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O’Driscoll J, Burke A, Mooney T, Phelan N, Baldelli P, Smith A, Lynch S, Fitzpatrick P, Bennett K, Flanagan F, Mullooly M. A scoping review of programme specific mammographic breast density related guidelines and practices within breast screening programmes. Eur J Radiol Open 2023; 11:100510. [PMID: 37560166 PMCID: PMC10407884 DOI: 10.1016/j.ejro.2023.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION High mammographic breast density (MBD) is an independent breast cancer risk factor. In organised breast screening settings, discussions are ongoing regarding the optimal clinical role of MBD to help guide screening decisions. The aim of this scoping review was to provide an overview of current practices incorporating MBD within population-based breast screening programmes and from professional organisations internationally. METHODS This scoping review was conducted in accordance with the framework proposed by the Joanna Briggs Institute. The electronic databases, MEDLINE (PubMed), EMBASE, CINAHL Plus, Scopus, and Web of Science were systematically searched. Grey literature sources, websites of international breast screening programmes, and relevant government organisations were searched to identify further relevant literature. Data from identified materials were extracted and presented as a narrative summary. RESULTS The search identified 78 relevant documents. Documents were identified for breast screening programmes in 18 countries relating to screening intervals for women with dense breasts, MBD measurement, reporting, notification, and guiding supplemental screening. Documents were identified from 18 international professional organisations with the majority of material relating to supplemental screening guidance for women with dense breasts. Key factors collated during the data extraction process as relevant considerations for MBD practices included the evidence base needed to inform decision-making processes and resources (healthcare system costs, radiology equipment, and workforce planning). CONCLUSIONS This scoping review summarises current practices and guidelines incorporating MBD in international population-based breast screening settings and highlights the absence of consensus between organised breast screening programmes incorporating MBD in current breast screening protocols.
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Affiliation(s)
- Jessica O’Driscoll
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
| | - Aileen Burke
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
| | - Therese Mooney
- National Screening Service, Kings Inn House, 200 Parnell Street, Dublin 1, Ireland
| | - Niall Phelan
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Paola Baldelli
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Alan Smith
- National Screening Service, Kings Inn House, 200 Parnell Street, Dublin 1, Ireland
| | - Suzanne Lynch
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Patricia Fitzpatrick
- National Screening Service, Kings Inn House, 200 Parnell Street, Dublin 1, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Kathleen Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
| | - Fidelma Flanagan
- BreastCheck, National Screening Service, 36 Eccles Street, Dublin 7, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Mercer St. Lower, Dublin 2, Ireland
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Wu S, Liang D, Shi J, Li D, Liu Y, Hao Y, Shi M, Du X, He Y. Evaluation of a population-based breast cancer screening in North China. J Cancer Res Clin Oncol 2023; 149:10119-10130. [PMID: 37266660 PMCID: PMC10423103 DOI: 10.1007/s00432-023-04905-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/20/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Despite mammography-based screening for breast cancer has been conducted in many countries, there are still little data on participation and diagnostic yield in population-based breast cancer screening in China. METHODS We enrolled 151,973 eligible women from four cities in Hebei Province within the period 2013-2021 and followed up until December 31, 2021. Participants aged 40-74 who assessed as high risk were invited to undergo breast ultrasound and mammography examination. Overall and group-specific participation rates were calculated. Multivariable analyses were used to estimate the factors associated with participation rates. The diagnostic yield of both screening and no screening groups was calculated. We further analyzed the stage distribution and molecular subtype of breast cancer cases by different modes of cancer detection. RESULTS A total of 42,547 participants were evaluated to be high risk of breast cancer. Among them, 23,009 subjects undertook screening services, with participation rate of 54.08%. Multivariable logistic regression model showed that aged 45-64, high education level, postmenopausal, current smoking, alcohol consumption, family history of breast cancer, and benign breast disease were associated with increased participation of screening. After median follow-up of 3.79 years, there were 456 breast cancer diagnoses of which 65 were screen-detected breast cancers (SBCs), 27 were interval breast cancers (IBCs), 68 were no screening cancers, and 296 were cancers detected outside the screening program. Among them, 92 participants in the screening group (0.40%) and 364 in the non-screening group (0.28%) had breast cancer detected, which resulted in an odds ratio of 1.42 (95% CI 1.13-1.78; P = 0.003). We observed a higher detection rate of breast cancer in the screening group, with ORs of 2.42 (95% CI 1.72-3.41) for early stage (stages 0-I) and 2.12 (95% CI 1.26-3.54) for luminal A subtype. SBCs had higher proportion of early stage (71.93%) and luminal A subtype (47.22%) than other groups. CONCLUSIONS The significant differences in breast cancer diagnosis between the screening and non-screening group imply an urgent need for increased breast cancer awareness and early detection in China.
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Affiliation(s)
- Siqi Wu
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Di Liang
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Jin Shi
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Daojuan Li
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Yanyu Liu
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Yahui Hao
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Miaomiao Shi
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Xinyu Du
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China
| | - Yutong He
- Cancer Institute, The Fourth Hospital of Hebei Medical University and Hebei Tumor Hospital, No. 12 Jian Kang Road, Changan District, Shijiazhuang, 050011, Hebei, China.
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Watanabe H, Hayashi S, Kondo Y, Matsuyama E, Hayashi N, Ogura T, Shimosegawa M. Quality control system for mammographic breast positioning using deep learning. Sci Rep 2023; 13:7066. [PMID: 37127674 PMCID: PMC10151341 DOI: 10.1038/s41598-023-34380-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/28/2023] [Indexed: 05/03/2023] Open
Abstract
This study proposes a deep convolutional neural network (DCNN) classification for the quality control and validation of breast positioning criteria in mammography. A total of 1631 mediolateral oblique mammographic views were collected from an open database. We designed two main steps for mammographic verification: automated detection of the positioning part and classification of three scales that determine the positioning quality using DCNNs. After acquiring labeled mammograms with three scales visually evaluated based on guidelines, the first step was automatically detecting the region of interest of the subject part by image processing. The next step was classifying mammographic positioning accuracy into three scales using four representative DCNNs. The experimental results showed that the DCNN model achieved the best positioning classification accuracy of 0.7836 using VGG16 in the inframammary fold and a classification accuracy of 0.7278 using Xception in the nipple profile. Furthermore, using the softmax function, the breast positioning criteria could be evaluated quantitatively by presenting the predicted value, which is the probability of determining positioning accuracy. The proposed method can be quantitatively evaluated without the need for an individual qualitative evaluation and has the potential to improve the quality control and validation of breast positioning criteria in mammography.
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Affiliation(s)
- Haruyuki Watanabe
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan.
| | - Saeko Hayashi
- Department of Radiology, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Yohan Kondo
- Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Eri Matsuyama
- Faculty of Informatics, The University of Fukuchiyama, Fukuchiyama, Japan
| | - Norio Hayashi
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
| | - Toshihiro Ogura
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
| | - Masayuki Shimosegawa
- School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
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Kregting LM, van Ravesteyn NT, Chootipongchaivat S, Heijnsdijk EAM, Otten JDM, Broeders MJM, de Koning HJ. Cumulative risks of false positive recall and screen-detected breast cancer after multiple screening examinations. Int J Cancer 2023; 153:312-319. [PMID: 37038266 DOI: 10.1002/ijc.34530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/10/2023] [Accepted: 03/21/2023] [Indexed: 04/12/2023]
Abstract
Women tend to make a decision about participation in breast cancer screening and adhere to this for future invitations. Therefore, our study aimed to provide high-quality information on cumulative risks of false-positive (FP) recall and screen-detected breast cancer over multiple screening examinations. Individual Dutch screening registry data (2005-2018) were gathered on subsequent screening examinations of 92 902 women age 49 to 51 years in 2005. Survival analyses were used to calculate cumulative risks of a FP and a true-positive (TP) result after seven examinations. Data from 66 472 women age 58 to 59 years were used to extrapolate to 11 examinations. Participation, detection and additional FP rates were calculated for women who previously received FP results compared to women with true negative (TN) results. After 7 examinations, the cumulative risk of a TP result was 3.7% and the cumulative risk of a FP result was 9.1%. After 11 examinations, this increased to 7.1% and 13.5%, respectively. Following a FP result, participation was lower (71%-81%) than following a TN result (>90%). In women with a FP result, more TP results (factor 1.59 [95% CI: 1.44-1.72]), more interval cancers (factor 1.66 [95% CI: 1.41-1.91]) and more FP results (factor 1.96 [95% CI: 1.87-2.05]) were found than in women with TN results. In conclusion, due to a low recall rate in the Netherlands, the cumulative risk of a FP recall is relatively low, while the cumulative risk of a TP result is comparable. Breast cancer diagnoses and FP results were more common in women with FP results than in women with TN results, while participation was lower.
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Affiliation(s)
- Lindy M Kregting
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nicolien T van Ravesteyn
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sarocha Chootipongchaivat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eveline A M Heijnsdijk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Mireille J M Broeders
- Department for Health Evidence, Radboudumc, Nijmegen, The Netherlands
- Dutch Expert Centre for Screening, Nijmegen, The Netherlands
| | - Harry J de Koning
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Araujo JM, Gómez AC, Jongh WZD, Ausejo J, Córdova I, Schwarz LJ, Bretel D, Fajardo W, Saravia-Huarca LG, Barboza-Meca J, Morante Z, Guillén JR, Gómez H, Cárdenas NK, Hernández L, Melo W, Villarreal-Garza C, Caglevic C, Palacio C, García H, Mejía G, Flores C, Vallejos C, Pinto JA. A nationwide pilot study on breast cancer screening in Peru. Ecancermedicalscience 2023; 17:1494. [PMID: 36816782 PMCID: PMC9937072 DOI: 10.3332/ecancer.2023.1494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction A high prevalence of advanced breast cancer (BC) is a common scenario in Latin America. In Peru, the frequency of BC at Stages III/IV is ≈50% despite implementation of a programme for breast cancer screening (BCS) along the country. We carried out a study to assess the feasibility and develop an instrument to evaluate the knowledge, barriers and perception about BCS in a nationwide pilot study in Peru among candidates for BCS. Methods We conducted a systematic review of 2,558 reports indexed in PubMed, Scopus, Web of Science, Medline-Ovid and EMBASE, regarding to our study theme. In total, 111 were selected and a 51-items survey was developed (eight items about sociodemographic characteristics). Patients were recruited in public hospitals or private clinics, in rural and urban areas of nine departments of Peru. Results We surveyed 488 women from: Lima (150), Cajamarca (93), Ica (59), Arequipa (56), Loreto (48), Ancash (38), Junín (15), Puerto Maldonado (15) and Huancavelica (14); 27.9% of them were from rural areas. The mean of age was 53.3 years (standard deviation ± 9.1). Regarding education level, 29.8% had primary, 33.2% secondary and 37.0% higher education. In total, 28.7% of women did not know the term 'mammogram' and 47.1% reported never receiving a BCS (36.9% from urban and 73.5% from rural population). In women that underwent BCS, only 67% knew it is for healthy women. In total, 54.1% of patients had low levels of knowledge about risk factors for BC (i.e. 87.5% of women respond that injuries in the breast produce cancer). Cultural, economic and geographic barriers were significantly associated with having a mammogram where 56.9% of participants considered a cost ≤ 7 USD as appropriate. Mammogram was perceived as too painful for 54.9% of women. In addition, women with a self-perception of low-risk for BC and a fatalistic perception of cancer were less likely to have a BCS. Conclusion We found that it is feasible to conduct a large-scale study in Peru. The results of this pilot study highlight an urgent need of extensive education and awareness about BCS in Peru.
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Affiliation(s)
- Jhajaira M Araujo
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 15067, Peru
| | - Andrea C Gómez
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Winston Zingg-De Jongh
- Department of Molecular and Cellular Medicine, Texas A&M University, TX 77843, E.E.U.U., USA
| | - Jhon Ausejo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Iván Córdova
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Luis J Schwarz
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Williams Fajardo
- Servicio de Medicina Interna, Hospital Nacional Dos de Mayo, Lima 15003, Peru
| | | | | | - Zaida Morante
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Juan R Guillén
- Hospital Félix Torrealva Gutiérrez- ESSALUD, Ica 11001, Peru
| | - Henry Gómez
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Nadezhda K Cárdenas
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Lady Hernández
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Walter Melo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Cynthia Villarreal-Garza
- Centro de Cáncer de Mama, Hospital Zambrano Hellion, Tecnológico de Monterrey, 66278 San Pedro Garza García, Monterrey, México
| | - Christian Caglevic
- Cancer Research Department, Fundacion Arturo Lopez Perez, Santiago de Chile 7500921, Chile
| | - Carolina Palacio
- Departamento de Oncología Clínica, Instituto de Cancerología Las Américas - AUNA, Medellín 050022, Colombia
| | - Héctor García
- Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Gerson Mejía
- Departamento de Oncología Médica, Hospital Clínico VIEDMA, Cochabamba 0304, Bolivia
| | - Claudio Flores
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Carlos Vallejos
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Joseph A Pinto
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
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Schneider N, Reed E, Kamel F, Ferrari E, Soloviev M. Rational Approach to Finding Genes Encoding Molecular Biomarkers: Focus on Breast Cancer. Genes (Basel) 2022; 13:genes13091538. [PMID: 36140706 PMCID: PMC9498645 DOI: 10.3390/genes13091538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 12/04/2022] Open
Abstract
Early detection of cancer facilitates treatment and improves patient survival. We hypothesized that molecular biomarkers of cancer could be rationally predicted based on even partial knowledge of transcriptional regulation, functional pathways and gene co-expression networks. To test our data mining approach, we focused on breast cancer, as one of the best-studied models of this disease. We were particularly interested to check whether such a ‘guilt by association’ approach would lead to pan-cancer markers generally known in the field or whether molecular subtype-specific ‘seed’ markers will yield subtype-specific extended sets of breast cancer markers. The key challenge of this investigation was to utilize a small number of well-characterized, largely intracellular, breast cancer-related proteins to uncover similarly regulated and functionally related genes and proteins with the view to predicting a much-expanded range of disease markers, especially that of extracellular molecular markers, potentially suitable for the early non-invasive detection of the disease. We selected 23 previously characterized proteins specific to three major molecular subtypes of breast cancer and analyzed their established transcription factor networks, their known metabolic and functional pathways and the existing experimentally derived protein co-expression data. Having started with largely intracellular and transmembrane marker ‘seeds’ we predicted the existence of as many as 150 novel biomarker genes to be associated with the selected three major molecular sub-types of breast cancer all coding for extracellularly targeted or secreted proteins and therefore being potentially most suitable for molecular diagnosis of the disease. Of the 150 such predicted protein markers, 114 were predicted to be linked through the combination of regulatory networks to basal breast cancer, 48 to luminal and 7 to Her2-positive breast cancer. The reported approach to mining molecular markers is not limited to breast cancer and therefore offers a widely applicable strategy of biomarker mining.
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Affiliation(s)
- Nathalie Schneider
- Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 0EX, UK
| | - Ellen Reed
- Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 0EX, UK
| | - Faddy Kamel
- Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 0EX, UK
| | - Enrico Ferrari
- School of Life Sciences, University of Lincoln, Lincoln LN6 7TS, UK
| | - Mikhail Soloviev
- Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 0EX, UK
- Correspondence:
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Kashyap D, Pal D, Sharma R, Garg VK, Goel N, Koundal D, Zaguia A, Koundal S, Belay A. Global Increase in Breast Cancer Incidence: Risk Factors and Preventive Measures. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9605439. [PMID: 35480139 PMCID: PMC9038417 DOI: 10.1155/2022/9605439] [Citation(s) in RCA: 139] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/25/2022] [Accepted: 03/21/2022] [Indexed: 02/07/2023]
Abstract
Breast cancer is a global cause for concern owing to its high incidence around the world. The alarming increase in breast cancer cases emphasizes the management of disease at multiple levels. The management should start from the beginning that includes stringent cancer screening or cancer registry to effective diagnostic and treatment strategies. Breast cancer is highly heterogeneous at morphology as well as molecular levels and needs different therapeutic regimens based on the molecular subtype. Breast cancer patients with respective subtype have different clinical outcome prognoses. Breast cancer heterogeneity emphasizes the advanced molecular testing that will help on-time diagnosis and improved survival. Emerging fields such as liquid biopsy and artificial intelligence would help to under the complexity of breast cancer disease and decide the therapeutic regimen that helps in breast cancer management. In this review, we have discussed various risk factors and advanced technology available for breast cancer diagnosis to combat the worst breast cancer status and areas that need to be focused for the better management of breast cancer.
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Affiliation(s)
- Dharambir Kashyap
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Deeksha Pal
- Department of Translational and Regenerative Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Riya Sharma
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Vivek Kumar Garg
- Department of Medical Laboratory Technology, University Institute of Applied Health Sciences, Chandigarh University (Gharuan), Mohali 140313, India
| | - Neelam Goel
- Department of Information Technology, University Institute of Engineering & Technology, Panjab University, Chandigarh 160014, India
| | - Deepika Koundal
- Department of Systemics, School of Computer Science, University of Petroleum & Energy Studies, Dehradun, India
| | - Atef Zaguia
- Department of computer science, College of Computers and Information Technology, Taif University, P.O. BOX 11099, Taif 21944, Saudi Arabia
| | - Shubham Koundal
- Department of Medical Laboratory Technology, University Institute of Applied Health Sciences, Chandigarh University (Gharuan), Mohali 140313, India
| | - Assaye Belay
- Department of Statistics, Mizan-Tepi University, Ethiopia
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Grimm LJ, Avery CS, Hendrick E, Baker JA. Benefits and Risks of Mammography Screening in Women Ages 40 to 49 Years. J Prim Care Community Health 2022; 13:21501327211058322. [PMID: 35068237 PMCID: PMC8796062 DOI: 10.1177/21501327211058322] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Breast cancer screening in the United States is complicated by conflicting recommendations from professional and governmental organizations. The benefits and risks of breast cancer screening differ though by age which should influence shared decision-making discussions. Compared to older women, women ages 40 to 49 years have a lower risk of breast cancer, but the types of breast cancer that develop are often more aggressive with a poorer prognosis. Furthermore, younger women have a longer life expectancy and fewer comorbidities. The primary benefits of screening for women in their 40s are a reduction in breast cancer mortality, years of life lost to breast cancer, and morbidity of breast cancer treatment by detecting cancers at an earlier stage. Compared to older women, the risks of breast cancer screening in women ages 40 to 49 years includes more false positive recalls and biopsies as well as transient anxiety. Concerns regarding radiation induced malignancy and overdiagnosis are minimal in this age group. The shorter lead time of breast cancer in women ages 40 to 49 years also favors shorter screening intervals. This information should help inform providers in their shared decision-making discussions with patients.
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Affiliation(s)
| | | | | | - Jay A Baker
- Duke University Medical Center, Durham, NC, USA
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9
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Schifferdecker KE, Vaclavik D, Wernli KJ, Buist DSM, Kerlikowske K, Sprague BL, Henderson LM, Johnson D, Budesky J, Jackson-Nefertiti G, Miglioretti DL, Tosteson ANA. Women's considerations and experiences for breast cancer screening and surveillance during the COVID-19 pandemic in the United States: A focus group study. Prev Med 2021; 151:106542. [PMID: 34217409 PMCID: PMC8721569 DOI: 10.1016/j.ypmed.2021.106542] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic resulted in numerous changes in delivery of healthcare services, including breast cancer screening and surveillance. Although facilities have implemented a number of strategies to provide services, women's thoughts and experiences related to breast cancer screening and surveillance during a pandemic are not well known. This focus group study with women across seven states recruited through the Breast Cancer Surveillance Consortium aims to remedy this gap in information. Thirty women ranging in age from 31 to 69 participated in five virtual focus groups, eight of whom had prior breast cancer. The first three focus groups covered a range of topics related to screening and surveillance during the pandemic while the last two groups covered experiences and then a review of sample communications to women about screening and surveillance during the pandemic to obtain reactions and recommendations. More than half of the women had screening or surveillance during the pandemic. Coding and analyses resulted in nine themes in three topic areas: decision factors, screening experiences, and preferred communications. Themes included weighing the risks of COVID-19 versus cancer; feelings that screening and surveillance were mostly safe but barriers may be heightened; feeling safe when undergoing screening but receiving a range of pandemic-specific communications from none to a lot; and wanting communications that are personalized, clear and concise. Based on these findings, providers and facilities should assure women of pandemic safety measures, review methods and content of communications, and assess for barriers to screening that may be amplified during the pandemic, including anxiety and access.
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Affiliation(s)
| | | | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, United States of America
| | - Diana S M Buist
- Kaiser Permanente Washington Health Research Institute, Seattle, United States of America
| | | | | | | | | | | | | | - Diana L Miglioretti
- Kaiser Permanente Washington Health Research Institute, Seattle, United States of America; Department of Public Health Sciences, University of California Davis, United States of America
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Bakhuizen JJ, Hanson H, van der Tuin K, Lalloo F, Tischkowitz M, Wadt K, Jongmans MCJ. Surveillance recommendations for DICER1 pathogenic variant carriers: a report from the SIOPE Host Genome Working Group and CanGene-CanVar Clinical Guideline Working Group. Fam Cancer 2021; 20:337-348. [PMID: 34170462 PMCID: PMC8484187 DOI: 10.1007/s10689-021-00264-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/19/2021] [Indexed: 12/15/2022]
Abstract
DICER1 syndrome is a rare genetic disorder that predisposes to a wide spectrum of tumors. Developing surveillance protocols for this syndrome is challenging because uncertainty exists about the clinical efficacy of surveillance, and appraisal of potential benefits and harms vary. In addition, there is increasing evidence that germline DICER1 pathogenic variants are associated with lower penetrance for cancer than previously assumed. To address these issues and to harmonize DICER1 syndrome surveillance programs within Europe, the Host Genome Working Group of the European branch of the International Society of Pediatric Oncology (SIOPE HGWG) and Clinical Guideline Working Group of the CanGene-CanVar project in the United Kingdom reviewed current surveillance strategies and evaluated additional relevant literature. Consensus was achieved for a new surveillance protocol and information leaflet that informs patients about potential symptoms of DICER1-associated tumors. The surveillance protocol comprises a minimum program and an extended version for consideration. The key recommendations of the minimum program are: annual clinical examination from birth to age 20 years, six-monthly chest X-ray and renal ultrasound from birth to age 6 years, and thyroid ultrasound every 3 years from age 8 to age 40 years. The surveillance program for consideration comprises additional surveillance procedures, and recommendations for DICER1 pathogenic variant carriers outside the ages of the surveillance interval. Patients have to be supported in choosing the surveillance program that best meets their needs. Prospective evaluation of the efficacy and patient perspectives of proposed surveillance recommendations is required to expand the evidence base for DICER1 surveillance protocols.
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Affiliation(s)
- Jette J Bakhuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Helen Hanson
- Department of Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - Karin Wadt
- Department of Clinical Genetics, Copenhagen University Hospital Righospitalet, Copenhagen, Denmark
| | - Marjolijn C J Jongmans
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. .,Department of Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
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11
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Fancellu A, Zhao XY, Cottu P, Sanna V, Li YP, Zhu Q, Tanda C, Zhang YY, Lai YM, Ginesu GC, Dai SQ, Porcu A. Comparing Clinicopathologic Features and Surgical Treatment of Premenopausal Breast Cancer across Italy and China: Report from a Medical Exchange Program. Breast Care (Basel) 2020; 15:511-518. [PMID: 33223995 DOI: 10.1159/000505448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 12/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background This study investigated the differences in clinicopathologic features and surgical treatment between an Italian and a Chinese cohort of premenopausal women with breast cancer, and highlighted the potential advantages of international medical exchange projects. Methods Premenopausal women who underwent surgical treatment between 2012 and 2016 at one Italian and one Chinese institution participating in a medical exchange program were compared. Factors associated with the probability to receive mastectomy were determined via logistic analysis. Changes in surgical management at the Chinese institution in the period 2018-2019, after the exchange program, were also evaluated. Results A total of 505 patients, 318 from Italy and 187 from China, were evaluated. The Chinese patients had more frequently advanced-stage tumours, large tumour size (30.9 vs. 18.1 mm, p < 0.01), invasive carcinoma (92.5 vs. 83.3%, p < 0.01), positive axillary lymph nodes (54.5 vs. 27.4%, p < 0.01), Her-2 positivity (36.4 vs. 22.0%, p < 0.01), and high proliferative index (55.1 vs. 30.2%, p < 0.01). Positive oestrogen receptor status and rates of triple-negative breast cancer did not differ (77.0 vs. 69.5%, p = 0.09 and 14.2 vs. 16%, p = 0.56, respectively). Mastectomy rates were higher among Chinese women (85 vs. 41%, p < 0.001), whereas use of sentinel node biopsy was more frequent among Italian women (77 vs. 33%, p < 0.001). Chinese women had more than 4-fold higher risk of receiving mastectomy. In the last 2 years, the rates of breast-conserving surgery and sentinel node biopsy at the Chinese institution increased from 15 to 23%, and from 33 to 42%, respectively. Conclusions Tumour features and surgical strategies for premenopausal breast cancer may differ significantly between Italy and China. Since the international exchange program, patients from the Chinese institution have been offered more frequently less invasive surgery. International exchange programs can help in designing epidemiological studies which may be useful for strategies to improve breast cancer management and control.
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Affiliation(s)
- Alessandro Fancellu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Xue Yun Zhao
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Pietrina Cottu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | - Yuan Ping Li
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Qin Zhu
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Cinzia Tanda
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ying Yi Zhang
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Yan Mei Lai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Giorgio Carlo Ginesu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Shu Qin Dai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Alberto Porcu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Qenam BA, Li T, Tapia K, Brennan PC. The roles of clinical audit and test sets in promoting the quality of breast screening: a scoping review. Clin Radiol 2020; 75:794.e1-794.e6. [PMID: 32139003 DOI: 10.1016/j.crad.2020.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/29/2020] [Indexed: 12/24/2022]
Abstract
Breast screening programmes enhance the probability of early breast cancer detection in many countries worldwide; however, the success of these efforts is highly dependent on the ability of breast screen readers to detect abnormalities in the screened population, which has low prevalence. Therefore, this task can be challenging. Clinical audit is a key quality assurance measure that aims to keep the screen reading performance within acceptable standards. Auditing, nonetheless, is a lengthy process, and its accuracy is dependent on available clinical data, which often can be limited. Mammographic standardised test sets are a different screen reading evaluation approach that provides participants with instant feedback based on a simulated environment. Although a test set provides unique evaluative qualities, its ability to represent clinical performance is debated. This article describes the distinctive roles of clinical audit and test sets in measuring and improving the quality of breast screening and highlights the relationship between test sets and clinical performance.
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Affiliation(s)
- B A Qenam
- BREAST, Medical Imaging Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East St, Lidcombe, NSW, 2141, Australia; Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11432, Saudi Arabia.
| | - T Li
- BREAST, Medical Imaging Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East St, Lidcombe, NSW, 2141, Australia; Medical Image Optimisation and Perception Research Group (MIOPeG), Medical Imaging Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East St, Lidcombe, NSW 2141, Australia
| | - K Tapia
- BREAST, Medical Imaging Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East St, Lidcombe, NSW, 2141, Australia
| | - P C Brennan
- BREAST, Medical Imaging Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East St, Lidcombe, NSW, 2141, Australia; Medical Image Optimisation and Perception Research Group (MIOPeG), Medical Imaging Science, Faculty of Health Sciences, The University of Sydney, Cumberland Campus, 75 East St, Lidcombe, NSW 2141, Australia
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Burnside ES, Vulkan D, Blanks RG, Duffy SW. Association between Screening Mammography Recall Rate and Interval Cancers in the UK Breast Cancer Service Screening Program: A Cohort Study. Radiology 2018; 288:47-54. [PMID: 29613846 PMCID: PMC6027996 DOI: 10.1148/radiol.2018171539] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To determine whether low levels of recall lead to increased interval cancers and the magnitude of this effect. Materials and Methods The authors retrospectively analyzed prospectively collected data from the UK National Health Service Breast Screening Programme during a 36-month period (April 1, 2005 to March 31, 2008), with 3-year follow-up in women aged 50-70 years. Data on recall, cancers detected at screening, and interval cancers were available for each of the 84 breast screening units and for each year (n = 252). The association between interval cancers and recalls was modeled by using Poisson regression on aggregated data and according to age (5-year intervals) and screening type (prevalent vs incident). Results The authors analyzed 5 126 689 screening episodes, demonstrating an average recall to assessment rate (RAR) of 4.56% (range, 1.64%-8.42%; standard deviation, 1.15%), cancer detection rate of 8.1 per 1000 women screened, and interval cancer rate (ICR) of 3.1 per 1000 women screened. Overall, a significant negative association was found between RAR and ICR (Poisson regression coefficient: -0.039 [95% confidence interval: -0.062, -0.017]; P = .001), with approximately one fewer interval cancer for every additional 80-84 recalls. Subgroup analysis revealed similar negative correlations in women aged 50-54 years (P = .002), 60-64 years (P = .01), and 65-69 years (P = .008) as well as in incident screens (P = .001) and prevalent screens (P = .04). No significant relationship was found in women aged 55-59 years (P = .46). Conclusion There was a statistically significant negative correlation between RAR and ICR, which suggests the merit of a minimum threshold for RAR. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Elizabeth S. Burnside
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252 (E.S.B.); Centre for Cancer Prevention, Queen Mary University of London, Wolfson Institute of Preventive Medicine, London, England (D.V., S.W.D.); and Nuffield Department of Population Health, University of Oxford, Oxford, England (R.G.B.)
| | - Daniel Vulkan
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252 (E.S.B.); Centre for Cancer Prevention, Queen Mary University of London, Wolfson Institute of Preventive Medicine, London, England (D.V., S.W.D.); and Nuffield Department of Population Health, University of Oxford, Oxford, England (R.G.B.)
| | - Roger G. Blanks
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252 (E.S.B.); Centre for Cancer Prevention, Queen Mary University of London, Wolfson Institute of Preventive Medicine, London, England (D.V., S.W.D.); and Nuffield Department of Population Health, University of Oxford, Oxford, England (R.G.B.)
| | - Stephen W. Duffy
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252 (E.S.B.); Centre for Cancer Prevention, Queen Mary University of London, Wolfson Institute of Preventive Medicine, London, England (D.V., S.W.D.); and Nuffield Department of Population Health, University of Oxford, Oxford, England (R.G.B.)
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Participants, Physicians or Programmes: Participants' educational level and initiative in cancer screening. Health Policy 2018; 122:422-430. [PMID: 29454541 DOI: 10.1016/j.healthpol.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 01/26/2023]
Abstract
This study is an in-depth examination of at whose initiative (participant, physician or screening programme) individuals participate in cervical, breast and colorectal cancer screening across the EU-28. Special attention is paid to (1) the association with educational attainment and (2) the country's cancer screening strategy (organised, pilot/regional or opportunistic) for each type of cancer screened. Data were obtained from Eurobarometer 66.2 'Health in the European Union' (2006). Final samples consisted of 10,186; 5443 and 9851 individuals for cervical, breast, and colorectal cancer, respectively. Multinomial logistic regressions were performed. Surprisingly, even in countries with organised screening programmes, participation in screenings for cervical, breast and colorectal cancer was most likely to be initiated by the general practitioner (GP) or the participant. In general, GPs were found to play a crucial role in making referrals to screenings, regardless of the country's screening strategy. The results also revealed differences between educational groups with regard to their incentive to participate in cervical and breast cancer screening and, to a lesser extent, in colorectal cancer screening. People with high education are more likely to participate in cancer screening at their own initiative, while people with less education are more likely to participate at the initiative of a physician or a screening programme. Albeit, the results varied according to type of cancer screening and national screening strategy.
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