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Breast Cancer ScreeningSINATRANCT07415499

Breast Density Impact on Mammographic Screening for Breast Cancer Diagnosis

An observational study of Breast Cancer Screening and Breast Cancer Screening and Diagnosis, run by Azienda Sanitaria Locale CN2 Alba-Bra at 1 site in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This retrospective, observational study aims to evaluate how breast density affects the accuracy and outcomes of mammographic screening for breast cancer within the regional screening program "Prevenzione Serena". Read more about this study

Who is it for?
Ages 45 to 75 years, women only
How many people
3,300 participants
Where
1 siteItaly
Study dates
12 Jan 2026to Sep 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 to 75 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Study population: The study will include women aged 45 to 75 years who participated in the "Prevenzione Serena" mammography screening program and underwent screening mammography at ASL CN2 using a Siemens MAMMOMAT Revelation mammography system between September 25, 2023, and May 3, 2024.

Who may be able to join

  • Women aged 45 to 75 years who participated in the "Prevenzione Serena" mammography screening program and underwent screening mammography at ASL CN2 between September 25, 2023, and May 3, 2024.
  • Signed informed consent or equivalent substitute declaration, when applicable.

Who cannot join

  • Women with a history of mastectomy.
  • Women with breast implants.
  • Women with cardiac implantable devices, such as pacemakers or loop recorders.
  • Cases in which the Insight BD software cannot be applied due to compression thickness below 15 mm.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Francesco Lucio, Principal Investigator contact

+39.0172.1408486

flucio@aslcn2.it

Italy1 site, 1 recruiting
  • SSD Fisica Sanitaria - Ospedale Michele e Pietro Ferrero di Verduno (CN) - ASL CN2

    Verduno, Italy/CN, 12060

    Francesco Lucio, Principal Investigator, +39.0172.1408486, flucio@aslcn2.it

    Anna Sardo

    Recruiting

Other trials in Italy

About this study

Official title: Retrospective Study on Patients Undergoing Mammographic Screening to Evaluate the Impact of Breast Density on Breast Cancer Diagnosis

This retrospective, observational study aims to evaluate how breast density affects the accuracy and outcomes of mammographic screening for breast cancer within the regional screening program "Prevenzione Serena".

Breast density is an important factor because dense breast tissue can make it more difficult to detect breast cancer on a mammogram. Dense tissue and tumors both appear white on a mammogram, which may hide abnormalities and lead to missed cancers or false-positive results.

Read more

Women aged 45 to 75 years who underwent routine mammographic screening at ASL CN2 between September 2023 and May 2024 will be included. Breast density will be classified using the BI-RADS system (categories A-D), and the study will assess whether women with dense breasts (categories C and D) experience higher rates of recalls for second-level examinations such as ultrasound, MRI, etc).

The study also includes an internal validation of Insight BD, an automated breast-density measurement software used at ASL CN2. The software will be evaluated using a mammography phantom (to verify technical accuracy) and by comparing its BI-RADS density classifications with readings from two radiologists (one expert and one less experienced). This will help determine whether the software can support radiologists, especially in evaluating dense breast tissue.

Additional factors such as menopausal status, family history of breast cancer, and hormone therapy will also be examined to understand how they relate to breast density and screening outcomes. The study aims to quantify the frequency of false-positive recalls-cases in which additional tests are recommended but cancer is not found-because these events can increase patient anxiety and healthcare workload.

Ultimately, this research seeks to provide evidence that may inform future screening guidelines and support more personalized approaches, particularly for women with dense breasts.

Read the detailed description

This retrospective, monocentric, observational study investigates the impact of breast density on mammographic screening performance in the regional program "Prevenzione Serena," implemented at ASL CN2 (Piedmont, Italy). The primary objective is to evaluate the association between BI-RADS breast-density categories and the frequency of recalls for second-level diagnostic examinations among women aged 45-75 undergoing screening mammography between 25 September 2023 and 3 May 2024.

Breast density is a known factor that can reduce the sensitivity of mammography. Dense fibroglandular tissue appears radiopaque and may mask suspicious lesions, leading to false-negative or false-positive examinations. Women with dense breasts (BI-RADS categories C-D) also have an independently increased risk of breast cancer. For these reasons, the study aims to characterize how breast density influences recall rates, diagnostic appropriateness, and overall screening performance in a real-world population.

A secondary goal is the internal validation of Insight BD, an automated breast-density assessment software integrated into the Siemens Mammomat Revelation mammography system used at ASL CN2. The validation includes:

  1. Technical validation using a dedicated mammographic phantom with known density values to determine measurement accuracy and repeatability;
  2. Diagnostic validation through comparison between the BI-RADS density category assigned by the software and those assigned by two radiologists (one expert, one non-expert).

The study will also examine associations between breast density and key clinical factors, including menopausal status, family history of breast cancer, and systemic hormone therapy. Furthermore, the frequency of false-positive recalls (additional testing without a final diagnosis of cancer) will be assessed, given their clinical, psychological, and organizational implications.

The study aims to characterize density-related patterns in screening performance, quantify false-positive recalls, and contribute evidence to support future updates to breast-screening guidelines and potential personalized screening strategies, especially for women with dense breast tissue.

Being tested
No intervention is administered.
Keywords
Breast cancer, Breast cancer screening, BRADS, Mammography, Dense breast, Breast imaging
Medical subject headings
Disease, Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • No intervention is administered.Other

    No intervention is administered.

Study groups in NCT07415499
Study groupRoleWhat they receive
Screening cohortWomen aged 45-75 who underwent routine mammographic screening within the "Prevenzione Serena" program at ASL CN2 between September 2023 and May 2024. Breast density (BI-RADS A-D) will be evaluated, along with recall rates, false-positive findings, and comparisons of automated breast-density assessment (Insight BD) with radiologist readings. No interventions are administered; data are collected retrospectively from clinical records.
Receives: Other: No intervention is administered.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recall Rate for Second-Level Examinations by BI-RADS Breast Density Category

    Percentage of women recalled for second-level diagnostic examinations among all women undergoing mammographic screening, calculated separately for each BI-RADS density category (A, B, C, D) and for the dichotomized groups A-B versus C-D.

    Measured: September 2023 - May 2024

Secondary outcomes (4)
  1. Technical Performance of Insight BD: Accuracy and Repeatability on Breast Density Phantom

    Evaluation of the volumetric breast density percentage produced by Insight BD on a standardized phantom, assessing measurement accuracy compared with the reference phantom values and repeatability across repeated acquisitions.

    Measured: September 2023 - May 2024

  2. Concordance Between Insight BD BI-RADS Classification and Radiologist Assessment

    Diagnostic agreement between Insight BD BI-RADS breast density classification and radiologist assessments. The outcome includes:

    • Percent agreement with the expert radiologist (primary reference).
    • Percent agreement with a non-expert radiologist to evaluate the tool's impact on less-experienced readers.

    Measured: September 2023 - May 2024

  3. Recall Rate for Second-Level Examinations in Negative Mammographic Screens by BI-RADS Density

    Proportion of women recalled for second-level diagnostic examinations among those with a negative screening mammogram, stratified by BI-RADS breast density categories (A, B, C, D) and by dichotomized density groups (A-B vs C-D).

    Measured: September 2023 - May 2024

  4. Distribution of Breast Density by Menopausal Status, Hormonal Therapy, and Family History

    Proportion of participants in each BI-RADS breast density category (A, B, C, D), and in dichotomized density groups (A-B vs C-D), stratified by:

    menopausal status (pre/post-menopause), use of hormonal therapy (yes/no), family history of breast cancer (yes/no).

    Measured: September 2023 - May 2024

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Feb 2026
  2. Study start12 Jan 2026
  3. Primary completionJun 2026 (estimated)
  4. Study completionSep 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Retrospective
Enrolment
3,300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07415499
Sponsor's protocol ID
SINATRA
Acronym
SINATRA
Status last verified
Feb 2026
First submitted
10 Feb 2026
Last updated
17 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Ray KM, Price ER, Joe BN. Breast density legislation: mandatory disclosure to patients, alternative screening, billing, reimbursement. AJR Am J Roentgenol. 2015 Feb;204(2):257-60. doi: 10.2214/AJR.14.13558.

    PubMed 25615746
  • Dehkordy SF, Carlos RC. Dense Breast Legislation in the United States: State of the States. J Am Coll Radiol. 2016 Nov;13(11S):R53-R57. doi: 10.1016/j.jacr.2016.09.027.

    PubMed 27814815
  • Damases CN, Brennan PC, Mello-Thoms C, McEntee MF. Mammographic Breast Density Assessment Using Automated Volumetric Software and Breast Imaging Reporting and Data System (BIRADS) Categorization by Expert Radiologists. Acad Radiol. 2016 Jan;23(1):70-7. doi: 10.1016/j.acra.2015.09.011. Epub 2015 Oct 26.

    PubMed 26514436
  • Pesce K, Tajerian M, Chico MJ, Swiecicki MP, Boietti B, Frangella MJ, Benitez S. Interobserver and intraobserver variability in determining breast density according to the fifth edition of the BI-RADS(R) Atlas. Radiologia (Engl Ed). 2020 Nov-Dec;62(6):481-486. doi: 10.1016/j.rx.2020.04.006. Epub 2020 May 31. English, Spanish.

    PubMed 32493654
  • Sheehan J. Brain fragments: Leksell's autobiography newly translated to English. J Neurooncol. 2022 Apr;157(2):383. doi: 10.1007/s11060-022-03968-y. Epub 2022 Mar 29. No abstract available.

    PubMed 35348987
  • Martinez-Navarro B, Sanchis R, Asedegbega-Nieto E, Solsona B, Ivars-Barcelo F. (Ag)Pd-Fe3O4 Nanocomposites as Novel Catalysts for Methane Partial Oxidation at Low Temperature. Nanomaterials (Basel). 2020 May 21;10(5):988. doi: 10.3390/nano10050988.

    PubMed 32455643
  • Zimri K, Hesseling AC, Godfrey-Faussett P, Schaaf HS, Seddon JA. Why do child contacts of multidrug-resistant tuberculosis not come to the assessment clinic? Public Health Action. 2012 Sep 21;2(3):71-5. doi: 10.5588/pha.12.0024.

    PubMed 26392955
  • Oliver A, Tortajada M, Llado X, Freixenet J, Ganau S, Tortajada L, Vilagran M, Sentis M, Marti R. Breast Density Analysis Using an Automatic Density Segmentation Algorithm. J Digit Imaging. 2015 Oct;28(5):604-12. doi: 10.1007/s10278-015-9777-5.

    PubMed 25720749
  • Eng A, Gallant Z, Shepherd J, McCormack V, Li J, Dowsett M, Vinnicombe S, Allen S, dos-Santos-Silva I. Digital mammographic density and breast cancer risk: a case-control study of six alternative density assessment methods. Breast Cancer Res. 2014 Sep 20;16(5):439. doi: 10.1186/s13058-014-0439-1.

    PubMed 25239205
  • Sartor H, Lang K, Rosso A, Borgquist S, Zackrisson S, Timberg P. Measuring mammographic density: comparing a fully automated volumetric assessment versus European radiologists' qualitative classification. Eur Radiol. 2016 Dec;26(12):4354-4360. doi: 10.1007/s00330-016-4309-3. Epub 2016 Mar 24.

    PubMed 27011371
  • Jeffers AM, Sieh W, Lipson JA, Rothstein JH, McGuire V, Whittemore AS, Rubin DL. Breast Cancer Risk and Mammographic Density Assessed with Semiautomated and Fully Automated Methods and BI-RADS. Radiology. 2017 Feb;282(2):348-355. doi: 10.1148/radiol.2016152062. Epub 2016 Sep 5.

    PubMed 27598536

Questions about this trial

What is this clinical trial studying?

An observational study of Breast Cancer Screening and Breast Cancer Screening and Diagnosis, run by Azienda Sanitaria Locale CN2 Alba-Bra at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 17 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Francesco Lucio, Principal Investigator (+39.0172.1408486, flucio@aslcn2.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recall Rate for Second-Level Examinations by BI-RADS Breast Density Category (time frame: September 2023 - May 2024). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07415499, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2026.

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