Collaborators, Affiliations
CollaboratorsItem in Clipboard
Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening OutcomesAmy Trentham-Dietz et al. Ann Intern Med. 2016.
. 2016 Nov 15;165(10):700-712. doi: 10.7326/M16-0476. Epub 2016 Aug 23. Authors Amy Trentham-Dietz 1 , Karla Kerlikowske 1 , Natasha K Stout 1 , Diana L Miglioretti 1 , Clyde B Schechter 1 , Mehmet Ali Ergun 1 , Jeroen J van den Broek 1 , Oguzhan Alagoz 1 , Brian L Sprague 1 , Nicolien T van Ravesteyn 1 , Aimee M Near 1 , Ronald E Gangnon 1 , John M Hampton 1 , Young Chandler 1 , Harry J de Koning 1 , Jeanne S Mandelblatt 1 , Anna N A Tosteson 1 ; Breast Cancer Surveillance Consortium and the Cancer Intervention and Surveillance Modeling Network CollaboratorsItem in Clipboard
AbstractBackground: Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits.
Objective: To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer.
Design: Collaborative simulation modeling using national incidence, breast density, and screening performance data.
Setting: United States.
Patients: Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0.
Intervention: Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years).
Measurements: Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted.
Results: Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained.
Limitation: Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods.
Conclusion: Average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density receiving annual screening will maintain a similar or better balance of benefits and harms than average-risk women receiving biennial screening.
Primary funding source: National Cancer Institute.
FiguresFigure 1
False-positives mammograms per breast cancer…
Figure 1
False-positives mammograms per breast cancer death averted for women (A) aged 50–74 and…
Figure 1False-positives mammograms per breast cancer death averted for women (A) aged 50–74 and (B) aged 65–74 according to screening frequency and risk level (relative risk group, breast density) using an exemplar model (Model E). Values for all screening frequencies compared to the scenario with no mammography screening. Values for ages 65–74 assume all women received biennial screening during ages 50–64. Dashed lines show this value for women with average density and average risk receiving biennial screening (147.7 for ages 50–74 and 105.8 for ages 65–74). Having fewer false-positives per death averted than this level, i.e., a value below the dashed line, would be more favorable.
Similar articlesMandelblatt JS, Stout NK, Schechter CB, van den Broek JJ, Miglioretti DL, Krapcho M, Trentham-Dietz A, Munoz D, Lee SJ, Berry DA, van Ravesteyn NT, Alagoz O, Kerlikowske K, Tosteson AN, Near AM, Hoeffken A, Chang Y, Heijnsdijk EA, Chisholm G, Huang X, Huang H, Ergun MA, Gangnon R, Sprague BL, Plevritis S, Feuer E, de Koning HJ, Cronin KA. Mandelblatt JS, et al. Ann Intern Med. 2016 Feb 16;164(4):215-25. doi: 10.7326/M15-1536. Epub 2016 Jan 12. Ann Intern Med. 2016. PMID: 26756606 Free PMC article.
Stout NK, Miglioretti DL, Su YR, Lee CI, Abraham L, Alagoz O, de Koning HJ, Hampton JM, Henderson L, Lowry KP, Mandelblatt JS, Onega T, Schechter CB, Sprague BL, Stein S, Trentham-Dietz A, van Ravesteyn NT, Wernli KJ, Kerlikowske K, Tosteson ANA. Stout NK, et al. JAMA Intern Med. 2024 Oct 1;184(10):1222-1231. doi: 10.1001/jamainternmed.2024.4224. JAMA Intern Med. 2024. PMID: 39186304
Sprague BL, Stout NK, Schechter C, van Ravesteyn NT, Cevik M, Alagoz O, Lee CI, van den Broek JJ, Miglioretti DL, Mandelblatt JS, de Koning HJ, Kerlikowske K, Lehman CD, Tosteson AN. Sprague BL, et al. Ann Intern Med. 2015 Feb 3;162(3):157-66. doi: 10.7326/M14-0692. Ann Intern Med. 2015. PMID: 25486550 Free PMC article.
Myers ER, Moorman P, Gierisch JM, Havrilesky LJ, Grimm LJ, Ghate S, Davidson B, Mongtomery RC, Crowley MJ, McCrory DC, Kendrick A, Sanders GD. Myers ER, et al. JAMA. 2015 Oct 20;314(15):1615-34. doi: 10.1001/jama.2015.13183. JAMA. 2015. PMID: 26501537 Review.
Nelson HD, Pappas M, Cantor A, Griffin J, Daeges M, Humphrey L. Nelson HD, et al. Ann Intern Med. 2016 Feb 16;164(4):256-67. doi: 10.7326/M15-0970. Epub 2016 Jan 12. Ann Intern Med. 2016. PMID: 26756737 Review.
Gao C, Polley EC, Hart SN, Huang H, Hu C, Gnanaolivu R, Lilyquist J, Boddicker NJ, Na J, Ambrosone CB, Auer PL, Bernstein L, Burnside ES, Eliassen AH, Gaudet MM, Haiman C, Hunter DJ, Jacobs EJ, John EM, Lindström S, Ma H, Neuhausen SL, Newcomb PA, O'Brien KM, Olson JE, Ong IM, Patel AV, Palmer JR, Sandler DP, Tamimi R, Taylor JA, Teras LR, Trentham-Dietz A, Vachon CM, Weinberg CR, Yao S, Weitzel JN, Goldgar DE, Domchek SM, Nathanson KL, Couch FJ, Kraft P. Gao C, et al. J Clin Oncol. 2021 Aug 10;39(23):2564-2573. doi: 10.1200/JCO.20.01992. Epub 2021 Jun 8. J Clin Oncol. 2021. PMID: 34101481 Free PMC article.
Sprague BL, Chen S, Miglioretti DL, Gard CC, Tice JA, Hubbard RA, Aiello Bowles EJ, Kaufman PA, Kerlikowske K. Sprague BL, et al. JAMA Netw Open. 2023 Feb 1;6(2):e230166. doi: 10.1001/jamanetworkopen.2023.0166. JAMA Netw Open. 2023. PMID: 36808238 Free PMC article.
Mital S, Nguyen HV. Mital S, et al. BMC Cancer. 2022 May 6;22(1):501. doi: 10.1186/s12885-022-09613-1. BMC Cancer. 2022. PMID: 35524200 Free PMC article.
Pal Choudhury P, Wilcox AN, Brook MN, Zhang Y, Ahearn T, Orr N, Coulson P, Schoemaker MJ, Jones ME, Gail MH, Swerdlow AJ, Chatterjee N, Garcia-Closas M. Pal Choudhury P, et al. J Natl Cancer Inst. 2020 Mar 1;112(3):278-285. doi: 10.1093/jnci/djz113. J Natl Cancer Inst. 2020. PMID: 31165158 Free PMC article.
Puzhko S, Gagnon J, Simard J, Knoppers BM, Siedlikowski S, Bartlett G. Puzhko S, et al. Public Health Rev. 2019 Feb 28;40:2. doi: 10.1186/s40985-019-0111-5. eCollection 2019. Public Health Rev. 2019. PMID: 30858992 Free PMC article. Review.
RetroSearch is an open source project built by @garambo | Open a GitHub Issue
Search and Browse the WWW like it's 1997 | Search results from DuckDuckGo
HTML:
3.2
| Encoding:
UTF-8
| Version:
0.7.3