Marcel Blum
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Item type:Publication, Retrospective evaluation of interval breast cancer screening mammograms by radiologists and AI(Springer Science and Business Media LLC, 2025-08-04); ;Morant, Rudolf; ;Gräwingholt, AxelObjectives To determine whether an AI system can identify breast cancer risk in interval breast cancer (IBC) screening mammograms. Materials and methods IBC screening mammograms from a Swiss screening program were retrospectively analyzed by radiologists/an AI system. Radiologists determined whether the IBC mammogram showed human visible signs of breast cancer (potentially missed IBCs) or not (IBCs without retrospective abnormalities). The AI system provided a case score and a prognostic risk category per mammogram. Results 119 IBC cases (mean age 57.3 (5.4)) were available with complete retrospective evaluations by radiologists/the AI system. 82 (68.9%) were classified as IBCs without retrospective abnormalities and 37 (31.1%) as potentially missed IBCs. 46.2% of all IBCs received a case score ≥ 25, 25.2% ≥ 50, and 13.4% ≥ 75. Of the 25.2% of the IBCs ≥ 50 (vs. 13.4% of a no breast cancer population), 45.2% had not been discussed during a consensus conference, reflecting 11.4% of all IBC cases. The potentially missed IBCs received significantly higher case scores and risk classifications than IBCs without retrospective abnormalities (case score mean: 54.1 vs. 23.1; high risk: 48.7% vs. 14.7%; p < 0.05). 13.4% of the IBCs without retrospective abnormalities received a case score ≥ 50, of which 62.5% had not been discussed during a consensus conference. Conclusion An AI system can identify IBC screening mammograms with a higher risk for breast cancer, particularly in potentially missed IBCs but also in some IBCs without retrospective abnormalities where radiologists did not see anything, indicating its ability to improve mammography screening quality. Key Points Question AI presents a promising opportunity to enhance breast cancer screening in general, but evidence is missing regarding its ability to reduce interval breast cancers. Findings The AI system detected a high risk of breast cancer in most interval breast cancer screening mammograms where radiologists retrospectively detected abnormalities. Clinical relevance Utilization of an AI system in mammography screening programs can identify breast cancer risk in many interval breast cancer screening mammograms and thus potentially reduce the number of interval breast cancers.Type:journal articleJournal:European Radiology - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Risk factors for interval breast cancer: insights from a decade of a mammography screening program(Springer Science and Business Media LLC, 2025-02-12); ;Rudolf Morant; ;Alena EichenbergerPurpose Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data. Methods In this retrospective cohort study, we merged data from the Swiss MSP “donna” with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses. Results We identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC (p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages (p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative (p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55–59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant (p < 0.05) risk factors for IBC diagnoses. Conclusions Women with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics).Type:journal articleJournal:Breast Cancer Research and TreatmentScopus© Citations 2 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The possible benefit of artificial intelligence in an organized population-related screening program : Initial results and perspective(2024-07-17) ;Morant, R ;Gräwingholt, A; ; Mammography screening programs (MSP) have shown that breast cancer can be detected at an earlier stage enabling less invasive treatment and leading to a better survival rate. The considerable numbers of interval breast cancer (IBC) and the additional examinations required, the majority of which turn out not to be cancer, are critically assessed. In recent years companies and universities have used machine learning (ML) to develop powerful algorithms that demonstrate astonishing abilities to read mammograms. Can such algorithms be used to improve the quality of MSP? The original screening mammographies of 251 cases with IBC were retrospectively analyzed using the software ProFound AI® (iCAD) and the results were compared (case score, risk score) with a control group. The relevant current literature was also studied. The distributions of the case scores and the risk scores were markedly shifted to higher risks compared to the control group, comparable to the results of other studies. Retrospective studies as well as our own data show that artificial intelligence (AI) could change our approach to MSP in the future in the direction of personalized screening and could enable a significant reduction in the workload of radiologists, fewer additional examinations and a reduced number of IBCs; however, the results of prospective studies are needed before implementationType:journal articleJournal:Die RadiologieScopus© Citations 2 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Breast cancer patients enrolled in the Swiss mammography screening program “donna” demonstrate prolonged survival(2024); ; ; ; Alena EichenbergerStudy goal We compared the survival rates of women with breast cancer (BC) detected within versus outside the mammography screening program (MSP) “donna”. Methods We merged data from the MSP with the data from corresponding cancer registries to categorize BC cases as within MSP (screen-detected and interval carcinomas) and outside the MSP. We analyzed the tumor stage distribution, tumor characteristics and the survival of the women. We further estimated hazard ratios using Cox-regressions to account for different characteristics between groups and corrected the survival rates for lead-time bias. Results We identified 1057 invasive (ICD-10: C50) and in-situ (D05) BC cases within the MSP and 1501 outside the MSP between 2010 and 2019 in the Swiss cantons of St. Gallen and Grisons. BC within the MSP had a higher share of stage I carcinoma (46.5% vs. 33.0%; < 0.01), a smaller (mean) tumor size (19.1 mm vs. 24.9 mm, < 0.01), and fewer recurrences and metastases in the follow-up period (6.7% vs. 15.6%, < 0.01). The 10-year survival rates were 91.4% for women within and 72.1% for women outside the MSP (< 0.05). Survival difference persisted but decreased when women within the same tumor stage were compared. Lead-time corrected hazard ratios for the MSP accounted for age, tumor size and Ki-67 proliferation index were 0.550 (95% CI 0.389, 0.778; for overall survival and 0.469 (95% CI 0.294, 0.749; < 0.01) for BC related survival. Conclusion Women participating in the “donna” MSP had a significantly higher overall and BC related survival rate than women outside the program. Detection of BC at an earlier tumor stage only partially explains the observed differences.Type:case review (law)Journal:Breast Cancer ResearchVolume:26Issue:1Scopus© Citations 10 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Can AI detect interval breast cancer in screening mammograms where radiologists do not identify abnormalities?(2025-03); ; ;Morant, Rudolf; Type:conference poster - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ability of artificial intelligence to reduce the number of interval breast cancer cases: Explorative analysis based on a decade of a Swiss mammography screening program(2024); ;Morant, Rudolf; ;Eichenberger, AlenaType:conference posterScopus© Citations 10 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, UTILIZATION OF AN AI DIAGNOSTIC SOFTWARE IN A MAMMOGRAPHY SCREENING PROGRAM SHOWS POTENTIAL FOR HIGHER SCREENING EFFICIENCY AND EFFECTIVENESS(2024-09-12); ; ; ; Type:conference poster - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Interval Carcinomas in the mammography screening program "Donna" (St.Gallen & Graubünden): A retrospective evaluation for quality control and improvement(2023); ; ; ;Morant, RudolfEichenberger, AlenaType:conference poster - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Optimal utilization of an AI diagnostic software in a mammography screening program in Switzerland(2025-02-27); ;Morant, Rudolf; ; Type:conference speech - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Retrospective evaluation of interval breast cancer with AI diagnostic software(2024); ; ; ;Morant, RudolfEichenberger, AlenaType:conference speech