New state insurance law, Australia INFORM, Study on parenchymal texture and risk
New State Insurance Law
Florida is the latest state to expand insurance coverage requirements for breast imaging. NOTE: this limited law applies only to Florida state employee health contracts or plans. For details, visit DBI’s legislative resources:
Australia INFORM!
Breaking news from research scientist and founder of InforMD Wendy Ingman, “In a landmark policy change, BreastScreen Australia now recommends that breast density be reported to women as part of routine mammography screening.” Find the Position Statement HERE. Congratulations to the advocates who have fought for this for nearly a decade!
New Study
Winham et al report on development and validation of mammographic parenchymal textural features that predict increased risk for breast cancer and also predict masking risk/ increased risk of interval cancer. They analyzed full-field digital screening mammograms from over 29,000 women at multiple centers and identified six breast parenchymal feature/texture types. The extracted types were then applied to a separate nested case-control cohort that included mammograms on over 1000 women with cancer.
- The feature/texture types were significantly associated with both risk of developing cancer¹ and risk of masking².
- These texture types did not distinguish higher or lower risk among women with dense breasts.
- One texture type distinguished lower risk among women with non-dense breasts³.
- The authors conclude that parenchymal textural features have potential to improve risk prediction and personalized screening strategies for women with high or low breast cancer risk.
The magnitudes of risk in this study were generally less than those associated with breast density, though this may help identify women at lower risk among those with non-dense breasts. Other studies have shown that textural features complement density in risk assessment and adding textural features to AI models of risk does appear to improve performance.
¹The highest risk types had odds ratio (OR) of 1.17 (95%CI 1.08, 1.27) and 1.12 (95%CI 1.03, 1.21) and the lowest 0.87 (95%CI 0.78, 0.96). The greatest impact on identifying a subset of women with reduced risk was observed in Black women.
² The highest masking risk types had OR of 1.60 (95%Ci 1.24, 2.07) for false negative findings and 1.65 (95%CI 1.21, 2.26) for symptomatic interval cancer, and the lowest 0.63 (95%CI 0.45, 0.88) for false negatives and 0.63 (95%CI 0.42, 0.94) for interval cancer.
³ Odds ratio for breast cancer risk was 0.78 (95%CI 0.68, 0.89) for one texture type in non-dense breasts.