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Diagnostic performance of screening mammography according to menstrual cycle among Asian women

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

To investigate the performance metrics of screening mammography according to menstrual cycle week in premenopausal Asian women.

Methods

This retrospective study included 69,556 premenopausal Asian women who underwent their first screening mammography between 2011 and 2019. The presence or absence of a breast cancer diagnosis within 12 months after the index screening mammography served as the reference standard, determined by linking the study data to the national cancer registry data. Menstrual cycles were calculated, and participants were assigned to groups according to weeks 1–4. The performance metrics included cancer detection rate (CDR), sensitivity, specificity, and positive predictive value (PPV), with comparisons across menstrual cycles.

Results

Among menstrual cycles, the lowest CDR at 4.7 per 1000 women (95% confidence interval [CI], 3.8–5.8 per 1000 women) was observed in week 4 (all P < 0.05). The highest sensitivity of 72.7% (95% CI, 61.4–82.3) was observed in week 1, although the results failed to reach statistical significance. The highest specificity of 80.4% (95% CI, 79.5–81.3%) was observed in week 1 (P = 0.01). The lowest PPV of 2.2% (95% CI, 1.8–2.7) was observed in week 4 (all P < 0.05).

Conclusion

Screening mammography tended to show a higher performance during week 1 and a lower performance during week 4 of the menstrual cycle among Asian women. These results emphasize the importance of timing recommendations that consider menstrual cycles to optimize the effectiveness of screening mammography for breast cancer detection.

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Data Availability

The datasets generated during and/or analysed during the current study are not publicly available due outside of Institutional Review Board restrictions (the data were not collected in a way that could be distributed widely) but are available from the corresponding author on reasonable request.

Abbreviations

AUC:

area under the receiver operating characteristic curve

BI-RADS:

Breast Imaging Reporting & Data System

CDR:

Cancer detection rate

CI:

Confidence interval

PPV:

Positive predictive value

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Acknowledgements

None.

Funding

This work was supported by the SKKU Excellence in Research Award Research Fund, Sungkyunkwan University (2021), and the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (NRF-2021R1A2C1014363).

Author information

Authors and Affiliations

  1. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Mi-ri Kwon, Inyoung Youn & Shin Ho Kook

  2. Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yoosoo Chang, Yoosun Cho & Seungho Ryu

  3. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yoosoo Chang & Seungho Ryu

  4. Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, 04514, Republic of Korea

    Yoosoo Chang & Seungho Ryu

  5. Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea

    Boyoung Park

  6. Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea

    Boyoung Park

Authors
  1. Mi-ri Kwon
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Contributions

Mi-ri Kwon, Yoosoo Chang, and Seungho Ryu planned, designed and implemented the study, including quality assurance and control. Seungho Ryu analyzed the data and designed the study’s analytic strategy. Yoosoo Chang, and Seungho Ryu supervised field activities. Material preparation, and data collection were performed by all authors. The first draft of the manuscript was written by Mi-ri Kwon, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yoosoo Chang or Seungho Ryu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Mi-ri Kwon, Yoosoo Chang, and Seungho Ryu. The first draft of the manuscript was written by Mi-ri Kwon, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Ethics approval

This study is a retrospective study. It was approved by the Institutional Review Board (KBSMC 2023-06-006).

Consent to participate

The requirement for obtaining informed consent was waived by the KBSMC Institutional Review Board owing to the use of de-identified retrospective data collected during the health screening process.

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Kwon, Mr., Chang, Y., Youn, I. et al. Diagnostic performance of screening mammography according to menstrual cycle among Asian women. Breast Cancer Res Treat 202, 357–366 (2023). https://doi.org/10.1007/s10549-023-07087-8

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