaria diagnosis. The proposed method is tested over images provided by pathology laboratory at Alberta Health Service. We also address the robustness and practicality of the solution proposed.

  19. Morphological abnormalities in elasmobranchs.

    PubMed

    Moore, A B M

    2015-08-01

    A total of 10 abnormal free-swimming (i.e., post-birth) elasmobranchs are reported from The (Persian-Arabian) Gulf, encompassing five species and including deformed heads, snouts, caudal fins and claspers. The complete absence of pelvic fins in a milk shark Rhizoprionodon acutus may be the first record in any elasmobranch. Possible causes, including the extreme environmental conditions and the high level of anthropogenic pollution particular to The Gulf, are briefly discussed. © 2015 The Fisheries Society of the British Isles.

  20. Enhanced visualization of abnormalities in digital-mammographic images

    NASA Astrophysics Data System (ADS)

    Young, Susan S.; Moore, William E.

    2002-05-01

    This paper describes two new presentation methods that are intended to improve the ability of radiologists to visualize abnormalities in mammograms by enhancing the appearance of the breast parenchyma pattern relative to the fatty-tissue surroundings. The first method, referred to as mountain- view, is obtained via multiscale edge decomposition through filter banks. The image is displayed in a multiscale edge domain that causes the image to have a topographic-like appearance. The second method displays the image in the intensity domain and is referred to as contrast-enhancement presentation. The input image is first passed through a decomposition filter bank to produce a filtered output (Id). The image at the lowest resolution is processed using a LUT (look-up table) to produce a tone scaled image (I'). The LUT is designed to optimally map the code value range corresponding to the parenchyma pattern in the mammographic image into the dynamic range of the output medium. The algorithm uses a contrast weight control mechanism to produce the desired weight factors to enhance the edge information corresponding to the parenchyma pattern. The output image is formed using a reconstruction filter bank through I' and enhanced Id.

  1. Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers.

    PubMed

    Nazzal, Zaher; Sholi, Hisham; Sholi, Suha; Sholi, Mohammad; Lahaseh, Rawya

    2016-01-01

    Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other

  2. Computerized decision support system for mass identification in breast using digital mammogram: a study on GA-based neuro-fuzzy approaches.

    PubMed

    Das, Arpita; Bhattacharya, Mahua

    2011-01-01

    In the present work, authors have developed a treatment planning system implementing genetic based neuro-fuzzy approaches for accurate analysis of shape and margin of tumor masses appearing in breast using digital mammogram. It is obvious that a complicated structure invites the problem of over learning and misclassification. In proposed methodology, genetic algorithm (GA) has been used for searching of effective input feature vectors combined with adaptive neuro-fuzzy model for final classification of different boundaries of tumor masses. The study involves 200 digitized mammograms from MIAS and other databases and has shown 86% correct classification rate.

  3. iPixel: a visual content-based and semantic search engine for retrieving digitized mammograms by using collective intelligence.

    PubMed

    Alor-Hernández, Giner; Pérez-Gallardo, Yuliana; Posada-Gómez, Rubén; Cortes-Robles, Guillermo; Rodríguez-González, Alejandro; Aguilar-Laserre, Alberto A

    2012-09-01

    Nowadays, traditional search engines such as Google, Yahoo and Bing facilitate the retrieval of information in the format of images, but the results are not always useful for the users. This is mainly due to two problems: (1) the semantic keywords are not taken into consideration and (2) it is not always possible to establish a query using the image features. This issue has been covered in different domains in order to develop content-based image retrieval (CBIR) systems. The expert community has focussed their attention on the healthcare domain, where a lot of visual information for medical analysis is available. This paper provides a solution called iPixel Visual Search Engine, which involves semantics and content issues in order to search for digitized mammograms. iPixel offers the possibility of retrieving mammogram features using collective intelligence and implementing a CBIR algorithm. Our proposal compares not only features with similar semantic meaning, but also visual features. In this sense, the comparisons are made in different ways: by the number of regions per image, by maximum and minimum size of regions per image and by average intensity level of each region. iPixel Visual Search Engine supports the medical community in differential diagnoses related to the diseases of the breast. The iPixel Visual Search Engine has been validated by experts in the healthcare domain, such as radiologists, in addition to experts in digital image analysis.

  4. Use of joint two-view information for computerized lesion detection on mammograms: improvement of microcalcification detection accuracy

    NASA Astrophysics Data System (ADS)

    Sahiner, Berkman; Gurcan, Metin N.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Petrick, Nicholas; Helvie, Mark A.

    2002-05-01

    We are developing new techniques to improve the accuracy of computerized microcalcification detection by using the joint two-view information on craniocaudal (CC) and mediolateral-oblique (MLO) views. After cluster candidates were detected using a single-view detection technique, candidates on CC and MLO views were paired using their radial distances from the nipple. Object pairs were classified with a joint two-view classifier that used the similarity of objects in a pair. Each cluster candidate was also classified as a true microcalcification cluster or a false-positive (FP) using its single-view features. The outputs of these two classifiers were fused. A data set of 38 pairs of mammograms from our database was used to train the new detection technique. The independent test set consisted of 77 pairs of mammograms from the University of South Florida public database. At a per-film sensitivity of 70%, the FP rates were 0.17 and 0.27 with the fusion and single-view detection methods, respectively. Our results indicate that correspondence of cluster candidates on two different views provides valuable additional information for distinguishing false from true microcalcification clusters.

  5. Mammograms on-the-go-predictors of repeat visits to mobile mammography vans in St Louis, Missouri, USA: a case-control study.

    PubMed

    Drake, Bettina F; Abadin, Salmafatima S; Lyons, Sarah; Chang, Su-Hsin; Steward, Lauren T; Kraenzle, Susan; Goodman, Melody S

    2015-03-20

    Among women, breast cancer is the most common non-cutaneous cancer and second most common cause of cancer-related death. The purpose of this study was to determine the extent to which women use mobile mammography vans for breast cancer screening and what factors are associated with repeat visits to these vans. A case-control study. Cases are women who had a repeat visit to the mammography van. (n=2134). Women who received a mammogram as part of Siteman Cancer Center's Breast Health Outreach Program responded to surveys and provided access to their clinical records (N=8450). Only visits from 2006 to 2014 to the mammography van were included. The main outcome is having a repeat visit to the mammography van. Among the participants, 25.3% (N=2134) had multiple visits to the mobile mammography van. Data were analysed using χ(2) tests, logistic regression and negative binomial regression. Women who were aged 50-65, uninsured, or African-American had higher odds of a repeat visit to the mobile mammography van compared with women who were aged 40-50, insured, or Caucasian (OR=1.135, 95% CI 1.013 to 1.271; OR=1.302, 95% CI 1.146 to 1.479; OR=1.281, 95% CI 1.125 to 1.457), respectively. However, the odds of having a repeat visit to the van were lower among women who reported a rural ZIP code or were unemployed compared with women who provided a suburban ZIP code or were employed (OR=0.503, 95% CI 0.411 to 0.616; OR=.868, 95% CI 0.774 to 0.972), respectively. This study has identified key characteristics of women who are either more or less likely to use mobile mammography vans as their primary source of medical care for breast cancer screening and have repeat visits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Breast Cancer Screening in Patients With Newly Diagnosed Lung and Colorectal Cancer: A Population-Based Study of Utilization.

    PubMed

    Sadigh, Gelareh; Carlos, Ruth C; Ward, Kevin C; Switchenko, Jeffrey M; Jiang, Renjian; Applegate, Kimberly E; Duszak, Richard

    2017-07-01

    To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls. Female fee-for-service Medicare beneficiaries who were ≥67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as the percentage of women with ≥1 screening mammogram during follow-up. Overall, 104,164 cases (48% colorectal, 52% lung; 30% advanced cancer) and 104,164 controls were included. Among women with lung or colorectal cancer, 22% underwent ≥1 screening mammogram versus 26% of controls (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.78-0.82). Stratified by cancer type, 28% of colorectal cancer cases versus 29% of controls (OR 0.98; 95% CI 0.95-1.01) and 17% of lung cancer cases versus 23% of controls (OR 0.63; 95% CI 0.60-0.65) received ≥1 mammogram. When stratified by stage, 8% with advanced cancer versus 18% of controls (OR 0.33; 95% CI 0.31-0.35) and 30% with early-stage cancer versus 30% of controls (OR 1; 95% CI 0.97-1.02) underwent ≥1 mammogram. Screening mammography utilization rates are similar between Medicare beneficiaries with early-stage cancer versus controls. Although the majority of patients with advanced-stage cancer appropriately do not pursue screening mammography, a small number (8%) continue with screening. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Ictal Cardiac Ryhthym Abnormalities.

    PubMed

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic-clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy.

  8. [Breast cancer screening: characteristics and results of the Spanish programs].

    PubMed

    Ascunce, Nieves; Delfrade, Josu; Salas, Dolores; Zubizarreta, Raquel; Ederra, María

    2013-07-07

    To describe national and regional indicators of process and outcome of breast cancer screening programs in Spain. Overall results and broken down by regions are studied for the period 2007-2008. Outcome indicators (participation, cancer detection rate and characteristics of tumors detected) and process indicators (and intermediate mammograms), classified by types of women screened (initial and consequent regular and irregular) and age groups, are analyzed. Results are compared with reference values established in the European Guidelines. Breast cancer screening coverage is 100% in the country. The overall participation was 69.68% with an adherence of 91.35%. Further assessments of any procedure were performed in 4.93% and invasive further assessments in 0.66%. Intermediate mammograms were indicated in 3.56%. The detection rate was 3.49‰ (5.35‰ age-adjusted); 14.29% of the tumors were intraductal. The 29.49% of the invasive tumors were≤1cm in diameter with 62.22% showing no axillary lymph node involvement. Despite the variability evident in the data provided by the different autonomous communities and the need to improve the homogeneity of information systems as a whole, the assessed indicators meet the standards specified in the European guidelines. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  9. Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial.

    PubMed

    Lee, Hee; Ghebre, Rahel; Le, Chap; Jang, Yoo Jeong; Sharratt, Monica; Yee, Douglas

    2017-11-07

    Despite the increasing breast cancer incidence and mortality rates, Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States. Mobile health (mHealth), defined as the delivery of health care information or services through mobile communication devices, has been utilized to successfully improve a variety of health outcomes. This study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women, an underserved community. Using a randomized controlled trial design, 120 Korean American women aged 40 to 77 years were recruited and randomly assigned to either the mMammogram intervention group (n=60) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group (n=60) to receive a printed brochure. Outcome measures included knowledge, attitudes, and beliefs about breast cancer screening, readiness for mammography, and mammogram receipt. The feasibility and acceptability of the mMammogram intervention was also assessed. The intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines (P=.01). The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group. A significantly higher proportion of women who received the mMammogram intervention (75%, 45/60) completed mammograms by the 6-month follow-up compared with the control group (30%, 18/60; P<.001). In addition, the intervention group rated satisfaction with the intervention (P=.003), effectiveness of the intervention (P<.001), and increase of knowledge on breast cancer and screenings (P=.001) significantly higher than the control group. A mobile phone app-based intervention combined with health navigator service was a feasible, acceptable, and

  10. Does routine screening for breast cancer raise anxiety? Results from a three wave prospective study in England.

    PubMed Central

    Sutton, S; Saidi, G; Bickler, G; Hunter, J

    1995-01-01

    feeling extremely anxious after they had received the referral letter but their retrospective anxiety was also higher than in the negative screenees at earlier stages in the breast screening process. They also reported having experienced more pain and discomfort during the x ray. CONCLUSIONS--Anxiety does not seem to be an important problem in routinely screened women who receive a negative result. This finding is very reassuring in relation to a major criticism of breast screening programmes. Thus, apart from maintaining current procedures such as keeping waiting times to a minimum, there seems to be no need to introduce special anxiety reducing interventions into the national programme. On the other hand, the findings for women who received false positive results suggest that there are aspects of the experience of being recalled for assessment after an abnormal mammogram that warrant further attention. The relationship between contemporaneous and retrospective anxiety should also be studied. PMID:7650466

  11. Breast Density Awareness and Knowledge, and Intentions for Breast Cancer Screening in a Diverse Sample of Women Age Eligible for Mammography.

    PubMed

    Santiago-Rivas, Marimer; Benjamin, Shayna; Andrews, Janna Z; Jandorf, Lina

    2017-08-14

    The objectives of this study were to assess breast density knowledge and breast density awareness, and to identify information associated with intention to complete routine and supplemental screening for breast cancer in a diverse sample of women age eligible for mammography. We quantitatively (self-report) assessed breast density awareness and knowledge (N = 264) in black (47.7%), Latina (35.2%), and white (17%) women recruited online and in the community. Most participants reported having heard about breast density (69.2%); less than one third knew their own breast density status (30.4%). Knowing their own breast density, believing that women should be notified of their breast density in their mammogram report, and feeling informed if being provided this information are associated with likelihood of completing mammogram. Intending mammogram completion and knowledge regarding the impact of breast density on mammogram accuracy are associated with likelihood of completing supplemental ultrasound tests of the breast. These findings help inform practitioners and policy makers about information and communication factors that influence breast cancer screening concerns and decisions. Knowing this information should prepare practitioners to better identify women who may have not been exposed to breast density messages.

  12. Analysis of perceived similarity between pairs of microcalcification clusters in mammograms

    SciTech Connect

    Wang, Juan; Jing, Hao; Wernick, Miles N.

    2014-05-15

    Purpose: Content-based image retrieval aims to assist radiologists by presenting example images with known pathology that are visually similar to the case being evaluated. In this work, the authors investigate several fundamental issues underlying the similarity ratings between pairs of microcalcification (MC) lesions on mammograms as judged by radiologists: the degree of variability in the similarity ratings, the impact of this variability on agreement between readers in retrieval of similar lesions, and the factors contributing to the readers’ similarity ratings. Methods: The authors conduct a reader study on a set of 1000 image pairs of MC lesions, in which amore » group of experienced breast radiologists rated the degree of similarity between each image pair. The image pairs are selected, from among possible pairings of 222 cases (110 malignant, 112 benign), based on quantitative image attributes (features) and the results of a preliminary reader study. Next, the authors apply analysis of variance (ANOVA) to quantify the level of variability in the readers’ similarity ratings, and study how the variability in individual reader ratings affects consistency between readers. The authors also measure the extent to which readers agree on images which are most similar to a given query, for which the Dice coefficient is used. To investigate how the similarity ratings potentially relate to the attributes underlying the cases, the authors study the fraction of perceptually similar images that also share the same benign or malignant pathology as the query image; moreover, the authors apply multidimensional scaling (MDS) to embed the cases according to their mutual perceptual similarity in a two-dimensional plot, which allows the authors to examine the manner in which similar lesions relate to one another in terms of benign or malignant pathology and clustered MCs. Results: The ANOVA results show that the coefficient of determination in the reader similarity ratings

  13. Sensitivity and specificity of mammographic screening as practised in Vermont and Norway

    PubMed Central

    Hofvind, S; Geller, B M; Skelly, J; Vacek, P M

    2012-01-01

    Objective The aim of this study was to examine the sensitivity and specificity of screening mammography as performed in Vermont, USA, and Norway. Methods Incident screening data from 1997 to 2003 for female patients aged 50–69 years from the Vermont Breast Cancer Surveillance System (116 996 subsequent screening examinations) and the Norwegian Breast Cancer Screening Program (360 872 subsequent screening examinations) were compared. Sensitivity and specificity estimates for the initial (based on screening mammogram only) and final (screening mammogram plus any further diagnostic imaging) interpretations were directly adjusted for age using 5-year age intervals for the combined Vermont and Norway population, and computed for 1 and 2 years of follow-up, which ended at the time of the next screening mammogram. Results For the 1-year follow-up, sensitivities for initial assessments were 82.0%, 88.2% and 92.5% for 1-, 2- and >2-year screening intervals, respectively, in Vermont (p=0.022). For final assessments, the values were 73.6%, 83.3% and 81.2% (p=0.047), respectively. For Norway, sensitivities for initial assessments were 91.0% and 91.3% (p=0.529) for 2- and >2-year intervals, and 90.7% and 91.3%, respectively, for final assessments (p=0.630). Specificity was lower in Vermont than in Norway for each screening interval and for all screening intervals combined, for both initial (90.6% vs 97.8% for all intervals; p<0.001) and final (98.8% vs 99.5% for all intervals; p<0.001) assessments. Conclusion Our study showed higher sensitivity and specificity in a biennial screening programme with an independent double reading than in a predominantly annual screening program with a single reading. Advances in knowledge This study demonstrates that higher recall rates and lower specificity are not always associated with higher sensitivity of screening mammography. Differences in the screening processes in Norway and Vermont suggest potential areas for improvement in the

  14. Insurance-Based Differences in Time to Diagnostic Follow-up after Positive Screening Mammography.

    PubMed

    Durham, Danielle D; Robinson, Whitney R; Lee, Sheila S; Wheeler, Stephanie B; Reeder-Hayes, Katherine E; Bowling, J Michael; Olshan, Andrew F; Henderson, Louise M

    2016-11-01

    Insurance may lengthen or inhibit time to follow-up after positive screening mammography. We assessed the association between insurance status and time to initial diagnostic follow-up after a positive screening mammogram. Using 1995-2010 data from a North Carolina population-based registry of breast imaging and cancer outcomes, we identified women with a positive screening mammogram. We compared receipt of follow-up within 60 days of screening using logistic regression and evaluated time to follow-up initiation using Cox proportional hazards regression. Among 43,026 women included in the study, 73% were <65 years and 27% were 65+ years. Median time until initial diagnostic follow-up was similar by age group and insurance status. In the adjusted model for women <65, uninsured women experienced a longer time to initiation of diagnostic follow-up [HR, 0.47; 95% confidence interval (CI), 0.25-0.89] versus women with private insurance. There were increased odds of these uninsured women not meeting the Centers for Disease Control and Prevention guideline for follow-up within 60 days (OR, 1.59; 95% CI, 1.31-1.94). Among women ages 65+, women with private insurance experienced a faster time to follow-up (adjusted HR, 2.09; 95% CI, 1.27-3.44) than women with Medicare and private insurance. Approximately 10% of women had no follow-up by 365 days. We found differences in time to initial diagnostic follow-up after a positive screening mammogram by insurance status and age group. Uninsured women younger than 65 years at a positive screening event had delayed follow-up. Replication of these findings and examination of their clinical significance warrant additional investigation. Cancer Epidemiol Biomarkers Prev; 25(11); 1474-82. ©2016 AACR. ©2016 American Association for Cancer Research.

  15. Sustaining mammography screening among the medically underserved: a follow-up evaluation.

    PubMed

    Davis, Terry C; Arnold, Connie L; Bennett, Charles L; Wolf, Michael S; Liu, Dachao; Rademaker, Alfred

    2015-04-01

    Our previous three-arm comparative effectiveness intervention in community clinic patients who were not up-to-date with screening resulted in mammography rates over 50% in all arms. Our aim was to evaluate the effectiveness and cost-effectiveness of the three interventions on improving biennial screening rates among eligible patients. A three-arm quasi-experimental evaluation was conducted in eight community clinics from 2008 to 2011. Screening efforts included (1) enhanced care: Participants received an in-person recommendation from a research assistant (RA) in year 1, and clinics followed usual clinic protocol for scheduling screening mammograms; (2) education intervention: Participants received education and in-person recommendation from an RA in year 1, and clinics followed usual clinic protocol for scheduling mammograms; or (3) nurse support: A nurse manager provided in-person education and recommendation, scheduled mammograms, and followed up with phone support. In all arms, mammography was offered at no cost to uninsured patients. Of 624 eligible women, biennial mammography within 24-30 months of their previous test was performed for 11.0% of women in the enhanced-care arm, 7.1% in the education- intervention arm, and 48.0% in the nurse-support arm (p<0.0001). The incremental cost was $1,232 per additional woman undergoing screening with nurse support vs. enhanced care and $1,092 with nurse support vs. education. Biennial mammography screening rates were improved by providing nurse support but not with enhanced care or education. However, this approach was not cost-effective.

  16. Sustaining Mammography Screening Among the Medically Underserved: A Follow-Up Evaluation

    PubMed Central

    Arnold, Connie L.; Bennett, Charles L.; Wolf, Michael S.; Liu, Dachao; Rademaker, Alfred

    2015-01-01

    Abstract Background: Our previous three-arm comparative effectiveness intervention in community clinic patients who were not up-to-date with screening resulted in mammography rates over 50% in all arms. Objective: Our aim was to evaluate the effectiveness and cost-effectiveness of the three interventions on improving biennial screening rates among eligible patients. Methods: A three-arm quasi-experimental evaluation was conducted in eight community clinics from 2008 to 2011. Screening efforts included (1) enhanced care: Participants received an in-person recommendation from a research assistant (RA) in year 1, and clinics followed usual clinic protocol for scheduling screening mammograms; (2) education intervention: Participants received education and in-person recommendation from an RA in year 1, and clinics followed usual clinic protocol for scheduling mammograms; or (3) nurse support: A nurse manager provided in-person education and recommendation, scheduled mammograms, and followed up with phone support. In all arms, mammography was offered at no cost to uninsured patients. Results: Of 624 eligible women, biennial mammography within 24–30 months of their previous test was performed for 11.0% of women in the enhanced-care arm, 7.1% in the education- intervention arm, and 48.0% in the nurse-support arm (p<0.0001). The incremental cost was $1,232 per additional woman undergoing screening with nurse support vs. enhanced care and $1,092 with nurse support vs. education. Conclusions: Biennial mammography screening rates were improved by providing nurse support but not with enhanced care or education. However, this approach was not cost-effective. PMID:25692910

  17. Who gets a mammogram amongst European women aged 50-69 years?

    PubMed Central

    2012-01-01

    On the basis of the Survey of Health, Ageing, and Retirement (SHARE), we analyse the determinants of who engages in mammography screening focusing on European women aged 50-69 years. A special emphasis is put on the measurement error of subjective life expectancy and on the measurement and impact of physician quality. Our main findings are that physician quality, better education, having a partner, younger age and better health are associated with higher rates of receipt. The impact of subjective life expectancy on screening decision substantially increases after taking measurement error into account. JEL Classification C 36, I 11, I 18 PMID:22828268

  18. Cancer Screening Practices of Asian American Physicians in New York City

    PubMed Central

    Islam, Nadia; Kwon, Simona C.; Zojwalla, Naseem; Ahsan, Habibul; Senie, Ruby T.

    2012-01-01

    Cancer screening rates are lower among Asian Americans than the general USA population. While prior studies examined characteristics of Asian American patients as predictors of cancer screening, few investigated their health care providers. Asian American primary care physicians practicing in New York City were surveyed by questionnaire regarding their demographics, practice characteristics, and cancer screening of their Asian American patients. Of the 117 eligible respondents, 96% recommended mammograms to their Asian patients 50+ years of age and 70% to patients 40–49-year-old. Only 30% of respondents use both age and onset of sexual activity to determine when to recommend Pap smears. For colorectal cancer screening, the rates of performing fecal occult blood testing or recommending colonoscopy or sigmoidoscopy were 77% and 74%. About 70% recommend screening for hepatitis B. Gender and ethnicity of the physician were found to be significant predictors for cancer screening practice. PMID:17653863

  19. Computerized multiple image analysis on mammograms: performance improvement of nipple identification for registration of multiple views using texture convergence analyses

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M.; Paramagul, Chintana

    2004-05-01

    Automated registration of multiple mammograms for CAD depends on accurate nipple identification. We developed two new image analysis techniques based on geometric and texture convergence analyses to improve the performance of our previously developed nipple identification method. A gradient-based algorithm is used to automatically track the breast boundary. The nipple search region along the boundary is then defined by geometric convergence analysis of the breast shape. Three nipple candidates are identified by detecting the changes along the gray level profiles inside and outside the boundary and the changes in the boundary direction. A texture orientation-field analysis method is developed to estimate the fourth nipple candidate based on the convergence of the tissue texture pattern towards the nipple. The final nipple location is determined from the four nipple candidates by a confidence analysis. Our training and test data sets consisted of 419 and 368 randomly selected mammograms, respectively. The nipple location identified on each image by an experienced radiologist was used as the ground truth. For 118 of the training and 70 of the test images, the radiologist could not positively identify the nipple, but provided an estimate of its location. These were referred to as invisible nipple images. In the training data set, 89.37% (269/301) of the visible nipples and 81.36% (96/118) of the invisible nipples could be detected within 1 cm of the truth. In the test data set, 92.28% (275/298) of the visible nipples and 67.14% (47/70) of the invisible nipples were identified within 1 cm of the truth. In comparison, our previous nipple identification method without using the two convergence analysis techniques detected 82.39% (248/301), 77.12% (91/118), 89.93% (268/298) and 54.29% (38/70) of the nipples within 1 cm of the truth for the visible and invisible nipples in the training and test sets, respectively. The results indicate that the nipple on mammograms can be

  20. [Breast cancer screening process indicators in Mexico: a case study].

    PubMed

    Uscanga-Sánchez, Santos; Torres-Mejía, Gabriela; Ángeles-Llerenas, Angélica; Domínguez-Malpica, Raúl; Lazcano-Ponce, Eduardo

    2014-01-01

    To identify, measure and compare the performance indicators of productivity, effective access and quality service for the early detection breast cancer program in Mexico. By means of a study case based on the 2011 Women Cancer Information System (SICAM), the indicators were measured and compared with the Mexican official standard NOM-041-SSA2-2011 and international standards. The analysis showed insufficient installed capacity (37%), low coverage in screening (15%), diagnostic evaluation (16%), biopsy (44%) and treatment (57%), and very low effectiveness in confirmed cases by the total number of screening mammograms performed (0.04%). There was no information available, from SICAM, to estimate the rest of the indicators proposed. Efficient health information systems are required in order to monitor indicators and generate performance observatories of screening programs.

  1. A screening mammography program. Staying alive and making it work.

    PubMed

    Monsees, B S; Destouet, J M

    1992-01-01

    The success of a mammography screening program requires thorough planning. A dependably high volume and a streamlined efficient operation are essential to survival of the program. Factors that warrant consideration prior to designing such a program include the following: Distinction between screening and diagnostic mammography examinations. Selection of a site that will meet the needs of the community and yet provide a consistently high volume. Low examination cost for screening mammography coupled with a detailed financial analysis and reappraisal on an ongoing basis. A customized marketing program that incorporates methods to increase awareness, compliance, and utilization by women and referring physicians. Well-trained, efficient, and dedicated personnel. An operation that is designed for rapid throughput and expeditious patient flow. An efficient plan for film handling, interpretation, reporting, and storage. Timely communication of examination results. A reliable mechanism for follow-up evaluation and outcome data collection. Establishment of a consistent and reliable quality assurance program and the production of high quality mammograms.

  2. Abnormal uterine bleeding.

    PubMed

    Cheong, Ying; Cameron, Iain T; Critchley, Hilary O D

    2017-09-01

    It is not uncommon for a woman to suffer from abnormal uterine bleeding (AUB) or heavy menstrual bleeding (HMB) at some point during her lifetime. Once pathology is excluded, in practice, management needs to be individualised, taking into account the improvement of the woman's symptoms and quality of life. Peer-reviewed journals, governmental and professional society publications. There is now agreement on a structured, universal approach to the diagnosis of AUB, with the aide memoirs PALM (polyps, adenomyosis, leiomyoma, malignancy) and COEIN (coagulopathies, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified). Once malignancy and significant pelvic pathology have been ruled out, medical treatment is an effective first-line therapeutic option, with surgery, including endometrial ablation and hysterectomy, offered when medical management has failed to resolve symptoms and fertility is no longer desired. There remains controversy around the management of the types and subtypes of adenomyosis and leiomyoma, and understanding their impact on clinical reproductive outcomes. Standardised assessment tools for measuring outcomes of AUB are being developed. Novel diagnostic and monitoring tools should be developed to help stratify treatment for women with AUB, particularly relating to 'unclassified' and 'endometrial' causes. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  3. Communication and abnormal behaviour.

    PubMed

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

  4. Autoshaping of abnormal children.

    PubMed

    Deckner, C W; Wilcox, L M; Maisto, S A; Blanton, R L

    1980-09-01

    Three experimentally naive abnormal children were exposed to a terminal operant contingency, i.e., reinforcement was delivered only if the children pressed a panel during intervals when it was lighted. Despite the absence of both successive approximation and manual shaping, it was found that each child began to respond discriminatively within a small number of trials. These data replicated previous animal studies concerned with the phenomena of autoshaping and signal-controlled responding. It was also found, however, that one type of autoshaping, the classical conditioning procedure, had a powerful suppressive effect on the discriminative responding. An experimental analysis that consisted procedure, had a powerful suppressive effect on discriminative responding. An experimental analysis that consisted of intrasubject reversal an multiple baseline designs established the internal validity of the findings. The finding of rapid acquisition of signal-controlled responding obtained with the initial procedure is suggessted to have practical significance. The disruptive effects of the classical form of autoshaping are discussed in terms of negative behavioral contrast.

  5. Breast and cervical cancer screening among South Asian immigrants in the United States.

    PubMed

    Menon, Usha; Szalacha, Laura A; Prabhughate, Abhijit

    2012-01-01

    South Asian (SA) immigrants (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) constitute the fastest growing of all Asian American immigrants to the United States, with a growth rate of 106% from 1990 to 2001. Data are lacking on health behaviors of this population subgroup, including cancer-related information. : The purpose of this study was to assess rates and correlates of breast and cervical cancer screening in a community sample of SAs. Participants were recruited from among attendees of 3 community-based agency programs. Data were collected in English, Hindi, and Gujarati from a convenience sample of 198 participants. Two-thirds of the sample (n = 127, 65.5%) had ever had a mammogram, whereas only a third (n = 65, 32.8%) had ever had a Papanicolaou smear or vaginal examination. Several predisposing factors (eg, country of birth, years in the United States, acculturation, age, and acknowledged barriers to screening) were significant predictors of breast and cervical screening, whereas the only enabling factor was past screening behavior. Additional study is warranted on cultural aspects of cancer screening behaviors. These data are formative on facilitators and barriers to mammogram and Papanicolaou test completion among these understudied minority women. Nurses who practice in primary care may begin to target health education based on sociodemographics of SA women and emphasize discussion of barriers to screening.

  6. Opt-Out Patient Navigation to Improve Breast and Cervical Cancer Screening Among Homeless Women.

    PubMed

    Asgary, Ramin; Naderi, Ramesh; Wisnivesky, Juan

    2017-09-01

    A patient navigation model was implemented to improve breast and cervical cancer screening among women who were homeless in five shelters and shelter clinics in New York City in 2014. Navigation consisted of opt-out screening to eligible women; cancer health and screening education; scheduling and following up for screening completion, obtaining, and communicating results to patients and providers; and care coordination with social services organizations. Women (n = 162, aged 21-74, 58% black) completed mammogram (88%) and Pap testing (83%) from baselines of 59% and 50%, respectively. There was no association between mental health or substance abuse and screening completion. Adjusted analysis showed a significant association between refusing/missing Pap testing and older age (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.04-1.20); independent predictors of mammogram included more pregnancies (OR 0.57, 95% CI 0.37-0.88) and older age (OR 0.84, 95% CI 0.79-0.90). Opt-out patient navigation is feasible and effective and may mitigate multilevel barriers to cancer screening among women with unstable housing.

  7. Breast cancer screening practices of African migrant women in Australia: a descriptive cross-sectional study.

    PubMed

    Ogunsiji, Olayide Oluyemisi; Kwok, Cannas; Fan, Lee Chun

    2017-04-17

    Breast cancer is the most diagnosed cancer among women and a leading cause of mortality and morbidity, globally. Breast cancer mortality can be improved through routine cancer screening, yet migrant populations have lower participation rates. While African migrants are among the fastest growing migrant population in Australia, their breast cancer screening behaviour is under-studied. The aims of this study were to report breast cancer screening status of African migrant women and factors associated with their breast cancer screening behaviour in Australia. A descriptive, cross-sectional approach was utilised for this study. Two hundred and sixty four African migrant women aged 18-69 years and recruited from a number of organisations responded to a self-reported African version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Main research variables are breast cancer screening practices and demographic characteristics and total scores on each of the BCSBQ subscales. Multivariable logistic regression analyses were performed to investigate the impact of the demographic variables on the likelihood of women in the target age range 50-74 years having screening practices as recommended. While most of the participants heard of breast awareness (76.1%) and mammogram (85.2%), only 11.4% practised monthly breast awareness, whereas 65.9% had ever had a mammogram as frequently as recommended. Age and employment were determining factors for participating in mammogram. Significant different scores were found in the "Practical barriers" between women at the target age who had and had not performed breast awareness (80.4 versus 77.5, p-value = 0.002) and mammogram (77.1 versus 70.3, p-value = 0.009) regularly as recommended. Moreover, attitudes towards general health check-ups subscale scores were significantly higher in women who had performed clinical breast examination as frequently as recommended than those who had not. The research reveals that practical

  8. Quantification of mammographic masking risk with volumetric breast density maps: how to select women for supplemental screening

    NASA Astrophysics Data System (ADS)

    Holland, Katharina; van Gils, Carla H.; Wanders, Johanna OP; Mann, Ritse M.; Karssemeijer, Nico

    2016-03-01

    The sensitivity of mammograms is low for women with dense breasts, since cancers may be masked by dense tissue. In this study, we investigated methods to identify women with density patterns associated with a high masking risk. Risk measures are derived from volumetric breast density maps. We used the last negative screening mammograms of 93 women who subsequently presented with an interval cancer (IC), and, as controls, 930 randomly selected normal screening exams from women without cancer. Volumetric breast density maps were computed from the mammograms, which provide the dense tissue thickness at each location. These were used to compute absolute and percentage glandular tissue volume. We modeled the masking risk for each pixel location using the absolute and percentage dense tissue thickness and we investigated the effect of taking the cancer location probability distribution (CLPD) into account. For each method, we selected cases with the highest masking measure (by thresholding) and computed the fraction of ICs as a function of the fraction of controls selected. The latter can be interpreted as the negative supplemental screening rate (NSSR). Between the models, when incorporating CLPD, no significant differences were found. In general, the methods performed better when CLPD was included. At higher NSSRs some of the investigated masking measures had a significantly higher performance than volumetric breast density. These measures may therefore serve as an alternative to identify women with a high risk for a masked cancer.

  9. Interval breast cancer characteristics before, during and after the transition from screen-film to full-field digital screening mammography.

    PubMed

    van Bommel, Rob M G; Weber, Roy; Voogd, Adri C; Nederend, Joost; Louwman, Marieke W J; Venderink, Dick; Strobbe, Luc J A; Rutten, Matthieu J C; Plaisier, Menno L; Lohle, Paul N; Hooijen, Marianne J H; Tjan-Heijnen, Vivianne C G; Duijm, Lucien E M

    2017-05-05

    To determine the proportion of "true" interval cancers and tumor characteristics of interval breast cancers prior to, during and after the transition from screen-film mammography screening (SFM) to full-field digital mammography screening (FFDM). We included all women with interval cancers detected between January 2006 and January 2014. Breast imaging reports, biopsy results and breast surgery reports of all women recalled at screening mammography and of all women with interval breast cancers were collected. Two experienced screening radiologists reviewed the diagnostic mammograms, on which the interval cancers were diagnosed, as well as the prior screening mammograms and determined whether or not the interval cancer had been missed on the most recent screening mammogram. If not missed, the cancer was considered an occult ("true") interval cancer. A total of 442 interval cancers had been diagnosed, of which 144 at SFM with a prior SFM (SFM-SFM), 159 at FFDM with a prior SFM (FFDM-SFM) and 139 at FFDM with a prior FFDM (FFDM-FFDM). The transition from SFM to FFDM screening resulted in the diagnosis of more occult ("true") interval cancers at FFDM-SFM than at SFM-SFM (65.4% (104/159) versus 49.3% (71/144), P < 0.01), but this increase was no longer statistically significant in women who had been screened digitally for the second time (57.6% (80/139) at FFDM-FFDM versus 49.3% (71/144) at SFM-SFM). Tumor characteristics were comparable for the three interval cancer cohorts, except of a lower porportion (75.7 and 78.0% versus 67.2% af FFDM-FFDM, P < 0.05) of invasive ductal cancers at FFDM with prior FFDM. An increase in the proportion of occult interval cancers is observed during the transition from SFM to FFDM screening mammography. However, this increase seems temporary and is no longer detectable after the second round of digital screening. Tumor characteristics and type of surgery are comparable for interval cancers detected prior to, during and after the

  10. SU-E-I-59: Investigation of the Usefulness of a Standard Deviation and Mammary Gland Density as Indexes for Mammogram Classification.

    PubMed

    Takarabe, S; Yabuuchi, H; Morishita, J

    2012-06-01

    To investigate the usefulness of the standard deviation of pixel values in a whole mammary glands region and the percentage of a high- density mammary glands region to a whole mammary glands region as features for classification of mammograms into four categories based on the ACR BI-RADS breast composition. We used 36 digital mediolateral oblique view mammograms (18 patients) approved by our IRB. These images were classified into the four categories of breast compositions by an experienced breast radiologist and the results of the classification were regarded as a gold standard. First, a whole mammary region in a breast was divided into two regions such as a high-density mammary glands region and a low/iso-density mammary glands region by using a threshold value that was obtained from the pixel values corresponding to a pectoral muscle region. Then the percentage of a high-density mammary glands region to a whole mammary glands region was calculated. In addition, as a new method, the standard deviation of pixel values in a whole mammary glands region was calculated as an index based on the intermingling of mammary glands and fats. Finally, all mammograms were classified by using the combination of the percentage of a high-density mammary glands region and the standard deviation of each image. The agreement rates of the classification between our proposed method and gold standard was 86% (31/36). This result signified that our method has the potential to classify mammograms. The combination of the standard deviation of pixel values in a whole mammary glands region and the percentage of a high-density mammary glands region to a whole mammary glands region was available as features to classify mammograms based on the ACR BI- RADS breast composition. © 2012 American Association of Physicists in Medicine.

  11. Predicting radiologists' true and false positive decisions in reading mammograms by using gaze parameters and image-based features

    NASA Astrophysics Data System (ADS)

    Gandomkar, Ziba; Tay, Kevin; Ryder, Will; Brennan, Patrick C.; Mello-Thoms, Claudia

    2016-03-01

    Radiologists' gaze-related parameters combined with image-based features were utilized to classify suspicious mammographic areas ultimately scored as True Positives (TP) and False Positives (FP). Eight breast radiologists read 120 two-view digital mammograms of which 59 had biopsy proven cancer. Eye tracking data was collected and nearby fixations were clustered together. Suspicious areas on mammograms were independently identified based on thresholding an intensity saliency map followed by automatic segmentation and pruning steps. For each radiologist reported area, radiologist's fixation clusters in the area, as well as neighboring suspicious areas within 2.5° of the center of fixation, were found. A 45-dimensional feature vector containing gaze parameters of the corresponding cluster along with image-based characteristics was constructed. Gaze parameters included total number of fixations in the cluster, dwell time, time to hit the cluster for the first time, maximum number of consecutive fixations, and saccade magnitude of the first fixation in the cluster. Image-based features consisted of intensity, shape, and texture descriptors extracted from the region around the suspicious area, its surrounding tissue, and the entire breast. For each radiologist, a userspecific Support Vector Machine (SVM) model was built to classify the reported areas as TPs or FPs. Leave-one-out cross validation was utilized to avoid over-fitting. A feature selection step was embedded in the SVM training procedure by allowing radial basis function kernels to have 45 scaling factors. The proposed method was compared with the radiologists' performance using the jackknife alternative free-response receiver operating characteristic (JAFROC). The JAFROC figure of merit increased significantly for six radiologists.

  12. Multiresolution Local Binary Pattern texture analysis for false positive reduction in computerized detection of breast masses on mammograms

    NASA Astrophysics Data System (ADS)

    Choi, Jae Young; Kim, Dae Hoe; Choi, Seon Hyeong; Ro, Yong Man

    2012-03-01

    We investigated the feasibility of using multiresolution Local Binary Pattern (LBP) texture analysis to reduce falsepositive (FP) detection in a computerized mass detection framework. A new and novel approach for extracting LBP features is devised to differentiate masses and normal breast tissue on mammograms. In particular, to characterize the LBP texture patterns of the boundaries of masses, as well as to preserve the spatial structure pattern of the masses, two individual LBP texture patterns are then extracted from the core region and the ribbon region of pixels of the respective ROI regions, respectively. These two texture patterns are combined to produce the so-called multiresolution LBP feature of a given ROI. The proposed LBP texture analysis of the information in mass core region and its margin has clearly proven to be significant and is not sensitive to the precise location of the boundaries of masses. In this study, 89 mammograms were collected from the public MAIS database (DB). To perform a more realistic assessment of FP reduction process, the LBP texture analysis was applied directly to a total of 1,693 regions of interest (ROIs) automatically segmented by computer algorithm. Support Vector Machine (SVM) was applied for the classification of mass ROIs from ROIs containing normal tissue. Receiver Operating Characteristic (ROC) analysis was conducted to evaluate the classification accuracy and its improvement using multiresolution LBP features. With multiresolution LBP features, the classifier achieved an average area under the ROC curve, , z A of 0.956 during testing. In addition, the proposed LBP features outperform other state-of-the-arts features designed for false positive reduction.

  13. Mapping 3D breast lesions from full-field digital mammograms using subject-specific finite element models

    NASA Astrophysics Data System (ADS)

    García, E.; Oliver, A.; Diaz, O.; Diez, Y.; Gubern-Mérida, A.; Martí, R.; Martí, J.

    2017-03-01

    Patient-specific finite element (FE) models of the breast have received increasing attention due to the potential capability of fusing images from different modalities. During the Magnetic Resonance Imaging (MRI) to X-ray mammography registration procedure, the FE model is compressed mimicking the mammographic acquisition. Subsequently, suspicious lesions in the MRI volume can be projected into the 2D mammographic space. However, most registration algorithms do not provide the reverse information, avoiding to obtain the 3D geometrical information from the lesions localized in the mammograms. In this work we introduce a fast method to localize the 3D position of the lesion within the MRI, using both cranio-caudal (CC) and medio-lateral oblique (MLO) mammographic projections, indexing the tetrahedral elements of the biomechanical model by means of an uniform grid. For each marked lesion in the Full-Field Digital Mammogram (FFDM), the X-ray path from source to the marker is calculated. Barycentric coordinates are computed in the tetrahedrons traversed by the ray. The list of elements and coordinates allows to localize two curves within the MRI and the closest point between both curves is taken as the 3D position of the lesion. The registration errors obtained in the mammographic space are 9.89 +/- 3.72 mm in CC- and 8.04 +/- 4.68 mm in MLO-projection and the error in the 3D MRI space is equal to 10.29 +/- 3.99 mm. Regarding the uniform grid, it is computed spending between 0.1 and 0.7 seconds. The average time spent to compute the 3D location of a lesion is about 8 ms.

  14. Antenatal care--antenatal screening for fetal abnormality.

    PubMed

    Baston, Helen

    2003-02-01

    JOANNA IS NOW 24 WEEKS pregnant. She is feeling very well and finding that now her energy has returned, she is really enjoying being preganant. She still proudly shows her precious scan picture to interested friends and takes the occasional glance herself during quiet moments. Joanna, has a cousin, Susan, who has Down's syndrome. Susan is a happy and loving child who has brought a lot of joy, as well as heartache, to the extended family. Although Joanna has no delusions about the hard work and continuing care that her cousin requires, she would not herself contemplate terminating a pregnancy if her baby had the condition.

  15. Abnormal pressure in hydrocarbon environments

    USGS Publications Warehouse

    Law, B.E.; Spencer, C.W.

    1998-01-01

    Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.

  16. Breast cancer screening practices among first-generation immigrant muslim women.

    PubMed

    Hasnain, Memoona; Menon, Usha; Ferrans, Carol Estwing; Szalacha, Laura

    2014-07-01

    The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women in Chicago, IL. A convenience sample of 207 first-generation immigrant Muslim women (Middle Eastern 51%; South Asian 49%) completed a culturally adapted questionnaire developed from established instruments. The questionnaire was administered in Urdu, Hindi, Arabic, or English, based on participant preference. Internal-consistency reliability was demonstrated for all scales (alpha coefficients ranged from 0.64 to 0.91). Associations between enabling, predisposing, and need variables and the primary outcome of mammography use were explored by fitting logistic regression models. Although 70% of the women reported having had a mammogram at least once, only 52% had had one within the past 2 years. Four factors were significant predictors of ever having had a mammogram: years in the United States, self-efficacy, perceived importance of mammography, and intent to be screened. Five factors were significant predictors of adherence (having had a mammogram in the past 2 years): years in the United States, having a primary care provider, perceived importance of mammography, barriers, and intent to be screened. This article sheds light on current screening practices and identifies theory-based constructs that facilitate and hinder Muslim women's participation in mammography screening. Our findings provide insights for reaching out particularly to new immigrants, developing patient education programs grounded in culturally appropriate approaches to address perceived barriers and building women's self-efficacy, as well as systems-level considerations for ensuring access to primary care providers.

  17. Patient Navigation Improves Subsequent Breast Cancer Screening After a Noncancerous Result: Evidence from the Patient Navigation in Medically Underserved Areas Study.

    PubMed

    Molina, Yamile; Kim, Sage J; Berrios, Nerida; Glassgow, Anne Elizabeth; San Miguel, Yazmin; Darnell, Julie S; Pauls, Heather; Vijayasiri, Ganga; Warnecke, Richard B; Calhoun, Elizabeth A

    2018-03-01

    Past efforts to assess patient navigation on cancer screening utilization have focused on one-time uptake, which may not be sufficient in the long term. This is partially due to limited resources for in-person, longitudinal patient navigation. We examine the effectiveness of a low-intensity phone- and mail-based navigation on multiple screening episodes with a focus on screening uptake after receiving noncancerous results during a previous screening episode. The is a secondary analysis of patients who participated in a randomized controlled patient navigation trial in Chicago. Participants include women referred for a screening mammogram, aged 50-74 years, and with a history of benign/normal screening results. Navigation services focused on identification of barriers and intervention via shared decision-making processes. A multivariable logistic regression intent-to-treat model was used to examine differences in odds of obtaining a screening mammogram within 2 years of the initial mammogram (yes/no) between navigated and non-navigated women. Sensitivity analyses were conducted to explore patterns across subsets of participants (e.g., navigated women successfully contacted before the initial appointment; women receiving care at Hospital C). The final sample included 2,536 women (741 navigated, 1,795 non-navigated). Navigated women exhibited greater odds of obtaining subsequent screenings relative to women in the standard care group in adjusted models and analyses including women who received navigation before the initial appointment. Our findings suggest that low-intensity navigation services can improve follow-up screening among women who receive a noncancerous result. Further investigation is needed to confirm navigation's impacts on longitudinal screening.

  18. Does Gender Discrimination Impact Regular Mammography Screening? Findings from the Race Differences in Screening Mammography Study

    PubMed Central

    DAILEY, AMY B.; KASL, STANISLAV V.; JONES, BETH A.

    2011-01-01

    Objective To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines. Methods African American and white women (1451) aged 40–79 years who obtained an index screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998 were enrolled in this study. This logistic regression analysis includes the 1229 women who completed telephone interviews at baseline and follow-up (average 29.4 months later) and for whom the study outcome, nonadherence to age-specific mammography screening guidelines, was determined. Gender discrimination was measured as lifetime experience in seven possible situations. Results Gender discrimination, reported by nearly 38% of the study population, was significantly associated with nonadherence to mammography guidelines in women with annual family incomes of ≥$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group. Conclusions Our findings suggest that gender discrimination can adversely influence regular mammography screening in some women. With nearly half of women nonadherent to screening mammography guidelines in this study and with decreasing mammography rates nationwide, it is important to address the complexity of nonadherence across subgroups of women. Life stressors, such as experiences of gender discrimination, may have considerable consequences, potentially influencing health prevention prioritization in women. PMID:18321171

  19. Does gender discrimination impact regular mammography screening? Findings from the race differences in screening mammography study.

    PubMed

    Dailey, Amy B; Kasl, Stanislav V; Jones, Beth A

    2008-03-01

    ABSTRACT Objective: To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines. African American and white women (1451) aged 40-79 years who obtained an index screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998 were enrolled in this study. This logistic regression analysis includes the 1229 women who completed telephone interviews at baseline and follow-up (average 29.4 months later) and for whom the study outcome, nonadherence to age-specific mammography screening guidelines, was determined. Gender discrimination was measured as lifetime experience in seven possible situations. Gender discrimination, reported by nearly 38% of the study population, was significantly associated with nonadherence to mammography guidelines in women with annual family incomes of > or =$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group. Our findings suggest that gender discrimination can adversely influence regular mammography screening in some women. With nearly half of women nonadherent to screening mammography guidelines in this study and with decreasing mammography rates nationwide, it is important to address the complexity of nonadherence across subgroups of women. Life stressors, such as experiences of gender discrimination, may have considerable consequences, potentially influencing health prevention prioritization in women.

  20. Increasing Breast and Cervical Cancer Screening in Rural and Border Texas with Friend to Friend Plus Patient Navigation.

    PubMed

    Falk, Derek; Cubbin, Catherine; Jones, Barbara; Carrillo-Kappus, Kristen; Crocker, Andrew; Rice, Carol

    2016-11-29

    The Friend to Friend plus Patient Navigation Program (FTF+PN) aims to build an effective, sustainable infrastructure to increase breast and cervical screening rates for underserved women in rural Texas. The objective of this paper is to identify factors that (1) distinguish participants who chose patient navigation (PN) services from those who did not (non-PN) and (2) were associated with receiving a mammogram or Papanicolaou (Pap) test. This prospective study analyzed data collected from 2689 FTF+PN participants aged 18-99 years from March 1, 2012 to February 28, 2015 who self-identified as African American (AA), Latina, and non-Hispanic white (NHW). Women who were younger, AA or Latina, had less than some college education, attended a FTF+PN event because of the cost of screening or were told they needed a screening, and who reported a barrier to screening had higher odds of being a PN participant. Women who were PN participants and had more contacts with program staff had greater odds of receiving a mammogram and a Pap compared with their reference groups. Latina English-speaking women had lower odds of receiving a mammogram and a Pap compared with NHW women and Latina Spanish-speaking women had higher odds of receiving a Pap test compared with NHW women. Women with greater need chose PN services, and PN participants had higher odds of getting a screening compared with women who did not choose PN services. These results demonstrate the success of PN in screening women in rural Texas but also that racial/ethnic disparities in screening remain.

  1. Disability and Preventive Cancer Screening: Results from the 2001 California Health Interview Survey

    PubMed Central

    Ramirez, Anthony; Farmer, Gail C.; Grant, David; Papachristou, Theodora

    2005-01-01

    Objective. We sought to evaluate preventive cancer screening compliance among adults with disability in California. Methods. We used data from the 2001 California Health Interview Survey to compare disabled and nondisabled adults for differences in preventive cancer screening behaviors. Compliance rates for cancer screening tests (mammography, Papanicolaou test, prostate-specific antigen, sigmoidoscopy/colonoscopy, and fecal occult blood test) between the 2 subpopulations were evaluated. Results. Women with disabilities were 17% (Papanicolaou tests) and 13% (mammograms) more likely than women without disabilities to report noncompliance with cancer screening guidelines. Interactions between disability and reports of a doctor recommendation on cervical cancer screening were significant; women with disabilities had a lower likelihood of receiving a recommendation. Men with disabilities were 19% less likely than men without disabilities to report a prostate-specific antigen test within the last 3 years. Conclusions.secondary to structural and/or clinical factors underpinning the differences found. PMID:16195509

  2. Chromosomal abnormalities in human sperm

    SciTech Connect

    Martin, R.H.

    1985-01-01

    The ability to analyze human sperm chromosome complements after penetration of zona pellucida-free hamster eggs provides the first opportunity to study the frequency and type of chromosomal abnormalities in human gametes. Two large-scale studies have provided information on normal men. We have studied 1,426 sperm complements from 45 normal men and found an abnormality rate of 8.9%. Brandriff et al. (5) found 8.1% abnormal complements in 909 sperm from 4 men. The distribution of numerical and structural abnormalities was markedly dissimilar in the 2 studies. The frequency of aneuploidy was 5% in our sample and only 1.6% in Brandriff's, perhapsmore » reflecting individual variability among donors. The frequency of 24,YY sperm was low: 0/1,426 and 1/909. This suggests that the estimates of nondisjunction based on fluorescent Y body data (1% to 5%) are not accurate. We have also studied men at increased risk of sperm chromosomal abnormalities. The frequency of chromosomally unbalanced sperm in 6 men heterozygous for structural abnormalities varied dramatically: 77% for t11;22, 32% for t6;14, 19% for t5;18, 13% for t14;21, and 0% for inv 3 and 7. We have also studied 13 cancer patients before and after radiotherapy and demonstrated a significant dose-dependent increase of sperm chromosome abnormalities (numerical and structural) 36 months after radiation treatment.« less

  3. Utilisation of cancer screening services by disabled women in Chile

    PubMed Central

    Rotarou, Elena S.

    2017-01-01

    Background Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. Methods We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Results Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. Conclusions This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an

  4. Utilisation of cancer screening services by disabled women in Chile.

    PubMed

    Sakellariou, Dikaios; Rotarou, Elena S

    2017-01-01

    Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and

  5. Detection of chromosomal abnormalities, congenital abnormalities and transfusion syndrome in twins.

    PubMed

    Sperling, L; Kiil, C; Larsen, L U; Brocks, V; Wojdemann, K R; Qvist, I; Schwartz, M; Jørgensen, C; Espersen, G; Skajaa, K; Bang, J; Tabor, A

    2007-05-01

    To evaluate the outcome of screening for structural malformations in twins and the outcome of screening for twin-twin transfusion syndrome (TTTS) among monochorionic twins through a number of ultrasound scans from 12 weeks' gestation. Enrolled into this prospective multicenter observational study were women with twin pregnancies diagnosed before 14 + 6 gestational weeks. The monochorionic pregnancies were scanned every second week until 23 weeks in order to rule out early TTTS. All pregnancies had an anomaly scan in week 19 and fetal echocardiography in week 21 that was performed by specialists in fetal echocardiography. Zygosity was determined by DNA analysis in all twin pairs with the same sex. Among the 495 pregnancies the prenatal detection rate for severe structural abnormalities including chromosomal aneuploidies was 83% by the combination of a first-trimester nuchal translucency scan and the anomaly scan in week 19. The incidence of severe structural abnormalities was 2.6% and two-thirds of these anomalies were cardiac. There was no significant difference between the incidence in monozygotic and dizygotic twins, nor between twins conceived naturally or those conceived by assisted reproduction. The incidence of TTTS was 23% from 12 weeks until delivery, and all those monochorionic twin pregnancies that miscarried had signs of TTTS. Twin pregnancies have an increased risk of congenital malformations and one out of four monochorionic pregnancies develops TTTS. Ultrasound screening to assess chorionicity and follow-up of monochorionic pregnancies to detect signs of TTTS, as well as malformation screening, are therefore essential in the antenatal care of twin pregnancies. Copyright (c) 2007 ISUOG.

  6. Skin - abnormally dark or light

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/003242.htm Abnormally dark or light skin To use the sharing features ... The bronze color can range from light to dark (in fair-skinned people) with the degree of ...

  7. Associations Between Religion-Related Factors and Breast Cancer Screening Among American Muslims

    PubMed Central

    Padela, Aasim I.; Murrar, Sohad; Adviento, Brigid; Liao, Chuanhong; Hosseinian, Zahra; Peek, Monica; Curlin, Farr

    2015-01-01

    American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77 % of respondents had at least one mammogram in their lifetime, yet 37 % had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions. PMID:24700026

  8. Associations between religion-related factors and breast cancer screening among American Muslims.

    PubMed

    Padela, Aasim I; Murrar, Sohad; Adviento, Brigid; Liao, Chuanhong; Hosseinian, Zahra; Peek, Monica; Curlin, Farr

    2015-06-01

    American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77% of respondents had at least one mammogram in their lifetime, yet 37% had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions.

  9. Biochemical abnormalities in neonatal seizures.

    PubMed

    Sood, Arvind; Grover, Neelam; Sharma, Roshan

    2003-03-01

    The presence of seizure does not constitute a diagnoses but it is a symptom of an underlying central nervous system disorder due to systemic or biochemical disturbances. Biochemical disturbances occur frequently in the neonatal seizures either as an underlying cause or as an associated abnormality. In their presence, it is difficult to control seizure and there is a risk of further brain damage. Early recognition and treatment of biochemical disturbances is essential for optimal management and satisfactory long term outcome. The present study was conducted in the department of pediatrics in IGMC Shimla on 59 neonates. Biochemical abnormalities were detected in 29 (49.15%) of cases. Primary metabolic abnormalities occurred in 10(16.94%) cases of neonatal seizures, most common being hypocalcaemia followed by hypoglycemia, other metabolic abnormalities include hypomagnesaemia and hyponateremia. Biochemical abnormalities were seen in 19(38.77%) cases of non metabolic seizure in neonates. Associated metabolic abnormalities were observed more often with Hypoxic-ischemic-encephalopathy (11 out of 19) cases and hypoglycemia was most common in this group. No infant had hyponateremia, hyperkelemia or low zinc level.

  10. Hearing screening in children with skeletal dysplasia.

    PubMed

    Tunkel, David E; Kerbavaz, Richard; Smith, Beth; Rose-Hardison, Danielle; Alade, Yewande; Hoover-Fong, Julie

    2011-12-01

    To determine the prevalence of hearing loss and abnormal tympanometry in children with skeletal dysplasia. Clinical screening program. National convention of the Little People of America. Convenience sample of volunteers aged 18 years or younger with skeletal dysplasias. Hearing screening with behavioral testing and/or otoacoustic emissions, otoscopy, and tympanometry. A failed hearing screen was defined as hearing 35 dB HL (hearing level) or greater at 1 or more tested frequencies or by a "fail" otoacoustic emissions response. Types B and C tympanograms were considered abnormal. A total of 58 children (aged ≤18 years) with skeletal dysplasia enrolled, and 56 completed hearing screening. Forty-one children had normal hearing (71%); 9 failed in 1 ear (16%); and 6 failed in both ears (10%). Forty-four children had achondroplasia, and 31 had normal hearing in both ears (71%); 8 failed hearing screening in 1 ear (18%), and 3 in both ears (7%). Tympanometry was performed in 45 children, with normal tympanograms found in 21 (47%), bilateral abnormal tympanograms in 15 (33%), and unilateral abnormal tympanograms in 9 (20%). Fourteen children with achondroplasia had normal tympanograms (42%); 11 had bilateral abnormal tympanograms (33%); and 8 had unilateral abnormal tympanograms (24%). For those children without functioning tympanostomy tubes, there was a 9.5 times greater odds of hearing loss if there was abnormal tympanometry (P = .03). Hearing loss and middle-ear disease are both highly prevalent in children with skeletal dysplasias. Abnormal tympanometry is highly associated with the presence of hearing loss, as expected in children with eustachian tube dysfunction. Hearing screening with medical intervention is recommended for these children.

  11. Neuroblastoma Screening

    MedlinePlus

    ... including physical and emotional problems. False-negative test results can occur. Screening test results may appear to ... even if there are symptoms. False-positive test results can occur. Screening test results may appear to ...

  12. Health Screening

    MedlinePlus

    Screenings are tests that look for diseases before you have symptoms. Screening tests can find diseases early, when they're easier ... Overweight and obesity Prostate cancer in men Which tests you need depends on your age, your sex, ...

  13. Characterization of architectural distortion on mammograms using a linear energy detector

    NASA Astrophysics Data System (ADS)

    Alvarez, Jorge; Narváez, Fabián.; Poveda, César; Romero, Eduardo

    2013-11-01

    Architectural distortion is a breast cancer sign, characterized by spiculated patterns that define the disease malignancy level. In this paper, the radial spiculae of a typical architectural distortion were characterized by a new strategy. Firstly, previously selected Regions of Interest are divided into a set of parallel and disjoint bands (4 pixels the ROI length), from which intensity integrals (coefficients) are calculated. This partition is rotated every two degrees, searching in the phase plane the characteristic radial spiculation. Then, these coefficients are used to construct a fully connected graph whose edges correspond to the integral values or coefficients and the nodes to x and y image positions. A centrality measure like the first eigenvector is used to extract a set of discriminant coefficients that represent the locations with higher linear energy. Finally, the approach is trained using a set of 24 Regions of Interest obtained from the MIAS database, namely, 12 Architectural Distortions and 12 controls. The first eigenvector is then used as input to a conventional Support Vector Machine classifier whose optimal parameters were obtained by a leave-one-out cross validation. The whole method was assessed in a set of 12 RoIs with different distribution of breast tissues (normal and abnormal), and the classification results were compared against a ground truth, already provided by the data base, showing a precision rate of 0.583%, a sensitivity rate of 0.833% and a specificity rate of 0.333%.

  14. Applying a social network analysis (SNA) approach to understanding radiologists' performance in reading mammograms

    NASA Astrophysics Data System (ADS)

    Tavakoli Taba, Seyedamir; Hossain, Liaquat; Heard, Robert; Brennan, Patrick; Lee, Warwick; Lewis, Sarah

    2017-03-01

    Rationale and objectives: Observer performance has been widely studied through examining the characteristics of individuals. Applying a systems perspective, while understanding of the system's output, requires a study of the interactions between observers. This research explains a mixed methods approach to applying a social network analysis (SNA), together with a more traditional approach of examining personal/ individual characteristics in understanding observer performance in mammography. Materials and Methods: Using social networks theories and measures in order to understand observer performance, we designed a social networks survey instrument for collecting personal and network data about observers involved in mammography performance studies. We present the results of a study by our group where 31 Australian breast radiologists originally reviewed 60 mammographic cases (comprising of 20 abnormal and 40 normal cases) and then completed an online questionnaire about their social networks and personal characteristics. A jackknife free response operating characteristic (JAFROC) method was used to measure performance of radiologists. JAFROC was tested against various personal and network measures to verify the theoretical model. Results: The results from this study suggest a strong association between social networks and observer performance for Australian radiologists. Network factors accounted for 48% of variance in observer performance, in comparison to 15.5% for the personal characteristics for this study group. Conclusion: This study suggest a strong new direction for research into improving observer performance. Future studies in observer performance should consider social networks' influence as part of their research paradigm, with equal or greater vigour than traditional constructs of personal characteristics.

  15. Screening for Pancreatic Cancer

    PubMed Central

    Brand, Randall E.

    2007-01-01

    Despite improvements in the clinical and surgical management of pancreatic cancer, limited strides have been made in the early detection of this highly lethal malignancy. The majority of localized pancreatic tumors are asymptomatic, and the recognized presenting symptoms of pancreatic adenocarcinoma are often vague and heterogeneous in nature. These factors, coupled with the lack of a sensitive and noninvasive screening method, have made population-based screening for pancreatic cancer impossible. Nevertheless, at least two large institutions have performed multimodality-screening protocols for individuals with high risk of pancreatic cancer based on genetic predisposition and strong family history. Abnormalities noted during these screening protocols prompted further investigation or surgery that resulted in the discovery of benign, potentially malignant, and malignant pancreatic lesions. In addition to ductal epithelial pancreatic intraepithelial neoplasia, greater sensitivity has recently been achieved in the identification and characterization of precancerous mucinous pancreatic tumors. Advancements in proteomics and DNA microarray technology may confirm serum-based biomarkers that could be incorporated into future screening algorithms for pancreatic cancer. PMID:21960811

  16. Quantitative comparison of clustered microcalcifications in for-presentation and for-processing mammograms in full-field digital mammography.

    PubMed

    Wang, Juan; Nishikawa, Robert M; Yang, Yongyi

    2017-07-01

    Mammograms acquired with full-field digital mammography (FFDM) systems are provided in both "for-processing'' and "for-presentation'' image formats. For-presentation images are traditionally intended for visual assessment by the radiologists. In this study, we investigate the feasibility of using for-presentation images in computerized analysis and diagnosis of microcalcification (MC) lesions. We make use of a set of 188 matched mammogram image pairs of MC lesions from 95 cases (biopsy proven), in which both for-presentation and for-processing images are provided for each lesion. We then analyze and characterize the MC lesions from for-presentation images and compare them with their counterparts in for-processing images. Specifically, we consider three important aspects in computer-aided diagnosis (CAD) of MC lesions. First, we quantify each MC lesion with a set of 10 image features of clustered MCs and 12 textural features of the lesion area. Second, we assess the detectability of individual MCs in each lesion from the for-presentation images by a commonly used difference-of-Gaussians (DoG) detector. Finally, we study the diagnostic accuracy in discriminating between benign and malignant MC lesions from the for-presentation images by a pretrained support vector machine (SVM) classifier. To accommodate the underlying background suppression and image enhancement in for-presentation images, a normalization procedure is applied. The quantitative image features of MC lesions from for-presentation images are highly consistent with that from for-processing images. The values of Pearson's correlation coefficient between features from the two formats range from 0.824 to 0.961 for the 10 MC image features, and from 0.871 to 0.963 for the 12 textural features. In detection of individual MCs, the FROC curve from for-presentation is similar to that from for-processing. In particular, at sensitivity level of 80%, the average number of false-positives (FPs) per image region is 9

  17. Strategies to increase breast and cervical cancer screening among Hawaiian, Pacific Islander, and Filipina women in Hawai’i

    PubMed Central

    Aitaoto, Nia; Tsark, JoAnn U.; Wong, Danette Tomiyasu; Yamashita, Barbara A.; Braun, Kathryn L.

    2016-01-01

    The Hawai’i Breast and Cervical Cancer Control Program (BCCCP) offers free mammograms and Pap smears to women who are uninsured or underinsured through a statewide provider network. Native Hawaiians, Pacific Islanders and Filipinas are priority populations for this program, and BCCCP providers are required through contract with the Hawaii Department of Health to utilize half of their allotted mammograms and Pap smears for eligible women from these groups. To identify strategies for increasing use by these groups of mammography and Pap smear screening services through BCCCP, we held focus groups with women who could potentially use BCCCP services, and we conducted key informant interviews with 9 of Hawai’i’s 11 BCCCP providers and 9 non-BCCCP outreach workers serving these populations. Findings led to recommendations for promoting awareness of BCCCP and enhancing outreach to Native Hawaiian, Pacific Islander and Filipina communities in Hawai’i. PMID:19842363

  18. Inter-Rater Reliability for Speech-Language Therapists' Judgement of Oesophageal Abnormality during Oesophageal Visualization

    ERIC Educational Resources Information Center

    Miles, Anna

    2017-01-01

    Background: Oesophageal abnormalities are common findings in a speech-language therapy videofluoroscopy clinic. Fluoroscopic screening involving oropharynx alone fails to identify these patients. Oesophageal screening as an adjunct to videofluoroscopy is gaining popularity. Yet currently, little is known about the reliability of speech and…

  19. Electrocardiographic abnormalities in opiate addicts.

    PubMed

    Wallner, Christina; Stöllberger, Claudia; Hlavin, Anton; Finsterer, Josef; Hager, Isabella; Hermann, Peter

    2008-12-01

    To determine in a cross-sectional study the prevalence of electrocardiographic (ECG) abnormalities in opiate addicts who were therapy-seeking and its association with demographic, clinical and drug-specific parameters. In consecutive therapy-seeking opiate addicts, a 12-lead ECG was registered within 24 hours after admission and evaluated according to a pre-set protocol between October 2004 and August 2006. Additionally, demographic, clinical and drug-specific parameters were recorded. Included were 511 opiate-addicts, 25% female, with a mean age of 29 years (range 17-59 years). One or more ECG abnormalities were found in 314 patients (61%). In the 511 patients we found most commonly ST abnormalities (19%), QTc prolongation (13%), tall R- and/or S-waves (11%) and missing R progression (10%). ECG abnormalities were more common in males than in females (64 versus 54%, P < 0.05), and in patients with positive than negative urine findings for cannabis (68 versus 57%, P < 0.05). Patients with ST abnormalities were more often males than females (21 versus 11%, P < 0.05), had a history of seizures less often (16 versus 27%, P < 0.05), had positive than negative urine findings for cannabis more often (26 versus 15%, P < 0.01) and had negative than positive urine findings for methadone more often (21 versus 11%, P < 0.05). QTc prolongation was more frequent in patients with high dosages of maintenance drugs than in patients with medium or low dosages (27 versus 12 versus 10%, P < 0.05) and in patients whose urine findings were positive than negative for methadone (23 versus 11%, P < 0.001) as well as for benzodiazepines (17 versus 9%, P < 0.05). Limitations of the data are that in most cases other risk factors for the cardiac abnormalities were not known. ECG abnormalities are frequent in opiate addicts. The most frequent ECG abnormalities are ST abnormalities, QTc prolongation and tall R- and/or S-waves. ST abnormalities are associated with cannabis, and QTc prolongation

  20. [Sensitivity and specificity of the breast screening program in the Isere region based on positive results between 1991 and 1999].

    PubMed

    Garnier, A; Poncet, F; Billette De Villemeur, A; Exbrayat, C; Bon, M F; Chevalier, A; Salicru, B; Tournegros, J M

    2009-06-01

    The screening program guidelines specify that the call back rate of women for additional imaging (positive mammogram) should not exceed 7% at initial screening, and 5% at subsequent screening. Materials and methods. Results in the Isere region (12%) have prompted a review of the correlation between the call back rate and indicators of quality (detection rate, sensitivity, specificity, positive predictive value) for the radiologists providing interpretations during that time period. Three groups of radiologists were identified: the group with call back rate of 10% achieved the best results (sensitivity: 92%, detection rate: 0.53%, specificity: 90%). The group with lowest call back rate (7.7%) showed insufficient sensitivity (58%). The last group with call back rate of 18.3%, showed no improvement in sensitivity (82%) and detection rate (0.53%), but showed reduced specificity (82%). The protocol update in 2001 does not resolve this problematic situation and national results continue to demonstrate a high percentage of positive screening mammograms. A significant increase in the number of positive screening examinations compared to recommended guidelines is not advantageous and leads to an overall decrease in the quality of the screening.

  1. Understanding breast cancer screening practices in Taiwan: a country with universal health care.

    PubMed

    Wu, Tsu-Yin; Chung, Scott; Yeh, Ming-Chen; Chang, Shu-Chen; Hsieh, Hsing-Fang; Ha, Soo Ji

    2012-01-01

    While the incidence of breast cancer (BC) has been relatively low in Asian countries, it has been rising rapidly in Taiwan. Within the last decade, it has replaced cervical cancer as the most diagnosed cancer site for women. Nevertheless, there is a paucity of studies reporting the attitudes and practices of breast cancer screening among Chinese women. The aim of this study is to assess Taiwanese women's knowledge of and attitudes toward BC screening and to identify potential factors that may influence screening behavior. The study population consisted of a sample of 434 Taiwanese women aged 40 and older. Despite access to universal health care for Taiwanese women and the fact that a majority of the women had heard of the breast cancer screening (mammogram, clinical breast exams, etc.), the actual utilization of these screening modalities was relatively low. In the current study, the majority of women had never had mammograms or ultrasound in the past 5 years. The number one most reported barriers were "no time, " "forgetfulness, " "too cumbersome, " and "laziness, " followed by the perception of no need to get screened. In addition, the results revealed several areas of misconceptions or incorrect information perceived by study participants. Based on the results from the regression analysis, significant predictors of obtaining repeated screening modalities included age, coverage for screening, barriers, self-efficacy, intention, family/friends diagnosed with breast cancer. The findings from the current study provide the potential to build evidence-based programs to effectively plan and implement policies in order to raise awareness in breast cancer and promote BC screening in order to optimize health outcomes for women affected by this disease.

  2. Breast cancer screening--prevalence of disease in women who only respond after an invitation reminder.

    PubMed

    Hofvind, Solveig

    2007-01-01

    An analysis of the Norwegian Breast Cancer Screening Programme, including 1,390,310 screening examinations, showed an attendance rate of 71.7% in response to one invitation letter (ordinary attendees) and a further 4.5% increase only after an additional reminder (reminded attendees). Our aim was to examine the prevalence of breast cancer in ordinary and reminded attendees, the frequency of positive mammograms, and the positive predictive value in the two groups. The prevalence of breast cancer in ordinary attendees was 5.6 per 1000 screens compared with 6.3 per 1000 screens in reminded attendees (p<0.001). The frequencies of positive mammograms were 3.5% and 4.0% (p<0.001), and the positive predictive values were 15.9% and 15.2% (p=0.387), respectively, in ordinary and reminded attendees. The risk of breast cancer is higher in women who respond only after a reminder letter, indicating that the value of sending a reminder should be assessed in the light of these results, as well as by the increase in the attendance rate.

  3. Evaluation of the "Angelina Jolie Effect" on Screening Mammography Utilization in an Academic Center.

    PubMed

    Huesch, Marco D; Schetter, Susann; Segel, Joel; Chetlen, Alison

    2017-08-01

    The aim of this study was to understand the impact on screening mammography at our institution, comparing weekly utilization in the 2 years before and the 2 years after Ms Angelina Jolie disclosed in the New York Times on May 13, 2013, that she had had a prophylactic double mastectomy. All 48,110 consecutive screening mammograms conducted at our institution between May 16, 2011, and May 16, 2015, were selected from our electronic medical record system. We used interrupted time series statistical models and graphical methods on utilization data to understand utilization changes before and after Ms Jolie's news. The graphed trend of weekly screening mammogram utilization failed to show changes around the time of interest. Analytical models and statistical tests also failed to show a step change increase or acceleration of utilization around May 2013. However, graphical and time series analyses showed a flattening of utilization in the middle of 2014. In our well-powered analysis in a large regional breast imaging center, we found no support for the hypothesis that this celebrity news drove increased screening. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Promoting mammography screening among Chinese American women using a message-framing intervention.

    PubMed

    Sun, Yiyuan; Sarma, Elizabeth A; Moyer, Anne; Messina, Catherine R

    2015-07-01

    This study examined the role of women's perceptions about the relative pros versus cons (decisional balance) of mammography in moderating Chinese American women's responses to gain- and loss-framed messages that promote mammography. One hundred and forty-three Chinese American women who were currently nonadherent to guidelines for receiving annual screening mammograms were randomly assigned to read either a gain- or loss-framed culturally appropriate print brochure about mammography screening. Mammography screening was self-reported at a 2-month follow-up. Although there was not a main effect for message frame, the hypothesized interaction between message frame and decisional balance was significant, indicating that women who received a framed message that matched their decisional balance were significantly more likely to have obtained a mammogram by the follow-up than women who received a mismatched message. Results suggest that decisional balance, and more generally, perceptions about mammography, may be an important moderator of framing effects for mammography among Chinese American women. The match between message frame and decisional balance should be considered when attempting to encourage Chinese American women to receive mammography screening, as a match between the two may be most persuasive. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Influence of Computer-Aided Detection on Performance of Screening Mammography

    PubMed Central

    Fenton, Joshua J.; Taplin, Stephen H.; Carney, Patricia A.; Abraham, Linn; Sickles, Edward A.; D'Orsi, Carl; Berns, Eric A.; Cutter, Gary; Hendrick, R. Edward; Barlow, William E.; Elmore, Joann G.

    2011-01-01

    Background Computer-aided detection identifies suspicious findings on mammograms to assist radiologists. Since the Food and Drug Administration approved the technology in 1998, it has been disseminated into practice, but its effect on the accuracy of interpretation is unclear. Methods We determined the association between the use of computer-aided detection at mammography facilities and the performance of screening mammography from 1998 through 2002 at 43 facilities in three states. We had complete data for 222,135 women (a total of 429,345 mammograms), including 2351 women who received a diagnosis of breast cancer within 1 year after screening. We calculated the specificity, sensitivity, and positive predictive value of screening mammography with and without computer-aided detection, as well as the rates of biopsy and breast-cancer detection and the overall accuracy, measured as the area under the receiver-operating-characteristic (ROC) curve. Results Seven facilities (16%) implemented computer-aided detection during the study period. Diagnostic specificity decreased from 90.2% before implementation to 87.2% after implementation (P<0.001), the positive predictive value decreased from 4.1% to 3.2% (P = 0.01), and the rate of biopsy increased by 19.7% (P<0.001). The increase in sensitivity from 80.4% before implementation of computer-aided detection to 84.0% after implementation was not significant (P = 0.32). The change in the cancer-detection rate (including invasive breast cancers and ductal carcinomas in situ) was not significant (4.15 cases per 1000 screening mammograms before implementation and 4.20 cases after implementation, P = 0.90). Analyses of data from all 43 facilities showed that the use of computer-aided detection was associated with significantly lower overall accuracy than was nonuse (area under the ROC curve, 0.871 vs. 0.919; P = 0.005). Conclusions The use of computer-aided detection is associated with reduced accuracy of interpretation of

  6. Obstetrical complications associated with abnormal maternal serum markers analytes.

    PubMed

    Gagnon, Alain; Wilson, R Douglas

    2008-10-01

    To review the obstetrical outcomes associated with abnormally elevated or decreased level of one or more of the most frequently measured maternal serum marker analytes used in screening for aneuploidy. To provide guidance to facilitate the management of pregnancies that have abnormal levels of one of more markers and to assess the usefulness of these markers as a screening test. Perinatal outcomes associated with abnormal levels of maternal serum markers analytes are compared with the outcomes of pregnancies with normal levels of the same analytes or the general population. The Cochrane Library and Medline were searched for English-language articles published from 1966 to February 2007, relating to maternal serum markers and perinatal outcomes. Search terms included PAPP-A (pregnancy associated plasma protein A), AFP (alphafetoprotein), hCG (human chorionic gonadotropin), estriol, unconjugated estriol, inhibin, inhibin-A, maternal serum screen, triple marker screen, quadruple screen, integrated prenatal screen, first trimester screen, and combined prenatal screen. All study types were reviewed. Randomized controlled trials were considered evidence of the highest quality, followed by cohort studies. Key individual studies on which the recommendations are based are referenced. Supporting data for each recommendation are summarized with evaluative comments and references. The evidence was evaluated using the guidelines developed by the Canadian Task Force on Preventive Health Care. The evidence collected was reviewed by the Genetics Committee of the Society of Obstetricians and Gynaecologists of Canada. The benefit expected from this guideline is to facilitate early detection of potential adverse pregnancy outcomes when risks are identified at the time of a maternal serum screen. It will help further stratification of risk and provide options for pregnancy management to minimize the impact of pregnancy complications. The potential harms resulting from such practice

  7. Factors Associated with Breast Cancer Screening in a Country with National Health Insurance: Did We Succeed in Reducing Healthcare Disparities?

    PubMed

    Hayek, Samah; Enav, Teena; Shohat, Tamy; Keinan-Boker, Lital

    2017-02-01

    The effectiveness of breast cancer screening programs in reducing mortality is well established in the scientific literature. The National Breast Cancer Screening Program in Israel provides biennial mammograms for women of average risk aged 50-74 and annual mammograms for women aged 40-49 at higher risk. Compliance is high, but differential. This study explores different factors associated with breast cancer screening attendance among women aged 40-74 years. Two main outcomes were studied: ever been screened and been screened in the 2 years preceding the study, using the cross-sectional Knowledge, Attitudes and Practices (KAP) Survey conducted in 2010-2012 among 2575 Israeli women aged 21+ years. The independent variables were sociodemographic characteristics, perceived health status, lifestyle habits, and healthcare fund membership. Bivariate and multivariable logistic regressions were conducted. Of the 943 participants aged 50-74, 87% had ever been screened and 74.8% had attended screening for breast cancer in the last 2 years. In multivariable models, Jewish compared to Arab women (adjusted prevalence ratio [APR] = 2.09, 95% confidence interval [CI]: 1.02-4.32), and unmarried compared to married women (APR = 2.9, 95% CI: 1.2-7.2), were more likely to have ever been screened. The only factor associated with breast cancer screening in the 2 years preceding the study was healthcare fund membership. In women aged 40-49 years, ethnicity was the only contributing factor associated with breast cancer screening, with higher screening rates in the 2 years preceding the study in Jewish versus Arab women (APR = 3.7, 95% CI: 1.52-9.3). Breast cancer screening attendance in Israel is high. However, significant differences are observed by membership of healthcare fund and by ethnicity, calling for better targeted outreach programs at this level.

  8. Inequity of healthcare utilization on mammography examination and Pap smear screening in Thailand: Analysis of a population-based household survey

    PubMed Central

    2017-01-01

    Healthcare in Thailand is not equally distributed, and not all people can equally access healthcare resources even if they are covered by health insurance. To examine factors associated with the utilization of mammography examination for breast cancer and Pap smear screening for cervical cancer, data from the national reproductive health survey conducted by the National Statistical Office of Thailand in 2009 was examined. The survey was carried out on 15,074,126 women aged 30–59 years. The results showed that the wealthier respondents had more mammograms than did the lower-income groups. The concentration index was 0.144. The data on Pap smears for cervical cancer also showed that the wealthier respondents were more likely to have had a Pap smear than their lower-income counterparts. The concentration index was 0.054. Determinants of mammography examination were education, followed by health welfare and wealth index, whereas the determinants of Pap smear screening were wealth index, followed by health welfare and education. The government should support greater education for women because education was associated with socioeconomic status and wealth. There should be an increase in the number of screening campaigns, mobile clinics, and low-cost mammograms and continued support for accessibility to mammograms, especially in rural areas and low-income communities. PMID:28282430

  9. Racial and Ethnic Disparity in Symptomatic Breast Cancer Awareness despite a Recent Screen: The Role of Tumor Biology and Mammography Facility Characteristics.

    PubMed

    Mortel, Mylove; Rauscher, Garth H; Murphy, Anne Marie; Hoskins, Kent; Warnecke, Richard B

    2015-10-01

    In a racially and ethnically diverse sample of recently diagnosed urban patients with breast cancer, we examined associations of patient, tumor biology, and mammography facility characteristics on the probability of symptomatic discovery of their breast cancer despite a recent prior screening mammogram. In the Breast Cancer Care in Chicago study, self-reports at interview were used to define patients as having a screen-detected breast cancer or having symptomatic awareness despite a recent screening mammogram (SADRS), in the past 1 or 2 years. Patients with symptomatic breast cancer who did not report a recent prior screen were excluded from these analyses. Characteristics associated with more aggressive disease [estrogen receptor (ER)- and progesterone receptor (PR)-negative status and higher tumor grade] were abstracted from medical records. Mammogram facility characteristics that might indicate aspects of screening quality were defined and controlled for in some analyses. SADRS was more common among non-Hispanic black and Hispanic than among non-Hispanic white patients (36% and 42% vs. 25%, respectively, P = 0.0004). SADRS was associated with ER/PR-negative and higher-grade disease. Patients screened at sites that relied on dedicated radiologists and sites that were breast imaging centers of excellence were less likely to report SADRS. Tumor and facility factors together accounted for two thirds of the disparity in SADRS (proportion mediated = 70%, P = 0.02). Facility resources and tumor aggressiveness explain much of the racial/ethnic disparity in symptomatic breast cancer among recently screened patients. A more equitable distribution of high-quality screening would ameliorate but not eliminate this disparity. ©2015 American Association for Cancer Research.

  10. TRICARE: changes included in the National Defense Authorization Act for Fiscal Year 2007; improvements to descriptions of cancer screening for women. Final rule.

    PubMed

    2010-08-06

    The Department is publishing this final rule to implement section 703 of the National Defense Authorization Act (NDAA) for Fiscal Year 2007 (FY07), Public Law 109-364. Specifically, that legislation authorizes breast cancer screening and cervical cancer screening for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou smears. The rule allows coverage for "breast cancer screening" and "cervical cancer screening" for female beneficiaries of the Military Health System, instead of constraining such testing to mammograms and Papanicolaou tests. This rule ensures new breast and cervical cancer screening procedures can be added to the TRICARE benefit as such procedures are proven to be a safe, effective, and nationally accepted medical practice. This amends the cancer specific recommendations for breast and cervical cancer screenings to be brought in line with the processes for updating other cancer screening recommendations. In response to public comment on the proposed rule, this final rule includes a clarification that the benefit encompasses screening based on Health and Human Services guidelines.

  11. Pinna abnormalities and low-set ears

    MedlinePlus

    ... Pinna abnormalities; Genetic defect - pinna; Congenital defect - pinna Images Ear abnormalities Pinna of the newborn ear References Haddad J, Keesecker S. Congenital malformations. In: Kliegman RM, Stanton BF, ...

  12. Do pre-trained deep learning models improve computer-aided classification of digital mammograms?

    NASA Astrophysics Data System (ADS)

    Aboutalib, Sarah S.; Mohamed, Aly A.; Zuley, Margarita L.; Berg, Wendie A.; Luo, Yahong; Wu, Shandong

    2018-02-01

    Digital mammography screening is an important exam for the early detection of breast cancer and reduction in mortality. False positives leading to high recall rates, however, results in unnecessary negative consequences to patients and health care systems. In order to better aid radiologists, computer-aided tools can be utilized to improve distinction between image classifications and thus potentially reduce false recalls. The emergence of deep learning has shown promising results in the area of biomedical imaging data analysis. This study aimed to investigate deep learning and transfer learning methods that can improve digital mammography classification performance. In particular, we evaluated the effect of pre-training deep learning models with other imaging datasets in order to boost classification performance on a digital mammography dataset. Two types of datasets were used for pre-training: (1) a digitized film mammography dataset, and (2) a very large non-medical imaging dataset. By using either of these datasets to pre-train the network initially, and then fine-tuning with the digital mammography dataset, we found an increase in overall classification performance in comparison to a model without pre-training, with the very large non-medical dataset performing the best in improving the classification accuracy.

  13. Neighborhood Structural Similarity Mapping for the Classification of Masses in Mammograms.

    PubMed

    Rabidas, Rinku; Midya, Abhishek; Chakraborty, Jayasree

    2018-05-01

    In this paper, two novel feature extraction methods, using neighborhood structural similarity (NSS), are proposed for the characterization of mammographic masses as benign or malignant. Since gray-level distribution of pixels is different in benign and malignant masses, more regular and homogeneous patterns are visible in benign masses compared to malignant masses; the proposed method exploits the similarity between neighboring regions of masses by designing two new features, namely, NSS-I and NSS-II, which capture global similarity at different scales. Complementary to these global features, uniform local binary patterns are computed to enhance the classification efficiency by combining with the proposed features. The performance of the features are evaluated using the images from the mini-mammographic image analysis society (mini-MIAS) and digital database for screening mammography (DDSM) databases, where a tenfold cross-validation technique is incorporated with Fisher linear discriminant analysis, after selecting the optimal set of features using stepwise logistic regression method. The best area under the receiver operating characteristic curve of 0.98 with an accuracy of is achieved with the mini-MIAS database, while the same for the DDSM database is 0.93 with accuracy .

  14. Radiologists’ Interpretive Skills in Screening vs. Diagnostic Mammography: Are They Related?

    PubMed Central

    Elmore, Joann G.; Cook, Andrea J.; Bogart, Andy; Carney, Patricia A.; Geller, Berta; Taplin, Stephen; Buist, Diana SM; Onega, Tracy; Lee, Christoph I.; Miglioretti, Diana L.

    2016-01-01

    Purpose To determine whether radiologists who perform well in screening also perform well in interpreting diagnostic mammography. Materials & Methods We evaluated the accuracy of 468 radiologists interpreting 2,234,947 screening and 196,164 diagnostic mammograms. Adjusting for site, radiologist, and patient characteristics, we identified radiologists with performance in the highest tertile and compared to those with lower performance. Results A moderate correlation was noted for radiologists’ accuracy when interpreting screening versus their accuracy on diagnostic exams: sensitivity (rspearman=0.51, 95% CI: 0.22, 0.80; P=0.0006), specificity (rspearman=0.40, 95% CI: 0.30, 0.49; P<0.0001). Conclusion Different educational approaches to screening and diagnostic imaging should be considered. PMID:27438069

  15. Complex patterns of abnormal heartbeats

    NASA Technical Reports Server (NTRS)

    Schulte-Frohlinde, Verena; Ashkenazy, Yosef; Goldberger, Ary L.; Ivanov, Plamen Ch; Costa, Madalena; Morley-Davies, Adrian; Stanley, H. Eugene; Glass, Leon

    2002-01-01

    Individuals having frequent abnormal heartbeats interspersed with normal heartbeats may be at an increased risk of sudden cardiac death. However, mechanistic understanding of such cardiac arrhythmias is limited. We present a visual and qualitative method to display statistical properties of abnormal heartbeats. We introduce dynamical "heartprints" which reveal characteristic patterns in long clinical records encompassing approximately 10(5) heartbeats and may provide information about underlying mechanisms. We test if these dynamics can be reproduced by model simulations in which abnormal heartbeats are generated (i) randomly, (ii) at a fixed time interval following a preceding normal heartbeat, or (iii) by an independent oscillator that may or may not interact with the normal heartbeat. We compare the results of these three models and test their limitations to comprehensively simulate the statistical features of selected clinical records. This work introduces methods that can be used to test mathematical models of arrhythmogenesis and to develop a new understanding of underlying electrophysiologic mechanisms of cardiac arrhythmia.

  16. Colon cancer screening

    MedlinePlus

    Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal ...

  17. Prevalence and distribution of congenital abnormalities in Turkey: differences between the prenatal and postnatal periods.

    PubMed

    Oztarhan, Kazim; Gedikbasi, Ali; Yildirim, Dogukan; Arslan, Oguz; Adal, Erdal; Kavuncuoglu, Sultan; Ozbek, Sibel; Ceylan, Yavuz

    2010-12-01

    The aim of this study was to determine the distribution of cases associated with congenital abnormalities during the following three periods: pregnancy, birth, and the neonatal period. This was a retrospective study of cases between 2002 and 2006. All abnormal pregnancies, elective terminations of pregnancies, stillbirths, and births with congenital abnormalities managed in the Neonatology Unit were classified based on the above distribution scheme. During the 5-year study period, 1906 cases with congenital abnormalities were recruited, as follows: 640 prenatally detected and terminated cases, with most abnormalities related to the central nervous system, chromosomes, and urogenital system (56.7%, 12.7%, and 8.9%, respectively); 712 neonates with congenital abnormalities (congenital heart disease [49.2%], central nervous system abnormalities [14.7%], and urogenital system abnormalities [12.9%]); and hospital stillbirths, of which 34.2% had malformations (220 prenatal cases [34.4%] had multiple abnormalities, whereas 188 liveborn cases [26.4%] had multiple abnormalities). The congenital abnormalities rate between 2002 and 2006 was 2.07%. Systematic screening for fetal anomalies is the primary means for identification of affected pregnancies. © 2010 The Authors. Congenital Anomalies © 2010 Japanese Teratology Society.

  18. Endocrine abnormalities in lithium toxicity.

    PubMed

    Shanks, Gabriella; Mishra, Vinita; Nikolova, Stanka

    2017-10-01

    Lithium toxicity can manifest as a variety of biochemical -abnormalities. This case report describes a patient -presenting to the emergency department with neuropsychiatric -symptoms on a background of bipolar disorder, for which she was prescribed lithium for 26 years previously. Cases of lithium toxicity are rare but can be severe and this case report -demonstrates to clinicians that they must be thorough in investigating patients with lithium toxicity, as there are many potential abnormalities that can manifest concurrently. © Royal College of Physicians 2017. All rights reserved.

  19. Breast cancer screening among Asian immigrant women in Canada.

    PubMed

    Sun, Zhuoyu; Xiong, Hui; Kearney, Anne; Zhang, Jin; Liu, Wei; Huang, Guowei; Wang, Peizhong Peter

    2010-02-01

    The objective of this study was to examine the pattern of breast cancer screening among Asian immigrant women aged 50-69 years and compare it with corresponding non-immigrant women in Canada. Data from the Canadian Community Health Survey cycle 2.1 (2003) were utilized. Self-reported screening histories were used as outcome variables: socioeconomic status and medical histories were used as predictive variables. Analyses were weighted to represent the target population. Multivariate logistic regression analyses were performed to compare the screening pattern among Asian immigrant women and corresponding non-immigrant Canadians. In total, 508 Asian immigrant women were included in this study. The results suggest that 71% and 60% of Asian immigrant women reported ever having had and recent mammogram use, respectively, while the corresponding figures for non-immigrant women were 89% and 72%. The observed differences were statistically significant and could not be explained by confounding factors. The ability to speak one of the two official languages is an important barrier to mammography screening among Asian immigrant women. The findings show lower rates of mammography screening among Asian immigrant women in Canada. If breast screening is to remain a health policy objective in Canada, targeted efforts to increase the recruitment of Asian immigrant women need to be developed or strengthened.

  20. Cost-effectiveness of targeted versus tailored interventions to promote mammography screening among women military veterans in the United States.

    PubMed

    Lairson, David R; Chan, Wen; Chang, Yu-Chia; del Junco, Deborah J; Vernon, Sally W

    2011-05-01

    We conducted an economic evaluation of mammography promotion interventions in a population-based, nationally representative sample of 5500 women veterans. Women 52 years and older were randomly selected from the National Registry of Women Veterans and randomly assigned to a survey-only control group and two intervention groups that varied in the extent of personalization (tailored vs. targeted). Effectiveness measures were the prevalence of at least one self-reported post-intervention mammogram and two post-intervention mammograms 6-15 months apart. Incremental cost-effectiveness ratios (ICERs) were the incremental cost per additional person screened. Uncertainty was examined with sensitivity analysis and bootstrap simulation. The targeted intervention cost $25 per person compared to $52 per person for the tailored intervention. About 27% of the cost was incurred in identifying and recruiting the eligible population. The percent of women reporting at least one mammogram were .447 in the control group, .469 in the targeted group, and .460 in the tailored group. The ICER was $1116 comparing the targeted group to the control group (95% confidence interval (CI)=$493 to dominated). The tailored intervention was dominated (more costly and less effective) by the targeted intervention. Decision-makers should consider effectiveness evidence and the full recruitment and patient time costs associated with the implementation of screening interventions when making investments in mammography screening promotion programs. Identification and recruitment of eligible participants add substantial costs to outreach screening promotion interventions. Tailoring adds substantial cost to the targeted mammography promotion strategy without a commensurate increase in effectiveness. Although cost-effectiveness has been reported to be higher for some in-reach screening promotion interventions, a recent meta-analysis revealed significant heterogeneity in the effect sizes of published health

  1. Effect of protocol-related variables and women's characteristics on the cumulative false-positive risk in breast cancer screening

    PubMed Central

    Román, R.; Sala, M.; Salas, D.; Ascunce, N.; Zubizarreta, R.; Castells, X.

    2012-01-01

    Background: Reducing the false-positive risk in breast cancer screening is important. We examined how the screening-protocol and women's characteristics affect the cumulative false-positive risk. Methods: This is a retrospective cohort study of 1 565 364 women aged 45–69 years who underwent 4 739 498 screening mammograms from 1990 to 2006. Multilevel discrete hazard models were used to estimate the cumulative false-positive risk over 10 sequential mammograms under different risk scenarios. Results: The factors affecting the false-positive risk for any procedure and for invasive procedures were double mammogram reading [odds ratio (OR) = 2.06 and 4.44, respectively], two mammographic views (OR = 0.77 and 1.56, respectively), digital mammography (OR = 0.83 for invasive procedures), premenopausal status (OR = 1.31 and 1.22, respectively), use of hormone replacement therapy (OR = 1.03 and 0.84, respectively), previous invasive procedures (OR = 1.52 and 2.00, respectively), and a familial history of breast cancer (OR = 1.18 and 1.21, respectively). The cumulative false-positive risk for women who started screening at age 50–51 was 20.39% [95% confidence interval (CI) 20.02–20.76], ranging from 51.43% to 7.47% in the highest and lowest risk profiles, respectively. The cumulative risk for invasive procedures was 1.76% (95% CI 1.66–1.87), ranging from 12.02% to 1.58%. Conclusions: The cumulative false-positive risk varied widely depending on the factors studied. These findings are relevant to provide women with accurate information and to improve the effectiveness of screening programs. PMID:21430183

  2. Conflicting national recommendations and the use of screening mammography: does the physician's recommendation matter?

    PubMed

    Taplin, S H; Urban, N; Taylor, V M; Savarino, J

    1997-01-01

    This study evaluated whether women's perceptions of the conflicting recommendations for breast cancer screening were associated with decreased use of mammography. We conducted a random-digit-dial telephone survey of 1024 women in four communities of western Washington State. In addition to collecting data for demographics, beliefs about mammography, and insurance coverage, we inquired whether the respondents were aware of any conflicting recommendations about when to begin or how frequently to perform screening mammography, wh