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4 results on '"Burke, Paolo"'

1. Breast Cancer Diagnosis under the Age of Forty Years

Author

Ciatto, Stefano, Smith, Andrea Herd, Di Maggio, Cosimo, Pescarini, Luigi, Lattanzio, Enzo, Ancona, Antonietta, Punzo, Clelia, De Leo, Giuseppe, Burke, Paolo, Bonomini, Mino Giorgio, and Melaranci, Pietro

Abstract

The authors report on a multicentric consecutive series of 382 cases of primary breast cancer detected before the age of 40 years. Physical examination (PE) was always performed, whereas other diagnostic tests were performed in selected cases, namely mammography (M) in 334, fine needle aspiration cytology (CYT) in 188 and thermography (TH) in 123 cases. Single tests showed a high rate of false-negative/benign cases (PE, 0.23; M, 0.26; CYT, 0.37 and TH, 0.50), especially when the T1 subgroup was considered (PE, 0.34; M, 0.38; CYT, 0.42 and TH, 0.78). The poor results recorded for TH make its current diagnostic use highly questionable. The policy of extensive biopsy of all « dubious » benign lesions on PE allowed for the detection of 41 of 382 cancers and reduced the PE false-negative/benign rate to 0.12 for the total or 0.15 for T1 cancers, although about 80 unnecessary biopsies for each cancer detected were performed in this way. The association of PE to one or more tests resulted in even lower false-negative rates (0.06 for the total, 0.10 for T1 cancers). The authors criticize the aggressive policy of extensive biopsy recommendation based only on a dubious report on PE alone and stress the opportunity of the routine association of M and CYT to PE, since this combination seems to achieve a higher breast cancer detection rate even in this age group.

Published
1987
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2. Inter-Observer Variability in the Interpretation of Mammograms

Author

Vineis, Paolo, Sinistrero, Giuseppe, Temporelli, Aurelio, Azzoni, Livio, Bigo, Aldo, Burke, Paolo, Ciccone, Giovannino, Fasciano, Fedele, Ferraris, Renato, Frigerio, Alfonso, Genovese, Maria Grazia, Luparia, Enrico, Potenzoni, Francesco, and Segnan, Nereo

Abstract

Inter-observer agreement was tested in the interpretation by 8 radiologists of mammograms from 45 women (for a total of 180 films per radiologist). The radiologists were representative of the whole range of those involved in mammography in the town of Torino, with a number of films read per year ranging from 100 to 4000. Out of the 45, 9 women were affected by breast cancer (histologically proved), 25 had benign disease (diagnosed with fine-needle aspiration) and 11 had normal breasts. Weighted kappa values were in the range 0.27–0.82 (median 0.60) for parenchymal patterns; 0.33–0.67 (0.48) for diagnosis in five categories; and 0.22–0.57 (0.38) for indications for further diagnostic tests. These values are comparable with those reported from other investigations.

Published
1988
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4. Diagnostic accuracy of commercial system for computer-assisted detection (CADx) as an adjunct to interpretation of mammograms.

Author

Menna S, Di Virgilio MR, Burke P, Frigerio A, Boglione E, Ciccarelli G, Di Filippo S, and Garretti L

Subjects
Calcinosis diagnostic imaging, Female, Humans, Predictive Value of Tests, Sensitivity and Specificity, Breast Neoplasms diagnostic imaging, Mammography, Radiographic Image Interpretation, Computer-Assisted
Abstract

Purpose: To evaluate the diagnostic accuracy of the commercial computer-aided detection CADx system for the reading of mammograms., Materials and Methods: The study assessed the Second Look system developed and marketed by CADx Medical Systems, Montreal, Canada. The diagnostic sensitivity was evaluated by means of a retrospective study on 98 consecutive cancers detected at screening by double independent reading. The specificity and the positive predictive value (PPV) for cancer of the CADx system were prospectively evaluated on a second group of 560 consecutive mammograms of asymptomatic women not included in screening program. The radiologist who was present during the test assessed the abnormal mammographic findings by one or more of the following diagnostic procedures: physical examination, additional mammographic detail views with or without magnification, ultrasonography, ultrasound- or mammography-guided fine needle aspiration cytology, and core-biopsy. The exams first underwent conventional reading and then a second reading carried out with the aid of the CADx system., Results: The overall diagnostic sensitivity of the CADx system on the 98 screening cancers was 81.6%; in particular it was 89.3% for calcifications, 83.9% for masses and only 37.5% for architectural distortion. The CADx markings for each mammography were 4.7 on average. Identification of invasive carcinoma was independent from tumour size. In the second group of 560 mammograms, the CADx system marked all cases identified as positive by conventional reading and confirmed by biopsy (7/7), but did not permit the detection of any additional cancer. The CADx markings per exam were 4.2 on average, the specificity was 13.7% and the PPV was 0.55% versus 13.7% recall rate of conventional reading. CADx reading led to a 1.96% (11/560) increase of the women necessitating further diagnostic investigation., Conclusions: The results of our study show that the diagnostic sensitivity of the CADx system is lower than that obtained by double independent reading at screening. Used in association with conventional reading of mammograms of asymptomatic women the CADx system did not increase diagnostic sensitivity.

Published
2005

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