Risk Models to Predict Screen-Detected and Interval Breast Cancers in Population Mammography Screening Participants.

Aim: The aim of this study was to determine whether women at risk of having screen-detected (including detected at advanced stage) and interval breast cancer can be accurately identified using conventional risk factors collected by national screening programs.

Methods: All 1,026,137 mammography screening examinations for 323,082 women attending the BreastScreen Western Australia program (part of Australia's national biennial screening program) in July 2007-June 2017 contributed to models for predicting screen-detected breast cancers, screen-detected advanced cancers (≥pT2), and interval cancers.

Results: In total, 7024 screen-detected (1551 in situ, 5472 invasive, of which 1329 were ≥pT2) and 1866 interval cancers (76 in situ, 1790 invasive) were diagnosed.

Measuring health sciences students' attitudes toward persons with disabilities: Is one scale better than another?

Negative attitudes toward persons with disabilities (PWDs) can lead to stigmatization and exclusion, underscoring the need for effective tools to measure and address such attitudes in educational settings. This study compares the psychometric properties of two scales used to assess attitudes toward PWDs among health science learners: the Multidimensional Attitudes Scale Toward Persons with Disabilities (MAS) and the Attitudes and Perspectives Toward Persons with Disabilities Scale (APPD). This research examines the internal consistency, factor stability, factor replicability, and convergent validity of these scales across different measurement occasions using data from second-year Medical (n = 102) and Doctor of Physical Therapy (n = 39) students.

Integration of Disability Awareness Improves Medical Students' Attitudes Toward People with Disabilities.

Unlabelled: Persons with disabilities (PWD) often require special accommodations and more comprehensive healthcare yet frequently have encounters with physicians who are unprepared to provide tailored and complete care. A multipronged disability awareness curriculum for second-year medical students was implemented, including content on disability etiquette, patient-centered and interprofessional learning sessions for individuals with physical disabilities and intellectual and developmental disabilities, and a debriefing session with physiatrists. The objective of this study was to utilize a mixed methods approach to evaluate the disability awareness curriculum in undergraduate medical education (UME).

Think of ink: Tattoo pigment masquerading as a breast mass.

Migration of tattoo pigment to axillary lymph nodes mimicking calcifications is a recognized phenomenon, however, pigment in an intra-mammary node masquerading as a breast mass is a rare complication of cosmetic tattoos. As the prevalence of tattooing increases among women presenting to Breastscreen, radiologists may expect to encounter this lesion mimicking a breast neoplasm. We present a 50-year-old female with extensive tattoos on her arms, chest wall and abdomen, recalled for a small calcified breast mass on her first screening mammogram.

The impact of height and weight on rescreening rates within a population-based breast screening program.

Introduction: Women with obesity are at increased risk of post-menopausal breast cancer and less likely to participate in breast screening. This study investigates the impact of asking women their height and weight within a population-based screening program, and the association of BMI with rescreening status.

Methods: Data regarding 666,130 screening events from 318,198 women aged 50-74 attending BreastScreen Western Australia between 2016 and 2021 were used to compare crude and age-standardised rescreening rates over time.

Health benefits and harms of mammography screening in older women (75+ years)-a systematic review.

Background: There is little evidence on the balance between potential benefits and harms of mammography screening in women 75 years and older. The aim of this systematic review was to synthesise the evidence on the outcomes of mammography screening in women aged 75 years and older.

Methods: A systematic review of mammography screening studies in women aged 75 years and over.

Radial scar appearances on contrast-enhanced mammography.

With modern technological advances in imaging, radial scars are more frequently encountered in clinical practice. The management of radial scars remains challenging due to associated upgrade to malignancy at excision. Contrast-enhanced mammography (CEM) has a similar sensitivity compared to MRI in addition to lower cost, better availability and fewer contra-indications.

The association between breast arterial calcification and atherosclerotic cardiovascular disease in an Australian population-based breast cancer case-control study.

Purpose: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality. Breast arterial calcification (BAC) on mammograms is not associated with breast cancer risk. However, there is increasing evidence supporting its association with cardiovascular disease (CVD).

Artificial intelligence (AI) for breast cancer screening: BreastScreen population-based cohort study of cancer detection.

Background: Artificial intelligence (AI) has been proposed to reduce false-positive screens, increase cancer detection rates (CDRs), and address resourcing challenges faced by breast screening programs. We compared the accuracy of AI versus radiologists in real-world population breast cancer screening, and estimated potential impacts on CDR, recall and workload for simulated AI-radiologist reading.

Methods: External validation of a commercially-available AI algorithm in a retrospective cohort of 108,970 consecutive mammograms from a population-based screening program, with ascertained outcomes (including interval cancers by registry linkage).

Reflections from Women with an Interval Breast Cancer Diagnosis: A Qualitative Analysis of Open Disclosure in the BreastScreen Western Australia Program.

Background: 'Interval breast cancer' describes a malignancy that is diagnosed after a negative screening mammogram. Open disclosure is a process of addressing a negative health outcome that includes an apology and an opportunity for the client to discuss concerns. BreastScreen Western Australia has implemented a policy of open disclosure.

Come Roll with Me: An Interprofessional Experience to Promote Disability Awareness.

One in four American adults have a disability, which makes people with disabilities the largest minority group in the United States (U.S.).

Mammary schistosomiasis: A rare case.

Schistosomiasis is prevalent in some developing countries; however, it does not commonly affect the breast. Mammary schistosomiasis may present as suspicious microcalcification or a mass on mammography. Image-guided biopsy is necessary to exclude malignancy and identify calcified Schistosoma ova on histology.

Evidence from a BreastScreen cohort does not support a longer inter-screen interval in women who have no conventional risk factors for breast cancer.

Objectives: To determine screening outcomes in women who have no recorded risk factors for breast cancer.

Methods: A retrospective population-based cohort study included all 1,026,137 mammography screening episodes in 323,082 women attending the BreastScreen Western Australia (part of national biennial screening) program between July 2007 and June 2017. Cancer detection rates (CDR) and interval cancer rates (ICR) were calculated in screening episodes with no recorded risk factors for breast cancer versus at least one risk factor stratified by age.

The impact of breast density notification on rescreening rates within a population-based mammographic screening program.

Background: High participation in mammographic screening is essential for its effectiveness to detect breast cancers early and thereby, improve breast cancer outcomes. Breast density is a strong predictor of breast cancer risk and significantly reduces the sensitivity of mammography to detect the disease. There are increasing mandates for routine breast density notification within mammographic screening programs.

Artificial intelligence (AI) to enhance breast cancer screening: protocol for population-based cohort study of cancer detection.

Introduction: Artificial intelligence (AI) algorithms for interpreting mammograms have the potential to improve the effectiveness of population breast cancer screening programmes if they can detect cancers, including interval cancers, without contributing substantially to overdiagnosis. Studies suggesting that AI has comparable or greater accuracy than radiologists commonly employ 'enriched' datasets in which cancer prevalence is higher than in population screening. Routine screening outcome metrics (cancer detection and recall rates) cannot be estimated from these datasets, and accuracy estimates may be subject to spectrum bias which limits generalisabilty to real-world screening.

Bloody nipple discharge in Carney complex: A case report.

Carney complex (CNC) is an extremely rare, autosomal dominant genetic syndrome consisting of pigmented skin and mucosal changes with multiple endocrine and nonendocrine tumors, including the breast. Breast tumors are typically multiple and benign and are most commonly reported as myxoid fibroadenomas and/or intraductal papillomas. We present a young female patient with known CNC who presented with copious bloody nipple discharge with multiple breast lumps and discuss the breast imaging features regarding this complex and often underrecognized genetic condition.

Screening outcomes by risk factor and age: evidence from BreastScreen WA for discussions of risk-stratified population screening.

Objectives: To estimate rates of screen-detected and interval breast cancers, stratified by risk factor, to inform discussions of risk-stratified population screening.

Design: Retrospective population-based cohort study; analysis of routinely collected BreastScreen WA program clinical and administrative data.

Setting, Participants: All BreastScreen WA mammography screening episodes for women aged 40 years or more during 1 July 2007 - 30 June 2017.

Radiological and pathological correlation of a rare case of primary breast follicular lymphoma in a male patient, presenting as gynaecomastia.

We present an exceptionally rare case of primary breast follicular lymphoma in a male patient, who presented to us with gynaecomastia for investigation. To our knowledge there have only been two other cases published in the literature to date. In Western Australia, there have been no cases in at least the past 10 years.

An atypically located pleomorphic adenoma: Radiological and pathological correlation.

Pleomorphic adenoma is a common benign salivary gland neoplasm which very rarely occurs in the breast. Its radiologic and pathologic appearance may be mistaken for other benign or malignant lesions such as a fibroadenoma or invasive ductal carcinoma. Due to the risk of local recurrence and, rarely, malignant transformation, wide local excision with clear margins is recommended.

Population screening detected non-lymphomatous non-mammary metastases to the breast. A radiology multimodality pictorial essay.

This pictorial essay is a presentation of imaging appearances of non-mammary cancer metastases to the breast detected in asymptomatic women attending BreastScreen Western Australia (BSWA) from 2005 to 2019. Haematological malignancies were excluded. Thirteen cases of histologically proven extramammary metastases to breast were identified from the BSWA data base.

Post-mammographic screening behaviour: A survey investigating what women do after being told they have dense breasts.

Issue Addressed: Despite widespread calls for women undergoing mammographic screening to be informed of their breast density, concerns remain as to how this is interpreted and acted upon given the absence of evidence-based supplemental screening recommendations for women with dense breasts. This study investigates the action women take in response to being notified they have dense breasts and what subsequent advice women receive from health professionals.

Methods: Via a survey of nearly 7000 women, we assessed the post-screening actions of women attending a population-based mammographic screening program (BreastScreen) in Western Australia from 21 November 2017 to 19 April 2018.

Is breast arterial calcification associated with coronary artery disease?-A systematic review and meta-analysis.

Background: There is increasing evidence that breast arterial calcification (BAC), an incidental finding on 3-29% of mammograms, could be used to screen for coronary artery disease (CAD). We conducted a systematic review to assess the associations between BAC and CAD and its risk factors (hypertension, hypercholesterolemia, diabetes mellitus and smoking).

Methods And Findings: MEDLINE and EMBASE databases and references of relevant papers were searched up to 18 February 2020 for English language studies that evaluated the associations of BAC and CAD and its risk factors.

No association between night shiftwork and mammographic density.

Background: Increased mammographic density is one of the strongest risk factors for breast cancer. Night shiftwork and its related factors, which include light at night, phase shift and sleep disruption, are believed to increase breast cancer risk however, their effects on mammographic density have barely been studied.

Methods: This study included 1821 women enrolled in the Breast Cancer Environment and Employment Study between 2009 and 2011.