{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T12:54:39Z","timestamp":1791032079362,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the pathology outcomes of image-guided breast biopsies across a multistate health care enterprise by the method of detection (MOD), including the positive predictive value (PPV3) and histological types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Biopsies from October 31, 2017, to July 6, 2023, across 18 imaging sites in 4 states were extracted. Radiologists prospectively assigned MODs, including symptomatic presentations (self-examination, clinical examination) and imaging modalities (mammogram, tomosynthesis, US, MRI, contrast-enhanced mammogram, molecular breast imaging, other imaging). For each MOD, the rates of malignancy and cancer subtypes were calculated. Univariate and multivariate logistic regression analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 26 932 biopsies on 22 582 patients (mean age 57.6 years \u00b1 14.2 [SD]; 22 416 women), 6068 (81.1%) cancers were detected by screening, and 1144 (15.3%) were detected by symptoms. Symptomatic presentation MODs had a higher PPV3 (43.0% vs 25.6%; P &amp;lt; .001), larger cancer lesion sizes (x\u0304 = 27.5 mm vs x\u0304 = 17.8 mm; P &amp;lt; 001), and a higher association with invasive carcinoma (96.7% vs 76.8%; P &amp;lt;.001) compared with screening imaging-based MODs. Methods of detection with higher PPV3s also tended to have higher rates of invasive carcinoma (Spearman\u2019s \u03c1 = 0.83).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with breast cancers detected after symptomatic presentations, those identified via image-based screening were smaller and less often invasive, confirming the value of screening in early detection. Positive predictive value and the rate of invasive carcinoma varied in parallel across MODs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jbi\/wbaf086","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T12:45:23Z","timestamp":1766493923000},"page":"512-522","source":"Crossref","is-referenced-by-count":0,"title":["Positive Predictive Value and Breast Cancer Histology by the Method of Detection Across a Multistate Health Care Enterprise"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4132-0177","authenticated-orcid":false,"given":"Alan","family":"Zhu","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine , Phoenix, AZ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6127-1547","authenticated-orcid":false,"given":"Laura","family":"Harper","sequence":"additional","affiliation":[{"name":"Division of Breast Imaging and Intervention, Mayo Clinic Arizona , Phoenix, AZ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3115-0090","authenticated-orcid":false,"given":"Santo","family":"Maimone IV","sequence":"additional","affiliation":[{"name":"Division of Breast Imaging and Intervention, Mayo Clinic Florida , Jacksonville, FL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8486-955X","authenticated-orcid":false,"given":"Bhavika K","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Breast Imaging and Intervention, Mayo Clinic Arizona , Phoenix, AZ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene E","family":"Girardo","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic Arizona , Phoenix, AZ 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