{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:59:44Z","timestamp":1774522784616,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007913","name":"Breast Cancer Now","doi-asserted-by":"publisher","award":["2018JULPR1125"],"award-info":[{"award-number":["2018JULPR1125"]}],"id":[{"id":"10.13039\/501100007913","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oestrogen-receptor positive breast cancer patients are typically treated with adjuvant endocrine therapy (AET), some develop AET resistance. Previous research suggests mammographic density (MD) may represent an imaging biomarker, with fewer local or distant recurrences occurring with decreasing MD. We investigate whether reduction in MD after 1 and\/or 3 years is associated with improved breast cancer specific survival (BCSS), metastasis-free survival (MFS) or disease-free survival (DFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study was generated from a Mammo-50 trial subset. Participants taking AET (cases) and controls were included. MD was assessed in the AET group using a 0\u2013100% visual analogue scale (VAS). Readers scored mammograms at diagnosis, 1 year and 3 years post-surgery. A decrease in MD was defined as \u226510% reduction from diagnosis. A second reader reviewed paired mammograms and assessed whether there had been a temporal change in MD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 1364 cases and 367 controls were included. Median VAS MD was approximately 30% for cases and controls at all time-points; 20% showed decreased MD at 1 year and 21% at 3 years for both cases and controls. Of the AET group, 23 died from breast cancer and 33 developed metastases during follow-up (median 8.7 years post-surgery). The 5-year BCSS rate was 99.6% (95%CI:97.4-99.9) versus 98.3% (95%CI:97.2-98.9) for those with and without a \u226510% reduction in MD at 1 year,\n                      <jats:italic>p<\/jats:italic>\n                      =0.35. The 5-year MFS rate for those with and without a \u226510% reduction in MD at 1 year was 94.2% (95%CI:90.7-96.4) versus 93.6% (95%CI:92.0-95.0) respectively;\n                      <jats:italic>p<\/jats:italic>\n                      =0.47. The 5-year DFS rate for those with a \u226510% reduction in MD at 1year was 92.4% (95% CI:88.5-94.9) versus 92.6% (95%CI:90.8-94.0);\n                      <jats:italic>p<\/jats:italic>\n                      = 0.47. Similar results for BCSS, MFS and DFS were seen for those with and without a \u226510% reduction in MD at 3 years and for those assessed as having a definite reduction in MD compared to those who had not at both 1 and 3 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reduction in MD had no significant association with rates of BCSS, MFS or DFS. Change in MD was not shown to be a useful prognostic indicator in women over 50 years, treated with AET.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13058-026-02239-2","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:16:57Z","timestamp":1771474617000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Change in mammographic density as a potential predictor of cancer recurrence after breast conservation surgery and adjuvant endocrine therapy: results of the MEDICI study"],"prefix":"10.1186","volume":"28","author":[{"given":"Sarah L","family":"Savaridas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kulsam","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M","family":"Astley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Halling-Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Vinnicombe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violet R","family":"Warwick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patsy","family":"Whelehan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonya","family":"Drummond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Ebsim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuala A","family":"Healy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Nash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Muscat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sreenivas","family":"Muthyala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashwini","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Telesca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"issue":"0 3","key":"2239_CR1","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.mce.2015.09.035","volume":"418","author":"R Clarke","year":"2015","unstructured":"Clarke R, Tyson JJ, Dixon JM. Endocrine resistance in breast cancer\u2013an overview and update. Mol Cell Endocrinol. 2015;418(0 3):220\u201334.","journal-title":"Mol Cell Endocrinol"},{"key":"2239_CR2","doi-asserted-by":"crossref","unstructured":"Fan M, Xia P, Clarke R, Wang Y, Li L. Radiogenomic signatures reveal multiscale intratumour heterogeneity associated with biological functions and survival in breast cancer. Nat Commun. 2020;11(1):4861.","DOI":"10.1038\/s41467-020-18703-2"},{"issue":"3","key":"2239_CR3","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1056\/NEJMoa062790","volume":"356","author":"NF Boyd","year":"2007","unstructured":"Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, et al. Mammographic density and the risk and detection of breast cancer. NEJM. 2007;356(3):227\u201336.","journal-title":"NEJM"},{"issue":"3","key":"2239_CR4","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1007\/s10549-014-2901-2","volume":"144","author":"CW Huo","year":"2014","unstructured":"Huo CW, Chew GL, Britt KL, Ingman WV, Henderson MA, Hopper JL, et al. Mammographic density-a review on the current Understanding of its association with breast cancer. Breast Cancer Res Treat. 2014;144(3):479\u2013502.","journal-title":"Breast Cancer Res Treat"},{"issue":"1","key":"2239_CR5","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13058-018-0932-z","volume":"20","author":"SM Astley","year":"2018","unstructured":"Astley SM, Harkness EF, Sergeant JC, Warwick J, Stavrinos P, Warren R, et al. A comparison of five methods of measuring mammographic density: a case-control study. Breast Cancer Res. 2018;20(1):10.","journal-title":"Breast Cancer Res"},{"issue":"4","key":"2239_CR6","doi-asserted-by":"publisher","first-page":"R64","DOI":"10.1186\/bcr2123","volume":"10","author":"SW Duffy","year":"2008","unstructured":"Duffy SW, Nagtegaal ID, Astley SM, Gillan MG, McGee MA, Boggis CR, et al. Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view. Breast Cancer Res. 2008;10(4):R64.","journal-title":"Breast Cancer Res"},{"issue":"1","key":"2239_CR7","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s13058-015-0653-5","volume":"17","author":"AR Brentnall","year":"2015","unstructured":"Brentnall AR, Harkness EF, Astley SM, Donnelly LS, Stavrinos P, Sampson S, et al. Mammographic density adds accuracy to both the Tyrer-Cuzick and gail breast cancer risk models in a prospective UK screening cohort. Breast Cancer Res. 2015;17(1):147.","journal-title":"Breast Cancer Res"},{"issue":"9","key":"2239_CR8","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1093\/jnci\/djr079","volume":"103","author":"J Cuzick","year":"2011","unstructured":"Cuzick J, Warwick J, Pinney E, Duffy SW, Cawthorn S, Howell A, et al. Tamoxifen-induced reduction in mammographic density and breast cancer risk reduction: a nested case-control study. J Natl Cancer Inst. 2011;103(9):744\u201352.","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"2239_CR9","doi-asserted-by":"publisher","first-page":"349","DOI":"10.3109\/0284186X.2014.964809","volume":"54","author":"JG van Nes","year":"2015","unstructured":"van Nes JG, Beex LV, Seynaeve C, Putter H, Sramek A, Lardenoije S, et al. Minimal impact of adjuvant exemestane or Tamoxifen treatment on mammographic breast density in postmenopausal breast cancer patients: a Dutch TEAM trial analysis. Acta Oncol. 2015;54(3):349\u201360.","journal-title":"Acta Oncol"},{"issue":"3","key":"2239_CR10","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s10549-013-2726-4","volume":"142","author":"KL Ko","year":"2013","unstructured":"Ko KL, Shin IS, You JY, Jung SY, Ro J, Lee ES. Adjuvant tamoxifen-induced mammographic breast density reduction as a predictor for recurrence in estrogen receptor-positive premenopausal breast cancer patients. Breast Cancer Res Treat. 2013;142(3):559\u201367.","journal-title":"Breast Cancer Res Treat"},{"issue":"18","key":"2239_CR11","doi-asserted-by":"publisher","first-page":"2249","DOI":"10.1200\/JCO.2012.44.5015","volume":"31","author":"J Li","year":"2013","unstructured":"Li J, Humphreys K, Eriksson L, Edgren G, Czene K, Hall P. Mammographic density reduction is a prognostic marker of response to adjuvant Tamoxifen therapy in postmenopausal patients with breast cancer. J Clin Oncol. 2013;31(18):2249\u201356.","journal-title":"J Clin Oncol"},{"issue":"1","key":"2239_CR12","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1158\/1055-9965.EPI-15-0412","volume":"25","author":"SJ Nyante","year":"2016","unstructured":"Nyante SJ, Sherman ME, Pfeiffer RM, Berrington de Gonzalez A, Brinton LA, Bowles EJ, et al. Longitudinal change in mammographic density among ER-positive breast cancer patients using Tamoxifen. Cancer Epidemiol Biomarkers Prev. 2016;25(1):212\u20136.","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2239_CR13","doi-asserted-by":"crossref","unstructured":"Nyante SJ, Sherman ME, Pfeiffer RM, Berrington de Gonzalez A, Brinton LA, Aiello Bowles EJ et al. Prognostic significance of mammographic density change after initiation of Tamoxifen for ER-positive breast cancer. J Natl Cancer Inst. 2015;107(3):dju425.","DOI":"10.1093\/jnci\/dju425"},{"key":"2239_CR14","doi-asserted-by":"publisher","first-page":"R102","DOI":"10.1186\/bcr3221","volume":"14","author":"J Kim","year":"2012","unstructured":"Kim J, Han W, Moon H, Ahn SK, Shin H, You J, et al. Breast density change as a predictive surrogate for response to adjuvant endocrine therapy in hormone receptor positive breast cancer. Breast Cancer Res. 2012;14:R102.","journal-title":"Breast Cancer Res"},{"issue":"4","key":"2239_CR15","doi-asserted-by":"publisher","first-page":"R57","DOI":"10.1186\/bcr3451","volume":"15","author":"ME Sandberg","year":"2013","unstructured":"Sandberg ME, Li J, Hall P, Hartman M, dos-Santos-Silva I, Humphreys K, et al. Change of mammographic density predicts the risk of contralateral breast cancer\u2014a case-control study. Breast Cancer Res. 2013;15(4):R57.","journal-title":"Breast Cancer Res"},{"issue":"10","key":"2239_CR16","first-page":"CD013091","volume":"10","author":"EC Atakpa","year":"2021","unstructured":"Atakpa EC, Thorat MA, Cuzick J, Brentnall AR. Mammographic density, endocrine therapy and breast cancer risk: a prognostic and predictive biomarker review. Cochrane Database Syst Rev. 2021;10(10):CD013091.","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"2239_CR17","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/JS9.0000000000000907","volume":"110","author":"SJ Bae","year":"2024","unstructured":"Bae SJ, Kim HJ, Kim HA, Ryu JM, Park S, Lee EG, et al. Breast density reduction as a predictor for prognosis in premenopausal women with estrogen receptor-positive breast cancer: an exploratory analysis of the updated ASTRRA study. Int J Surg. 2024;110(2):934\u201342.","journal-title":"Int J Surg"},{"key":"2239_CR18","doi-asserted-by":"publisher","first-page":"107327482311609","DOI":"10.1177\/10732748231160991","volume":"30","author":"WC Shia","year":"2023","unstructured":"Shia WC, Lin LS, Wu HK, Chen CJ, Chen DR. Mammographic density reduction is associated to the prognosis in Asian breast cancer patients receiving hormone therapy. Cancer Control. 2023;30:10732748231160991.","journal-title":"Cancer Control"},{"key":"2239_CR19","doi-asserted-by":"crossref","unstructured":"Abubakar M, Mullooly M, Nyante S, Pfeiffer RM, Aiello Bowles EJ, Cora R et al. Mammographic density decline, Tamoxifen response, and prognosis by molecular characteristics of estrogen receptor-positive breast cancer. JNCI Cancer Spectr. 2022;6(3):pkac028.","DOI":"10.1093\/jncics\/pkac028"},{"key":"2239_CR20","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.breast.2016.01.006","volume":"26","author":"L Ryden","year":"2016","unstructured":"Ryden L, Heibert Arnlind M, Vitols S, Hoistad M, Ahlgren J. Aromatase inhibitors alone or sequentially combined with Tamoxifen in postmenopausal early breast cancer compared with Tamoxifen or placebo\u2014meta-analyses on efficacy and adverse events based on randomized clinical trials. Breast. 2016;26:106\u201314.","journal-title":"Breast"},{"issue":"1\u20135","key":"2239_CR21","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.jsbmb.2005.04.022","volume":"95","author":"M Dowsett","year":"2005","unstructured":"Dowsett M, Martin LA, Smith I, Johnston S. Mechanisms of resistance to aromatase inhibitors. J Steroid Biochem Mol Biol. 2005;95(1\u20135):167\u201372.","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"11","key":"2239_CR22","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1177\/1758834017732966","volume":"9","author":"K Wimmer","year":"2017","unstructured":"Wimmer K, Strobl S, Bolliger M, Devyatko Y, Korkmaz B, Exner R, et al. Optimal duration of adjuvant endocrine therapy: how to apply the newest data. Ther Adv Med Oncol. 2017;9(11):679\u201392.","journal-title":"Ther Adv Med Oncol"},{"issue":"10476","key":"2239_CR23","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/S0140-6736(24)02715-6","volume":"405","author":"JA Dunn","year":"2025","unstructured":"Dunn JA, Donnelly P, Elbeltagi N, Marshall A, Hopkins A, Thompson AM, et al. Annual versus less frequent mammographic surveillance in people with breast cancer aged 50 years and older in the UK (Mammo-50): a multicentre, randomised, phase 3, non-inferiority trial. Lancet. 2025;405(10476):396\u2013407.","journal-title":"Lancet"},{"issue":"1","key":"2239_CR24","doi-asserted-by":"publisher","first-page":"e54","DOI":"10.1016\/S2666-7568(21)00280-4","volume":"3","author":"N Carleton","year":"2022","unstructured":"Carleton N, Nasrazadani A, Gade K, Beriwal S, Barry PN, Brufsky AM, et al. Personalising therapy for early-stage oestrogen receptor-positive breast cancer in older women. Lancet Healthy Longev. 2022;3(1):e54\u201366.","journal-title":"Lancet Healthy Longev"},{"issue":"1","key":"2239_CR25","doi-asserted-by":"publisher","first-page":"e70167","DOI":"10.1111\/hex.70167","volume":"28","author":"A Anto","year":"2025","unstructured":"Anto A, Basu A, Selim R, Eisingerich AB. Women\u2019s menopausal experiences in the UK: a systemic literature review of qualitative studies. Health Expect. 2025;28(1):e70167.","journal-title":"Health Expect"},{"issue":"17","key":"2239_CR26","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1200\/JCO.20.02598","volume":"39","author":"M Eriksson","year":"2021","unstructured":"Eriksson M, Eklund M, Borgquist S, Hellgren R, Margolin S, Thoren L, et al. Low-dose Tamoxifen for mammographic density reduction: a randomized controlled trial. J Clin Oncol. 2021;39(17):1899\u2013908.","journal-title":"J Clin Oncol"},{"issue":"4","key":"2239_CR27","doi-asserted-by":"publisher","first-page":"pky071","DOI":"10.1093\/jncics\/pky071","volume":"2","author":"L Eriksson","year":"2018","unstructured":"Eriksson L, He W, Eriksson M, Humphreys K, Bergh J, Hall P, et al. Adjuvant therapy and mammographic density changes in women with breast cancer. JNCI Cancer Spectr. 2018;2(4):pky071.","journal-title":"JNCI Cancer Spectr"},{"issue":"2","key":"2239_CR28","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1002\/ijc.34939","volume":"155","author":"M Gabrielson","year":"2024","unstructured":"Gabrielson M, Hammarstrom M, Bergqvist J, Lang K, Rosendahl AH, Borgquist S, et al. Baseline breast tissue characteristics determine the effect of Tamoxifen on mammographic density change. Int J Cancer. 2024;155(2):339\u201351.","journal-title":"Int J Cancer"},{"issue":"3","key":"2239_CR29","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1200\/JCO.2005.09.121","volume":"23","author":"EP Winer","year":"2005","unstructured":"Winer EP, Hudis C, Burstein HJ, Wolff AC, Pritchard KI, Ingle JN, et al. American society of clinical oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004. J Clin Oncol. 2005;23(3):619\u201329.","journal-title":"J Clin Oncol"}],"container-title":["Breast Cancer Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13058-026-02239-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13058-026-02239-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13058-026-02239-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:05:26Z","timestamp":1774519526000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13058-026-02239-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2239"],"URL":"https:\/\/doi.org\/10.1186\/s13058-026-02239-2","relation":{},"ISSN":["1465-542X"],"issn-type":[{"value":"1465-542X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"assertion":[{"value":"19 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"\u2022 Mammo-50 was approved by the UK Health Research Authority (HRA) (West Midlands Research Ethics Committee 13\/WM\/0419). Patients gave written consent for their data to be used in future research. MEDICI was also approved by the UK HRA (CAG: 19\/CAG\/0149, REC: 19\/WS\/0112).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"\u2022 Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"62"}}