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Kim YE, Cha JH, Kim HH, Shin HJ, Chae EY, Choi WJ. Analysis of false-negative findings of breast cancer on previous magnetic resonance imaging. Acta Radiol 2021; 62:722-734. [PMID: 32686458 DOI: 10.1177/0284185120941830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the excellent contribution of contrast-enhanced breast magnetic resonance imaging (MRI), there are variable false-negative cases on MRI. PURPOSE To evaluate the false-negative findings of breast cancer on previous MRI. MATERIAL AND METHODS Between 2012 and 2016, we collected 132 patients who underwent surgery for a second primary cancer and had both current and previous MRI at an interval of <3 years. We included 45 patients; we excluded 38 patients who could not find a second cancer in the previous MRI and 49 patients who had a second cancer near to the original cancer and within within the same quadrant. Compared with current MRI, we retrospectively assessed the second primary cancer on previous MRI according to BI-RADS and analyzed the reasons of misinterpretation. RESULTS Analysis of previous MRI revealed 26 (57.8%) masses (mean size 7.7 ± 2.25 mm), 12 (26.7%) non-mass enhancements (mean size 14.7 ± 4.76 mm), and 7 (15.5%) foci. At first reading, 24 (53.3%) were missed, 17 (37.8%) were assessed as BI-RADS category 2 or 3, and 4 (8.9%) were assessed as category 4. On current MRI, 39 (86.7%) lesions showed an increase in size and 22 (48.9%) showed a change in kinetics to wash-out pattern. CONCLUSION On previous MRI, missed or misinterpreted cancers show variable findings of mass and non-mass enhancements with any types of kinetics. Careful application of BI-RADS is necessary as well as an appropriate biopsy. Any lesion that increases in size and changes in kinetics should not be underestimated.
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Affiliation(s)
- Young Eun Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Joo Hee Cha
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Hak Hee Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Hee Jung Shin
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Eun Young Chae
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Woo Jung Choi
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
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2
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Zhang J, Zhang S, Li X, Pi H. Relationship of ITPKA expression with the prognosis of breast cancer. Mol Genet Genomic Med 2021; 9:e1598. [PMID: 33624455 PMCID: PMC8123748 DOI: 10.1002/mgg3.1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/06/2020] [Accepted: 12/15/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Breast cancer (BC) represents a most common cancer among women worldwide. The outcomes of this disease remain dismal due to frequent recurrence and metastasis. Inositol-1,4,5-trisphosphate-3-kinase-A (ITPKA) plays an important role in regulating calcium signaling and actin dynamics. The dysregulation of ITPKA has been observed in several human cancers. The present study aimed to assess ITPKA expression and its prognostic value in BC. METHODS ITPKA expression was examined via quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) methods. In addition, Kaplan-Meier survival analysis and Cox regression analysis were performed to evaluate prognostic value of ITPKA in BC. RESULTS Upregulated ITPKA expression was found in BC samples, according to both qRT-PCR and IHC analyses (all p < .05). ITPKA expression was positively correlated with lymph node metastasis (p = .021) and TNM stage (p = .009). Moreover, BC patients with high expression of ITPKA had poor overall survival compared with those with low expression (log-rank p < .05). Cox analysis verified that ITPKA expression was an independent prognostic factor for BC patients (HR = 4.239, 95%CI = 2.221-8.093 and p = .000). CONCLUSION BC cases show increased expression of ITPKA. ITPKA may act as an independent prognostic biomarker in BC.
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Affiliation(s)
- Jie Zhang
- Nursing Department, Sixth Medical Center of Chinese PLA Hospital, Medical School of Chinese PLA, Beijing, China
| | - Sujie Zhang
- Department of Oncology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China
| | - Xiaoyan Li
- Department of Oncology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China
| | - Hongying Pi
- Nursing Department, Sixth Medical Center of Chinese PLA Hospital, Medical School of Chinese PLA, Beijing, China
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3
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Uzan C, Mazouni C, Rossoni C, De Korvin B, de Lara CT, Cohen M, Chabbert N, Zilberman S, Boussion V, Vincent Salomon A, Espie M, Coutant C, Marchal F, Salviat F, Boulanger L, Doutriaux-Dumoulin I, Jouve E, Mathelin C, de Saint Hilaire P, Mollard J, Balleyguier C, Joyon N, Triki ML, Delaloge S, Michiels S. Prospective Multicenter Study Validate a Prediction Model for Surgery Uptake Among Women with Atypical Breast Lesions. Ann Surg Oncol 2020; 28:2138-2145. [PMID: 32920723 DOI: 10.1245/s10434-020-09107-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Diagnosis of atypical breast lesions (ABLs) leads to unnecessary surgery in 75-90% of women. We have previously developed a model including age, complete radiological target excision after biopsy, and focus size that predicts the probability of cancer at surgery. The present study aimed to validate this model in a prospective multicenter setting. - METHODS Women with a recently diagnosed ABL on image-guided biopsy were recruited in 18 centers, before wire-guided localized excisional lumpectomy. Primary outcome was the negative predictive value (NPV) of the model. RESULTS The NOMAT model could be used in 287 of the 300 patients included (195 with ADH). At surgery, 12 invasive (all grade 1), and 43 in situ carcinomas were identified (all ABL: 55/287, 19%; ADH only: 49/195, 25%). The area under the receiving operating characteristics curve of the model was 0.64 (95% CI 0.58-0.69) for all ABL, and 0.63 for ADH only (95% CI 0.56-0.70). For the pre-specified threshold of 20% predicted probability of cancer, NPV was 82% (77-87%) for all ABL, and 77% (95% CI 71-83%) for patients with ADH. At a 10% threshold, NPV was 89% (84-94%) for all ABL, and 85% (95% CI 78--92%) for the ADH. At this threshold, 58% of the whole ABL population (and 54% of ADH patients) could have avoided surgery with only 2 missed invasive cancers. CONCLUSION The NOMAT model could be useful to avoid unnecessary surgery among women with ABL, including for patients with ADH. CLINICAL TRIAL REGISTRATION NCT02523612.
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Affiliation(s)
- Catherine Uzan
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Paris, France. .,Sorbonne University, INSERM UMR_S_938, "Cancer Biology and Therapeutics", Centre de Recherche Saint-Antoine (CRSA), Paris, France. .,Institut Universitaire de Cancérologie (IUC), Paris, France.
| | | | | | | | | | | | | | | | | | - Anne Vincent Salomon
- Institut Curie, Université Paris-Sciences Lettres, INSERM U934, Département de Médecine Diagnostique et Théranostique, Paris, France
| | - Marc Espie
- University of Paris, Hôpital Saint Louis, APHP, Paris, France
| | | | - Frederic Marchal
- Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - Flore Salviat
- Service de Biostatistique et d'Épidémiologie, Gustave Roussy, Villejuif, France.,CESP INSERM U1018, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | | | | | - Eva Jouve
- Institut Claudius Regaud-Oncopole, Toulouse, France
| | - Carole Mathelin
- Les Hôpitaux universitaires de Strasbourg, Strasbourg, France
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Schiaffino S, Calabrese M, Melani EF, Trimboli RM, Cozzi A, Carbonaro LA, Di Leo G, Sardanelli F. Upgrade Rate of Percutaneously Diagnosed Pure Atypical Ductal Hyperplasia: Systematic Review and Meta-Analysis of 6458 Lesions. Radiology 2019; 294:76-86. [PMID: 31660803 DOI: 10.1148/radiol.2019190748] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Management of percutaneously diagnosed pure atypical ductal hyperplasia (ADH) is an unresolved clinical issue. Purpose To calculate the pooled upgrade rate of percutaneously diagnosed pure ADH. Materials and Methods A search of MEDLINE and EMBASE databases was performed in October 2018. Preferred Reporting Items for Systematic Reviews and Meta-Analyses, or PRISMA, guidelines were followed. A fixed- or random-effects model was used, along with subgroup and meta-regression analyses. The Newcastle-Ottawa scale was used for study quality, and the Egger test was used for publication bias. Results Of 521 articles, 93 were analyzed, providing data for 6458 ADHs (5911 were managed with surgical excision and 547 with follow-up). Twenty-four studies used core-needle biopsy; 44, vacuum-assisted biopsy; 21, both core-needle and vacuum-assisted biopsy; and four, unspecified techniques. Biopsy was performed with stereotactic guidance in 29 studies; with US guidance in nine, with MRI guidance in nine, and with mixed guidance in eight. Overall heterogeneity was high (I2 = 80%). Subgroup analysis according to management yielded a pooled upgrade rate of 29% (95% confidence interval [CI]: 26%, 32%) for surgically excised lesions and 5% (95% CI: 4%, 8%) for lesions managed with follow-up (P < .001). Heterogeneity was entirely associated with surgically excised lesions (I2 = 78%) rather than those managed with follow-up (I2 = 0%). Most variability was explained by guidance and needle caliper (P = .15). At subgroup analysis of surgically excised lesions, the pooled upgrade rate was 42% (95% CI: 31%, 53%) for US guidance, 23% (95% CI: 19%, 27%) for stereotactic biopsy, and 32% (95% CI: 22%, 43%) for MRI guidance, with heterogeneity (52%, 63%, and 56%, respectively) still showing the effect of needle caliper. When the authors considered patients with apparent complete lesion removal after biopsy (subgroups in 14 studies), the pooled upgrade rate was 14% (95% CI: 8%, 23%). Study quality was low to medium; the risk of publication bias was low (P = .10). Conclusion Because of a pooled upgrade rate higher than 2% (independent of biopsy technique, needle size, imaging guidance, and apparent complete lesion removal), atypical ductal hyperplasia diagnosed with percutaneous needle biopsy should be managed with surgical excision. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Brem in this issue.
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Affiliation(s)
- Simone Schiaffino
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
| | - Massimo Calabrese
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
| | - Enrico Francesco Melani
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
| | - Rubina Manuela Trimboli
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
| | - Andrea Cozzi
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
| | - Luca Alessandro Carbonaro
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
| | - Giovanni Di Leo
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
| | - Francesco Sardanelli
- From the Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (S.S., L.A.C., G.D.L., F.S.); Unit of Radiology, IRCCS Policlinico San Martino, Genoa, Italy (M.C.); Unit of Radiology, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E.F.M.); and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy (R.M.T., A.C., F.S.)
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5
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Sergesketter AR, Thomas SM, Fayanju OM, Menendez CS, Rosenberger LH, Greenup RA, Hyslop T, Parrilla Castellar ER, Hwang ES, Plichta JK. The Influence of Age on the Histopathology and Prognosis of Atypical Breast Lesions. J Surg Res 2019; 241:188-198. [PMID: 31028940 PMCID: PMC6571073 DOI: 10.1016/j.jss.2019.03.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/08/2019] [Accepted: 03/22/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Although several prognostic variables and risk factors for breast cancer are age-related, the association between age and risk of cancer with breast atypia is controversial. This study aimed to compare the type of breast atypia and risk of underlying or subsequent breast cancer by age. METHODS Adult women with breast atypia (atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ) at a single institution from 2008 to 2017 were stratified by age at initial diagnosis: <50 y, 50-70 y, and >70 y. Regression modeling was used to estimate the association of age with risk of underlying carcinoma or subsequent cancer diagnosis. RESULTS A total of 530 patients with atypia were identified: 31.1% < 50 y (n = 165), 58.1% 50-70 y (n = 308), and 10.8% > 70 y (n = 57). The proportion of women with atypical ductal hyperplasia steadily increased with age, compared with atypical lobular proliferations (P = 0.04). Of those with atypia on needle biopsy, the overall rate of underlying carcinoma was 17.5%. After adjustment, older age was associated with a greater risk of underlying carcinoma (odds ratio: 1.028, 95% confidence interval: 1.003-1.053; P = 0.03). Of those confirmed to have atypia on surgical excision, the overall rate of a subsequent cancer diagnosis was 15.7%. Age was not associated with a long-term risk for breast cancer (P = 0.48) or the time to a subsequent diagnosis of carcinoma (log-rank P = 0.41). CONCLUSIONS Although atypia diagnosed on needle biopsy may be sufficient to warrant surgical excision, older women may be at a greater risk for an underlying carcinoma, albeit the long-term risk for malignancy associated with atypia does not appear to be affected by age.
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Affiliation(s)
| | - Samantha M Thomas
- Duke Cancer Institute, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Oluwadamilola M Fayanju
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Durham, North Carolina
| | - Carolyn S Menendez
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Durham, North Carolina
| | - Laura H Rosenberger
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Durham, North Carolina
| | - Rachel A Greenup
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Durham, North Carolina
| | - Terry Hyslop
- Duke Cancer Institute, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Edgardo R Parrilla Castellar
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - E Shelley Hwang
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Durham, North Carolina
| | - Jennifer K Plichta
- Department of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Durham, North Carolina.
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6
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Nutter EL, Weiss JE, Marotti JD, Barth RJ, Eliassen MS, Goodrich ME, Petersen CL, Onega T. Personal history of proliferative breast disease with atypia and risk of multifocal breast cancer. Cancer 2018; 124:1350-1357. [PMID: 29266172 PMCID: PMC5867212 DOI: 10.1002/cncr.31202] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND A history of proliferative breast disease with atypia (PBDA) may be indicative of an increased risk not just of breast cancer but also of a more aggressive form of breast cancer. METHODS Multifocal breast cancer (MFBC), defined as 2 or more tumors in the same breast upon a diagnosis of cancer, is associated with a poorer prognosis than unifocal (single-tumor) breast cancer. PBDA, including atypical ductal hyperplasia and atypical lobular hyperplasia, is a known risk factor for breast cancer. Using New Hampshire Mammography Network data collected for 3567 women diagnosed with incident breast cancer from 2004 to 2014, this study assessed the risk of MFBC associated with a previous diagnosis of PBDA. RESULTS Women with a history of PBDA were found to be twice as likely to be subsequently diagnosed with MFBC as women with no history of benign breast disease (BBD; odds ratio [OR], 2.23; 95% confidence interval [CI], 1.08-4.61). Ductal carcinoma in situ on initial biopsy was associated with a 2-fold increased risk of MFBC in comparison with invasive cancer (OR, 2.13; 95% CI, 1.58-2.88). BBD and proliferative BBD without atypia were not associated with MFBC. CONCLUSIONS Women with a history of previous PBDA may be at increased risk for MFBC. Women with a history of PBDA may benefit from additional presurgical clinical workup. Cancer 2018;124:1350-7. © 2017 American Cancer Society.
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Affiliation(s)
- Ellen L. Nutter
- Quantitative Biomedical Science Program, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Julia E. Weiss
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Jonathan D. Marotti
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth
| | - Richard J. Barth
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth
| | - M. Scottie Eliassen
- Department of Community & Family Medicine; Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Martha E. Goodrich
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Curtis L Petersen
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Tracy Onega
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Norris Cotton Cancer Center, Lebanon, NH, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, USA
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7
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Abstract
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4).Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States. This can lead to missed opportunities to identify women at high risk of breast cancer and may result in applying average-risk screening recommendations to high-risk women. Risk assessment and identification of women at high risk allow for referral to health care providers with expertise in cancer genetics counseling and testing for breast cancer-related germline mutations (eg, BRCA), patient counseling about risk-reduction options, and cascade testing to identify family members who also may be at increased risk.The purpose of this Practice Bulletin is to discuss breast cancer risk assessment, review breast cancer screening guidelines in average-risk women, and outline some of the controversies surrounding breast cancer screening. It will present recommendations for using a framework of shared decision making to assist women in balancing their personal values regarding benefits and harms of screening at various ages and intervals to make personal screening choices from within a range of reasonable options. Recommendations for women at elevated risk and discussion of new technologies, such as tomosynthesis, are beyond the scope of this document and are addressed in other publications of the American College of Obstetricians and Gynecologists (ACOG) (5-7).
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8
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Kuhl CK, Strobel K, Bieling H, Leutner C, Schild HH, Schrading S. Supplemental Breast MR Imaging Screening of Women with Average Risk of Breast Cancer. Radiology 2017; 283:361-370. [DOI: 10.1148/radiol.2016161444] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Christiane K. Kuhl
- From the Department of Diagnostic and Interventional Radiology (C.K.K., K.S., S.S.) and Section of Biostatistics, Department of Diagnostic and Interventional Radiology (H.B.), University of Aachen, RWTH, Pauwelsstr 30, 52074 Aachen, Germany; and Department of Radiology, University of Bonn, Bonn, Germany (C.L., H.H.S.)
| | - Kevin Strobel
- From the Department of Diagnostic and Interventional Radiology (C.K.K., K.S., S.S.) and Section of Biostatistics, Department of Diagnostic and Interventional Radiology (H.B.), University of Aachen, RWTH, Pauwelsstr 30, 52074 Aachen, Germany; and Department of Radiology, University of Bonn, Bonn, Germany (C.L., H.H.S.)
| | - Heribert Bieling
- From the Department of Diagnostic and Interventional Radiology (C.K.K., K.S., S.S.) and Section of Biostatistics, Department of Diagnostic and Interventional Radiology (H.B.), University of Aachen, RWTH, Pauwelsstr 30, 52074 Aachen, Germany; and Department of Radiology, University of Bonn, Bonn, Germany (C.L., H.H.S.)
| | - Claudia Leutner
- From the Department of Diagnostic and Interventional Radiology (C.K.K., K.S., S.S.) and Section of Biostatistics, Department of Diagnostic and Interventional Radiology (H.B.), University of Aachen, RWTH, Pauwelsstr 30, 52074 Aachen, Germany; and Department of Radiology, University of Bonn, Bonn, Germany (C.L., H.H.S.)
| | - Hans H. Schild
- From the Department of Diagnostic and Interventional Radiology (C.K.K., K.S., S.S.) and Section of Biostatistics, Department of Diagnostic and Interventional Radiology (H.B.), University of Aachen, RWTH, Pauwelsstr 30, 52074 Aachen, Germany; and Department of Radiology, University of Bonn, Bonn, Germany (C.L., H.H.S.)
| | - Simone Schrading
- From the Department of Diagnostic and Interventional Radiology (C.K.K., K.S., S.S.) and Section of Biostatistics, Department of Diagnostic and Interventional Radiology (H.B.), University of Aachen, RWTH, Pauwelsstr 30, 52074 Aachen, Germany; and Department of Radiology, University of Bonn, Bonn, Germany (C.L., H.H.S.)
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9
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Buckley ES, Sullivan T, Farshid G, Hiller JE, Roder DM. The utility of linked cancer registry and health administration data for describing system-wide outcomes and research: a BreastScreen example. J Eval Clin Pract 2016; 22:755-60. [PMID: 27001547 DOI: 10.1111/jep.12536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Stratification of women with screen-detected ductal carcinoma in situ (DCIS) by risk of subsequent invasive breast cancer (IBC) could assist treatment planning and selection of surveillance protocols that accord with risk. We assessed the utility of routinely collected administrative data for stratifying by IBC risk following DCIS detection in a population-based screening programme to inform ongoing surveillance protocols. METHODS A retrospective cohort design was used, employing linked data from the South Australian breast screening programme and cancer registry. Women entered the study at screening commencement and were followed until IBC diagnosis, death or end of the study period (1 December 2010), whichever came first. Routinely collected administrative data were analyzed to identify predictors of invasive breast cancer. RESULTS Proportional hazards regression confirmed that the DCIS cohort had an elevated risk of IBC after adjustment for relevant confounders (HR = 4.0 (95% CL 3.4, 4.8)), which accorded with previous study results. Within the DCIS cohort, conservative breast surgery and earlier year of screening commencement were both predictive of an elevated invasive breast cancer risk. CONCLUSIONS These linked cancer registry and administrative data gave plausible estimates of IBC risk following DCIS diagnosis, but were limited in coverage of key items for further risk stratification. It is important that the research utility of administrative datasets is maximized in their design phase in collaboration with researchers.
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Affiliation(s)
- Elizabeth S Buckley
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
| | - Tom Sullivan
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Janet E Hiller
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia.,Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - David M Roder
- Cancer Epidemiology and Population Health School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Zhang M, Xu W, Ke M, Xu J, Deng Y. Evaluation of individual aging degree by standard-free, label-free LC-MS/MS quantification of formaldehyde-modified peptides. Analyst 2015; 140:4137-42. [PMID: 25905659 DOI: 10.1039/c5an00355e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this study, a standard-free, label-free LC-MS/MS method is proposed to evaluate aging based on the cross-linkage theory. First, an aging-biomarker screening model was set up in vitro with formaldehyde and the most abundant protein in plasma, human serum albumin (HSA), based on the Maillard reaction. The modification level of peptides cleaved from HSA was investigated using a liquid chromatography tandem mass spectrometry (LC-MS/MS) method with an (18)O-labeling technique. One formaldehyde-insensitive peptide and six formaldehyde-sensitive peptides that would be verified for being putative peptide-biomarkers were screened via the in vitro aging model. These six putative biomarkers were then preliminarily verified by plasma samples with the aldehyde-insensitive peptide serving as the internal standard. The verification results indicated that the peptides LDELRDEGK and VFDEFKPLVEEPQNLIK showed a significant quantitative difference among young/mid-aged/elderly groups of people.
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Affiliation(s)
- Mei Zhang
- National Institute for Communicable Disease Control and Prevention, Beijing, 102206, China.
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