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Mammogram image quality as a potential contributor to disparities in breast cancer stage at diagnosis: an observational study

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Title: Mammogram image quality as a potential contributor to disparities in breast cancer stage at diagnosis: an observational study
Author(s): Rauscher, Garth H; Conant, Emily F; Khan, Jenna A; Berbaum, Michael L
Subject(s): Breast cancer Disparities Screening
Abstract: Background: In an ongoing study of racial/ethnic disparities in breast cancer stage at diagnosis, we consented patients to allow us to review their mammogram images, in order to examine the potential role of mammogram image quality on this disparity. Methods: In a population-based study of urban breast cancer patients, a single breast imaging specialist (EC) performed a blinded review of the index mammogram that prompted diagnostic follow-up, as well as recent prior mammograms performed approximately one or two years prior to the index mammogram. Seven indicators of image quality were assessed on a five-point Likert scale, where 4 and 5 represented good and excellent quality. These included 3 technologist-associated image quality (TAIQ) indicators (positioning, compression, sharpness), and 4 machine associated image quality (MAIQ) indicators (contrast, exposure, noise and artifacts). Results are based on 494 images examined for 268 patients, including 225 prior images. Results: Whereas MAIQ was generally high, TAIQ was more variable. In multivariable models of sociodemographic predictors of TAIQ, less income was associated with lower TAIQ (p < 0.05). Among prior mammograms, lower TAIQ was subsequently associated with later stage at diagnosis, even after adjusting for multiple patient and practice factors (OR = 0.80, 95% CI: 0.65, 0.99). Conclusions: Considerable gains could be made in terms of increasing image quality through better positioning, compression and sharpness, gains that could impact subsequent stage at diagnosis.
Issue Date: 2013-04
Publisher: BioMed Central
Citation Info: Rauscher, G. H., Conant, E. F., Khan, J. A. and Berbaum, M. L. Mammogram image quality as a potential contributor to disparities in breast cancer stage at diagnosis: an observational study. Bmc Cancer. 2013. 13. DOI: 10.1186/1471-2407-13-208
Type: Article
Description: © 2013 Rauscher et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
URI: http://hdl.handle.net/10027/19612
ISSN: 1471-2407
Sponsor: This work was funded by grants to the University of Illinois at Chicago from the Illinois division of the American Cancer Society, and the Illinois Department of Public Health (#86280168). Additional funding was provided by the National Cancer Institute (Grant # 2P50CA106743-06); the National Center for Minority Health Disparities (Grant # 1 P60MD003424-01); and the Agency for Health Research and Quality (Grant # 1 R01 HS018366-01A1).
Date Available in INDIGO: 2015-08-13
 

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