Abstract
Objectives: After a 500 ms presentation, experts can
distinguish abnormal mammograms at above chance
levels even when only the breast contralateral to the
lesion is shown. Here, we show that this signal of abnormality
is detectable 3 years before localized signs of
cancer become visible.
Methods: In 4 prospective studies, 59 expert observers
from 3 groups viewed 116–200 bilateral mammograms
for 500 ms each. Half of the images were prior exams
acquired 3 years prior to onset of visible, actionable
cancer and half were normal. Exp. 1D included cases
having visible abnormalities. Observers rated likelihood
of abnormality on a 0–100 scale and categorized breast
density. Performance was measured using receiver operating
characteristic analysis.
Results: In all three groups, observers could detect
abnormal images at above chance levels 3 years prior
to visible signs of breast cancer (p < 0.001). The results
were not due to specific salient cases nor to breast
density. Performance was correlated with expertise
quantified by the number of mammographic cases read
within a year. In Exp. 1D, with cases having visible actionable
pathology included, the full group of readers failed
to reliably detect abnormal priors; with the exception of
a subgroup of the six most experienced observers.
Conclusions: Imaging specialists can detect signals of
abnormality in mammograms acquired years before
lesions become visible. Detection may depend on expertise
acquired by reading large numbers of cases.
Advances in knowledge: Global gist signal can serve as
imaging risk factor with the potential to identify patients
with elevated risk for developing cancer, resulting in
improved early cancer diagnosis rates and improved
prognosis for females with breast cancer.
Original language | English |
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Article number | 20190136 |
Number of pages | 10 |
Journal | The British Journal of Radiology |
Volume | 92 |
Issue number | 1099 |
Early online date | 5 Jun 2019 |
DOIs | |
Publication status | Published - 13 Jun 2019 |
Keywords
- Adult
- Aged
- Breast Neoplasms/diagnostic imaging
- Breast/diagnostic imaging
- Early Detection of Cancer/methods
- Female
- Humans
- Mammography/methods
- Middle Aged
- Prospective Studies
- Sensitivity and Specificity