ABSTRACT
INTRODUCTION: The purpose of our study was to compare the performance of 2D (FFDM) against 3D (FFDM plus DBT) examinations in the post-treatment surveillance of asymptomatic breast cancer survivors. METHODS: A list of women with a history of breast cancer who underwent screening mammography (2D or 3D) from 5/2017 to 5/2020 was retrieved. A total of 20,210 examinations were identified and performance metrics were compared. RESULTS: There were no statistically significant difference in cancer detection rate (CDR) (p = 0.38), recall rate (RR) (p = 0.087), or positive predictive value (PPV) (p = 0.74) between 2D vs. 3D examinations. Stratification by breast tissue identified no statistically significant difference in CDR (p = 0.581 and p = 0.428), RR (p = 0.230 and p = 0.205), or PPV (p = 0.908 and p = 0.721) between fatty/scattered and heterogeneous/extremely dense breast tissue when comparing 2D vs 3D examinations. Stratification by age did not identify a significant difference in RR or PPV between the two groups. CDR was statistically increased with 2D vs. 3D examinations in the 60-69 years group (p = 0.021). Stratification by race did not identify a significant difference in RR or PPV between the two groups. CDR was statistically increased with 3D vs. 2D examinations in white women (p = 0.036). Stratification by laterality (bilateral vs. unilateral post mastectomy) did not identify a significant difference in RR or PPV between the two groups. CDR was statistically increased in 2D vs. 3D examinations in unilateral studies (p = 0.009). CONCLUSION: For asymptomatic women with a history of breast cancer, there is no evidence that the addition of DBT to FFDM improves CDR, RR, or PPV. IMPLICATIONS FOR PRACTICE: More studies are needed concerning screening methodologies supplementing FFDM in the screening regimens of breast cancer survivors.
Subject(s)
Breast Neoplasms , Humans , Female , Breast Neoplasms/diagnosis , Mammography/methods , Retrospective Studies , Breast Density , Mass Screening , Early Detection of Cancer/methods , MastectomySubject(s)
Air Pollutants, Occupational/adverse effects , Air Pollutants/adverse effects , Lead/adverse effects , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Lead/blood , Lead Poisoning/blood , Male , TexasABSTRACT
Blood lead levels were determined on a random sample of persons in all age groups living near a lead-emitting smelter in El Paso, Texas. A blood lead level of greater than or equal to 40 mug per 100 ml, which was considered indicative of undue lead absorption, was found in 53 per cent of the children one to nine years old living within 1.6 km of the smelter and in 18 per cent of those from 1.6 to 6.6 km; beyond that distance in older persons levels were lower. Children in the first 1.6 km with blood levels of greater than or equal to mug per 100 ml were exposed to 3.1 times as much lead in dust as children there with lower blood values (6447 vs 2067 ppm). There was also airborne lead exposure (8 to 10 mug per cubic meter, annual mean). Paint, water, food, and pottery were less important as sources. The data suggest that particulate lead in dust and air accounted for most of the lead absorption in El Paso children. The smelter was the principal source of this lead, especially within 1.6km of itself.
