Positive predictive values by mammographic density and screening mode in the Norwegian Breast Cancer Screening Program. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Moshina, Nataliia; Ursin, Giske; Roman, Marta; Sebuødegård, Sofie; Hofvind, Solveig
• Is Part Of: European journal of radiology. Volume 85:Issue 1(2016)
• Page Start: 248
• Page End: 254
• Publication Date: 2016-01
• Subjects: Breast cancer screening -- Mammographic density -- Positive predictive value -- Screening mode; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2015.11.030
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Positive predictive values decreased by increasing mammographic density among recalled women. Women with dense breasts are more likely subjected to harms of false positive screening mammograms. Compared with screen-film mammography, digital mammography is associated with higher positive predictive values in women with fatty breasts. Abstract: Objective: 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. Methods: 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. Results: 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. Conclusion: 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.