Abstract
Purpose. To assess the influence of mammography mapping with the help of computer-aided detection system (CAD) MammCheck II of our own design on the relapse-free survival (RFS) in breast cancer (BC) patients detected during the combined (mammographic and ultrasound [US]) screening.
Materials and methods. 10732 women aged 40-87 years old (mean age: 52.20±8.63) who performed mammography were randomized to the standard screening group (mammography → US of the dense breasts) or to the group of CAD-assisted screening (mammography → CAD → targeted US of suspicious CAD markings, as well as the standard US of the dense breasts; CAD group). The primary endpoint was the 3-years RFS.
Results. Totally, in the standard screening group we identified 230 BCs (4.29%), in the CAD group — 248 BCs (4.62%; p>0.05), including 49 (21.20%) и 88 (35.48%) 0-I stage BCs, respectively (p<0.05). Median of the primary tumor size was significantly lower in the CAD group (18 mm) compared to the standard screening group (25 mm; р<0.05). 3-years RFS was significantly higher (87.90%) in the CAD group compared to the standard screening group (81.20%; р<0.05).
Conclusion. Breast US after the previous mammography CAD mapping significantly increases the 3-years RFS of women with combined screening-detected BC.
References
Azamjah N, Soltan-Zadeh Y, Zayeri F. Global Trend of Breast Cancer Mortality Rate: A 25-Year Study // Asian Pac. J. Cancer Prev. 2019;1(20(7):2015–2020. doi:10.31557/APJCP.2019.20.7.2015
Состояние онкологической помощи населению России в 2019 году / Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена — филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2020 [Kaprin AD, Starinsky VV, Shakhzadova AO. The oncology care for Russian population in 2019: state of the art. Moscow: MNIOI im. P.A. Gertzena, 2020 (In Russ.)].
Lauby-Secretan B, Scoccianti C, Loomis D et al. Breast-Cancer Screening — Viewpoint of the IARC Working Group // The New England J. Med. 2015;372(24(11):2353–2358.
Mousa AL, Ryan EA, Mello-Thoms C, Brennan PC. What effect does mammographic breast density have on lesion detection in digital mammography? // Clinical Radiology. 2014;69:333–341.
Kerlikowske K, Hubbard RA, Miglioretti DL. Comparative effectiveness of digital versus film-screen mammography in community practice in the United States: a cohort study // Ann. Intern. Med. 2011;155(8):493–502. doi:10.7326/0003-4819-155-8-201110180-00005
Пасынков Д.В., Егошин И.А., Колчев А.А. и др. Сравнительный анализ диагностической ценности систем компьютерного анализа маммограмм I и II поколений // Медицинская визуализация. 2017;21(1): 90–102. doi:10.24835/1607-0763-2017-1-90-102 [Pasynkov DV, Egoshin IA, Kolchev АА et al. Diagnostic Value of 1st and 2nd Generation Computer Aided Detection Systems for Mammography: a Comparative Assessment // Medical visualization. 2017;21(1):90–102 (In Russ.)]. doi:10.24835/1607-0763-2017-1-90-102
Пасынков Д.В., Егошин И.А., Колчев А.А и др. Эффективность системы компьютерного анализа маммограмм в диагностике вариантов рака молочной железы, трудно выявляемых при скрининговой маммографии // REJR. 2019;9(2):107–118. doi:10.21569/2222-7415-2019-9-2-107-118 [Pasynkov DV, Egoshin IA, Kolchev АА et al. The value of computer aided detection system in breast cancer difficult to detect at screening mammography // REJR. 2019;9(2):107–118 (In Russ.)]. doi:10.21569/2222-7415-2019-9-2-107-118
Egoshin I, Pasynkov D, Kolchev A et al. A segmentation approach for mammographic images and its clinical value (2018) // 2017 IEEE International Conference on Microwaves, Antennas, Communications and Electronic Systems, COMCAS. 2017, 2018:1–6. doi: 10.1109/COMCAS.2017.8244764
Brandt J, Garne JP, Tengrup I et al. Age at diagnosis in relation to survival following breast cancer: a cohort study // World J. Surg. Onc. 2015;13:33. doi.org/10.1186/s12957-014-0429-x
Vacek PM, Geller BM. A prospective study of breast cancer risk using routine mammographic breast density measurements // Cancer Epidemiol. Biomarkers Prev. 2004;13(5):715–722.
Лабазанова П.Г., Рожкова Н.И., Бурдина И.И. и др. Маммографическая плотность и риск развития рака молочной железы. Взгляд на историю изучения вопроса // REJR. 2020;10(2):205–222. doi:10.21569/2222-7415-2020-10-2-205-222 [Labazanova PG, Rozhkova NI, Burdina II et al. Mammographic density and risk of breast cancer. A look at the history of studying the issue // REJR. 2020;10(2):205–222. doi:10.21569/2222-7415-2020-10-2-205-222 (In Russ.)]. doi:10.21569/2222-7415-2020-10-2-205-222
Kim S-Y, Kim MJ, Moon HJ et al. Application of the downgrade criteria to supplemental screening ultrasound for women with negative mammography but dense breasts // Medicine. 2016;95(44):e5279. doi:10.1097/MD.0000000000005279
Freer PE. Mammographic Breast Density: Impact on Breast Cancer Risk and Implications for Screening // Radiographics. 2015;35(2):302–315. doi: 10.1148/rg.352140106
Saad ED, Squifflet P, Burzykowski T et al. Disease-free survival as a surrogate for overall survival in patients with HER2-positive, early breast cancer in trials of adjuvant trastuzumab for up to 1 year: a systematic review and meta-analysis // Lancet Oncol. 2019;20(3):361–370. doi:10.1016/S1470-2045(18)30750-2
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2021