Evidence map›Paper›PMID 27548583›Full record

ArticleAnnals of internal medicine2016

Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

Amy Trentham-Dietz, Karla Kerlikowske, Natasha K Stout, Diana L Miglioretti, Clyde B Schechter, Mehmet Ali Ergun, Jeroen J van den Broek, Oguzhan Alagoz, Brian L Sprague, Nicolien T van Ravesteyn and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
  2. Extending the Age Range in Mammography Screening: A Benefit-Risk Assessment from a Radiation Protection Perspective.RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · 2026
    Pooled it
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  4. Systematic Review of the Cost Effectiveness of Breast Cancer Prevention, Screening, and Treatment Interventions.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020
    Pooled it
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22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Amy Trentham-DietzFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Karla KerlikowskeFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Natasha K StoutFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Diana L MigliorettiFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Clyde B SchechterFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Mehmet Ali ErgunFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Jeroen J van den BroekFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Oguzhan AlagozFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Brian L SpragueFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Nicolien T van RavesteynFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Aimee M NearFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Ronald E GangnonFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
John M HamptonFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Young ChandlerFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Harry J de KoningFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Jeanne S MandelblattFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Anna N A TostesonFrom the University of Wisconsin-Madison, Madison, Wisconsin; University of California, San Francisco, San Francisco, California; Harvard Medical School, Boston, Massachusetts; University of California Davis School of Medicine, Sacramento, California; Albert Einstein College of Medicine, Bronx, New York; Erasmus Medical Center, Rotterdam, the Netherlands; University of Vermont, Burlington, Vermont; Georgetown University Medical Center, Washington, DC; and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Breast Cancer Surveillance Consortium and the Cancer Intervention and Surveillance Modeling Network

Funding

UW COMPREHENSIVE CANCER CENTER SUPPORTP30CA014520 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI Christian Capitini · 1985 to 2026
$142.6M
Translational Engineering in Cancer (TEC)P30CA023108 · NCI · DARTMOUTH COLLEGE · PI Fred W Kolling IV · 1985 to 2026
$91.3M
Staff InvestigatorsP30CA093373 · NCI · UNIVERSITY OF CALIFORNIA DAVIS · PI Gina M Dayton · 2002 to 2026
$84.9M
Risk-based Imaging Strategies to Improve Breast Cancer Surveillance OutcomesP01CA154292 · NCI · UNIVERSITY OF CALIFORNIA AT DAVIS · PI KARLA M KERLIKOWSKE · 2011 to 2026
$52.9M
Comparative Modeling: Informing Breast Cancer Control Practice and PolicyU01CA199218 · NCI · GEORGETOWN UNIVERSITY · PI BERRY, DONALD A, DE KONING, HARRY J · 2015 to 2019
$9.0M
Comparative Modeling: Informing Breast Cancer Control Practice & PolicyU01CA152958 · NCI · GEORGETOWN UNIVERSITY · PI BERRY, DONALD A, DE KONING, HARRY J · 2010 to 2015
$7.6M
Vermont Screening Process Documentation UnitU54CA163303 · NCI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI SPRAGUE, BRIAN L · 2011 to 2017
$6.4M
NCI NIH HHS P01 CA154292NCI NIH HHS P30 CA014520NCI NIH HHS P30 CA023108NCI NIH HHS P30 CA093373NCI NIH HHS U01 CA152958NCI NIH HHS U01 CA199218NCI NIH HHS U54 CA163303
6 · The paper itself

Abstract

Background: Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. Objective: To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Design: Collaborative simulation modeling using national incidence, breast density, and screening performance data. Setting: United States. Patients: Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Intervention: Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Measurements: Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Results: Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Limitation: Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Conclusion: Average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density receiving annual screening will maintain a similar or better balance of benefits and harms than average-risk women receiving biennial screening. Primary Funding Source: National Cancer Institute.

Indexed as

Breast DensityEarly Detection of CancerMammographyAgedBreast NeoplasmsComputer SimulationCost-Benefit AnalysisFalse Positive ReactionsFemaleHumansLife ExpectancyMass ScreeningMedical OveruseMiddle AgedModels, StatisticalQuality-Adjusted Life Years

Identifiers

PMID27548583
PMCPMC5125086

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.