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Title: Case control study on the effectiveness of using standard mammogram form to predict breast cancer risk
Author: Ding, J. J.
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2007
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The aim of my project was to associate breast density with cancer risk by comparing SMF to the conventional density measurement methods. This case control study comprised cancers with age-matched controls from the Cambridge and Norwich Breast Screening Programmes. Data collection involved assessing the films based on Wolfe’s patterns, SCC and 21-categorisation classification, and then digitising the films for computer analyses (Cumulus and SMF). Conditional logistic regression was used to produce odds ratios associated with mammographic density. Results from a pilot study of 220 cancers and 220 controls demonstrated that compared to the conventional methods the SMF measurement was the most effective means of predicting breast cancer risk. This was shown by a methods comparison graph illustrating that the SMF percent volume measurement scheme had the highest density-risk association. Compared to the other density assessment methods, SMF measure of percent volume most clearly discriminated between women at high risk for breast cancer from those at low risk (odds ratio up to 27.1). The study was then expanded to increase the population size to 505 cancers with 1830 controls. Results from the full study contradicted those from the pilot study by showing that SMF measurements were not as effective at predicting breast cancer risk as the gold standard Cumulus measurements. The odds ratios showed a risk of 1.79 (95% CI 1.26-2.55) using SMF percent volume method compared to 3.38 (95% CI 2.32-4.92) as obtained by Cumulus absolute area measurements. I looked into the inconsistencies in the results from the pilot and full studies. After I examined several factors including digitiser effect, reader subjectivity and SMF version effect, I concluded that the promising results in the pilot study were most likely due to chance as I could not explain them by epidemiological or clinical means.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available