Supplemental Ultrasonography Screening for Women With Dense Breasts
Bibliographic record
Abstract
Letters2 June 2015Supplemental Ultrasonography Screening for Women With Dense BreastsBrandon Hayse, BS and Donald R. Lannin, MDBrandon Hayse, BSFrom Yale University School of Medicine, New Haven, Connecticut.Search for more papers by this author and Donald R. Lannin, MDFrom Yale University School of Medicine, New Haven, Connecticut.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5061-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Sprague and colleagues (1) nicely describe the limited benefit of screening breast ultrasonography and the high cost and harm of false-positive results leading to unnecessary biopsies. However, they did not mention the most serious harm of screening: overdiagnosis (2, 3) leading to unnecessary treatment of cases of indolent cancer that would never become clinically apparent. Our experience in Connecticut since enactment of the Breast Density Insurance and Notification Law of 2009 leads us to believe that screening breast ultrasonography greatly increases the risk for overdiagnosis.A total of 46% (17 of 37) of cases of breast cancer ...References1. Sprague BL, Stout NK, Schechter C, van Ravesteyn NT, Cevik M, Alagoz O, et al. Benefits, harms, and cost-effectiveness of supplemental ultrasonography screening for women with dense breasts. Ann Intern Med. 2015;162:157-66. [PMID: 25486550] doi:10.7326/M14-0692 LinkGoogle Scholar2. Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012;367:1998-2005. [PMID: 23171096] doi:10.1056/NEJMoa1206809 CrossrefMedlineGoogle Scholar3. Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348:g366. [PMID: 24519768] doi:10.1136/bmj.g366 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Brandon Hayse, BS; Donald R. Lannin, MDAffiliations: From Yale University School of Medicine, New Haven, Connecticut.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0183. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBenefits, Harms, and Cost-Effectiveness of Supplemental Ultrasonography Screening for Women With Dense Breasts Brian L. Sprague , Natasha K. Stout , Clyde Schechter , Nicolien T. van Ravesteyn , Mucahit Cevik , Oguzhan Alagoz , Christoph I. Lee , Jeroen J. van den Broek , Diana L. Miglioretti , Jeanne S. Mandelblatt , Harry J. de Koning , Karla Kerlikowske , Constance D. Lehman , and Anna N.A. Tosteson Benefits, Harms, and Cost-Effectiveness of Supplemental Ultrasonography Screening for Women With Dense Breasts Brian L. Sprague , Natasha K. Stout , Clyde Schechter , Nicolien T. van Ravesteyn , Mucahit Cevik , Oguzhan Alagoz , Christoph I. Lee , Jeroen J. van den Broek , Diana L. Miglioretti , Jeanne S. Mandelblatt , Harry J. de Koning , Karla Kerlikowske , Constance D. Lehman , and Anna N.A. Tosteson Supplemental Ultrasonography Screening for Women With Dense Breasts Wendie A. Berg and David Gur Supplemental Ultrasonography Screening for Women With Dense Breasts Elaine J. Schattner Supplemental Ultrasonography Screening for Women With Dense Breasts Brian L. Sprague , Constance D. Lehman , and Anna N.A. Tosteson Supplemental Ultrasonography Screening for Women With Dense Breasts Wendie A. Berg and David Gur Supplemental Ultrasonography Screening for Women With Dense Breasts Elaine J. Schattner Supplemental Ultrasonography Screening for Women With Dense Breasts Brian L. Sprague , Constance D. Lehman , and Anna N.A. Tosteson Metrics Cited byBreast Cancer Screening: Is There Room for De-escalation?Breast cancer biology varies by method of detection and may contribute to overdiagnosis 2 June 2015Volume 162, Issue 11Page: 801-802KeywordsBreast cancerCancer screeningCancer treatmentConflicts of interestDatabasesDisclosureMammographyMortalitySurveillance Epidemiology and End ResultsUltrasound imaging ePublished: 2 June 2015 Issue Published: 2 June 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.050 | 0.009 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".