• Korean Journal of Adult Nursing
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• v.16 no.1
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• pp.72-81
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• 2004

Purpose: The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). Method: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. Result: According to the stage of adoption of mammography, 17.4% of the women were In pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption ($R^{2}=26%$). Conclusion: Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9817-9822
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• 2014

Background: Breast cancer is a serious health problem. Early detection is crucial for optimal treatment and reducing mortality. Objective: The aim of this study was to evaluate health beliefs concerning performance of breast self- examination (BSE) and mammography in a sample of Iranian female health workers. Materials and Methods: This cross-sectional study was performed among 441 female health care workers (physicians=88, nurses=163, midwives=38, officers=68, and others=84) in 3 different health centers in Yazd, Iran. Data were collected using a self administered questionnaire which included demographic characteristics and thenPersian version of the Champion's Health Belief Model Scale (CHBMS). Results: The mean age of the participants was $34.7{\pm}13.7$. It was found that 41.9% of the workers performed BSE in the past and 14.9% of them regularly, but only 10.6% of them had undergone a mammogram. Perceived barriers to BSE (F=6.351, P=0.021) and mammography (F=5.214, p=0.022) were significantly higher in officers than physicians, nurses or midwives. Perceived barriers were lower among those who had performed BSE and mammography, but not significant (p=0.34 and p=0.56, respectively). Furthermore, perceived susceptibility and perceived benefits of the workers who had BSE and mammography were significantly higher than who did not (p<0.05). Perceived seriousness was not a significant variable in BSE and mammography (p=0.71 and p=0.43, respectively). Conclusions: The health beliefs of health workers concerning the perceived susceptibility of breast cancer and the perceived benefits BSE and mammography significantly impact their screening practices.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7731-7736
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• 2013

Aim: To compare the agreement of screening breast mammography plus ultrasound and reviewed mammography alone in asymptomatic women. Materials and Methods: All breast imaging data were obtained for women who presented for routine medical checkup at National Cancer Institute (NCI), Thailand from January 2010 to June 2013. A radiologist performed masked interpretations of selected mammographic images retrieved from the computer imaging database. Previous mammography, ultrasound reports and clinical data were blinded before film re-interpretation. Kappa values were calculated to assess the agreement between BIRADS assessment category and BIRADS classification of density obtained from the mammography with ultrasound in imaging database and reviewed mammography alone. Results: Regarding BIRADS assessment category, concordance between the two interpretations were good. Observed agreement was 96.1%. There was moderate agreement in which the Kappa value was 0.58% (95%CI; 0.45, 0.87). The agreement of BI-RADS classification of density was substantial, with a Kappa value of 0.60 (95%CI; 0.54, 0.66). Different results were obtained when a subgroup of patients aged ${\geq}60$ years were analyzed. In women in this group, observed agreement was 97.6%. There was also substantial agreement in which the Kappa value was 0.74% (95%CI; 0.49, 0.98). Conclusions: The present study revealed that concordance between mammography plus ultrasound and reviewed mammography alone in asymptomatic women is good. However, there is just moderate agreement which can be enhanced if age-targeted breast imaging is performed. Substantial agreement can be achieved in women aged ${\geq}60$. Adjunctive breast ultrasound is less important in women in this group.

• Korean Journal of Radiology
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• v.21 no.1
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• pp.15-24
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• 2020

Mammography is the primary screening method for breast cancers. However, the sensitivity of mammographic screening is lower for dense breasts, which are an independent risk factor for breast cancers. Automated breast ultrasound (ABUS) is used as an adjunct to mammography for screening breast cancers in asymptomatic women with dense breasts. It is an effective screening modality with diagnostic accuracy comparable to that of handheld ultrasound (HHUS). Radiologists should be familiar with the unique display mode, imaging features, and artifacts in ABUS, which differ from those in HHUS. The purpose of this study was to provide a comprehensive review of the clinical significance of dense breasts and ABUS screening, describe the unique features of ABUS, and introduce the method of use and interpretation of ABUS.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1385-1391
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• 2016

Background: To investigate the prevalence of and factors associated with performance of annual mammography by women above 40 years of age. Materials and Methods: This cross-sectional retrospective study was conducted at an oncology reference service in Southern Brazil from October 2013 to October 2014 with 525 women aged 40 years or older. Results: The prevalence of annual mammography was 54.1%; annual mammographic screening was performed for women without private medical insurance, who were under hormone replacement therapy and who had used contraception in the past. An association was found between non-performance of breast clinical and self-examination and non-performance of mammographic screening. Conclusions: Use of mammography for breast cancer screening in the public health care setting proved to be accessible; nevertheless, the proportion of screened women was low, and they exhibited poor adherence to the basic measures of care recommended for breast assessment. Thus, control of breast cancer requires implementing actions targeting the population most vulnerable to non-adherence to screening in addition to continuously monitoring and assessing that population to reduce the prevalence of this disease.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.2-11
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• 2021

More than 4 million women undergo breast cancer (BC) screening with mammography each year in Korea. Digital mammography (DM) was introduced in 2000, and it has been reported to have a higher diagnostic accuracy than screen-film mammography (SFM) or computed radiography (CR) in women with dense breasts. According to a study using data from the National Cancer Screening Program for BC, the diagnostic accuracy of DM was higher than those of SFM and CR, regardless of age, breast density, and screening round. Currently, despite high supply rate among OECD countries, the distribution of DM equipment is approximately 35% in Korea. For quick replacement with DM, it will be necessary to improve its fee for the National Health Insurance and support an educational program for radiologists. In addition, efforts should be made to increase the accessibility of DM.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5759-5765
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• 2014

Electrical impedance tomography (EIT) is a potential supplement for mammogram screening. This study aimed to evaluate and feasibility of EIT as opposed to mammography and to determine pain perception with both imaging methods. Women undergoing screening mammography at the Radiology Department of National University of Malaysia Medical Centre were randomly selected for EIT imaging. All women were requested to give a pain score after each imaging session. Two independent raters were chosen to define the image findings of EIT. A total of 164 women in the age range from 40 to 65-year-old participated and were divided into two groups; normal and abnormal. EIT sensitivity and specificity for rater 1 were 69.4% and 63.3, whereas for rater 2 they were 55.3% and 57.0% respectively. The reliability for each rater ranged between good to very good (p<0.05). Quantitative values of EIT showed there were significant differences in all values between groups (ANCOVA, p<0.05). Interestingly, EIT scored a median pain score of $1.51{\pm}0.75$ whereas mammography scored $4.15{\pm}0.87$ (Mann Whitney U test, p<0.05). From these quantitative values, EIT has the potential as a health discriminating index. Its ability to replace image findings from mammography needs further investigation.

• Korean Journal of Digital Imaging in Medicine
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• v.12 no.1
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• pp.33-41
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• 2010

National Cancer Screening Project and Korean Society of Breast Imaging recommend that breast cancer screening should be performed on those aged 40 and above. Nevertheless, this recommendation is usually ignored by a number of medical institutions. The purpose of this study is to emphasize the necessity of an age limitation in screening mammography. Ten institutions were randomly selected and telephone inquiries about patients' age limitation and internal guidelines were set up. The 3,214 women, who underwent screening mammography through 'GE Senography 2000D' in each hospital, were classified into five groups according to age(from 20s to 40s, at intervals of 5). And then, collected data was analyzed by a radiologist in accordance with ACR-BIRADS(American College of Radiology Breast Imaging Reporting and Data System), through which breast parenchymal density and the results of analysis were categorized in order to predict the sensitivity of mammography. Information about craniocaudal-view mammograms was automatically produced by use of GE Senography 2000D, and the average glandular dose was retrospectively analyzed through the program 'Excel 2007.' Two institutions did not set the age limitation. Other seven institutions internally allowed those who wanted to receive mammography regardless of age. Approximately 99% of those aged 20 to 29 were judged as having the dense breast. In those aged 35 to 39, breast parenchymal density tended to be lower, but the fatty breast to increase. In the case of 'category-zero' that does not need additional tests, the rate of 'heterogeneously dense' and 'extremely dense' reached to 83.1% and 15.1% respectively. Regarding dense breasts, there was no sufficient information for image reading. The glandular dose, applied to 3,214, was 1.47mGy on the average. In those aged 20 to 24 who are sensitive to radiation, the average glandular dose indicated 1.59mGy. Those aged 35 and above showed the lowest value, 1.43mGy. In those aged 35 to 39, the breast tended to change from denseness to fattiness. The average glandular dose was lowest in those aged 35 and above, which suggests that screening mammography should be periodically performed on those aged 35 and above in order that breast cancer may be early detected. On the other hand, in those aged less than 35, it is difficult to analyze mammograms due to the high density of breast parenchyma, and also retakes become frequent. In particular, subjects may be exposed to excessive doses. Accordingly, it should be substituted by breast self-examination or clinical breast examination. In case of need, it is advisable to perform ultrasonography.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.4137-4141
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• 2016

Background: A recent guideline by the American Cancer Society recommended that mammography (MMG) should be done for women starting in their mid-40s. In Thailand, information on opportunistic mammography screening is limited and data on the total incidence of breast cancer are also lacking. The purpose of this study was to estimate the breast cancer detection, incident and prevalence rates among Thai women. Materials and Methods: We retrospectively reviewed the opportunistic mammography screening of normal women between 30 and 80 years who underwent the procedure between 2001 and 2010. All cases were followed until 2012. The detection rate was calculated for the whole period of observation using 'number of women with positive findings' divided by 'total number of women screened'. The incidence rate was calculated only at the first MMG while the subsequence rate was calculated based on all new cases detected at each subsequent MMG. Results: Among the 47,430 women, there were 152,091 MMGs or approximately 3.2 occasions per person (range, 1-10). The average duration of the interval between each subsequence visit was 1.8 years. Overall, breast cancer was detected in 543 women, with a detection rate of 10.3 per 1,000 persons. The prevalence rate of breast cancer at the first visit was 5.78 per 1,000 persons. The incidence or new cases detected at any follow-up visit was 10.4 per 1,000 persons. The overall interval cancer was 0.91 per 1,000 women, mainly detected before their second and third MMG, with a rate of 0.0.47 and 0.76 per 1,000 women. Conclusions: Opportunistic mammography screening in Thailand detected 10 case of breast cancer from each 1,000 women. This paper indicated a high rate of cancer detection during a two year interval, hence, a screening mammogram should be performed more often.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2137-2139
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• 2013

Breast cancer is the most common cancer among females, worldwide, accounting for 22.9% of all cancers (excluding non-melanoma skin cancer) in females. Mammography is a sensitive (77-95%) and specific (94-97%) screening method for breast cancer. Previously, females between the 40-50 years old were recommended to have mammograms every one to two years. However, based on current evidence, in 2009, USPSTF recommended that the decision to start regular, biennial screening mammography for females younger than 50 years should be an individual decision and take patient context into account, including the patient's values regarding specific benefits and harms. This decision was based on findings regarding radiation exposure, false-positive and false-negative rates, over-diagnosis, and pain and psychological responses. The goal of this paper is to focus on evidence for updating the U.S. Preventive Services Task Force (USPSTF) recommendation against routine mammography for females between 40-49 years of age.