Journal of Breast Imaging最新文献

{"title":"Commentary on \"Dual-Layer Spectral CT-Based Models for the Differential Diagnosis of Breast Lesions\".","authors":"Eren Yeh","doi":"10.1093/jbi/wbag026","DOIUrl":"10.1093/jbi/wbag026","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"509-511"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive Predictive Value and Breast Cancer Histology by the Method of Detection Across a Multistate Health Care Enterprise.","authors":"Alan Zhu, Laura Harper, Santo Maimone Iv, Bhavika K Patel, Marlene E Girardo, Jacob Varner, Tariq Rashid, Aditya Khurana, Richard E Sharpe","doi":"10.1093/jbi/wbaf086","DOIUrl":"10.1093/jbi/wbaf086","url":null,"abstract":"<p><strong>Objective: </strong>To compare the pathology outcomes of image-guided breast biopsies across a multistate health care enterprise by the method of detection (MOD), including the positive predictive value (PPV3) and histological types.</p><p><strong>Methods: </strong>Biopsies from October 31, 2017, to July 6, 2023, across 18 imaging sites in 4 states were extracted. Radiologists prospectively assigned MODs, including symptomatic presentations (self-examination, clinical examination) and imaging modalities (mammogram, tomosynthesis, US, MRI, contrast-enhanced mammogram, molecular breast imaging, other imaging). For each MOD, the rates of malignancy and cancer subtypes were calculated. Univariate and multivariate logistic regression analyses were performed.</p><p><strong>Results: </strong>In 26 932 biopsies on 22 582 patients (mean age 57.6 years ± 14.2 [SD]; 22 416 women), 6068 (81.1%) cancers were detected by screening, and 1144 (15.3%) were detected by symptoms. Symptomatic presentation MODs had a higher PPV3 (43.0% vs 25.6%; P < .001), larger cancer lesion sizes (x̄ = 27.5 mm vs x̄ = 17.8 mm; P < 001), and a higher association with invasive carcinoma (96.7% vs 76.8%; P <.001) compared with screening imaging-based MODs. Methods of detection with higher PPV3s also tended to have higher rates of invasive carcinoma (Spearman's ρ = 0.83).</p><p><strong>Conclusion: </strong>Compared with breast cancers detected after symptomatic presentations, those identified via image-based screening were smaller and less often invasive, confirming the value of screening in early detection. Positive predictive value and the rate of invasive carcinoma varied in parallel across MODs.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"512-522"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned in the Early Adoption of Method of Detection Reporting.","authors":"Michelle V Lee, Sarah M Pittman, Eric Rosen, Luther W Meyer, Peter Eby, Sujata V Ghate, Lars J Grimm","doi":"10.1093/jbi/wbag001","DOIUrl":"10.1093/jbi/wbag001","url":null,"abstract":"<p><p>Until recently, no breast cancer database in the United States records how breast cancers are initially detected, and, therefore, current data lack the fundamental ability to link breast cancer outcomes to screening directly. Consequently, the magnitude and relative contributions that screening and treatment play in the reduction of breast cancer mortality are unknown, and the debate over breast cancer screening continues. To address these shortcomings, advocates have proposed that the Method of Detection (MOD) be documented with every breast cancer diagnosis. MOD data can then be abstracted to cancer registries to provide direct evidence of the impact of screening on breast cancer diagnoses and subsequent outcomes and thereby resolve the debate about the benefits of screening. Given the widespread support of MOD reporting, there is also great potential to improve and facilitate its clinical implementation. Barriers to MOD adoption include a lack of an organized national breast cancer screening program, the cost of implementation, a lack of radiologist MOD training, and technical lapses, among others. The American College of Radiology and the Society of Breast Imaging have addressed barriers to MOD implementation through educational opportunities and the Breast Imaging Reporting and Data System 6th Edition provides comprehensive education on the MOD program. However, consistent and accurate MOD reporting and linkage to tumor registries on a national level will require a multifaceted approach to achieve success. Ultimately, the information gained from the direct role of MOD will result in breast cancer screening recommendations built on science-based policy.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"564-568"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Risk-based Screening Justified by the WISDOM Trial?","authors":"Debra L Monticciolo, R Edward Hendrick","doi":"10.1093/jbi/wbag048","DOIUrl":"10.1093/jbi/wbag048","url":null,"abstract":"<p><p>Widespread mammography screening has resulted in a significant decline in breast cancer deaths, but it is resource intensive. The WISDOM (Women Informed to Screen Depending on Measures of Risk) trial attempts to assess screening based on individual risk as an alternative to age-based screening (annual screening starting at age 40 years). In their initial report, the authors concluded that risk-based screening is safe and acceptable. Their results do not support this conclusion. The first primary endpoint to test the noninferiority of risk-based screening used the metric of stage IIB and higher breast cancers. Many of these cancers would be apparent on physical exam, thus eliminating some advantages of early detection and ignoring shortcomings of the risk-based approach. In addition, the study set an extremely weak noninferiority margin, compromising their conclusion concerning noninferiority. Details of mammography and MRI use in WISDOM reflect poor compliance with screening protocols in both arms of the study. Substantial non-compliance as well as out-of-study imaging in both cohorts resulted in two nearly identical protocols, rather than a comparison of different screening strategies. The study's findings of substantial non-compliance to the risk-based protocol make it difficult to justify risk-based screening being acceptable to women. The trial's second primary endpoint, to test whether risk-based screening yielded fewer biopsies than annual screening, failed. The risk-based screening protocol is labor intensive and would be challenging to implement in the typical primary care practice. The vast majority of breast cancers occur in average-risk women and could be missed in a risk-based system, especially in women under age 50 and minority women.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"471-476"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-Layer Spectral CT-Based Models for the Differential Diagnosis of Breast Lesions.","authors":"Puzhen Li, Yu Zhou, Jianhong Qiu, Xinyi Zhou, Zhou Zhou, Yurong Zhou, Liying Xu","doi":"10.1093/jbi/wbag018","DOIUrl":"10.1093/jbi/wbag018","url":null,"abstract":"<p><strong>Objective: </strong>To develop a hybrid model integrating morphological features with quantitative parameters from dual-layer spectral computed tomography (DSCT) to noninvasively differentiate benign breast lesions from breast cancer.</p><p><strong>Methods: </strong>This retrospective study included patients with breast lesions incidentally detected on spectral CT between January 2020 and May 2024. Lesions were categorized as benign or malignant based on histopathology or greater than two years' stability on follow-up imaging. Clinical variables, morphological characteristics, and DSCT parameters were collected. The cohort was randomly divided into training, validation, and independent testing sets using stratified sampling. Feature selection was performed exclusively within the training set using univariate analysis, collinearity assessment, and least absolute shrinkage and selection operator regression with the one-standard-error criterion. Clinico-radiological, DSCT-based, and hybrid models were constructed using multivariate logistic regression. Model discrimination was evaluated using receiver operating characteristic analysis and, model stability was assessed using nested cross-validation. A nomogram was constructed based on the best-performing model.</p><p><strong>Results: </strong>A total of 102 patients (mean age 52 ± 11 years) were included, including 27 patients (26%) with benign breast lesions and 75 patients (74%) with breast cancer. In the independent testing set, the DSCT-based model outperformed the clinical-radiological model (AUC = 0.967 vs 0.933), while the hybrid model achieved the highest diagnostic performance (AUC, 0.983). Calibration curves demonstrated strong concordance between predicted and observed outcomes. Decision curve analysis indicated favorable net benefit.</p><p><strong>Conclusion: </strong>The hybrid model demonstrated good diagnostic performance in noninvasively differentiating benign from malignant breast lesions detected preoperatively on DSCT.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"495-508"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Framework for Aligning 5-Year and Lifetime Breast Cancer Risk in Women Without High-Penetrance Mutations.","authors":"Graham A Colditz, Debbie L Bennett, Kala Visvanathan, Bernie A Rosner, Shu Jiang","doi":"10.1093/jbi/wbag011","DOIUrl":"10.1093/jbi/wbag011","url":null,"abstract":"<p><strong>Objective: </strong>Reconciling cutoff thresholds for short-term (5-year) and long-term (lifetime) breast cancer risk could support tailored and evidence-based approaches to supplemental screening and risk management most relevant to short-term clinical actions. This study aims to consistently classify women at increased risk and provide 5-year risk cutoff that corresponds to a 20% lifetime risk.</p><p><strong>Methods: </strong>Using U.S. Surveillance, Epidemiology and End Results (SEER) program population incidence data for women 40 to 74 years of age, this study reports both lifetime and 5-year population-based risk estimates controlling for competing risk and age varying breast cancer incidence. A cut point for 5-year risk equivalent to lifetime risk of 20% which triggers increased screening is generated. This computation is a weighted average incorporating age, remaining life expectancy, and population risk distribution. The primary outcome is breast cancer incidence (in situ and invasive).</p><p><strong>Results: </strong>A lifetime risk threshold of 20% corresponded to markedly age-dependent 5-year risk cut points, increasing from ∼1.3% at ages 40-44 to ∼10.9% at ages 70-74. For women 40-74, 20% lifetime risk corresponds to a 5-year risk cut-off of 3.16%.</p><p><strong>Conclusions: </strong>Aligning lifetime risk of ≥20% and the 5-year breast cancer risk cutoff enhances consistency of classification of women at increased risk and clinical decision-making. Women with a ≥3.16% 5-year risk of breast cancer have risk equivalent to a lifetime risk of ≥20% on average. This can facilitate rational and evidence-based approaches to short-term and long-term risk assessment results for both risk reduction and tailored screening.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"523-529"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unknown Case: Man With a Palpable Breast Mass.","authors":"Stephanie Ntim, Cherie M Kuzmiak","doi":"10.1093/jbi/wbaf046","DOIUrl":"10.1093/jbi/wbaf046","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"597-599"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Allostatic Load as a Framework for Breast Cancer Risk Assessment Across Sociodemographic Groups: Insights from a Safety-Net Population.","authors":"Antonio R Lopez, Laura Jean Podewils, Joanna Garcia, Antonio Escamilla Guevera, Gelareh Sadigh, Eniola T Oluyemi, Elizabeth S McDonald, Ruth Carlos, Randy C Miles","doi":"10.1093/jbi/wbag020","DOIUrl":"10.1093/jbi/wbag020","url":null,"abstract":"<p><strong>Objective: </strong>Allostatic load (AL) is an emerging framework quantifying physiological dysregulation from cumulative exposure to stressors over an individual's life. We evaluated the relationship between AL and malignant breast biopsy results in women across sociodemographic subgroups.</p><p><strong>Methods: </strong>Women 18 years and older who underwent at least one image-guided breast biopsy at a safety-net hospital between April 2016 and December 2023 were identified. Consistent with prior studies, AL was defined as a score based on eight values: resting pulse rate, systolic blood pressure, diastolic blood pressure, body-mass index, serum albumin, creatinine, estimated glomerular filtration rate, and white blood cell count. Multivariable logistic regression models were used to assess the association between AL and malignant breast biopsy results among different sociodemographic groups. Effect modification by racial/ethnic category was then examined using stratified models.</p><p><strong>Results: </strong>668 participants had data available for all eight biomarkers. Most participants were Hispanic (n = 376, 54.5%), reported English as their primary language (n = 423, 63.3%), and had Medicaid for insurance (n = 300, 44.9%). In stratified analyses, the association between AL and malignant breast biopsy result was significant in White, non-Hispanic patients. In White, non-Hispanic patients, after adjusting for age, every one-unit increase in AL was associated with a 46% increased likelihood of malignant breast biopsy result (OR 1.46, P = 0.03).</p><p><strong>Conclusion: </strong>AL was associated with malignant breast biopsy results in specific sociodemographic subgroups, potentially representing a modifiable risk factor for breast cancer prevention. Further research with large, diverse populations is required to evaluate additional factors impacting breast cancer outcomes across sociodemographic groups.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"530-539"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Reductive\" Reasoning: Identifying Normal Postoperative Changes Versus Malignancy After Reduction Mammoplasty.","authors":"Stephanie B Shamir, Colleen McNally, Anandita Mathur, Erin Choe, Laurie R Margolies","doi":"10.1093/jbi/wbag031","DOIUrl":"10.1093/jbi/wbag031","url":null,"abstract":"<p><p>Given the increasing frequency of reduction mammoplasty (RM) procedures, it is essential for radiologists to develop expertise in the accurate evaluation and interpretation of postoperative breast imaging findings. This pictorial essay reviews common RM surgical techniques with the resultant expected imaging findings on mammography, ultrasound, and MRI. Findings include symmetric parenchymal redistribution, architectural distortion and scar tissue, benign calcifications, and fat necrosis. Recognizing these patterns is essential to avoid misinterpreting benign postoperative changes as malignancy as well as to identify suspicious findings that require further evaluation. Diagnostic challenges include differentiating post-surgical scarring from malignancy, especially in the lower half of the breast. Cases of breast malignancy after RM are presented to highlight important differentiation between expected postoperative changes and breast cancer.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"581-593"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Interventions to Reduce Breast Cancer Screening Barriers using Community Centered Prioritization Exercises.","authors":"Lewis Jordan, Arissa Milton, Mai Elezaby, Tyler Prout, Nicci Owusu-Brackett, Anand K Narayan","doi":"10.1093/jbi/wbag003","DOIUrl":"10.1093/jbi/wbag003","url":null,"abstract":"<p><p>PICK charts are Lean Six Sigma tools used to prioritize improvements based on effort required and potential impact. Our purpose was to conduct PICK chart prioritization exercises with a low income, diverse community advisory group to identify and prioritize patient and community centered interventions to reduce mammography screening disparities. Community advisory focus group was composed of 22 adults from low-income neighborhoods in Madison, Wisconsin. Included participants were from the Wisconsin Network for Research Support Community Advisory on Research Design and Strategies, recruited from community centers and food banks that serve individuals from diverse racial, socioeconomic, and educational backgrounds. Structured, divergent thinking brainstorming sessions were conducted to identify interventions to improve the mammography screening process. The idea generation process revealed 52 unique ideas across 7 process map domains. Among participants, the most highly cited ideas that were classified as high impact, low effort ideas included: reminders, sharing positive stories about mammography experiences, offering reassurance during mammograms, and reducing co-pays. Community centered prioritization exercises identify patient-centered, contextually relevant interventions to improve cancer screening percentages in medically underserved patient populations, including high-quality, patient centered communication about the mammography screening process and reduced costs.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"550-555"},"PeriodicalIF":1.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}