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Historical Origins for the Overestimation of Mammographic Sensitivity

机译：乳房X XMPOCTIVE敏感性的历史起源

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The sensitivity of screening mammography for the early detection of breast cancer has improved over the years due to advances in technology.?However, guidelines for screening mammography are often based on the mortality reductions demonstrated in the historic trials, where sensitivity with the first-generation mammography was relatively low.?With attempts to establish risk:benefit ratios for population screening, it is important to understand the wide range of sensitivities that have been reported for mammography. Original calculations for mammographic sensitivity were often based on studies that included palpable tumors, thus generating inflated numbers not fully applicable to non-palpable tumors.?If restricted to asymptomatic screening, sensitivity calculations were often based on the inverse of interval cancers, a relatively inaccurate method since breast cancers missed on mammography?can remain undetected clinically for several years.?It was not until multi-modality imaging was developed, primarily ultrasound and MRI, where sensitivity determinations could be made in real time by cross-checking outcomes with each modality.?From this, it became apparent that there was a strong correlation between breast density levels and sensitivity levels, such that a single number to denote mammographic sensitivity was disingenuous. The increasing awareness that mortality reductions in the historic trials were achieved with a low sensitivity tool has prompted great interest in additional technologic improvements in mammography, as well as multi-modality imaging approaches for women with high density and/or high risk.?In order to appreciate the potential benefit of these new approaches, it is helpful to understand the historical basis behind overestimating the sensitivity of screening mammography.
机译：由于技术进步，筛选乳房X线摄影的敏感性在早期检测乳腺癌的早期检测已经提高了。无论何种一年，筛查乳房X线摄影指南往往基于历史试验中所示的死亡率，其中敏感性乳房X线照相术相对较低。试图建立风险：人口筛查的效益比，重要的是要了解乳房X线照相术的广泛敏感性。乳腺素敏感性的原始计算通常基于包括可触及的肿瘤的研究，从而产生不完全适用于非明显肿瘤的膨胀数。限于无症状筛查，敏感性计算通常基于间隔癌的倒数，相对不准确由于乳腺癌XIMPOCTION的乳腺癌（乳房X癫痫发射）临床上未被发现几年。 。由于低灵敏度工具实现了历史试验中死亡率降低的越来越感激促使对乳房X线摄影的额外技术改进以及高密度和/或高风险风险的妇女的多模态成像方法感兴趣。为了欣赏这些新方法的潜在利益，了解高估筛选乳房X线摄影X X线摄影的敏感性背后的历史基础是有助于的。

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