title: Can mechanical imaging increase the specificity of mammography screening?
abstract: OBJECTIVE
  This study aimed to investigate the effects of adding adjunct mechanical imaging to mammography breast screening. We hypothesized that mechanical imaging could detect increased local pressure caused by both malignant and benign breast lesions and that a pressure threshold for malignancy could be established. The impact of this on breast screening was investigated with regard to reductions in recall and biopsy rates.
  
  
  METHODS
  155 women recalled from breast screening were included in the study, which was approved by the regional ethical review board (dnr 2013/620). Mechanical imaging readings were acquired of the symptomatic breast. The relative mean pressure on the suspicious area (RMPA) was defined and a threshold for malignancy was established.
  
  
  RESULTS
  Biopsy-proven invasive cancers had a median RMPA of 3.0 (interquartile range (IQR) = 3.7), significantly different from biopsy-proven benign at 1.3 (IQR = 1.0) and non-biopsied cases at 1.0 (IQR = 1.3) (P < 0.001). The lowest RMPA for invasive cancer was 1.4, with 23 biopsy-proven benign and 33 non-biopsied cases being below this limit. Had these women not been recalled, recall rates would have been reduced by 36% and biopsy rates by 32%.
  
  
  CONCLUSIONS
  If implemented in a screening situation, this may substantially lower the number of false positives.
  
  
  CONCLUSIONS
  • Mechanical imaging is used as an adjunct to mammography in breast screening. • A threshold pressure can be established for malignant breast cancer. • Recalls and biopsies can be substantially reduced.
authors.affiliation: Medical Radiation Physics, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden. magnus.dustler@med.lu.se.
authors.forename: Magnus
authors.initials: M
authors.lastname: Dustler
authors.affiliation: Medical Radiation Physics, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Förnvik
authors.affiliation: Medical Radiation Physics, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
authors.forename: Pontus
authors.initials: P
authors.lastname: Timberg
authors.affiliation: Mammography Clinic, Unilabs AB, Jan Waldenströms Gata 22, SE-205 02, Malmö, Sweden.
authors.forename: Ingvar
authors.initials: I
authors.lastname: Andersson
authors.affiliation: Medical Radiation Physics, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
authors.forename: Hannie
authors.initials: H
authors.lastname: Petersson
authors.affiliation: Plastic and Reconstructive Surgery, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Brorson
authors.affiliation: Medical Radiation Physics, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Tingberg
authors.affiliation: Diagnostic Radiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
authors.forename: Sophia
authors.initials: S
authors.lastname: Zackrisson
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods* / Q000592:standards; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011312:Pressure; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds
keywords: Biopsy rate; Breast screening; Mammography; Mechanical imaging; Recall rates