A Risk-Based Approach for Triaging Mammography Examinations During Periods of Reduced Capacity

New study finds risk-based approach detects most cancers with fewest exams

Posted by Diana Miglioretti at 1:00 PM on Mar 25, 2021

In a new BCSC study published in JAMA Network Open, BCSC researchers developed a novel risk-based approach for triaging individuals for mammography during times of limited capacity, such as pandemic surges, when individuals may also experience anxiety about COVID-19. Using the large BCSC cohort, the study evaluated close to 2 million mammograms performed between 2014-2019 at more than 90 BCSC radiology facilities. The study found that the 12% of mammograms with the highest cancer detection rates accounted for 55% of detected cancers, while 44% of mammograms with the lowest cancer detection rates accounted for 13% of detected cancers.

The initial phase of the COVID-19 pandemic had a profound impact on the U.S. health care system. To rapidly respond to local stay-at-home orders, radiology facilities cancelled or reduced nonurgent services, including breast cancer cancer screening, surveillance, and some diagnostic services. While working through backlogs of canceled mammograms, this study suggests that facilities should triage women most likely to have cancer detected. Mammograms with the highest cancer detection rates include most diagnostic mammograms performed for breast symptoms, especially in women aged ≥60 years. Mammograms with very low cancer detection rates include all screening mammograms in individuals <50 years (regardless of interval) and annual screening mammograms in individuals aged 50-69 years.

Researchers stress that women should contact their healtcare providers if they develop breast symptoms and schedule overdue screening mammograms as soon as possible.

Full text citation and Link: Miglioretti DL, Bissell MCS, Kerlikowske K, Buist DSM, Cummings SR, Henderson LM, Onega T, O’Meara ES, Rauscher GH, Sprague BL, Tosteson ANA, Wernli KJ, Lee JM, Lee CI, for the Breast Cancer Surveillance Consortium. Assessment of a risk-based approach for triaging mammography examinations during periods of reduced capacity. JAMA Network Open. 2021;4(3):e211974. Epub ahead of print doi.org/10.1001/jamanetworkopen.2021.1974. [Link to Article]

Find media coverage of the article:

Diagnostic Imaging featured lead author Dr. Diana Miglioretti in a video interview: https://www.diagnosticimaging.com/view/diagnostic-imaging-s-weekly-scan-april-2-2021

HealthCare Business News: https://www.dotmed.com/news/story/54393

MedWire News: https://www.medwirenews.com/oncology/breast-cancer/risk-based-approach-feasible-resource-limited-settings/19049022

PCORI: https://www.pcori.org/research-results/2016/role-breast-density-decision-making-breast-cancer-screening-and-diagnostic?utm_source=weeklyemail&utm_medium=email&utm_campaign=033021

Health Imaging: https://www.healthimaging.com/topics/oncology/radiologists-prioritize-mammograms-emergency

Modern Healthcare: https://www.modernhealthcare.com/patient-care/research-points-way-prioritize-patients-mammograms

Aunt Minnie: https://www.auntminnie.com/index.aspx?sec=sup&sub=wom&pag=dis&ItemID=131941

Becker's Hospital Review: https://www.beckershospitalreview.com/oncology/uc-davis-study-risk-based-approach-maximizes-cancer-detection-when-screening-capacity-is-limited.html

Newswise: https://www.newswise.com/articles/catching-more-breast-cancers-when-mammograms-are-limited

Doc Wire News: https://www.docwirenews.com/abstracts/assessment-of-a-risk-based-approach-for-triaging-mammography-examinations-during-periods-of-reduced-capacity/

The Imaging Wire: https://www.theimagingwire.com/2021/03/29/multimodal-cxr-radnets-ai-plan-ctc-opportunity/