Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study.
Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study.
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DOI：
10.7326/0003-4819-155-8-201110180-00004
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发表时间：
2011-10-18
影响因子：
39.2
通讯作者：
Miglioretti DL
中科院分区：
文献类型：
--
作者：
Hubbard RA;Kerlikowske K;Flowers CI;Yankaskas BC;Zhu W;Miglioretti DL
假阳性的乳房X光检查结果很常见。两年一次的筛查可能会降低重复筛查多年的累积假阳性结果的可能性，但也可能推迟癌症诊断。比较10年一次或两年一次的乳房X光检查后假阳性结果的累积概率和乳腺癌发病的分期分布。未来的队列。国家癌症研究所资助的乳腺癌监测联盟的七个乳房X光检查登记。在1994至2006年间，169,456名年龄在40-59岁之间接受首次筛查的女性接受了乳房X光检查，而在1996至2006年间被诊断为浸润性乳腺癌的女性为4,492人。假阳性召回和活检建议；发生乳腺癌的分期分布。假阳性召回概率最初为16.3%，随后进行乳房X光检查时为9.6%。最初的假阳性活检推荐概率为2.5%，后续检查的假阳性推荐概率为1.0%。对比影片的可获得性使假阳性召回的几率减半(调整后的OR为0.50(CI为0.45，0.56))。当筛查开始于40岁时，女性在10年后接受至少一次假阳性回忆的累积概率在每年筛查时为61.3%(95%CI，59.4%至63.1%)，在两年筛查时为41.6%(CI，40.6%至42.5%)。每年一次的活检推荐假阳性累积概率为7.0%(CI，6.1%~7.8%)，两年一次筛查的累积假阳性概率为4.8%(CI，4.4%~5.2%)。在50岁开始筛查时，估计值是可比的。我们观察到，在发生乳腺癌的女性人群中，两年一次的晚期癌症比例比每年一次的筛查(40-49岁的绝对值增加了3.3%(CI−1.1，7.8)，50-59岁的绝对值增加了2.3%(CI−1.0，5.7))没有统计学意义上的显著增加。在整个10年的时间里，很少有女性接受过筛查。放射科医生的特征会影响召回率，因此无法联系到。大多数乳房X光检查是胶片，而不是数字检查。在一小部分患癌症的女性中分析了发生癌症的情况。经过10年的年度筛查，超过一半的女性将收到至少一次假阳性召回，7%-9%的女性将收到假阳性活检建议。两年一次的筛查似乎降低了10年后假阳性结果的累积概率，但可能与被诊断为晚期癌症的概率略有绝对增加有关。
False-positive mammography results are common. Biennial screening may decrease the cumulative probability of false-positive results across many years of repeat screening but could also delay cancer diagnosis. To compare the cumulative probability of false-positive results and the stage distribution of incident breast cancer after 10 years of annual or biennial screening mammography. Prospective cohort. Seven mammography registries in the National Cancer Institute–funded Breast Cancer Surveillance Consortium. 169,456 women who received a first screening mammogram at age 40–59 between 1994 and 2006 and 4,492 women with an incident invasive breast cancer diagnosed between 1996 and 2006. False-positive recalls and biopsy recommendations; stage distribution of incident breast cancer. False-positive recall probability was 16.3% at first and 9.6% at subsequent mammography. False-positive biopsy recommendation probability was 2.5% at first and 1.0% at subsequent examinations. Availability of comparison films halved the odds of a false-positive recall (adjusted OR 0.50 (CI 0.45, 0.56)). When screening began at age 40, the cumulative probability of a woman receiving at least one false-positive recall after 10 years was 61.3% (95% CI, 59.4% to 63.1%) with annual and 41.6% (CI, 40.6% to 42.5%) with biennial screening. Cumulative probability of false-positive biopsy recommendation was 7.0% (CI, 6.1% to 7.8%) with annual and 4.8% (CI, 4.4% to 5.2%) with biennial screening. Estimates were comparable when screening began at age 50. We observed a non-statistically significant increase in the proportion of late-stage cancers with biennial compared to annual screening (absolute increase 3.3% (CI −1.1, 7.8) age 40–49, 2.3% (CI −1.0, 5.7) age 50–59) among a population of women with incident breast cancer. Few women underwent screening over the entire 10 year period. Radiologist characteristics influence recall rates and were unavailable. Most mammograms were film rather than digital exams. Incident cancers were analyzed in a small population of women who developed cancer. After 10 years of annual screening, more than half of women will receive at least one false-positive recall, and 7–9% will receive a false-positive biopsy recommendation. Biennial screening appears to reduce the cumulative probability of false-positive results after 10 years but may be associated with a small absolute increase in the probability of being diagnosed with late stage cancer.
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影响因子：
19.7
作者：
Ichikawa, Laura E.;Barlow, William E.;Brenner, R. James
通讯作者：
Brenner, R. James
影响因子：
1.9
作者：
LANE, PW;NELDER, JA
通讯作者：
NELDER, JA
影响因子：
39.2
作者：
Carney, PA;Miglioretti, DL;Ballard-Barbash, R
通讯作者：
Ballard-Barbash, R
影响因子：
158.5
作者：
Pisano, ED;Gatsonis, C;Rebner, M
通讯作者：
Rebner, M
影响因子：
--
作者：
Beam, CA;Layde, PM;Sullivan, DC
通讯作者：
Sullivan, DC