Table 3.
Screening Mammography Accuracy and Cancer Rates in Women With a Personal History of Breast Cancer (n = 58830 Screens)
| % (95% CI) |
Rate (95% CI) |
|||||||
|---|---|---|---|---|---|---|---|---|
| Sensitivity | Specificity | AIRa | PPVb | Cancerc | Cancer Detectiond |
Interval Cancere |
||
| Age at mammography, y | ||||||||
| <50 | 51.0 (41.4–60.4)f | 97.8 (97.4–98.1)f | 2.9 (2.6–3.4)f | 26.5 (20.9–33.0)f | 15.2 (12.6–18.4)f | 7.8 (5.9–10.2) | 7.5 (5.7–9.8)f | |
| 50–59 | 64.0 (56.0–71.3)f | 98.1 (97.9–98.4)f | 2.5 (2.3–2.8)f | 26.4 (22.2–31.2)f | 10.3 (8.8–12.1)f | 6.6 (5.4–8.1) | 3.7 (2.9–4.9)f | |
| 60–69 | 71.8 (63.3–78.9)f | 98.3 (98.1–98.5)f | 2.3 (2.0–2.5)f | 26.7 (22.2–31.8)f | 8.4 (7.0–10.0)f | 6.0 (4.9–7.4) | 2.4 (1.7–3.3)f | |
| ≥70 | 69.2 (63.1–74.7)f | 98.6 (98.4–98.7)f | 2.1 (1.9–2.3)f | 34.1 (29.9–38.5)f | 10.4 (9.2–11.9)f | 7.2 (6.2–8.4) | 3.2 (2.6–4.0)f | |
| BI-RADS breast density; excludes 12 956 screens missing data | ||||||||
| 1, Almost entirely fatty | 73.3 (46.7–89.6) | 99.0 (98.6–99.3)f | 1.3 (1.0–1.7)f | 24.4 (14.1–39.0) | 4.4 (2.6–7.2)f | 3.2 (1.8–5.8)f | 1.2 (0.4–3.1)f | |
| 2, Scattered fibroglandular tissue | 69.4 (62.8–75.3) | 98.4 (98.2–98.6)f | 2.2 (2.0–2.4)f | 29.6 (25.7–33.8) | 9.4 (8.2–10.8)f | 6.5 (5.6–7.7)f | 2.9 (2.3–3.7)f | |
| 3, Heterogeneously dense | 61.2 (54.4–67.5) | 98.3 (98.1–98.5)f | 2.4 (2.1–2.6)f | 30.0 (25.8–34.5) | 11.5 (10.0–13.2)f | 7.1 (5.9–8.4)f | 4.5 (3.6–5.6)f | |
| 4, Extremely dense | 55.3 (39.5–70.1) | 97.7 (97.0–98.3)f | 3.1 (2.5–3.9)f | 28.0 (19.0–39.2) | 15.7 (11.4–21.6)f | 8.7 (5.7–13.3)f | 7.0 (4.4–11.3)f | |
| Time since last mammogram; excludes 1061 screens missing data, mo | ||||||||
| 9–14 | 63.8 (59.4–67.9) | 98.5 (98.3–98.6)f | 2.2 (2.0–2.3)f | 29.7 (27.0–32.6) | 10.1 (9.2–11.0) | 6.4 (5.8–7.2) | 3.7 (3.2–4.2) | |
| 15–23 | 70.5 (59.5–79.6) | 98.0 (97.6–98.3)f | 2.8 (2.4–3.2)f | 27.0 (21.3–33.5) | 10.6 (8.5–13.2) | 7.5 (5.7–9.7) | 3.1 (2.1–4.7) | |
| ≥24 | 67.5 (51.7–80.1) | 97.7 (97.0–98.2)f | 3.3 (2.7–4.1)f | 31.4 (22.5–41.9) | 15.5 (11.4–21.1) | 10.5 (7.2–15.3) | 5.1 (2.9–8.7) | |
| Time since first breast cancer diagnosis, y | ||||||||
| <1 | 64.0 (49.9–76.0)f | 97.0 (96.4–97.4)f | 3.7 (3.2–4.3)f | 19.5 (14.1–26.3)f | 11.4 (8.6–14.9) | 7.3 (5.1–10.3)f | 4.1 (2.6–6.5) | |
| 1–2 | 59.7 (51.0–67.8)f | 97.8 (97.6–98.1)f | 2.7 (2.4–3.0)f | 20.3 (16.5–24.6)f | 9.1 (7.7–10.8) | 5.5 (4.4–6.8)f | 3.7 (2.8–4.8) | |
| 3–4 | 59.3 (50.8–67.2)f | 98.4 (98.2–98.6)f | 2.1 (1.9–2.4)f | 26.8 (22.0–32.1)f | 9.6 (8.1–11.4) | 5.7 (4.6–7.1)f | 3.9 (3.0–5.1) | |
| 5–6 | 75.4 (66.9–82.4)f | 98.5 (98.3–98.8)f | 2.3 (2.0–2.6)f | 36.8 (31.0–43.0)f | 11.1 (9.3–13.2) | 8.3 (6.8–10.3)f | 2.7 (1.9–3.9) | |
| 7–9 | 63.7 (54.6–71.9)f | 98.8 (98.5–99.0)f | 2.0 (1.7–2.3)f | 37.7 (31.0–44.8)f | 11.7 (9.7–14.1) | 7.4 (5.9–9.4)f | 4.2 (3.1–5.7) | |
| ≥10 | 74.3 (62.8–83.2)f | 99.2 (98.9–99.4)f | 1.7 (1.4–2.1)f | 51.5 (41.7–61.2)f | 11.9 (9.4–15.0) | 8.8 (6.7–11.6)f | 3.1 (1.9–4.8) | |
| Type of first breast cancer | ||||||||
| DCIS | 72.9 (66.2–78.7)f | 98.0 (97.8–98.3)f | 3.1 (2.8–3.4)f | 37.4 (32.6–42.5)f | 15.8 (13.7–18.2)f | 11.5 (9.8–13.6)f | 4.3 (3.3–5.6) | |
| Invasive cancer | 61.9 (57.2–66.4)f | 98.4 (98.3–98.5)f | 2.1 (2.0–2.3)f | 26.1 (23.5–28.9)f | 9.1 (8.2–10.0)f | 5.6 (5.0–6.3)f | 3.4 (3.0–4.0) | |
| Primary surgery; excludes 1149 screens missing data | ||||||||
| Breast conserving without radiation | 63.6 (55.1–71.4) | 97.9 (97.6–98.2)f | 3.1 (2.8–3.6)f | 35.6 (29.7–41.9)f | 17.6 (14.9–20.8)f | 11.2 (9.1–13.8)f | 6.4 (4.8–8.5)f | |
| Breast conserving with radiation | 64.8 (59.5–69.7) | 98.0 (97.8–98.2)f | 2.7 (2.5–2.9)f | 26.9 (23.9–30.0)f | 11.2 (10.0–12.4)f | 7.2 (6.3–8.3)f | 3.9 (3.3–4.7)f | |
| Mastectomy | 65.0 (56.1–72.9) | 99.0 (98.9–99.1)f | 1.4 (1.2–1.5)f | 27.5 (22.6–33.1)f | 5.8 (4.8–7.0)f | 3.8 (3.0–4.7)f | 2.0 (1.5–2.8)f | |
| Radiation therapy; excludes 1136 screens missing data | ||||||||
| None | 64.5 (58.0–70.6) | 98.6 (98.5–98.8)f | 2.0 (1.8–2.2)f | 33.1 (28.8–37.7)f | 10.4 (9.1–11.9) | 6.7 (5.7–7.9) | 3.7 (3.0–4.6) | |
| Any | 64.5 (59.5–69.2) | 98.2 (98.0–98.3)f | 2.5 (2.3–2.6)f | 26.3 (23.5–29.3)f | 10.0 (9.0–11.1) | 6.5 (5.7–7.3) | 3.6 (3.0–4.2) | |
| Adjuvant systemic therapy; excludes 3501 screens missing data | ||||||||
| None | 71.0 (66.0–75.5)f | 98.3 (98.1–98.4) | 2.6 (2.4–2.8)f | 33.8 (30.4–37.4)f | 12.4 (11.2–13.8)f | 8.8 (7.8–10.0)f | 3.6 (3.0–4.4) | |
| Any, chemotherapy or endocrine | 54.1 (47.5–60.6)f | 98.4 (98.2–98.6) | 2.0 (1.8–2.2)f | 21.5 (18.2–25.1)f | 8.0 (7.0–9.1)f | 4.3 (3.6–5.2)f | 3.7 (3.0–4.5) | |
| Self-reported history of breast implant, reduction, or reconstruction; excludes 14 387 screens missing data | ||||||||
| No | 66.0 (61.3–70.3) | 98.5 (98.4–98.6) | 2.2 (2.0–2.3)f | 31.0 (28.1–34.2) | 10.2 (9.2–11.2)f | 6.7 (6.0–7.5)f | 3.5 (2.9–4.1) | |
| Yes | 50.0 (29.4–70.6) | 98.8 (98.3–99.1) | 1.5 (1.1–2.0)f | 21.3 (11.8–35.4) | 6.5 (4.2–10.0)f | 3.2 (1.7–6.0)f | 3.2 (1.7–6.0) | |
Abbreviations: AIR, abnormal interpretation rate; BI-RADS, Breast Imaging Reporting and Data System; CI, confidence interval; DCIS, ductal carcinoma in situ; PPV, positive predictive value.
a
Percentage with positive mammogram results based on final imaging assessment.
b
Percentage of positive mammogram results on final imaging assessment associated with a cancer diagnosis.
c
Cancer rates per 1000 screening mammograms (all screen-detected and interval cancers identified).
d
Cancer detection rates per 1000 screening mammograms (based on true-positive mammograms).
e
Interval cancer rates per 1000 screening mammograms (based on false-negative mammograms).
f
P<.05 based on score statistics obtained in generalized estimating equation analyses.