Breast Cancer Clinical Trial
Official title:
To Determine the Impact on Reader Performance, as Defined by the Area Under the Receiver Operating Characteristic Curve, When Automated Breast Ultrasound and a Screening Mammogram Are Combined, Compared to a Screening Mammogram Alone in Asymptomatic Women With >50% Parenchymal Density and a Screening Mammogram Assigned a BI-RADS Assessment Category 1 (Negative) or 2 (Normal With Benign Findings).
To determine the impact on Interpreting Physician performance in detecting breast cancer, as
defined by the area under the Receiver Operating Characteristic Curve (ROC), when Automated
Breast Ultrasound (ABUS) and screening mammography (XRM) are combined, compared to screening
mammography alone in asymptomatic women with >50% parenchymal density and a screening
mammogram assigned a BI-RADS Assessment Category 1 (negative) or 2 (normal with benign
findings).
The effect of the improved Reader performance is illustrated by plotting the ROC curves for
XRM alone and XRM+ABUS. If Reader performance improves with the addition of ABUS to the XRM,
the area under the curve (AUC) for XRM+ABUS (AUCXRM+ABUS) will be greater than the area
under the curve for XRM Alone (AUCXRM Alone). This difference is represented as ∆AUCABUS.
The null and alternative hypotheses can be formally expressed as follows:
H0: ∆AUCABUS = 0, AUCXRM+ABUS = AUCXRM Alone The null hypothesis is that Reader performance
will be unchanged with the addition of ABUS to a screening mammogram assigned a BI-RADS
Assessment Category of 1 or 2.
HA: ∆AUCABUS ≠ 0, AUCXRM+ABUS ≠ AUCXRM Alone The alternative hypothesis is that Reader
performance will be changed with the addition of ABUS to a screening mammogram assigned a
BI-RADS Assessment Category of 1 or 2. A statistically significant change will be considered
equivalent to a statistically significant improvement if the estimated value of AUCXRM+ABUS
is greater than that of AUCXRM Alone with statistical significance at an alpha level of .05
for a two-sided test.
The Clinical Retrospective Reader Study is an observational case-controlled, multi-reader
multi-case Receiver Operating Characteristic (ROC) study involving approximately 16
Interpreting Physicians (Readers) and approximately 200 breast screening cases which will be
reviewed and of those, 164 breast screening cases will be included in the primary data
analysis. All primary data analysis cases will consist of screening mammogram and Automated
Breast Ultrasound image readings from the same asymptomatic females with >50% parenchymal
density for whom the screening mammogram was assigned a BI-RADS Assessment Category 1
(negative) or 2 (normal with benign findings).
The Readers will review a total of 200 cases: the Non-Cancer Case Set, the Cancer Case Set,
and additional Control and Supplemental Case Sets. These cases will be randomized during the
reading session so each Reader will review the entire Case Set in a unique order.
The primary Receiver Operating Characteristic analysis will be performed on the Readers'
Likelihood of Malignancy (LOM) ratings from their initial review of the screening mammogram
alone and their final review of the screening mammogram and Automated Breast Ultrasound for
the Non-Cancer Case Set and Cancer Case Set.
;
Observational Model: Case Control, Time Perspective: Retrospective
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