Abstract A026: Use of recommended diagnostic breast imaging among women under 40 in a community-based registry
Notice bibliographique
Résumé
Abstract Diagnostic imaging is a critical step in obtaining a timely breast cancer diagnosis. The American College of Radiology (ACR) recommends initial diagnostic evaluation with breast ultrasound for women 18-29 with focal breast symptoms and initial diagnostic evaluation with mammography and/or ultrasound for women 30-39 with symptoms. These guidelines are evidence-based and deviation from them has the potential to lead to performance of unnecessary exams and/or delayed diagnosis. We evaluated the prevalence of appropriate diagnostic imaging among breast cancer patients <40 years. Data were from the Carolina Mammography Registry (CMR), a community-based registry of breast imaging in North Carolina that links to cancer diagnoses from the North Carolina Central Cancer Registry. The analysis included CMR women aged 18-39 years who were diagnosed with breast cancer between 2005-2021 and had at least one breast imaging exam (any type or indication) in the year before diagnosis (n=311). Women with a self-reported first-degree family history of breast cancer or imaging facility-reported increased risk were excluded due to differing guidelines for high-risk women. Presence of self-reported symptoms (lump, nipple discharge, pain or other) were obtained from pre-diagnosis exams. Use of appropriate imaging was based on the ACR Appropriateness Criteria for women with symptoms (described above). Between-group differences were assessed using the Fisher exact text. The majority of patients were 35-39 years old (63%), with fewer in 30-34 year (27%) and 18-29 year (10%) age groups. Symptom data was available for 98% of women, with symptoms present for 59% (18-29: 60%; 30-34: 70%; 35-39: 54%). The most common diagnostic approach in the year prior to diagnosis was ultrasound alone (50%) followed by mammography alone (28%). Use of multiple diagnostic modalities was uncommon (ultrasound plus mammogram: 10%; ultrasound plus MRI: 1%). 97% of patients with diagnostic imaging received an exam consistent with ACR guidelines, though appropriate imaging was lower among women 18-29 (76%) compared with women 30-34 (100%) or 35-39 (99%) (P<0.0001). This pattern was consistent for women with symptoms (18-29: 65%; 30-34: 100%; 35-39: 100%; P<0.0001), but there was no difference by age among women without symptoms (18-29: 100%; 30-34: 100%; 35-39: 97%; P>0.99). Limitations of our analysis include that some women may have obtained exams at facilities outside the CMR, which may lead to under-ascertainment of appropriate imaging or of symptoms if ongoing symptoms were not documented on subsequent exams. In sum, 35% of women 18-29 with self-reported symptoms received diagnostic imaging that was not consistent with ACR recommendations. Departures from ACR guidelines may be due to unique clinical situations, non-receipt of a recommended exam, or other factors. Future research will investigate provider, patient, and health system factors that influence breast imaging patterns among women 18-39 and the impact of different imaging approaches on prognosis among young breast cancer patients. Citation Format: Sarah J. Nyante, Thad Benefield, Anisha P. Ganguly, Caroline A. Thompson, Sasha Anderson, Erin J. Aiello Bowles, Genevieve A. Woodard. Use of recommended diagnostic breast imaging among women under 40 in a community-based registry [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr A026.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».