Interim Analysis of MEDICI: Mammographic Predictors of Cancer Recurrence after Breast Conservation and Adjuvant Endocrine Therapy

TY - CONF

T1 - Interim Analysis of MEDICI

T2 - British Society of Breast Radiology Annual Scientific Meeting 2024

AU - Savaridas, Sarah

AU - Marshall, Andrew

AU - Vinnicombe, Sarah

AU - Halling-Brown, Mark

AU - Ali, Kulsam

AU - Whelehan, Patsy

AU - Evans, Andrew

AU - Astley, Sue

AU - Healy, Nuala

AU - Sharma, Ashwini

AU - Drummond, Sonya

AU - Nash, Jonathon

AU - Muthyala, Sreenivas

AU - Muscat, Elizabeth

AU - Telesca, Marianna

AU - Dunn, Janet

PY - 2024/11

Y1 - 2024/11

N2 - Background: Mammographic density (MD) is a well-established breast cancer risk factor. Decreasing MD has been demonstrated to be a risk-reduction biomarker in a landmark chemoprevention study in high-risk women. A few small studies suggest that a decreasing MD in women taking adjuvant endocrine therapy (AET) may be associated with a lower risk of recurrence and breast cancer specific death. Aim: This interim analysis aims to measure inter and intra-reader variability of MD classification within a current study (MEDICI) investigating whether a reduction in MD after one and/or three years in women taking AET is associated with a lower risk of breast cancer recurrence and death compared to no reduction. Methods: Retrospective cohort study, generated from a subset of participants from the Mammo-50 trial. Eleven readers assessed MD using a 0 to 100% visual analogue scale (VAS), scoring mammograms from time of diagnosis and at one and three years after diagnosis. A subset of four readers re-analysed the mammograms. Inter and intra- reader agreement were estimated using intra-class correlation coefficients (ICC). Results: Eleven readers classified MD in 50 patients at three timepoints (150 mammograms), using the VAS. Four readers re-interpreted all 150 mammograms. The ICC between all 11 readers (inter-reader agreement) was 0.80 (95% confidence interval (CI): 0.77-0.84). The ICC within readers (intra-reader agreement) was 0.86 (95% CI 0.77-0.91). Conclusion: Interim analysis demonstrates good inter- and intra-reader agreement for assessment of MD on VAS, suggesting validity of the human MD assessment to be performed within the MEDICI study.

AB - Background: Mammographic density (MD) is a well-established breast cancer risk factor. Decreasing MD has been demonstrated to be a risk-reduction biomarker in a landmark chemoprevention study in high-risk women. A few small studies suggest that a decreasing MD in women taking adjuvant endocrine therapy (AET) may be associated with a lower risk of recurrence and breast cancer specific death. Aim: This interim analysis aims to measure inter and intra-reader variability of MD classification within a current study (MEDICI) investigating whether a reduction in MD after one and/or three years in women taking AET is associated with a lower risk of breast cancer recurrence and death compared to no reduction. Methods: Retrospective cohort study, generated from a subset of participants from the Mammo-50 trial. Eleven readers assessed MD using a 0 to 100% visual analogue scale (VAS), scoring mammograms from time of diagnosis and at one and three years after diagnosis. A subset of four readers re-analysed the mammograms. Inter and intra- reader agreement were estimated using intra-class correlation coefficients (ICC). Results: Eleven readers classified MD in 50 patients at three timepoints (150 mammograms), using the VAS. Four readers re-interpreted all 150 mammograms. The ICC between all 11 readers (inter-reader agreement) was 0.80 (95% confidence interval (CI): 0.77-0.84). The ICC within readers (intra-reader agreement) was 0.86 (95% CI 0.77-0.91). Conclusion: Interim analysis demonstrates good inter- and intra-reader agreement for assessment of MD on VAS, suggesting validity of the human MD assessment to be performed within the MEDICI study.

UR - https://www.delegate-reg.co.uk/bsbr2024/programme

M3 - Paper

Y2 - 3 November 2024 through 5 November 2024

ER -