Mammographic sensitivity as a function of tumor size: A novel estimation based on population-based screening data

Jing Wang, Pam Gottschal, Lilu Ding, DaniëlleW A van Veldhuizen, Wenli Lu, Nehmat Houssami, Marcel J W Greuter, Geertruida H de Bock*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

3 Citaten (Scopus)
34 Downloads (Pure)


BACKGROUND: Instead of a single value for mammographic sensitivity, a sensitivity function based on tumor size more realistically reflects mammography's detection capability. Because previous models may have overestimated size-specific sensitivity, we aimed to provide a novel approach to improve sensitivity estimation as a function of tumor size.

METHODS: Using aggregated data on interval and screen-detected cancers, observed tumor sizes were back-calculated to the time of screening using an exponential tumor growth model and a follow-up time of 4 years. From the observed number of detected cancers and an estimation of the number of false-negative cancers, a model for the sensitivity as a function of tumor size was determined. A univariate sensitivity analysis was conducted by varying follow-up time and tumor volume doubling time (TVDT). A systematic review was conducted for external validation of the sensitivity model.

RESULTS: Aggregated data of 22,915 screen-detected and 10,670 interval breast cancers from the Dutch screening program were used. The model showed that sensitivity increased from 0 to 85% for tumor sizes from 2 to 20 mm. When TVDT was set at the upper and lower limits of the confidence interval, sensitivity for a 20-mm tumor was 74% and 93%, respectively. The estimated sensitivity gave comparable estimates to those from two of three studies identified by our systematic review.

CONCLUSION: Derived from aggregated breast screening outcomes data, our model's estimation of sensitivity as a function of tumor size may provide a better representation of data observed in screening programs than other models.

Originele taal-2English
Pagina's (van-tot)69-74
Aantal pagina's6
TijdschriftThe Breast
Vroegere onlinedatum9-dec-2020
StatusPublished - feb-2021

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