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Bi Y, Lv X, Wang K, Wu J, Shi X, Zheng X, Lin X. An ultra-sensitive and rapid immunosensor for the onsite detection of circulating tumor DNA in breast cancer. Front Bioeng Biotechnol 2024; 12:1412598. [PMID: 39070168 PMCID: PMC11273087 DOI: 10.3389/fbioe.2024.1412598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/10/2024] [Indexed: 07/30/2024] Open
Abstract
Breast cancer currently stands as the most prevalent form of cancer worldwide and the primary cause of cancer-related deaths among women. However, the current diagnostic methods for breast cancer exhibit several limitations, including invasiveness, high costs, and limited sensitivity and specificity. The detection of the PIK3CA-H1047R variant is of paramount importance due to its close association with tumor growth and treatment resistance. Consequently, developing a straightforward, rapid, and highly sensitive approach for detecting PIK3CA-H1047R is of utmost importance. We have been working on the development of a rapid and ultrasensitive biosensor, leveraging the alternating current (AC) electrokinetic (ACEK) capacitive sensing method. This biosensor involves modifying the surface of interdigital electrodes with antibodies, facilitating the antibody-antigen-binding process through AC electrokinetic techniques. Our sensor strategy directly measures the interface capacitance, and the rate of change serves as a quantitative marker for event identification. Remarkably, our biosensor successfully detects the PIK3CA-H1047R antigen within a concentration range of 1 ng/mL to 1 μg/mL. In conclusion, this study proposes a fast and highly sensitive biosensor for the detection of a key breast cancer marker, the PIK3CA-H1047R variant. This technology is expected to improve breast cancer diagnosis, address the limitations of current methods, and provide patients with better treatment options. This detection method offers a promising avenue for on-site and real-time sensitive detection of the PIK3CA-H1047R antigen, potentially revolutionizing breast cancer diagnosis.
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Affiliation(s)
- Yi Bi
- Chongqing University Cancer Hospital, Chongqing University, Chongqing, China
| | - Xiao Lv
- Key Laboratory of Optoelectronic Technology and Systems of Ministry of Education of China, Chongqing University, Chongqing, China
| | - Ke Wang
- Key Laboratory of Optoelectronic Technology and Systems of Ministry of Education of China, Chongqing University, Chongqing, China
| | - Jinyu Wu
- Key Laboratory of Optoelectronic Technology and Systems of Ministry of Education of China, Chongqing University, Chongqing, China
| | - Xiang Shi
- Key Laboratory of Optoelectronic Technology and Systems of Ministry of Education of China, Chongqing University, Chongqing, China
| | - Xiaodong Zheng
- Chongqing University Cancer Hospital, Chongqing University, Chongqing, China
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, China
- Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chenjiaqiao Hospital of Shapingba District, Chongqing, China
| | - Xiaogang Lin
- Key Laboratory of Optoelectronic Technology and Systems of Ministry of Education of China, Chongqing University, Chongqing, China
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Uematsu T. Rethinking screening mammography in Japan: next-generation breast cancer screening through breast awareness and supplemental ultrasonography. Breast Cancer 2024; 31:24-30. [PMID: 37823977 PMCID: PMC10764506 DOI: 10.1007/s12282-023-01506-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: 08/03/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023]
Abstract
Breast cancer mortality has not been reduced in Japan despite more than 20 years of population-based screening mammography. Screening mammography might not be suitable for Japanese women who often have dense breasts, thus decreasing mammography sensitivity because of masking. The J-START study showed that breast ultrasonography increases the sensitivity and the detection rate for early invasive cancers and lowers the rate of interval cancers for Japanese women in their 40 s. Breast awareness and breast cancer survival are directly correlated; however, breast awareness is not widely known in Japan. Next-generation breast cancer screening in Japan should consist of breast awareness campaigns for improving breast cancer literacy and supplemental breast ultrasonography to address the problem of false-negative mammograms attributable to dense breasts.
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Affiliation(s)
- Takayoshi Uematsu
- Department of Breast Imaging and Breast Intervention Radiology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Shizuoka, 411-8777, Japan.
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Uematsu T, Izumori A, Moon WK. Overcoming the limitations of screening mammography in Japan and Korea: a paradigm shift to personalized breast cancer screening based on ultrasonography. Ultrasonography 2023; 42:508-517. [PMID: 37697823 PMCID: PMC10555688 DOI: 10.14366/usg.23047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 09/13/2023] Open
Abstract
Screening mammography programs have been implemented in numerous Western countries with the aim of reducing breast cancer mortality. However, despite over 20 years of population-based screening mammography, the mortality rates in Japan and Korea continue to rise. This may be due to the fact that screening mammography is not as effective for Japanese and Korean women, who often have dense breasts. This density decreases the sensitivity of mammography due to a masking effect. Therefore, the early detection of small invasive cancers requires more than just mammography, particularly for women in their 40s. This review discusses the limitations and challenges of screening mammography, as well as the keys to successful population-based breast cancer screening in Japan and Korea. This includes a focus on breast ultrasonography techniques, which are based on histopathologic anatomical knowledge, and personalized screening strategies that are based on risk assessments measured by glandular tissue components.
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Affiliation(s)
- Takayoshi Uematsu
- Department of Breast Imaging and Breast Intervention Radiology and Department of Clinical Physiology, Shizuoka Cancer Center Hospital, Japan
| | - Ayumi Izumori
- Department of Breast Surgery, Takamatsu Heiwa Hospital, Takamatsu, Japan
| | - Woo Kyung Moon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
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Wang O, Zhang W, Chen S, Cao F, Chen L, Chen H. A Multicenter, Randomized, Controlled Study of the Breast Biopsy and Circumferential Excision System for Breast Lesions. Clin Breast Cancer 2023:S1526-8209(23)00129-5. [PMID: 37331895 DOI: 10.1016/j.clbc.2023.05.007] [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: 11/04/2022] [Revised: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND This study aimed to verify the effectiveness, safety, and reliability of the breast biopsy and circumferential excision system. METHODS It was designed as a multicenter, randomized, open-label, positive control, noninferiority trial. A total of 168 subjects who met the breast lesion screening requirements of the clinical trial protocol were randomly divided into a breast biopsy and circumferential excision dual cutting system test group or Mammotome control group. The main outcome was the successful removal rate of suspected lumps during surgery. Secondary outcomes included the operative times for individual lumps, weight of removed cord tissue, and several indicators of device performance. Safety indicators, including routine blood, blood biochemical and electrocardiogram examinations, were measured at baseline and 24 hours and 48 hours after the operation. Postoperative complications and combined medication use were observed and recorded until 7 days after the operation. RESULTS The results showed no significant differences in efficacy and safety between the 2 groups (main efficacy, P = .7463; all secondary efficacy indicators, P > .05, except weight of removed cord tissue [P = .0070] and touch sensitivity of the device interface [P = .0275]; all safety indicators, P > .05). The results suggested that the test device is effective and is acceptable safe for use in breast lesion biopsy. CONCLUSION For patients with a high incidence of breast lesions, the results of this study provide a safe, effective, sensitive and accessible option for the removal of breast mass biopsies at a price much lower than that of imported devices.
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Affiliation(s)
- Ouchen Wang
- Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wei Zhang
- Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuzheng Chen
- Breast Surgery, Taizhou hospital Zhejiang Province, Taizhou, China
| | - Feilin Cao
- Breast Surgery, Lishui Central hospital, Lishui, China
| | - Liran Chen
- Shenzhen Yiren Management Consulting Co Ltd, Shenzhen, China.
| | - Huafang Chen
- Clinical Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Nagayasu M, Morishima T, Fujii M, Kudo H, Sobue T, Ohno Y, Miyashiro I. Age-Dependent Causes of Death among Patients with Breast Cancer Based on Osaka Cancer Registry and Vital Statistics in Japan. Healthcare (Basel) 2023; 11:healthcare11101409. [PMID: 37239701 DOI: 10.3390/healthcare11101409] [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: 02/18/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
We aimed to clarify the differences in causes of death among patients with breast cancer according to age at diagnosis and years elapsed since diagnosis. Using data from the Osaka Cancer Registry and Vital Statistics databases, 40,690 female patients diagnosed with primary breast cancer between 1985 and 2006 were included in this study. The statistics on all deaths between 1985 to 2016 were collected, and the observation period was 10 years (2006-2016). Mortality hazards according to age at diagnosis and years elapsed since diagnosis were estimated using a flexible parametric estimation. Of the 40,690 patients, 13,676 (34%) died from all-cause death, and the 10-year survival rate was 65.74% (95% confidence interval: 65.28-66.21). The proportions of deaths were 10,531 (77%) from breast cancer, 1048 (8%) from other cancers, and 2097 (15%) from non-cancer causes. The mortality hazard for deaths from breast cancer was initially high and then declined, whereas that for deaths from other cancers and non-cancer causes was initially low and then increased. The more likely causes of death 5 years after breast cancer diagnosis were other cancers or non-cancer causes among patients aged ≥70 years.
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Affiliation(s)
- Mayumi Nagayasu
- Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita 5650871, Japan
- Department of Nursing, Hyogo Medical University, 1-3-6 Minatojima, Kobe 6508530, Japan
| | - Toshitaka Morishima
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Osaka 5418567, Japan
| | - Makoto Fujii
- Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita 5650871, Japan
| | - Haruka Kudo
- Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita 5650871, Japan
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Osaka 5418567, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 5650871, Japan
- Institute for Cancer Control, National Cancer Center Japan, 5-1-1 Tsukiji, Tokyo 1040045, Japan
| | - Yuko Ohno
- Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita 5650871, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Osaka 5418567, Japan
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Hashimoto R, Akashi-Tanaka S, Watanabe C, Masuda H, Taruno K, Takamaru T, Ide Y, Kuwayama T, Kobayashi Y, Takimoto M, Nakamura S. Diagnostic performance of dedicated breast positron emission tomography. Breast Cancer 2022; 29:1013-1021. [PMID: 35768684 PMCID: PMC9587931 DOI: 10.1007/s12282-022-01381-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/12/2022] [Indexed: 11/18/2022]
Abstract
Background Dedicated breast positron emission tomography (dbPET) has been developed for detecting smaller breast cancer. We investigated the diagnostic performance of dbPET in patients with known breast cancer. Methods Eighty-two preoperative patients with breast cancer were included in the study (84 tumours: 11 ductal carcinomas in situ [DCIS], 73 invasive cancers). They underwent mammography (MMG), ultrasonography (US), and contrast-enhanced breast magnetic resonance imaging (MRI) before whole-body PET/MRI (WBPET/MRI) and dbPET. We evaluated the sensitivity of all modalities, and the association between the maximum standard uptake value (SUVmax) level and histopathological features. Results The sensitivities of MMG, US, MRI, WBPET/MRI and dbPET for all tumours were 81.2% (65/80), 98.8% (83/84), 98.6% (73/74), 86.9% (73/84), and 89.2% (75/84), respectively. For 11 DCIS and 22 small invasive cancers (≤ 2 cm), the sensitivity of dbPET (84.9%) tended to be higher than that of WBPET/MRI (69.7%) (p = 0.095). Seven tumours were detected by dbPET only, but not by WBPET/MRI. Five tumours were detected by only WBPET/MRI because of the blind area of dbPET detector, requiring a wider field of view. After making the mat of dbPET detector thinner, all 22 scanned tumours were depicted. The higher SUVmax of dbPET was significantly related to the negative oestrogen receptor status, higher nuclear grade, and higher Ki67 (p < 0.001). Conclusions The sensitivity of dbPET for early breast cancer was higher than that of WBPET/MRI. High SUVmax was related to aggressive features of tumours. Moreover, dbPET can be used for the diagnosis and oncological evaluation of breast cancer.
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Affiliation(s)
- Rikako Hashimoto
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan.
| | - Sadako Akashi-Tanaka
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Chie Watanabe
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Hiroko Masuda
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Kanae Taruno
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Tomoko Takamaru
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Yoshimi Ide
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Takashi Kuwayama
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Yasuhiro Kobayashi
- Tokyo Midtown Clinic, Midtown Tower 6F, Akasaka 9-7-1, Minato, Tokyo, 107-6206, Japan
| | - Masafumi Takimoto
- Department of Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Seigo Nakamura
- Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
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Uematsu T. Sensitivity and specificity of screening mammography without clinical breast examination among Japanese women aged 40-49 years: analysis of data from the J-START results. Breast Cancer 2022; 29:928-931. [PMID: 35507294 DOI: 10.1007/s12282-022-01353-1] [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: 12/10/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current breast cancer screening programs worldwide offer only mammography for asymptomatic women, without clinical breast examination (CBE). The sensitivity and specificity of true asymptomatic screening mammography are important, especially in Japan. METHODS This study used data from the Japan Strategic Anti-cancer Randomized Trial (J-START) results, and then calculated the sensitivity and specificity of screening mammography without CBE among Japanese women aged 40-49 years. RESULTS The sensitivity and specificity of modern film mammography, performed biennially, among Japanese women aged 40-49 years were 71.7% and 92.6%, respectively. The sensitivity of mammography alone was 47.4%. From the secondary analysis, the sensitivity of mammography alone was 44.1% for women with dense breasts and 34.8% for women with non-dense breasts. CONCLUSION The sensitivity of mammography alone of 47.4% is too low. The low sensitivity of screening mammography for true asymptomatic Japanese women aged 40-49 years places this population at an elevated risk, which can justify performing adjunctive ultrasonography.
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Affiliation(s)
- Takayoshi Uematsu
- Department of Breast Imaging and Breast Intervention Radiology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Shizuoka, 411-8777, Japan.
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Harada-Shoji N, Suzuki A, Ishida T, Zheng YF, Narikawa-Shiono Y, Sato-Tadano A, Ohta R, Ohuchi N. Evaluation of Adjunctive Ultrasonography for Breast Cancer Detection Among Women Aged 40-49 Years With Varying Breast Density Undergoing Screening Mammography: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2121505. [PMID: 34406400 PMCID: PMC8374606 DOI: 10.1001/jamanetworkopen.2021.21505] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
IMPORTANCE Mammography has limited accuracy in breast cancer screening. Ultrasonography, when used in conjunction with mammography screening, is helpful to detect early-stage and invasive cancers for asymptomatic women with dense and nondense breasts. OBJECTIVE To evaluate the performance of adjunctive ultrasonography with mammography for breast cancer screening, according to differences in breast density. DESIGN, SETTING, AND PARTICIPANTS This study is a secondary analysis of the Japan Strategic Anti-cancer Randomized Trial. Between July 2007 and March 2011, asymptomatic women aged 40 to 49 years were enrolled in Japan. The present study used data from cases enrolled from the screening center in Miyagi prefecture during 2007 to 2020. Participants were randomly assigned in a 1:1 ratio to undergo either mammography with ultrasonography (intervention group) or mammography alone (control group). Data analysis was performed from February to March 2020. EXPOSURES Ultrasonography adjunctive to mammography for breast cancer screening regardless of breast density. MAIN OUTCOMES AND MEASURES Sensitivity, specificity, recall rates, biopsy rates, and characteristics of screen-detected cancers and interval breast cancers were evaluated between study groups and for each modality according to breast density. RESULTS A total of 76 119 women were enrolled, and data for 19 213 women (mean [SD] age, 44.5 [2.8] years) from the Miyagi prefecture were analyzed; 9705 were randomized to the intervention group and 9508 were randomized to the control group. A total of 11 390 women (59.3%) had heterogeneously or extremely dense breasts. Among the overall group, 130 cancers were found. Sensitivity was significantly higher in the intervention group than the control group (93.2% [95% CI, 87.4%-99.0%] vs 66.7% [95% CI, 54.4%-78.9%]; P < .001). Similar trends were observed in women with dense breasts (sensitivity in intervention vs control groups, 93.2% [95% CI, 85.7%-100.0%] vs 70.6% [95% CI, 55.3%-85.9%]; P < .001) and nondense breasts (sensitivity in intervention vs control groups, 93.1% [95% CI, 83.9%-102.3%] vs 60.9% [95% CI, 40.9%-80.8%]; P < .001). The rate of interval cancers per 1000 screenings was lower in the intervention group compared with the control group (0.5 cancers [95% CI, 0.1-1.0 cancers] vs 2.0 cancers [95% CI, 1.1-2.9 cancers]; P = .004). Within the intervention group, the rate of invasive cancers detected by ultrasonography alone was significantly higher than that for mammography alone in both dense (82.4% [95% CI, 56.6%-96.2%] vs 41.7% [95% CI, 15.2%-72.3%]; P = .02) and nondense (85.7% [95% CI, 42.1%-99.6%] vs 25.0% [95% CI, 5.5%-57.2%]; P = .02) breasts. However, sensitivity of mammography or ultrasonography alone did not exceed 80% across all breast densities in the 2 groups. Compared with the control group, specificity was significantly lower in the intervention group (91.8% [95% CI, 91.2%-92.3%] vs 86.8% [95% CI, 86.2%-87.5%]; P < .001). Recall rates (13.8% [95% CI, 13.1%-14.5%] vs 8.6% [95% CI, 8.0%-9.1%]; P < .001) and biopsy rates (5.5% [95% CI, 5.1%-6.0%] vs 2.1% [95% CI, 1.8%-2.4%]; P < .001) were significantly higher in the intervention group than the control group. CONCLUSIONS AND RELEVANCE In this secondary analysis of a randomized clinical trial, screening mammography alone demonstrated low sensitivity, whereas adjunctive ultrasonography was associated with increased sensitivity. These findings suggest that adjunctive ultrasonography has the potential to improve detection of early-stage and invasive cancers across both dense and nondense breasts. Supplemental ultrasonography should be considered as an appropriate imaging modality for breast cancer screening in asymptomatic women aged 40 to 49 years regardless of breast density. TRIAL REGISTRATION NIPH Clinical Trial Identifier: UMIN000000757.
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Affiliation(s)
- Narumi Harada-Shoji
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akihiko Suzuki
- Department of Breast and Endocrine Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takanori Ishida
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ying-Fang Zheng
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoko Narikawa-Shiono
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiko Sato-Tadano
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rie Ohta
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriaki Ohuchi
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Yang ZL, Hu YQ, Huang J, Zhan CA, Zhou MX, Zhang XY, Zhang HT, Xia LM, Ai T. Detection and Classification of Breast Lesions With Readout-Segmented Diffusion-Weighted Imaging in a Large Chinese Cohort. Front Oncol 2021; 11:636471. [PMID: 33828984 PMCID: PMC8020903 DOI: 10.3389/fonc.2021.636471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/08/2021] [Indexed: 01/22/2023] Open
Abstract
Objectives: To evaluate the performance of readout-segmented echo-planar imaging DWI (rs-EPI DWI) in detecting and characterizing breast cancers in a large Chinese cohort with comparison to dynamic contrast-enhanced MRI (DCE-MRI). Methods: The institutional review board approved this retrospective study with waived written informed consent. A total of 520 women (mean age, 43.1- ± 10.5-years) were included from July 2013 to October 2019. First, the ability of rs-EPI DWI in detecting breast lesions identified by DCE-MRI was evaluated. The lesion conspicuity of rs-EPI-DWI and DCE-MRI was compared using the Wilcoxon signed rank test. With pathology as a reference, the performance of rs-EPI DWI and DCE-MRI in distinguishing breast cancers was evaluated and compared using the Chi-square test. Results: Of 520 women, 327/520 (62.9%) patients had 423 lesions confirmed by pathology with 203 benign and 220 malignant lesions. The rs-EPI DWI can detect 90.8% (659/726) (reader 1) and 90.6% (663/732) (reader 2) of lesions identified by DCE-MRI. The lesion visibility was superior for DCE-MRI than rs-EPI-DWI (all p < 0.05). With pathology as a reference, the sensitivities and specificities of rs-EPI DWI in diagnosing breast cancers were 95.9% (211/220) and 85.7% (174/203) for reader 1 and 97.7% (215/220) and 86.2% (175/203) for reader 2. No significant differences were found for the performance of DCE-MRI and rs-EPI DWI in discriminating breast cancers (all p > 0.05). Conclusions: Although with an inferior lesion visibility, rs-EPI DWI can detect about 90% of breast lesions identified by DCE-MRI and has comparable diagnostic capacity to that of DCE-MRI in identifying breast cancer.
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Affiliation(s)
- Zhen Lu Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Qi Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Huang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Ao Zhan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Xiong Zhou
- College of Medical Imaging, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | | | | | - Li Ming Xia
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Ai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Goto Y, Tsugawa K, Furuya Y, Maezato M, Tagami Y, Ogawa Y, Saisu M, Yamazaki M, Kuramochi F. Behavior of Japanese women after being informed about the benefits and disadvantages of breast cancer screening: a questionnaire survey. Breast Cancer 2020; 27:739-747. [PMID: 32140843 DOI: 10.1007/s12282-020-01071-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The US Preventative Services Task Force assessed the efficacy of breast cancer screening according to the sum of its benefits and disadvantages. We estimate that the balance of the benefits and disadvantages varies among women depending on their demographic background. METHODS Between March 2016 and March 2017, we conducted a questionnaire survey among Japanese women who underwent population-based or opportunistic breast cancer screening at our multicenter institutions. We investigated the behavior modification among women after being informed about the benefits and disadvantages of breast cancer screening depending on their demographic background. RESULTS Out of 3032 questionnaires that were returned, 2936 (96.8%) were evaluated. The percentage of women with prior knowledge about the benefits and disadvantages of breast cancer screening before reading the leaflets that we created was 24%. However, 95% of the women were willing to undergo screening next time, despite knowing the disadvantages. Regarding overdiagnosis, the young women tended to choose usual treatment, and the elderly women tended to choose active surveillance. In response to the question on the significance of screening, the young women wished to avoid death by breast cancer; whereas, the elderly women wished to live a safe life. CONCLUSION Our results indicate that the information of disadvantages does not lead to a reduction in screening rates. Additionally, we found that the balance between the benefits and disadvantages of breast cancer screening varies among women depending on their demographic background, especially age.
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Affiliation(s)
- Yuka Goto
- Advanced Breast Imaging Center of St. Marianna University School of Medicine, 6-7-2 Manpukuji Asao-ku, Kawasaki, Kanagawa, 215-8520, Japan.
| | - Koichiro Tsugawa
- Division of Breast Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine Hospital, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yuko Furuya
- Advanced Breast Imaging Center of St. Marianna University School of Medicine, 6-7-2 Manpukuji Asao-ku, Kawasaki, Kanagawa, 215-8520, Japan
| | - Miwako Maezato
- Imaging Center of St. Marianna University School of Medicine Hospital, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yoshimi Tagami
- Imaging Center of St. Marianna University School of Medicine Hospital, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yuri Ogawa
- Imaging Center of St. Marianna University School of Medicine Hospital, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Misako Saisu
- Imaging Center of St. Marianna University School of Medicine Hospital, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Memi Yamazaki
- St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashichou, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan
| | - Fuyumi Kuramochi
- Kawasaki Municipal Tama Hospital, 1-30-37 Syukugawara, Tama-ku, Kawasaki, Kanagawa, 214-8525, Japan
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11
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Tanaka H, Chiu SW, Watanabe T, Kaoku S, Yamaguchi T. Computer-aided diagnosis system for breast ultrasound images using deep learning. Phys Med Biol 2019; 64:235013. [PMID: 31645021 DOI: 10.1088/1361-6560/ab5093] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to develop a computer-aided diagnosis (CAD) system for the classification of malignant and benign masses in the breast using ultrasonography based on a convolutional neural network (CNN), a state-of-the-art deep learning technique. We explored the regions for the correct classification by generating a heat map that presented the important regions used by the CNN for human malignancy/benign classification. Clinical data was obtained from a large-scale clinical trial previously conducted by the Japan Association of Breast and Thyroid Sonology. Images of 1536 breast masses (897 malignant and 639 benign) confirmed by pathological examinations were collected, with each breast mass captured from various angles using an ultrasound (US) imaging probe. We constructed an ensemble network by combining two CNN models (VGG19 and ResNet152) fine-tuned on balanced training data with augmentation and used the mass-level classification method to enable the CNN to classify a given mass using all views. For an independent test set consisting of 154 masses (77 malignant and 77 benign), our network showed outstanding classification performance with a sensitivity of 90.9% (95% confidence interval 84.5-97.3), a specificity of 87.0% (79.5-94.5), and area under the curve (AUC) of 0.951 (0.916-0.987) compared to that of the two CNN models. In addition, our study indicated that the breast masses themselves were not detected by the CNN as important regions for correct mass classification. Collectively, this CNN-based CAD system is expected to assist doctors by improving the diagnosis of breast cancer in clinical practice.
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Affiliation(s)
- Hiroki Tanaka
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. Author to whom any correspondence should be addressed
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12
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Nishiyama K, Taira N, Mizoo T, Kochi M, Ikeda H, Iwamoto T, Shien T, Doihara H, Ishihara S, Kawai H, Kawasaki K, Ishibe Y, Ogasawara Y, Toyooka S. Influence of breast density on breast cancer risk: a case control study in Japanese women. Breast Cancer 2019; 27:277-283. [DOI: 10.1007/s12282-019-01018-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
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13
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Thigpen D, Kappler A, Brem R. The Role of Ultrasound in Screening Dense Breasts-A Review of the Literature and Practical Solutions for Implementation. Diagnostics (Basel) 2018; 8:E20. [PMID: 29547532 PMCID: PMC5872003 DOI: 10.3390/diagnostics8010020] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/09/2018] [Accepted: 03/13/2018] [Indexed: 01/21/2023] Open
Abstract
Breast cancer is the second leading cause of cancer death in women. Estimates indicate a nearly 40% breast cancer mortality reduction when screening women annually starting at age 40. Although mammography is well known to be a powerful screening tool in the detection of early breast cancer, it is imperfect, particularly for women with dense breasts. In women with dense breast tissue, the sensitivity of mammography is reduced. Additionally, women with dense breasts have an increased risk of developing breast cancer while mammography has a lower sensitivity. Screening ultrasound, both handheld and automated, is effective in detecting mammographically occult cancer in women with dense tissue. Studies have shown that ultrasound significantly increases detection of clinically important, small, largely invasive, node-negative cancers. The purpose of this review article is to summarize the literature to date regarding screening breast ultrasound, emphasizing differences in cancer detection in high risk and intermediate risk women, and to discuss practical ways to implement screening ultrasound in clinical practice, including automated whole breast ultrasound, as a viable solution to the increasing need for additional screening.
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Affiliation(s)
- Denise Thigpen
- Department of Radiology, The George Washington University, Washington, DC 20037, USA.
| | - Amanda Kappler
- Department of Radiology, The George Washington University, Washington, DC 20037, USA.
| | - Rachel Brem
- Department of Radiology, The George Washington University, Washington, DC 20037, USA.
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14
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Benz RM, Garcia MA, Amsler F, Voigt J, Fieselmann A, Falkowski AL, Stieltjes B, Hirschmann A. Initial evaluation of image performance of a 3-D x-ray system: phantom-based comparison of 3-D tomography with conventional computed tomography. J Med Imaging (Bellingham) 2018. [PMID: 29541651 DOI: 10.1117/1.jmi.5.1.015502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Phantom-based initial performance assessment of a prototype three-dimensional (3-D) x-ray system and comparison of 3-D tomography with computed tomography (CT) were proposed. A 3-D image quality phantom was scanned with a prototype version of 3-D cone-beam CT imaging implemented on a twin robotic x-ray system using three trajectories (163 deg = table, 188 deg = upright, and 200 deg = side), six tube voltages (60, 70, 81, 90, 100, and 121 kV), and four detector doses (0.348, 0.696, 1.740, and [Formula: see text]). CT was obtained with a clinical protocol. Spatial resolution (line pairs/cm) and soft-tissue-contrast resolution were assessed by two independent readers. Radiation dose was assessed. Descriptive and analysis of variance (ANOVA) ([Formula: see text]) were performed. With 3-D tomography, a maximum of 16 lp/cm was visible and best soft-tissue-contrast resolution was 2 mm at 30 Hounsfield units (HU) for 160 projections. With CT, 10 lp/cm was visible and soft-tissue-contrast resolution was 4 mm at 20 HU. The upright trajectory yielded significantly better spatial resolution and soft tissue contrast, and the side trajectory yielded significantly higher soft tissue contrast than the table trajectory ([Formula: see text]). Radiation dose was higher in 3-D tomography (45 to 704 mGycm) than CT (44 mGycm). Three-dimensional tomography renders overall equal or higher spatial resolution and comparable soft tissue contrast to CT for medium- and high-dose protocols in the side and upright trajectories, but with higher radiation doses.
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Affiliation(s)
- Robyn Melanie Benz
- University Hospital Basel, Clinic of Radiology and Nuclear Medicine, Basel, Switzerland
| | | | | | | | | | - Anna Lucja Falkowski
- University Hospital Basel, Clinic of Radiology and Nuclear Medicine, Basel, Switzerland
| | - Bram Stieltjes
- University Hospital Basel, Clinic of Radiology and Nuclear Medicine, Basel, Switzerland
| | - Anna Hirschmann
- University Hospital Basel, Clinic of Radiology and Nuclear Medicine, Basel, Switzerland
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15
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Fluctuating Behavior of the French Population in Cancer Screening: 5th Edition of the EDIFICE Survey. Curr Oncol Rep 2018; 20:14. [DOI: 10.1007/s11912-017-0646-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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16
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Liang G, Fang X, Lin X, Feng X, Lu H, Wan Y, Gu Z. Cross-reactivity between MUC1 antigen and MCA: false elevation of serum CA 15-3 level in pregnant and lactating women by Ma695-Ma552-based assay. Breast Cancer Res Treat 2018; 169:341-347. [PMID: 29396666 DOI: 10.1007/s10549-018-4700-7] [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: 01/24/2018] [Accepted: 01/29/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Cancer antigen 153 (CA 15-3) is one of the most commonly used biomarkers of breast cancer. However, elevated CA 15-3 is reported in pregnant and lactating women more frequently on Beckman DxI 800 immunoassay system (Ma695-Ma552 antibody pair) than on Abbott ARCHITECT system (115D8-DF3 antibody pair) in laboratory methodological evaluation. We conducted this study in order to figure out the reason behind this phenomenon. METHODS Serum CA 15-3 concentration was analyzed in 426 subjects, including 180 patients with breast cancer, 121 patients with benign breast disease, and 125 healthy volunteers (45 pregnant and 80 non-pregnant women). CA 15-3 assay was further validated using another cohort of 112 pregnant or postpartum women. Immunological cross reaction was analyzed by Western blotting and immunoprecipitation. RESULTS The serum CA 15-3 level was abnormally higher in almost 95% of the pregnant and lactating women detected using Ma695-Ma552 antibody pair (median: 71.4 U/mL) than that detected using 115D8-DF3 antibody pair (median: 16.5 U/mL). Western blotting and immunoprecipitation indicated that such a significant difference was mainly due to the cross reaction between monoclonal antibody Ma552 and mucin-like carcinoma-associated antigen (MCA). CONCLUSIONS The CA 15-3 assay using 115D8-DF3 antibody pair is more suitable for monitoring therapy in pregnancy-associated breast cancer.
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Affiliation(s)
- Guangshu Liang
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Streets, Ruijin Second Road, Shanghai, 200025, People's Republic of China
| | - Xuqian Fang
- Department of Pathology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, 201801, People's Republic of China
| | - Xiaoyi Lin
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Streets, Ruijin Second Road, Shanghai, 200025, People's Republic of China
| | - Xiaojing Feng
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Streets, Ruijin Second Road, Shanghai, 200025, People's Republic of China
| | - Huangying Lu
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Streets, Ruijin Second Road, Shanghai, 200025, People's Republic of China
| | - Yinglei Wan
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Streets, Ruijin Second Road, Shanghai, 200025, People's Republic of China
| | - Zhidong Gu
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Streets, Ruijin Second Road, Shanghai, 200025, People's Republic of China.
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Hocaoğlu M, Erşahin AA, Akdeniz E. Evaluation on the Practice and Behaviour of Women Applied for Gynecology Outpatient Clinics About Screening Methods for Early Diagnosis of Breast Cancer. Eur J Breast Health 2017; 13:150-155. [PMID: 28894855 DOI: 10.5152/ejbh.2017.3230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/28/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Breast self-examination (BSE), clinical breast exam (CBE), mammography and ultrasound imaging (UI) are screening methods used for early diagnosis of breast cancer (BC). The purpose of this study is to put forth the utilization frequency of these screening methods among women presenting to the gynecology outpatient clinics and the relation of these data with the socio-demographic characteristics of the women. MATERIALS AND METHODS A survey was conducted among 429 women (age, 16-80 years) who were admitted to the gynecology outpatient clinics. The survey inquired about the rate and frequency of the performance of BSE, CBE, mammography and UI; personal and family history of breast cancer and social-demographic characteristics of the women. RESULTS The mean age was 40.08 (SD: 3.67). More than half of the women above 40 years of age (59.7 %) had never undergone mammography. 99.8 % of the women who had undergone mammography had also received ultrasound imaging. A significant relationship was identified between the BSE performance and having mammography. 57.4% of the women above 40 years of age (117) had UI, 53.9% (110) had CBE and 57.3% (117) performed BSE. There was a significant relationship between the age, education status and regular BSE; positive family history of BC and having CBE and mammography. CONCLUSION The results reveal that the rate of BSE performance, having mammography and CBE are at less-than-ideal levels. In this context, it is apparent that breast cancer screening methods are needed to be introduced and guidance about their application frequency should be provided for women in gynecology outpatient clinics.
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Affiliation(s)
- Meryem Hocaoğlu
- Obstetrics and Gynecology Clinic, Istanbul Medeniyet University, Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Aynur Adeviye Erşahin
- Department of Obstetrics and Gynecology, Bahçeşehir University Faculty of Medicine, İstanbul, Turkey
| | - Esra Akdeniz
- Division of Biostatistics, Marmara University School of Medicine, İstanbul, Turkey
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Uematsu T. Possible supplemental breast cancer screening modalities. Breast Cancer 2016; 24:25. [PMID: 27605223 DOI: 10.1007/s12282-016-0727-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Takayoshi Uematsu
- Breast Imaging and Breast Intervention Section, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
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