title: How Can Advanced Imaging Be Used to Mitigate Potential Breast Cancer Overdiagnosis?
abstract: Radiologists, as administrators and interpreters of screening mammography, are considered by some to be major contributors to the potential harms of screening, including overdiagnosis and overtreatment. In this article, we outline current efforts within the breast imaging community toward mitigating screening harms, including the widespread adoption of tomosynthesis and potentially adjusting screening frequency and thresholds for image-guided breast biopsy. However, the emerging field of breast radiomics may offer the greatest promise for reducing overdiagnosis by identifying imaging-based biomarkers strongly associated with tumor biology, and therefore helping prevent the harms of unnecessary treatment for indolent cancers.
authors.affiliation: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA 98109-1023.
authors.forename: Habib
authors.initials: H
authors.lastname: Rahbar
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-4283; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-4283.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: McDonald
authors.affiliation: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA 98109-1023; Hutchinson Institute for Cancer Outcomes Research, Seattle, Washington 98109-1023.
authors.forename: Janie M
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA 98109-1023.
authors.forename: Savannah C
authors.initials: SC
authors.lastname: Partridge
authors.affiliation: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA 98109-1023; Department of Health Services, University of Washington School of Public Health, Seattle, Washington 98109-1023; Hutchinson Institute for Cancer Outcomes Research, Seattle, Washington 98109-1023. Electronic address: stophlee@uw.edu.
authors.forename: Christoph I
authors.initials: CI
authors.lastname: Lee
mesh_terms: D015415:Biomarkers; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008327:Mammography; D008403:Mass Screening / Q000379:methods*; D000069342:Medical Overuse
chemical_list: D015415:Biomarkers
keywords: Overdiagnosis; breast cancer; breast imaging; screening risks