Accepted for/Published in: JMIR AI
Date Submitted: Apr 12, 2023
Open Peer Review Period: Apr 12, 2023 - Apr 26, 2023
Date Accepted: Aug 3, 2023
(closed for review but you can still tweet)
Benign biopsy effect on artificial intelligence cancer detector in screening mammography: a retrospective study
ABSTRACT
Background:
Artificial intelligence (AI) cancer detectors are showing promising results and may soon be used for clinical breast cancer screening in radiology departments. Validation of such programs in different settings is mandatory.
Objective:
Our goal is to corroborate the hypothesis that women with previous benign biopsy and cytology would subsequently show increased AI abnormality scores for screening mammograms even though they remained healthy.
Methods:
This is a retrospective study after the application of a commercial AI cancer detector program to a cancer-enriched mammography screening dataset where 10 889 women with a median age for the study population of 56 years and a range between 40 and 74 years old where included. The program, is intended for 2D mammography and it generate a prediction score for tumor presence with a decimal number between 0 and 1, where 1 represented the highest level of suspicion. The AI score median and interquartile range for women who were healthy, who had a benign biopsy, and who were diagnosed with breast cancer, was calculated. For women with a previous benign biopsy, the time between mammogram and the biopsy was stratified. The effect of increasing age was examined using stratified analysis and linear regression modelling.
Results:
Two hundred and thirty-four (234) women had had a benign biopsy. The proportion of healthy women above the AI abnormality threshold (0.4) defined at our hospital was 3.5%, 11% and 84% for healthy women without a benign biopsy, healthy women with a benign biopsy, and for women with breast cancer, respectively (p<.001) and the AI score correlated positively with increasing age of the women in the cancer group (p<.05). The proportion of women with AI-scores above the threshold was 16% for those with benign biopsy within 6 months from mammography and 33% for those with benign biopsy 6 months before mammography.
Conclusions:
AI cancer detection systems can reliable be used in a screening setting. Adding information about possible prior benign biopsy and other symptoms can probably improve accuracy and subsequently reduce the workload for radiologists.
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