OctavaPink for Women With Dense Breast After Negative Mammography

This is a multicenter, prospective study containing 3 parts: Part 1 consists of Part 1A (optimization/training) and Part 1B (evaluation/testing) as follows: Part 1A will optimize the OctavaPink test for women with dense breast tissue, and will not affect the treatment of the participants. Part 1A is an internal part done by EventusDx and no statistical evaluation is needed. Objectives: To optimize the OctavaPink test, with the target of ≥95% specificity and ≥70% sensitivity. Part 1B will assess the properties of the OctavaPink test using cases and controls obtained via the same criteria as in Part 1A. The sensitivity and specificity of the OctavaPink test must be confirmed as sufficiently high in samples in which EventusDx is blind to case/control status before using the test to affect clinical management of patients. Objectives: (i) To obtain a sensitivity estimate ≥60% with 95% CI lower limit ≥50% in the whole group of cancer cases (DCIS, IDC and ILC); also to obtain a sensitivity estimate with the same properties in the subset of cases with invasive cancer (IDC and ILC). (ii) To obtain a specificity estimate ≥90% in controls with 95% CI lower limit ≥85%. Part 2 will examine the yield of cancer detection by MRI/biopsy among women who have a positive OctavaPink test result in the dense breast negative mammography population. Objectives: (i) To compare the yield of cancer detection via MRI/biopsy among women with a positive OctavaPink test versus a negative OctavaPink test result. (ii) To estimate the proportion of patients who are positive for the test in the target population Part 3 will assess sensitivity of OctavaPink test in an enriched population of women with dense breasts and negative mammography. Objectives: To obtain an estimate of sensitivity in women with dense breast tissue and negative mammography that is broadly consistent with that found in the dense breast population (but not necessarily negative mammogram) in Parts 1A and 1B.