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Risk-Based Approach Developed to Triage Mammography Use

FRIDAY, April 16, 2021 -- Clinical indication and individual risk factors are associated with breast cancer detection and could help triage mammography examinations, according to a study published online March 25 in JAMA Network Open.

Diana L. Miglioretti, Ph.D., from the University of California, Davis, School of Medicine, and colleagues collected data from mammography examinations performed in 2014 to 2019 to develop a risk-based strategy for triaging mammograms during periods of decreased capacity. The cohort included 898,415 individuals contributing 1,878,924 mammograms interpreted by 448 radiologists.

The researchers observed wide variation in cancer detection rates based on clinical indication, breast symptoms, personal history of breast cancer, and age. Fifty-five percent of all detected cancers were accounted for by the 12 percent of mammograms with very high (89.6 to 122.3 cancers detected per 1,000 mammograms) or high (36.1 to 47.5 cancers detected per 1,000 mammograms) cancer detection rates; these included mammograms to assess an abnormal mammogram or breast lump in individuals of all ages, to assess breast symptoms other than lump in individuals with a breast cancer history or without history but aged 60 years or older, and for a short follow-up interval in individuals aged 60 years or older without breast cancer history. Overall, 13.1 percent of detected cancers were accounted for by the 44.2 percent of mammograms with very low cancer detection rates and included annual screening mammograms in individuals aged 50 to 69 years and all screening mammograms in those younger than 50 years.

"The study results provide important guidance for navigating through any crisis that could impact the availability of mammograms," Miglioretti said in a statement.

Several authors disclosed financial ties to GE Healthcare and the publishing industry.

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