Determination of the Breast Cancer Risk Levels and Health Beliefs of Women With and Without Previous Mammography in the Eastern Part of Turkey

Baysal, Hasret Yalcinoz,Polat, Hatice Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.10

Objective: This research was conducted to determine the breast cancer risk levels of women with and without previous mammography and their beliefs on breast cancer and mammography. Methods: The sample for this descriptive research consisted of women aged 50 years or older who were registered at the Family Health Center in the city center of Erzurum. The research was conducted with a total of 420 women with at least one mammography (210) and without mammography (210) who presented to the center on Wednesdays and Thursdays for any reason between 1 January 2010 and 1 January 2011. Research data were collected using the personal information "Breast Cancer Risk Assessment Form" accepted and recommended by the Turkish Ministry of Health, and the Champion's Health Belief Model Scale for Breast Cancer and Screening (CHBMS). Data were evaluated using percentages and means with the t-test. Results: According to the research data, 89.8% of the women were found to be in the low risk group, 87.6% with and 91.9% without mammography. When the health beliefs of women with and without mammography were compared, it was found that susceptibility, seriouness, motivation, mammography benefit scores were higher among those with mammography (p<0.01). The mammography barrier score average was higher in the group without mammography (p<0.01). Conclusion: Knowing women's health beliefs, which have positive and negative effects on participating in mammography screening, may increase the rate of mammography uptake among women. Moreover, women with high breast cancer risk may be determined by increasing society's level of knowledge on breast cancer and risk factors.

유방조직등가 팬텀을 이용한 Screen-Film과 Digital Mammography에서의 평균 유선선량

신귀순(Gwi-Soon Shin),김정민(Jung-Min Kim),김유현(You-Hyun Kim),최종학(Jong-Hak Choi),김창균(Chang-Kyun Kim) 대한방사선과학회(구 대한방사선기술학회) 2007 방사선기술과학 Vol.30 No.1

  유방촬영장치가 screen-film system에서 최근에는 빠른 속도로 digital system으로 교체되고 있는 추세이다. Digital system이 screen-film system에 비해 여러 가지 장점을 가지고 있다. 그 중의 하나가 digital detector가 screen-film보다 X선 흡수효율이 더 높으며, digital system 중에서도 direct digital detector가 indirect digital detector보다 흡수효율이 높다. 이에 입각하면 촬영 시 적은 선량을 주어도 되기 때문에 환자피폭선량이 감소한다. 그러나 임상 방사선사들이 느끼는 바는 달랐다.<BR>  따라서 이번 연구에서는 screen-film mammography system, computed mammography system, indirect digital mammography system, direct digital mammography system에서 glandularity가 30%, 50% 및 70%인 세 종류의 유방조직 등가팬텀을 이용하여 평균유선선량(AGD)을 측정하여 다음과 같은 결론을 얻었다.<BR>  Screen-film보다 digital detector가 X선 흡수효율이 높지만, glandularity가 30%인 경우의 AGD는 오히려 SFM에서 가장 낮았고, 그다음 CM, IDM, DDM 순으로 증가되었다.<BR>  자동노출장치로 설정하였지만 두께나 glandularity에 따라 target/filter의 조합이 바뀌지 않고 Mo/Mo으로 계속 사용된 SFM에서는 AGD가 급격히 증가되었다. 따라서 높은 glandularity를 가진 두꺼운 팬텀을 위한 고에너지 촬영에서는 SFM에서 AGD값이 가장 높았고, 저에너지 촬영에서는 DDM에서 AGD값이 가장 높았다. 그러나 target/filter의 조합이 다양하게 바뀐 CM에서는 두께나 glandularity에 따른 AGD의 곡선이 가장 완만하게 증가하였으며, AGD값이 가장 낮았다.<BR>  이와 같이 두께와 glandularity가 증가함에 따라 target/filter의 조합이 Mo/Mo에서 Mo/Rh으로 더 증가하면 Rh/Rh으로 바뀌는 것이 AGD의 증가량이 적어 환자의 피폭선량 측면에서 바람직하다. 따라서 유방촬영에서 환자의 피폭선량을 평가하기 위해서는 검출효율 외에도 여러 가지 촬영 변수가 중요한 역할을 한다.   In recent years, mammography system is changed rapidly from conventional screen-film system to digital system for application to screening and diagnosis.<BR>  Digital mammography system provides several advantages over screen-film mammography system. According to the information provided by the manufacturer, digital mammography system offers radiation dose reduction in comparison with screen-film mammography system, because of digital detector, particularly direct digital detector has higher x-ray absorption efficiency than screen-film combination or imaging plate(IP).<BR>  We measured average glandular doses(AGD) in screen-film mammography(SFM) system with slow screen-film combination, computed mammography(CM) system, indirect digital mammography(IDM) system and direct digital mammography(DDM) system using brest tissue-equivalent phantom(glandularity 30%, 50% and 70%). <BR>  The results were shown as follows :<BR>  AGD values for DDM system were highest than those for other systems. Although automatic exposure control(AEC) mode was selected, the curve of the AGD values against thickness or glandularity increased significantly for the SFM system with the uniform target/filter(Mo/Mo) combination. Therefore, the AGD values for the high energy examinations were highest in the SFM system, and those for the low energy examinations were highest in the DDM system. But the curve of the AGD values against thickness and glandularity increased gently for CM system with the automatic selection of the target/filter combination (from Mo/Mo to Mo/Rh or from Mo/Rh to Rh/Rh), and the AGD values were lowest.<BR>  Consequently, the parameters in mammography for each exposure besides detection efficiency play an important role in oder to estimate a patient radiation dose.

국내 유방촬영 방사선량 평가 및 국내·외 진단참고수준 조사 분석

남형우,허재빈,이민영,라현준,김광표 한국방사선산업학회 2021 방사선산업학회지 Vol.15 No.3

Mammography is an important medical tool used to diagnose breast cancer. The usageof mammography is continuously increasing due to the development of the medical industry inKorea. The glandular tissue which is sensitive to radiation is exposed during mammography, so itis necessary to manage the patient dose for mammography. Therefore, the objective of this studyis to evaluate the radiation dose for mammography and to investigate and analyze domestic andforeign diagnostic reference levels. In this study, radiation dose assessment methodology based onMonte-Carlo was established for the evaluation of patient radiation dose by mammography. Thestudies on the diagnostic reference level of countries and associations such as the United States,Australia, Spain, Ireland, Bulgaria, and Slovenia were investigated. In Korea, the studies on themammography diagnostic reference level conducted by the Ministry of Food and Drug Safety(MFDS) and the Korea Centers for Disease Control and Prevention (KCDC) were investigated. As a result of evaluating the mean glandular dose and effective dose by mammography usingthe MCNP program, the mean glandular dose and effective dose for the compression breastthickness range of 4~5 cm which is largest number of patients in Korea were 1.36 mGy, 0.163mSv and 1.34 mGy, 0.161 mSv for CC and MLO. In a study conducted by the KCDC in 2018,the mammography diagnostic reference level for phantom and patient was established. Thediagnostic reference level for phantom was 1.59 mGy, which was 14% and 18% higher thanKorea in 2007 and Australia, and 26%, 45%, 7% lower than US, Bulgaria, and Slovenia. Thediagnostic reference level for patient was 1.97 and 1.98 mGy in the CC and MLO, similar to Spainand higher than other countries and associations. The result of patient radiation dose evaluationfor mammography and domestic and foreign diagnostic reference level analysis conducted in thisstudy can be used as basic data for reducing patient dose by mammography in Korea.

Which Phantom Is Better for Assessing the Image Quality in Full-Field Digital Mammography?: American College of Radiology Accreditation Phantom versus Digital Mammography Accreditation Phantom

송성은,서보경,이안,구본경,김희영,조규란,정환훈,이승화,황규원 대한영상의학회 2012 Korean Journal of Radiology Vol.13 No.6

Objective: To compare between the American College of Radiology (ACR) accreditation phantom and digital mammography accreditation phantom in assessing the image quality in full-field digital mammography (FFDM). Materials and Methods: In each week throughout the 42-week study, we obtained phantom images using both the ACR accreditation phantom and the digital mammography accreditation phantom, and a total of 42 pairs of images were included in this study. We assessed the signal-to-noise ratio (SNR) in each phantom image. A radiologist drew a square-shaped region of interest on the phantom and then the mean value of the SNR and the standard deviation were automatically provided on a monitor. SNR was calculated by an equation, measured mean value of SNR-constant coefficient of FFDM/standard deviation. Two breast radiologists scored visible objects (fibers, specks, and masses) with soft-copy images and calculated the visible rate (number of visible objects/total number of objects). We compared SNR and the visible rate of objects between the two phantoms and calculated the k-coefficient for interobserver agreement. Results: The SNR of the ACR accreditation phantom ranged from 42.0 to 52.9 (Mean, 47.3 ± 2.79) and that of Digital Phantom ranged from 24.8 to 54.0 (Mean, 44.1 ± 9.93) (p = 0.028). The visible rates of all three types of objects were much higher in the ACR accreditation phantom than those in the digital mammography accreditation phantom (p < 0.05). Interobserver agreement for visible rates of objects on phantom images was fair to moderate agreement (k-coefficients: 0.34-0.57). Conclusion: The ACR accreditation phantom is superior to the digital mammography accreditation phantom in terms of SNR and visibility of phantom objects. Thus, ACR accreditation phantom appears to be satisfactory for assessing the image quality in FFDM. Objective: To compare between the American College of Radiology (ACR) accreditation phantom and digital mammography accreditation phantom in assessing the image quality in full-field digital mammography (FFDM). Materials and Methods: In each week throughout the 42-week study, we obtained phantom images using both the ACR accreditation phantom and the digital mammography accreditation phantom, and a total of 42 pairs of images were included in this study. We assessed the signal-to-noise ratio (SNR) in each phantom image. A radiologist drew a square-shaped region of interest on the phantom and then the mean value of the SNR and the standard deviation were automatically provided on a monitor. SNR was calculated by an equation, measured mean value of SNR-constant coefficient of FFDM/standard deviation. Two breast radiologists scored visible objects (fibers, specks, and masses) with soft-copy images and calculated the visible rate (number of visible objects/total number of objects). We compared SNR and the visible rate of objects between the two phantoms and calculated the k-coefficient for interobserver agreement. Results: The SNR of the ACR accreditation phantom ranged from 42.0 to 52.9 (Mean, 47.3 ± 2.79) and that of Digital Phantom ranged from 24.8 to 54.0 (Mean, 44.1 ± 9.93) (p = 0.028). The visible rates of all three types of objects were much higher in the ACR accreditation phantom than those in the digital mammography accreditation phantom (p < 0.05). Interobserver agreement for visible rates of objects on phantom images was fair to moderate agreement (k-coefficients: 0.34-0.57). Conclusion: The ACR accreditation phantom is superior to the digital mammography accreditation phantom in terms of SNR and visibility of phantom objects. Thus, ACR accreditation phantom appears to be satisfactory for assessing the image quality in FFDM.

유방 방사선 검사를 위한 압박 패드의 제작 및 유방 압박 통증에 영향을 주는 요인 분석

김도희(Do-Hee Kim),이안(Ann Yi),권보라(Bo-Ra Kwon),구홍욱(Hong-Uk Ku),방용식(Yong-Sik Bang),조명주(Myeong-Ju Cho) 한국방사선학회 2021 한국방사선학회 논문지 Vol.15 No.5

본 연구는 여러 재질의 맘모 패드를 제작함으로써 환자의 압박 통증 및 불편함 감소 효과와 단일 패드의 대체 가능성을 살펴보고 유방촬영 시 환자의 압박 통증변화와 다양한 요인에 대하여 알아보고자 하였다. 이를 위해 기존의 H사의 맘모 패드를 대체할 수 있는 고경도, 고탄성의 맘모 패드를 제작하였고 제작된 패드의 유용성을 평가하기 위하여 각각의 화질을 비교 평가하였다. 또한 유방촬영 시 통증 관련 요소를 파악하기 위해 2018년 12월부터 2020년 3월까지 서울의 일 종합병원 내원자 중 유방검사를 실시한 환자를 대상으로 설문 조사하여 총 200명의 데이터를 비교 분석하였다. 영상평가 결과, 기존 패드와 신규 제작 패드 모두 화질평가와 임상영상평가의 기준 내 적합치를 나타내었다. 또한 유방촬영 시 압박 통증의 변화와 관련된 요인들을 분석한 결과 일반적 분석항목 요인으로 나이, 키, BMI수치로 나타났으며 여성적·경험적 분석항목 요인으로 생리여부, 출산 경험, 모유 수유 경험, 폐경여부, 유방 GRADE, 유방 형태, 유방촬영 경험으로 나타났다. 결과적으로 나이, 모유 수유 경험, 유방촬영 경험, 폐경여부는 유방촬영 시 통증 변화 정도의 54.0%의 설명력을 나타내었고 유방촬영 시 통증의 변화는 중간 통증에서 유방촬영 경험이 증가할수록 약 0.26배, 심한 통증 이상에서 유방촬영 경험이 증가할수록 약 0.14배씩의 차이를 나타내었다. The purpose of this study was to identify the effects of mammo pad made of different kinds of materials on the reduced inconvenience and compression pains of patients to examine plausible interchangeability of existing pads made of single kind of material, and to examine the changes in pains of patients taking mammography and various factors therein. The high-hardness and highly-elastic mammo pressure pads, capable of replacing existing mammo pad of “H” company, were manufactured, and the display quality of mammography obtained from respective mammo pad were compared to each other to appraise the availability of manufactured mammo pad. In addition, 200 patients, who came to a general hospital in Seoul, were selected as subjects for the survey employing a questionnaire which was distributed to the subjects from December 2018 to March 2020 to identify the factors involved with the mammo pad of patients while taking mammography. The results of mammography obtained from both of the existing and newly manufactured mammo pad revealed appropriate display qualities fell within the range of clinical criteria. Besides, the factors associated with changing compression pains of patients taking mammography were analyzed wherefrom the general factors in the following order of age, height, and BMI index appeared, while the experiential and female factors appeared as in the following order: presence of menstruation, experience of child-birth, experience of breast feeding, menopause, grade of breast, shape of breast, and experience of mammography. In conclusion, the following factors comprising the age, experience of breast feeding, experience of mammography, and menopause rendered approximately 54% of power of explaining the degree of changing pains during mammography. Regarding the changes in compression pains while taking mammography, the increasing experience of mammography of patients rendered approximately 0.26 times more at the intermediate range of compression pains and approximately 0.14 times more at the range of severe pains.

Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers

Nazzal, Zaher,Sholi, Hisham,Sholi, Suha,Sholi, Mohammad,Lahaseh, Rawya Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.5

Background: Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. Materials and Methods: A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. Results: The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Conclusions: Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other important factors that would improve the acceptance and compliance for mammography screening programs.

디지털 유방촬영술

조나리야,차주희,문우경 대한영상의학회 2005 대한영상의학회지 Vol.52 No.4

Mammography is the best imaging modality for the detection of early breast cancer in asymptomatic women. However, 10-30% of cases are missed with current film-screen mammography. Digital mammography allows for the separate optimization of image acquisition and display. In addition to the obvious data storage, retrieval, and transmission advantages that digital mammography allows, additional advances such as computer-aided diagnosis, tomosynthesis and dual energy mammography are in development. This review will discuss the technology of digital mammography including detectors and displays, the results of clinical trials comparing film-screen and digital mammography, and the use of computer-aided detection. Digital mammography is a promising new technology for breast cancer detection in the Korean women. 유방촬영술은 무증상 여성에서 유방암을 조기 발견하는데 최선의 방법이다. 하지만 기존의 필름-스크린 유방촬영술은 낮은 관용도와 잡음으로 인해 10-30%정도의 유방암을 간과할 수 있다. 디지털 유방촬영술은 영상 획득과 표시가 분리되어 있다. 디지털 유방촬영술은 데이터의 저장, 검색 및 전달 등의 장점이외에도 컴퓨터보조진단, 단층촬영기, 이중에너지 유방촬영술 등도 가능하게 한다. 이 글에서는 최근 유방방사선과학 분야의 최고 관심 영역인 디지털유방촬영술의 도입배경 및 장점, 기술적 원리, 임상연구 결과, 컴퓨터보조진단 및 향후 전망등 에 관해 토론하고자 한다. 디지털 유방촬영술은 우리나라 여성의 유방암 발견에 유망한 신기술이다.

Survival Rates of Breast Cancer Patients Aged 40 to 49 Years according to Detection Modality in Korea: Screening Ultrasound versus Mammography

Won So Yeon,Park Hyung Seok,Kim Eun-Kyung,Kim Seung Il,Moon Hee Jung,Yoon Jung Hyun,Park Vivian Youngjean,Park Seho,Kim Min Jung,Cho Young Up,Park Byeong-Woo 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.2

Objective: The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone. Materials and Methods: This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS. Results: Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001–0.705) compared to the mammography group. Conclusion: Our study found that Korean females aged 40–49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

Factors Associated with Mammography Adherence among Married Chinese Women in Yanbian, China

Gang, Moonhee,Kim, Jong Im,Oh, Kyong Ok,Li, Chun Yu,Song, Youngshin Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

Background: Despite the efficacy of regular mammograms, the incidence and mortality rate of breast cancer have been increasing in China. Insufficient studies on the factors affecting mammography adherence in Chinese married women have been conducted. The purpose of the present study was to explore the factors associated with adherence to guidelines for regular mammography among Chinese married women. Materials and Methods: The participants were recruited conveniently and included Chinese and Korean Chinese women who were married, living at Yanbian City in China. Demographic information, status regarding eight risk factors of breast cancer, health responsibility, and perceived benefits/barriers of mammography were obtained. Descriptive analyses, t-test, and multivariate analysis were performed. Hierarchical logistic regression was conducted to explore the factors associated with regular mammography adherence in Chinese and Korean Chinese subgroups. Results: About 24% of the sample population was adherent in going for regular mammography. The adherent group was significantly more educated, had more children, and had a lower proportion experiencing early menarche and a greater menopausal proportion than the non-adherent group. The final model using logistic regression analysis showed that being Chinese [OR=2.199 (1.224-3.951)], having no or one child [OR=4.879 (1.835-12.976)], early menarche [OR=3.515 (1.057-11.694)], being menopausal [OR=3.120 (0.965-10.088)], aged 40-49 [OR=2.374 (1.099-5.124)], having low education [OR=0.400 (0.211-0.765)], and perceiving greater benefits in doing mammography [OR=1.080 (1.014-1.151)] were significantly associated with mammography adherence, after controlling for covariates. Conclusions: Sociocultural sensitive intervention for minorities should be emphasized when improving the adherence of regular mammography. Intervention tailored for women with lower education should be delivered and the benefits of mammography should be propagated to women in rural areas of China.

Relationship Between Perceived Risk and Physician Recommendation and Repeat Mammography in the Female Population in Tehran, Iran

Moshki, Mahdi,Taymoori, Parvaneh,Khodamoradi, Sahmireh,Roshani, Daem Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.no.sup3

Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs, and no regular visits to a physician. Thus research is needed to explore factors associated with repeated mammography participation. Applying the concept of perceived risk as the guiding model, this study aimed to test the fit and strength of the relationship between perceived risk and physician recommendation in explaining repeat mammography. A total of 601 women, aged 50 years and older referred to mammography centers in region 6, were recruited via a convenience sampling method. Using path analysis, family history of breast cancer and other types of cancer were modeled as antecedent perceived risk, and physician recommendation and knowledge were modeled as an antecedent of the number of mammography visits. The model explained 49% of the variance in repeat mammography. The two factors of physician recommendation and breast self-examination had significant direct effects (P < 0.05) on repeat mammography. Perceived risk, knowledge, and family history of breast cancer had significant indirect effects on repeat mammography through physician recommendation. The results of this study provide a background for further research and interventions not only on Iranian women but also on similar cultural groups and immigrants who have been neglected to date in the mammography literature.