Supplemental breast cancer screening after negative mammography in U.S. women with dense breasts
Menée aux Etats-Unis à partir de données portant sur 1 176 251 mammographies de dépistage concernant 498 855 femmes et dont les résultats se sont avérés négatifs (âge : de 40 à 74 ans), cette étude évalue le taux d'échographies et d'IRM mammaires réalisées dans l'année qui suit la mammographie
The extent and determinants of supplemental screening among women with dense breasts are unclear. We evaluated a retrospective cohort of 498,855 women aged 40-74 years with heterogeneously or extremely dense breasts who obtained 1,176,251 negative screening mammography examinations during 2011-2019 in the United States. Overall, 2.8% and 0.3% of mammograms had supplemental ultrasound or MRI within one year, respectively. Onsite availability was associated with ultrasound (odds ratio [OR]=4.35; 95%CI : 4.21-4.49) but not MRI (OR = 0.94; 95%CI : 0.85-1.04). Facility academic affiliation and for-profit status were inversely associated with supplemental ultrasound (OR = 0.53; 95%CI : 0.49-0.57 and OR = 0.83; 95%CI : 0.81-0.86, respectively) and positively associated with supplemental MRI (OR = 3.04; 95%CI : 2.86-3.46 and OR = 1.88; 95%CI : 1.66-2.12, respectively). Supplemental screening was more likely to occur after passage of state-specific density notification laws than before passage (OR = 3.56; 95%CI 3.30-3.84 and OR = 1.79; 95%CI 1.60-2.00, respectively). These results show that supplemental breast imaging utilization has been uncommon and was related to facility factors and density legislation.
Journal of the National Cancer Institute , résumé, 2023