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The effect of age and density of the breast on the sensitivity of breast cancer diagnostic by mammography and ultasonography

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Abstract

Purpose. We studied which, age of the patient or density of the breast accounts for the sensitivity of mammography and ultrasonography (US). Furthermore we studied whether the overall impression on the density of the breast or the density in tumour area accounts for the sensitivity of mammography and ultrasonography.

Materials and methods. The material consisted of 572 consecutive histologically and 5 cytologically verified breast cancer cases. Mammography and US examinations were performed immediately before breast cancer operations and information on the findings were received from the original patient files and classified as malignant or benign. The density of breast parenchyma to fatty, mixed or dense in total breast and separately in tumour area was defined by a radiologist group from the original mammograms by comparing to model mammograms. The sensitivity (Se) of mammography and US was compared in 3 age groups (26–49, 50–59 and 60–92) and in the different density classes.

Results. Sensitivity of mammography increased by age (density-adjusted OR=0.2, 95%, CI 0.1–0.5) in age group 26–49 compared to age group 60–92) and with fattiness of the breast (age-adjusted OR=0.4, 95%, CI 0.1–1.0 for dense breast parenchyma in tumour area compared to fatty breast). Sensitivity of US was inversely related to age (density-adjusted OR=2.3, 95%, CI 1.0–5.2 in age group 26–49 compared to age group 60–92) and directly related with fattiness of breast (age-adjusted OR=0.5, 95%, CI 0.2–0.9 by dense breast parenchyma in tumour area compared to fatty breast). Density in the tumour area compared to total breast density was related only mariginally better sensitivity both of mammography (0.4 vs. 0.6) and of US (0.5 vs. 0.6).

itConclusion. Sensitivity of both mammography and sensitivity of US are independently related both to the age of the patient and to the density of the breast. The effect of age is inverse and that of density parallel between mammography and US on sensitivity. The effect of overall breast density was close to the effect of density at the site of the tumour on the sensitivity of both mammography and US.

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Authors and Affiliations

  1. Pirkanmaa Cancer Society, Tampere, Finland

    Irma Saarenmaa, Ulla Geiger, Juhani Pakkanen & Marja-Liisa Talviala

  2. STUK- Radiation and Nuclear Safety Authority, Helsinki, Finland

    Tiina Salminen

  3. Radiological Clinic, North Karelia Central Hospital, Joensuu, Finland

    Pirkko Heikkinen & Seppo Hyvärinen

  4. Department of Biomedical Sciences, University of Tampere, Tampere, Finland

    Jorma Isola

  5. Oncological Clinic, Kuopio University Hospital, Kuopio, Finland

    Vesa Kataja & Eero Kumpulainen

  6. Department of Diagnostic Radiology, Tampere City Hospital, Tampere, Finland

    Marja-Liisa Kokko, Anneli Piironen & Anja Salo

  7. Oncological Clinic, Tampere University Hospital, Tampere, Finland

    Riitta Kokko

  8. Röntgentutka, Tampere, Finland

    Alpo Kärkkäinen

  9. Cancer Society of Finland, Mammography Screening Unit, Joensuu, Finland

    Pirkko Peltonen

  10. University of Tampere School of Public Health, Tampere, Finland

    Matti Hakama

  11. Finnish Cancer Registry, Helsinki, Finland

    Matti Hakama

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  1. Irma Saarenmaa
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  2. Tiina Salminen
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Saarenmaa, I., Salminen, T., Geiger, U. et al. The effect of age and density of the breast on the sensitivity of breast cancer diagnostic by mammography and ultasonography. Breast Cancer Res Treat 67, 117–123 (2001). https://doi.org/10.1023/A:1010627527026

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