A study of surveillance mammography (SM) of the contralateral breast (CLB) following total mastectomy (TM) for breast cancer (BC)
Bibliographic record
Abstract
6048 Background: Following a diagnosis of primary BC, SM is recommended at yearly intervals. However, there has never been a direct evaluation of SM. Methods: This is an observational case-cohort study. Endpoints include the clinical outcome following detection of contralateral breast cancer (CLBC) by SM; stage of tumor, type of surgery (TM or breast conserving surgery (BCS)), and the percentage that develop subsequent distant metastases. The underlying population consisting of all women with a new diagnosis of invasive BC that had a TM within four months of diagnosis between 07/91 and 12/93 in Ontario, Canada was identified from the Ontario Cancer Registry (OCR). The OCR was linked to administrative databases and a clinical database formed from chart review to ascertain dates of SM, dates of surgeries and to obtain pathological confirmation of CLBC and tumor stage by TNM system. Cases were a stratified random sample of women who had subsequent CLB surgery following TM. The sub-cohort was a random sample of those who had a TM as their initial treatment regardless of the outcome. Current minimum follow-up is seven years and the maximum twelve. Results: To date 26 confirmed metachronous CLBC have been identified; 15% (4/26, T2 x 4) had CLBC detected by both palpation and SM; 15% (4/26, T1 x 1, T2 x 3) were detected by palpation alone and 70% (18/26, Tis x 5, T1 x 12, T2 x 1) were detected by SM alone. Following a diagnosis by SM, 67% of cases had a subsequent TM and 22% developed subsequent metastatic disease. Conclusions: Twenty eight percent of SM detected lesions appear to be in situ disease. The majority of CLBC detected by SM had subsequent TM. This study is ongoing and further data will be collected to investigate the outcomes of SM. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Aventis, Biomira, Ortho- Biotech, Pfizer, Pharmacia, Roche, YM Biosciences AstraZeneca, Aventis, Pfizer, Pharmacia AstraZeneca, Aventis
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".