Should We Adjust Visually Assessed Mammographic Density for Observer Variability?

  • Elaine F. Harkness
  • Jamie C. Sergeant
  • Mary Wilson
  • Ursula Beetles
  • Soujanya Gadde
  • Yit Y. Lim
  • Anthony Howell
  • D. Gareth Evans
  • Susan M. Astley
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 9699)

Abstract

This study aimed to determine whether correcting for observer variability alters estimations of breast cancer risk associated with mammographic density. A case control design examined the relationship between mammographic density, measured by visual analogue scales (VAS), and the risk of breast cancer after correcting for observer variability. Mammographic density was assessed by two observers and average scores (V2) were adjusted to correct for observer variability (V2ad). Two case-control sets were identified: (i) breast cancer detected during screening at entry and (ii) breast cancer detected subsequently. Cases were matched to three controls. In the first case-control set the odds ratio for breast cancer was 4.6 (95 %CI 2.8–7.5) for the highest compared to the lowest quintile of V2, and was attenuated for V2ad (OR 3.1, 95 %CI 1.9–4.8). Similar findings were observed for the second case-control set. Not adjusting for observer variability may lead to an overestimate of the risk of breast cancer.

Keywords

Digital Mammogram Breast cancer Visual analogue scales (VAS) Observer bias Case-control study 

Notes

Acknowledgements

We acknowledge the support of the National Institute for Health Research (NIHR) and the Genesis Prevention Appeal for their funding of the PROCAS study. We would like to thank the women who agreed to take part in the study and the study staff for recruitment and data collection. This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (reference number RP-PG-0707-10031: “Improvement in risk prediction, early detection and prevention of breast cancer”). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Elaine F. Harkness
    • 1
    • 2
    • 3
  • Jamie C. Sergeant
    • 4
    • 5
  • Mary Wilson
    • 2
  • Ursula Beetles
    • 2
  • Soujanya Gadde
    • 2
  • Yit Y. Lim
    • 2
  • Anthony Howell
    • 2
    • 6
  • D. Gareth Evans
    • 2
    • 7
  • Susan M. Astley
    • 1
    • 3
  1. 1.Centre for Imaging SciencesInstitute of Population Health, University of ManchesterManchesterUK
  2. 2.Genesis Breast Cancer Prevention Centre and Nightingale Breast Screening CentreUniversity Hospital of South Manchester NHS TrustManchesterUK
  3. 3.The University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation TrustManchesterUK
  4. 4.Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal ResearchInstitute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, University of ManchesterManchesterUK
  5. 5.NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUK
  6. 6.The Christie NHS FoundationManchesterUK
  7. 7.Genomic Medicine, Manchester Academic Health Sciences CentreUniversity of Manchester and Central Manchester Foundation TrustManchesterUK

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